The Difference That Sixty Years Can Make
I am writing a book the timeline of which extends from the late 1940s to the present. This process involves quite a bit of research. Inevitably, the process makes me think of how much life has changed in 60 years. This is particularly true of the state of medicine. We take a lot now for granted that simply did not exist, or was not expected, in a previous time.
In the book a character has a heart attack in the year 1960. The setting, Glasgow, Scotland. I needed to discover what the treatment would have been in that year. The answer came quickly and was a revelation. The only tools in the medical arsenal then was administration of a pain killer such as morphia and bed rest.
Philippa Roxby, a health reporter for BBC News tells the story in an online article dated July 9, 2011. According to the article if heart attack victims “died in their 50s and 60s it was considered a fact of life.” The article also reports that,
“In 1961, there were 322,917 deaths from cardiovascular disease, accounting for nearly half of all deaths in the UK. Heart attacks and angina chest pain were common, but little understood.”
My grandfather, like the character in my book, died of a heart attack in 1960. He was stricken at work and walked home. His family called the doctor and he was admitted to hospital. Today, such an event would result in an immediate call to the emergency number. Subsequent events would have proceeded with some urgency. My grandfather survived the initial heart attack but not the subsequent one that took his life. He was 65.
In 1955, at age five, I had my own brush with death. My event began in school. I experienced extreme abdominal pain. My mother was summoned and she took me home and put me in bed. My father came home from work. It was now early evening. Our family doctor was called. This would have involved going to a public telephone box since no working class family like ours had access to a personal telephone. This was an era when your doctor would visit your home. Before he arrived my abdominal pain abruptly stopped. My acute appendicitis had now become peritonitis, a potentially life threatening condition.
It is interesting to note the mindset of the time period. In the current world, I think the majority of people would consider severe abdominal pain in a five year old child to be a medical emergency. An adult experiencing a heart attack would not walk home. I don’t know whether this reflected family attitudes or a more general approach to illness and medical services. My sense is that people in this time period had fewer expectations. I have the impression that people were more likely to wait to be told what to do, to place considerable weight on the word of key members of the community such as the doctor. Perhaps also, since medicine offered far fewer options in those days, people tended to be more fatalistic.
Interestingly, our doctor, reportedly, gave my parents a hard time about their delay in seeking attention. He immediately instructed my father to call for an ambulance. In those days, ambulances functioned mainly as transportation. No treatment was available en route. On arrival at the hospital I was wheeled immediately into the operating theater.
It is clear to me that, if I had experienced peritonitis 15 or 20 years prior to when I did, my survival would have been unlikely. Antibiotics such as penicillin were only them becoming available. My survival and recovery took quite a bit of post-operative care. Antibiotics doubtless played a significant role.
I wonder if, perhaps, our expectations of what medicine can do have swung rather too far the other way. Certainly, enormous progress has been made. However, for many conditions, satisfactory treatments have yet to be found. I suspect that finding a cure for many of them will remain elusive. The progress that has been made has raised the hopes and expectations of many patients to levels that may not be justified in every case.
Fifty years ago, heart attacks were poorly understood and there was no good treatment available for those who experienced them. Fifty years from now, will we have found treatments for medical conditions such as some forms of cancer for which no good solutions exist today? Let’s hope so.