Michael Bliss (1) (1941–2017)

This short work by noted medical historian Michael Bliss of the University of Toronto focuses on three events that led to the transformation of the public view of medicine in North America, from a profession that was often powerless to alter the course of serious illnesses in the late 19th century, to one in which scientific advances and changes in medical education led to the possibility of cure of dreaded diseases and, more importantly, the hope for further cures in the early 20th century.

Bliss first describes the smallpox epidemic in Montréal in 1885, a disease preventable by vaccination at that time, which claimed the lives of over 3,000 residents within the city's limits in less than one year. The majority of the deaths did not occur among the poorest residents, who were largely vaccinated by their personal physicians in childhood. Instead, the victims were concentrated in the French Canadian population within and outside of Montréal, who erroneously believed that vaccination against smallpox was a dangerous tool designed by the English speaking medical community to sicken them. This opinion was supported and encouraged by several anti-vaccinationists in the French Canadian community, whose proclamations were eerily similar to those of the current lot of scaremongers in the anti-vaccine community.

The second story concerns the career of William Osler, the "father of modern medicine", who was trained and later taught at McGill University, before he accepted a position as Physician in Chief at the new Johns Hopkins Hospital and Medical School. Johns Hopkins was founded by a wealthy philanthropist, and the medical school was based on the training methods of the prestigious schools in Europe; as a result, Hopkins became the gold standard for medical education in the United States, even superseding the University of Pennsylvania, the oldest medical college in North America. Osler, one of the "Big Four" founding professors at Johns Hopkins Medical School, wrote the famed textbook The Principles and Practice of Medicine as he waited for the medical school to admit its first students, which was published in 1892 and continues to be widely read today; created the clerkship system, in which medical students moved from the classroom and laboratory to the hospital wards and clinics to observe direct patient care; and instituted the modern internship and residency programs for medical school graduates. His teaching methods, thoughtful approach to the patient and collegial collaboration with other specialists continue to be practiced and taught to this day.

The final segment describes the discovery of insulin by Frederick Banting and his colleagues at the University of Toronto in 1922. The hormone was isolated from pancreatic extracts, purified, and then tested on diabetic animals. It was first administered to a human patient at the Hospital for Sick Children in January of that year, and it had an immediate and long lasting effect, as the then teenage boy would live for another 13 years. The most famous of Banting's early patients was Elizabeth Hughes, the 15 year old daughter of the US Secretary of State Charles Hughes, who was close to death from starvation, the standard treatment for diabetes in August 1922, as she weighed only 45 pounds. She was brought to Toronto and administered insulin, which led to a remarkable recovery. Hughes went on to lead a full and active life until her death in 1981 at the age of 73. Banting was awarded the Nobel Prize in Physiology or Medicine in 1923 at the age of 32, and he remains the youngest Nobel laureate in this field.

At just over 100 pages, The Making of Modern Medicine serves best as an introduction to Bliss and his previous books, on which this one is based, and to the reader with little or no knowledge of the history of North American medicine. Thanks to this book I will read William Osler: A Life in Medicine and Harvey Cushing: A Life in Surgery, Bliss's noted biographies of these two giants of medicine, in the near future.… (más)

As a type 1 diabetic of 44 years' duration, I found this story of the drug that saved my life at the age of 19 fascinating. Insulin is a curious "cure", in that it is no cure at all, and in that it has a distinct dark side that those who are not insulin-dependent can never understand. I have been in the emergency room too many times to even want to count. I know of no other therapeutic drug that requires its recipients to expose themselves to such risks (i.e. hypglycemia). Yet it's all we've got, and it keeps us alive. So I guess all I can say is: Bravo!… (más)