How much has American medicine changed in the past 30 years?
Let’s turn the clock back to 1983. A middle-aged man, Dan, is crossing the street on a busy midday Monday. An inattentive driver runs a red light and plows into Dan at 45 mph, sending him flying across the pavement. Bystanders immediately call for help. An ambulance rushes Dan to the nearest hospital. In the ER, the doctors can’t stabilize his falling blood pressure. They prep him for emergency surgery. The trauma surgeon tries desperately to stop the internal bleeding from his badly fractured pelvis but is unsuccessful. Dan dies on the operating table.
The surgeon gives Dan’s wife the sad news: “I’m sorry, but your husband’s injuries were too severe. We did everything we could. But we weren’t able to save him.”
Fast forward to 2013. Dan’s now-grown son Don suffers the same accident. But within minutes of his arrival in the ER, he’s sent for a rapid trauma body CT scan that shows the extent of the pelvic fractures — and more importantly, shows two badly torn blood vessels that can’t be easily reached with surgery.
An interventional radiologist inserts a catheter into the femoral artery in Don’s right leg. Watching live on the fluoroscopy screen, the radiologist skillfully guides the catheter through the various twists and turns of the arterial system and positions it at the first of the two “bleeders.” From within the blood vessel, he injects specially designed “microcoils” into the torn artery and stops the bleeding. He then guides the catheter to the second bleeder and repeats the procedure. Don’s blood pressure recovers. The surgeons now have time to repair Don’s pelvic fractures and other internal injuries.
The surgeons give Don’s wife the good news: “Your husband’s injuries were pretty bad. But we were able to fix everything. He’ll still have to go through recovery and physical therapy. But he should be back to normal in six months.”
Most Americans are familiar with the enormous changes in consumer technology over the past 30 years.
VCRs have been replaced by DVDs, which have in turn been replaced by streaming and on-demand video. Home computers are now smaller and cheaper than in 1983, yet far more powerful. Smartphones didn’t exist 30 years ago. Today, most people take for granted that they have access to the nearly the entire sum of human knowledge at their fingertips. As Twitter CEO Dick Costolo told students in his 2013 University of Michigan commencement address: “When I was your age we didn’t have the Internet in our pants. We didn’t even have the Internet not in our pants — that’s how bad it was.”
However, many Americans may not be aware of similar advances in medical technology. CT scanners in 1983 used to take several minutes to acquire relatively crude pictures of the human body. Today, a high-resolution full body scan takes only a few seconds. Typically, the limiting step is no longer the scan time, but rather how long it takes to safely move an injured patient on and off the CT table.
Similarly, the specialized microcoils used by Don’s doctors to save his life didn’t exist 30 years ago.
In 1983, being diagnosed with AIDS was tantamount to a death sentence. Now, new drugs allow patients infected with HIV to live for decades. Survival rates for many common cancers such as breast cancer and prostate cancer have improved significantly due to advances in surgery, chemotherapy, and radiation therapy. Modern PET-CT scanners now routinely use antimatter (as in Star Trek) to diagnose early cancers more accurately than was ever possible in the 1980s.