GAME CHANGERS
In 1900, 76 million people lived in the U.S., 200,000 miles of railroad tracks crisscrossed the continent, and people traveled in horse drawn carriages and wagons on narrow dirt and gravel roads. Trains dominated commerce, the modern internal combustion engine was 15 years old and 1575 electric and 900 gasoline powered vehicles were produced each year.
Electricity was new and scarce. Thomas Edison’s incandescent light bulb was 20 years old and an American city, Cleveland had started using electric lamps to illuminate some of its streets.
By the turn of the century sixty seven years had passed since drinking water was first pumped into the White House from a nearby reservoir; Chicago’s “comprehensive sewer system” had been up and running for 15 years, and a revolutionary toilet made by Thomas Crapper’s was 9 years old.8
My wife had two uncles who died in the 1930s from a strep throat, an infection that’s currently rapidly cured with a few doses of an antibiotic. A family member who had a severe asthma attack and who was getting exhausted responded to medications and didn’t need to be intubated and placed on a breathing machine. Another who was stung by a bee and developed anaphylactic shock was treated aggressively and was well enough to go home the next day. Either relative could have died a century ago.
As recently as sixty years back, people with new myocardial infarctions were treated with “quiet and rest”. Nowadays a heart attack victim who doesn’t instantly die can call 911 and be rushed to a hospital where a cardiologist and team are waiting to stent open an occluded artery.
The 20th and 21st centuries were filled with transformative medical advances and I chose a few that I think were game changers.
- Anesthesia, the first “game changer” got its start in 1846. A monument in the Boston Public Garden commemorates the day that William Morton proved to the world that “the inhalation of ether causes insensibility to pain.”
- Early in the 20th century we learned how to collect, store, and “safely” transfuse blood.
- In the 1940s, during and after the Second World War, Penicillin and antibiotics became available. They revolutionized our ability to fight bacterial infections.
4. The planet wide eradication of smallpox wasn’t the result of a new drug. It was the consequence of the expansive use of the century old vaccine that prevented people from developing the infection. A viral disease that plagued the human race for at least 10 centuries, Smallpox caused high fevers, severe headaches, vomiting, exhaustion, and a papular rash. It killed as many as three in 10 of those who were afflicted, and the people who survived were sometimes permanently scarred. George Washington got the disease when he was19 and was visiting Barbados. He was sick for a month and the disease left him with lifelong facial pock-marks.9
In1853 and 1867 the British Parliament made vaccination with modified cowpox compulsory. Much as cats and tigers are members of the same species, the viruses that cause cowpox and small pox are members of the same family. Each can cause pustular lesions. People who develop cowpox sometimes run a fever and are sick for a week. When a person recovers (or is vaccinated) their body is protected from the oft lethal disease.
Widespread vaccination in the U.S. contained the illness in the early 19th century. Then people in the U.S. stopped vaccinating. There were outbreaks, and states attempted to enforce existing vaccination laws or pass new ones. The disease disappeared from North America in 1952 and from Europe in 1953. As recently as 1967 (according to the CDC) 10 to 15 million people in Africa, Asia, Indonesia, and Brazil contracted Smallpox each year. That year 2 million died, many were scarred for life, and the World Health Organization started a program of worldwide vaccinations. They hoped to eliminate the terrible disease and seem to have succeeded. The bug’s last known “natural” victim was infected in 1977.5
Game changer 5: We learned and are learning how to prevent our immune system from destroying transplanted kidneys, livers, and hearts. We’re stopping our protectors from attacking our joints (rheumatoid arthritis), intestines (colitis) and our nerve fibers and the myelin that surrounds them. (Multiple sclerosis.) And we’re increasingly, using antibodies and T-lymphocytes to attack and destroy cancer cells.
6. Controlling HIV: A once uniformly lethal infection has been turned into a controllable, chronic disease in parts, but not all of the world.
7. Gene therapy: CRISPR and other gene “editing” techniques are up and running. Scientists using them are on the verge of curing a number of inherited and genetic disorders like hemophilia and sickle cell disease.
8. In 2010 the Bill and Melinda Gates foundation started spending $5 billion a year and using the vast resources of Microsoft to help rid the planets poor and impoverished of many of the diseases that diminish and shorten their lives.
The Troubled Health Dollar by Steve Fredman