Montrose County Health & Human Services

The Two Faces of Medicine

The oldest of the baby boomers (and those of us who are a little older) have seen more advances in medicine in a lifetime than had occurred from the dawn of humans to the Second World War. The physician who treated President Eisenhower's heart attack in Denver in 1955 would be guilty of malpractice by today's standards, as he used no medications specifically for the President's heart attack or for his falling blood pressure and irregular heart rhythm. And even though the attack occurred in the middle of the night, the doctor allowed Eisenhower to sleep at home until noon before he called a cardiologist to do an electrocardiogram. After that, Ike went to the hospital by car, where he remained largely confined to bed for the next seven weeks.

In the years since that not so long ago time, the advances in cardiac care are mind-boggling. The 911 call you can make today triggers a response in the emergency system designed to get the help you need in minutes—not hours. While coronary care units now monitor hearts around the clock, other advances such as angioplasty to clear the arteries and implantable pacemakers and defibrillators along with powerful new heart medications have changed everything about the way we take care of hearts since those I Love Lucy days of yore.

The heart is not the only organ of the body to receive attention in the years since World War II. CAT scans, MRI's and PET scans have given us entirely new ways to look at different organs of the body. We've developed techniques for growing replacement bones and in using nerve cells grown from stem cells to heal spinal cord injuries. We've developed a 3-D computer imaging process that allows doctors to screen for colon cancer painlessly and we've mapped all the genes in humans. We've learned how to transplant everything from hearts to faces, and we've developed a miniaturized, totally self contained artificial heart. Techniques have been developed that allow us to both diagnose and perform surgery on fetuses still inside the mother's womb so that deadly heart valve defects can be corrected.

Americans can certainly take pride in the fact that an inordinate number of those advances came out of research here in the United States. We know medicine as well as anyone does. But at the same time we should be doing more to see that more Americans benefit from the advances that have been made. We now have the technology to nearly eliminate cervical cancer. A new Human Papilloma Virus vaccine, if given to all the nine year old girls in the country, would prevent the vast majority of cervical cancers that would otherwise emerge in those girls as they aged, yet we currently work with a health care delivery system that is as out of date as Eisenhower's heart attack treatment. As a consequence the uninsured and underinsured girls of today will be the victims of unnecessary cervical cancer tomorrow because they and their families can't afford the vaccine. At some point we need to ask the basic question: Should we bother to fund research many of us may never have a chance to use, or should we do more to assure that health care delivery is in line with the dazzling advances in health care research?