Tuesday, September 30, 2014
FAIRFIELD-SUISUN, CALIFORNIA
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Nostalgia in medicine isn’t what it used to be

By
From page B8 | February 22, 2014 |

A few years back I chaired a committee that developed a new library for a local hospital. In the process, we discovered many out-of-date textbooks that were stored in the previous make-shift facility.

No one expressed any sincere interest in these decades-old texts. Even a state university, boasting a division devoted to the history of medicine, declined to take them. Eventually, the books were transferred to the hospital’s basement for storage. This experience taught me a lesson. In a technologically advanced culture, there is little reverence for outdated technologies. Americans like what is new and up-to-date.

Popular culture is another matter. I recently attended a 1970s nostalgia-themed birthday party. Although the bell-bottomed trousers and long-hair wigs evoked laughter, I think many of us recalled the music of the era with fondness. A similar nostalgia surrounds old cars. A vintage car, for example, reminds us of our youth, even if it is an old jalopy by modern standards. My nostalgic reveries cease when I recall past medical treatments, however. Consider some examples:

In the 1970s, our understanding of cholesterol metabolism was primitive. We prescribed niacin, for example, but it often caused flushing of the skin or liver toxicity. Now we have the class of drugs called “statins” that cut heart attack risks dramatically, with fewer side effects. These miracle drugs were developed in the 1980s, becoming widespread in usage by the early 21st century. Smoking was allowed in restaurants, businesses and public places until two decades ago. I recall seeing doctors smoke in hospital wards and emergency rooms, for example. By comparison, our indoor air quality today is excellent. That is a major public health victory.

If you were nearsighted in the 1970s, you would obtain eyeglasses, perhaps with a clip-on attachment for wearing them outdoors in the sun. Now, you might choose to undergo an outpatient surgical procedure to reconfigure your cornea and restore your visual acuity.

If you purchase eyeglasses, you may choose from a variety of lenses, some of which transition from clear to tinted appearance, as you walk into the sun. Medical technology is unraveling the causes of macular degeneration and other vision-robbing conditions. If you need to have cataract surgery, it will likely be a minor outpatient procedure.

Surgery in the 1970s tended to result in large incisions. Today, it is hard to locate scars in patients who have undergone laparoscopic procedures, including gall bladder removals and other major surgeries.

A hernia operation that might have required hospitalization in years past is now an outpatient procedure.

Anesthesia is safer.

Post-operative care is more sophisticated, with greater attention to mobilizing patients immediately in order to prevent blood clots, pneumonia and other complications.

We now recognize that prolonged hospitalizations may result in infections, weakening of muscle tissue and other problems. Awareness of hospital-acquired infections is greater, although drug-resistant bacteria continue to challenge medical providers.

Current treatments for rheumatoid arthritis and similar arthritic conditions are far more sophisticated today than in the 1970s, reflecting a revolution in therapy that reflects the use of so-called “biological agents.”

Some of these miracle drugs derived from DNA technologies that use cell cultures to grow bacteria that manufacture the drugs. The challenge, of course, is now as much economic as technological, as these drugs tend to be very expensive.

I would never want to go back to the years of looking for medical textbooks in dusty libraries. I have been spoiled by the information revolution, as I access online medical journals and textbooks with a couple of keystrokes. I also like my satellite car radio. As the old saying goes, “Nostalgia isn’t what it used to be . . . ”

Scott T. Anderson, M.D., Ph.D. (stamdphd@comcast.net) is clinical professor of medicine, UC Davis. This column is informational and does not constitute medical advice.

Scott Anderson

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  • so i sayFebruary 22, 2014 - 9:05 am

    Very interesting. I do hope there is a place to save and treasure the old medical text books. We fail our future when we forget the past.

    Reply | Report abusive comment
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