I study the history of medicine because I believe that it is extremely important to understand the whole context around medicine in order to better take care of patients. When talking about medicine, it is very easy for many people to become tunnel-visioned on the science. They often think that it boils down to just chemistry and biology and if you lean on that, you’ll be okay. However, when I have conversations with people and want to emphasize that science is only one aspect of medicine, there are a few examples that I usually go to. The first one is that according to the Department of Health and Human Services, 20-30% of the prescriptions written in the United States are not filled. Additionally, more than 50% of prescriptions are not followed as directed.1 These numbers also fluctuate when you look at age, social class and race. So for a physician, it is not just as easy as prescribing a drug that controls hypertension because it won’t be very effective if your patient never fills the prescription. Another example is the traditional practice of “coining” used in various cultures. This practice involves using a metal coin and vigorously rubbing it along the back or neck to alleviate symptoms of fever or other illnesses. Sometimes, when a patient enters goes to see a physician and the physician notices large marks and welts on the back and neck, they may suspect some sort of domestic violence. And if there are any language barriers between the physician and patient/family members, this situation may evolve past a medical issue, when in reality there may just be a difference in cultural approaches to healing.2 These are just two examples of how the physician’s care for a patient extends beyond just the science of a treatment. There are numerous social, cultural and economic factors that play into healthcare that need to be taken into consideration for more appropriate treatment of patients.
As I continue a career in medicine, i also hope to be able to continue researching and be able to work in an academic setting as well. The goal is to able to teach at a medical school about the history of medicine so that they could be better equipped to treat a variety of patients that they will undoubtedly be caring for. In this future I expect to have to be able to convey medical information to my patients. Being able to explain tests, scans and medical issues to someone who did not spend many years studying those things can be difficult. Additionally, as part of teaching, I will have to teach history to students who have a heavy focus on the natural sciences and may not see the humanities as relevant. Both of these situations will require me to take something that I have spent a lot of time studying and make it understandable to an audience that most likely has not.
1) https://millionhearts.hhs.gov/files/Medication-Adherence-Action-Guide-for-PHPs.pdf
2) For more information about coining and other practices, see “Caring for Patients from Different Cultures”: https://ebookcentral.proquest.com/lib/pitt-ebooks/detail.action?docID=3442455
The featured image that I chose for this blog post is of immigrant inspection at Ellis Island in 1923. This process became known as the “line” where immigrants would literally line up in front of Public Health Service physicians for medical inspection. Among other things, physicians specifically checked the under eyelids for Trachoma and Favus, two very contagious skin infections. Often times, indications of one of these two infections would result in refusal of entry for immigrants.
Image from National Archives: https://i0.wp.com/prologue.blogs.archives.gov/wp-content/uploads/2014/10/01996_2011_001_pr.jpg?ssl=1
