The Masters of Medicine

Description:
An in-depth look at the mavericks, moments, and mistakes that sparked the greatest medical discoveries in modern times—plus the cures that will help us live longer and healthier lives in this century . . . and beyond.

Human history hinges on the battle to confront our most dangerous enemies—the half-dozen diseases responsible for killing almost all of mankind. And while the story of our triumphs over these afflictions reveals an inspiring tapestry of human achievement, the journey was far from smooth.

In The Masters of Medicine, Dr. Andrew Lam distills the long arc of medical progress down to the crucial moments that were responsible for the world’s greatest medical miracles.

Discover fascinating true stories of scientists and doctors throughout history, including:

• Rival surgeons who killed patient after patient in their race to operate on beating hearts—and put us on the path toward the heart transplant
• A quartet of Canadians whose miraculous discovery of insulin was marred by jealousy and resentment
• The doctors who discovered penicillin, but were robbed of the credit
• The feud between two Americans in the quest for the polio vaccine
• A New York surgeon whose “heretical” idea to cure patients by deliberately infecting them has now inspired our next-best hope to defeat cancer
• A Hungarian doctor who solved the greatest mystery of maternal deaths in childbirth, only to be ostracized for his discovery

The Masters of Medicine is a fascinating chronicle of human courage, audacity, error, and luck. This riveting ode to mankind reveals why the past is prelude to the game-changing breakthroughs of tomorrow.

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Introduction

By the end of this century we will have found a cure for cancer. We will use stem cells to regrow nervous tissue and repair damaged spinal cords. Our knowledge of each individual’s genetic makeup will allow us to diagnose, and preemptively treat, many diseases before they become manifest. The average life span will exceed ninety years, and reaching centenarian status will be commonplace.

Most, if not all of us, believe that attainment of these ambitious goals is not only possible, but probable. We should be forgiven our hubris, for we have been conditioned to believe in mankind’s almost limitless potential. Just think of what we have had the good fortune to witness in our lifetimes—an extraordinary, exponential increase in scientific knowledge that dwarfed the modest achievements of prior centuries. Consider the life of just one person, my great-grandfather who was born in 1893 and died in 1977. In his youth, horses remained a primary mode of transportation. The airplane had not been invented. No one in his family had ever used a telephone or seen an electric light bulb. But by the time he died, man had landed on the moon. Since then, our world has continued to evolve in innumerable ways, benefiting from such varied advances as the Internet and the deciphering of the human genome. We have also beheld a quantum leap in medical knowledge and treatment that would be unfathomable to our ancestors.

At the turn of the twentieth century, hundreds of thousands died annually from infectious diseases like smallpox, tuberculosis, and cholera. The germ theory of disease was just beginning to gain widespread acceptance over prevailing nineteenth-century theories that blamed “bad air” or “miasmas.” Legitimate medical doctors believed harmful treatments like radium water could cure a plethora of ailments including arthritis, impotence, and anemia. Others used mercury to treat syphilis. Quackery and snake oil salesmen abounded. The average life expectancy, worldwide, was only thirty-three years (forty-seven in developed countries).

Then several changes occurred. Medical education became standardized. Improvements in sanitation, the introduction of vaccines and antibiotics, and advances in surgery and anesthesia had dramatic, beneficial effects. To a physician of the late nineteenth century, the idea that man might one day tame fatal infectious diseases, use a patient’s own immune system to cure cancer, and operate on the human heart would be just as unbelievable as the idea of landing on the moon. If life expectancy can double, so that today average worldwide longevity has reached 73.4 years (77.8 in the United States), is it so far-fetched to envision a future in which ordinary people will live to 100? Or even 110?

Historian and philosopher Yuval Noah Harari, author of the international bestselling books Sapiens and Homo Deus, goes even further, contemplating a day when mankind may even conquer death due to disease entirely. Pointing to advances in genetic engineering, regenerative medicine, and nanotechnology, he notes that some futurists anticipate the achievement of a form of human “immortality” by 2100 or 2200, wherein diseases have been conquered and aging tissues will be regenerated, upgraded, or transplanted. This view of the future sees no limit to science’s ability to prolong life and postpone death from physiological causes; in such a world, death might only occur due to war, accidents, and homicide.

The future is always uncertain, but it is clear that we are living in the midst of a remarkable continuum of technological progress. It’s a journey in which our recent past informs our view of a potentially limitless future. And yet, despite our penchant for optimism, a close study of history yields this crucial lesson: progress is not inevitable, nor inexorable.

