American Medicine

SINCE ITS FOUNDING , this magazine has published over forty articles on the history of medicine in the United States. Among them we’ve told of the discovery of anesthesia and the conquest of yellow fever; in 1955 we recounted George Washington’s personal medical history in a story that has been reprinted more times than any other we have published. In the special section on American medicine in this issue, we add six more stories to the count, stories with an emphasis on what has happened in medicine over the past century.

It is obvious why a magazine of history returns frequently to this subject: it is dramatic, it is almost always a story of victory over an appalling danger, and it is the one subject that always relates to and justifies the use of that tired phrase “quality of life.”

Life itself, healthy life, is so unarguable a boon that the medical profession—the profession of health and healing—must always have seemed indispensable. And yet the doctor’s high status is a relatively recent phenomenon. For most of our history, doctors had so little ability to deal with disease and injury that they were lucky to earn a living, let alone be seen as wise and worthy. Thanks to the advances of science and the standards of the profession, doctors now can be both effective and rich—a phenomenon that is at once a source of pride and some trepidation to them. They are aware that when so much hope and trust is invested in another human being, any lapse—real or perceived—is met with anger, incomprehension, and loss of confidence. With the glory of curative power comes a rise in malpractice suits. With the increased availability of new but expensive therapies comes an insistent pressure for more equitable and universal health care.

There is another good reason for thinking about the past and present of medicine these days. In the next decade the nation will, for the first time, have to deal with a surplus of doctors. Where they will find jobs, who will pay them, and how they will be able to maintain their autonomy in an increasingly corporate culture are urgent questions. Our bet is that whatever changes may occur in the way medical care is practiced and delivered, doctors are never going to be considered mere technicians and suppliers of services. We owe them too much. Imagine how different our lives and the history of our country would be if we were still dying at the same rate as only fifty years ago from pneumonia, tuberculosis, syphilis, gastritis, common accidents, and all those shocks that flesh is no longer inevitably heir to.

Doctors may not know it all (only quacks pretend to), but we’re very grateful for what they do know.