Spring 2017

Health Care Then and Now

On a dark morning just after Christmas a few years ago, I headed to work on my bike. A freezing mist had settled on the valley, but the street looked fine. Then, as I rounded a corner, my front tire lost its grip. I hit the pavement. One look at my leg told me I wasn’t getting up.

Fortunately, an ambulance was just a 911 call away. The crew arrived, gave me painkillers and bundled me onto a stretcher. Less than a half hour later, I was in a hospital emergency room where an orthopedic surgeon took a look at the X-rays and scheduled an operation. That night, I was the owner of a titanium rod down the middle of my tibia. Screws held it in place like the post on a porch.

Not so long ago, say in 1800, this would have turned out differently. I might have gotten some whiskey for pain, but laudanum, a mixture of alcohol and opium, was also popular. It would be decades before one of its components, morphine, would become commercially available.

There would have been no X-rays (discovered in 1895) and no trip to the hospital. Such institutions did not exist as we know them. I would probably have been carried home, where surgical treatment would have been done in bed. Or maybe on the kitchen table. If a doctor was available, and I could afford to pay.

In this issue of Terra (“Medicine and the State”), Oregon State University historians of science offer important perspectives on what it took to create the modern health-care system. New knowledge and technologies save lives, but these advances came slowly and at a cost. And they are still not universally accessible.

The United States has struggled with the public role in health care since colonial times. In 1917, we missed an opportunity to take a different path. The arguments continue.

I’m thankful for the advances we’ve made. My grandfather wasn’t so lucky. He broke his leg in a bicycle accident at the same age that I was when I broke mine. No titanium rod for him. His leg was wrapped in a plaster cast. A few days later, his pain hadn’t subsided. A blood clot had developed. He died of a heart attack before the cast could be removed.

Nick Houtman