In 1961, my father was a teenager who watched the first American, Alan Shepard, launched into space on a trip that lasted only fifteen minutes and twenty-eight seconds. Eight short years later, Neil Armstrong and Buzz Aldrin were walking on the lunar surface. If you asked my father in 1969 what he thought the future held for space exploration, these astonishingly rapid scientific advances might have prompted him and many others to enthusiastically predict manned flights to Mars within a couple more decades, perhaps by the year 2000 at the latest.

What we assume or expect to happen will not always come to pass. What seems assured or even everlasting is not. Nothing is certain. The Western Roman Empire encompassed five centuries of remarkable technological progress in Europe, yet receded from world history and was followed by the Dark Ages—a greater number of centuries marked by regression and ignorance.

Perpetual medical progress is no more assured than any other aspect of human history. Our greatest medical accomplishments—the discoveries that saved millions of lives and alleviated untold suffering—were not preordained, nor inevitable. Far from it. More often than not, these crucial advances depended on just one, or a handful, of individuals—fallible people who, through perseverance, skill, and sometimes dumb luck, took risks or made key observations that no one else had previously been willing or able to. Such physicians and scientists were often ridiculed and even ostracized by their peers, especially if their newfangled ideas threatened medical elites of their day. They dared to confront problems others assumed were unsolvable, and sought answers to questions no one else in history had thought to ask.

And yet, none of these innovators were martyrs or saints. Their brilliance was often marred by jealousy, pettiness, and astounding arrogance. Their remarkable stories illustrate that medical progress is not linear. It advances in fits and starts, and sometimes even moves backward. An examination of medical history reveals that the most crucial discoveries—ones that have proved more consequential than any atomic bomb or world war—hinged upon fleeting moments of breathtaking risk, mundane observation, or serendipitous error.

This is a book about those moments. This is a book about those people—heroes, most of them unsung, whose discoveries were milestones in our perpetual quest to heal the sick, mitigate suffering, and delay death. It is impossible to understate the impact of these singular moments, for they relate to diseases that will afflict, and kill, us all. As such, this narrative of mankind’s greatest modern medical achievements is organized by disease—the world’s most common afflictions, and most important killers.

Heart disease, the world’s number one predator, rightly sits atop any list of most crucial disorders for laypeople to understand.

Diabetes, an epidemic instigated by the tragic irony that for the first time in human history, people are dying from eating too much instead of too little.

Infectious disease, that tireless enemy against which we have celebrated many successes, but that continues to threaten global health like no other condition can.

Cancer, our loathsome nemesis that has touched every family and strikes down young as well as old.

Trauma, the ubiquitous infirmity that will surely persist even after all other diseases are someday defeated.

And the “affliction” of childbirth, a top killer of mothers and children—until doctors uncovered the secrets that would finally bring the practice of obstetrics kicking and screaming into a new age of improved health and better outcomes.

This is not a comprehensive history of medicine. Instead, it is a tale of human audacity and courage that cannot fail to leave one with the astonishing impression that, save for one person, fortuitous observation, or sometimes, mistake, life for all of us could be drastically different today.

In the process, we will investigate the pathophysiology of diseases that have touched all our lives, and the lives of our loved ones. An understanding of these conditions should not and cannot be reserved for the medical school graduate. Just as any parent would encourage a son or daughter to understand how a car runs, or the basics of the Internet, we should all know how our most common maladies affect us. To understand the human body and what can malfunction within it is not mere intellectual exercise; it is practical knowledge that will help us each recognize dangerous symptoms of disease, live healthier lives, and better understand our own conditions when we are the ones sitting across from the doctor. Each of us will one day be that person, and most likely, the news will not be pleasant.

Yet, now more than ever we are in position to wrest from nature its secrets and use this knowledge to combat disease in ways inconceivable to our predecessors. In this journey we will also look to the future and, with luck, inspire the young to take up the mantle of discovery so that the next generation will succeed in achieving breakthroughs that transform our expectations of health and longevity. Most people born today will enjoy lifetimes that reach into the twenty-second century. We hope that they will look back with astonishment at how much has been accomplished between now and then. We pray that the scourges that kill and perplex us today will become mere footnotes in tomorrow’s books of history and science, and that our legacy of progress continues unabated.

Contents

INTRODUCTION: To Wrest from Nature

1.HEART DISEASE: The Mavericks

2.DIABETES: The Pissing Evil

3.BACTERIAL INFECTION: The Magic Bullet

4.VIRAL INFECTION: Pandemicj

5.CANCER: A Bewilderingly Complex Array

6.TRAUMA: The Only Winner in War Is Medicine

7.CHILDBIRTH: The Mysterious Killer

CONCLUSION: The Masters of Medicine