Fresh off his fascinating article on Dr. Michael DeBakey’s confrontation with death (here and here), the NY Times’ Lawrence K. Altman reminds us in this article that — despite the dysfunctional U.S. health care finance system — medical advances are continuing at an increasing rate:
As a reporter for The New York Times for 37 years, I have witnessed many important medical events, from new treatments to new diseases. In reflecting on that panorama, it is clear that technology has accounted for the greatest changes in medicine. Technology has improved laboratory testing; allowed for the development of CT scans, magnetic resonance imaging exams and positron emission tomography, or PET, imaging to improve diagnostic accuracy; and produced new drugs and devices. Basic science, too, has deepened our understanding of disease, and much of that work depends on technology.
At the same time, the care for many ailments has been greatly improved by ancillary developments like better nursing care, newer antibiotics, transfusions of platelets to prevent bleeding, the insertion of monitoring tubes in major veins, and better organization of some services. [. . .]
Few people appreciate that medicine has advanced more since World War II than in all of earlier history. Newer drugs and devices and better understanding of disease mechanisms have vastly improved the care of patients. For male babies born in this country in 1960, the life expectancy was 66.6 years; for female babies, it was 73.1 years. In 2004, the figures, respectively, were 75.2 and 80.4. Medical advances account for much, though not all, of the gain.
Altman’s point regarding the importance of medical advances reminds me of a similar one that Donald J. DiPette, the chairman of the Texas A&M Internal Medicine Department, made while giving the Walter M. Kirkendall Lecture at the University of Texas Health Science Center this past spring. Given the advances in treatment of hypertension over the past 60 years, Dr. DiPette noted that President Franklin D. Roosevelt would have never been allowed to participate in the Yalta Conference at the end of World War II had his doctors known then what doctors knew a decade later about the traumatic implications of acute hypertension. In short, a better understanding of hypertension at the time of Yalta almost certainly would have changed the course of human history.
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Malcolm Gladwell, he of Tipping Point fame, has authored this must-read New Yorker article on the demise of Enron. Although Gladwell gets a couple of things wrong, his article provides a refreshingly candid and objective view of what happened to Enron and highlights several aspects of the company’s demise that makes criminalization of the affair so troubling. Reading Gladwell’s account along side this earlier post on the case against Jeff Skilling, is there really any meaningful doubt that an enormous injustice has occurred in regard to the conviction and sentencing of Skilling to 24 years in prison?
