An accident landed me in a local medical center where I could observe and reflect upon the accelerating changes in the technology of medicine.
When I first began practicing medicine in Chattanooga in 1971, the city featured many fine caregivers at a time when technology was severely limited. The two principal hospitals had excellent reputations for nursing care. Many patients arrived in emergency rooms via hearses provided by funeral homes. Emergency rooms were modest in space and equipment.
CT and MRI scans had not yet been perfected. Fiberoptics, which revolutionized examination and therapy of lungs, digestive tracts and joints, was several years away from clinical deployment. Arteriography allowed diagnosis of narrowed or blocked arteries, but the technology of dilating vessels and placing stents was a few years away. Open heart surgery was the only option for clearing a blocked artery. Today, clots that block arteries can be rapidly dissolved or removed, thus preventing or limiting damage to organs. Patients may be safely discharged to their homes after a few days.
Heart attacks would run their course in the absence of clot-dissolving medication. Once in the hospital, the victim of the heart attack would typically be hospitalized for 10 to 14 days in a program of gradually increasing exercise.
Before the advent of minimally invasive surgery, a patient with a diseased gall bladder might require a week of post-operative care before discharge.
Until the discovery that bacteria caused most peptic ulcers, patients with severe ulcer disease often required various surgeries, which included removal of