Your health care and responsibilities

By Tom Putnam | Nov 19, 2010

In the 1930s, physicians were useful for diagnosing illnesses, hand holding, consoling, and occasionally for some form of active disease treatment. We had little immunization abilities, other than vaccination for small pox. There were no antibiotics; but there were quarantine signs on house’s front doors when a child had whooping cough, scarlet fever, or some other contagious “childhood” disease. They warned visitors to enter at their own peril.

Municipal swimming pools were closed in the summer when polio was “around." Hospitals had separate wings where there were iron lungs that would assist patients in their breathing. They were large metal cylinders into which the patient was placed with his head protruding from one end through a rubber diaphragm. Sanitaria also housed patients with tuberculosis so they were kept separate from the population until their disease healed spontaneously, or they died. Strep throat could lead to heart disease, or meningitis, or kidney disease. That bacterium was a really bad “bug!"

Every time I had a really sore throat, Mother would call the doctor. They all made house calls then. “I’m afraid that Tommy has strep throat again, Mrs. Putnam.” That diagnosis was like a “death threat” to me as a young child. It meant that my throat would “kill me” for the next five or six days and I was bed-ridden during that time.

Surgery was good for some inflammatory diseases, such as appendicitis, gall stones, lung and abdominal abscesses, and trauma; but little else. Surgery had little promise for malignant diseases because they were discovered too late after the tumor had spread elsewhere. In short, we had little preventive care and little promise in active care.

When the 1940s rolled around, things began to look up. Sulfa drugs were developed in the late 1930s and penicillin and streptomycin were developed in the early 1940s. They were useful in World War II. (Very different from wound care in World War I.) I’ll never forget getting the diagnosis of strep throat in late 1939. After the doctor made the diagnosis, he said, “However, Mrs. Putnam, I have a new drug that has just been released that I would like to try. It is called a sulfa drug.” I heard him say sulphur and couldn’t imagine what that bad smelling substance would do. Anyway, I took the medicine. Twenty-four hours later, I was on the mend and my sore throat had faded. To my young mind, it was truly a miracle!

Over the decades, immunizations were developed, more effective antibiotics came into being. They were over-used by physicians trying to prevent infections, and bacteria demonstrated an ability to develop strains that were resistant to current antibiotics. New antibiotics were developed and physicians became more discerning in their use.

Diagnostic abilities were rapidly improved with new imaging techniques, and diseases could be diagnosed definitively and earlier in onset when they were vastly more treatable and at a curable stage. Newborn infants with developmental abnormalities could have corrective surgery: esophagus not intact, rectum not open, kidneys blocked, intestines blocked, hearts not normal in their development, spines open to the back. Surgery evolved from working through wide open incisions to working through tubes and minute incisions: all to the advantage of the patient. Malignancies could be diagnosed at earlier stages, which increased the opportunity for curable treatments.

Yes, more recently, human beings, being what we are, stopped immunizing our children when the false opinion became common that mercury preservatives in the immunizing fluids could lead to emotional and mental problems. Science has never verified the supposed ill effects of mercury, but that didn’t matter: humans knew better and now our kids are getting childhood diseases again like they did half a century ago. I am waiting for the quarantine signs to reappear on front doors. However, I realize that we’ll finally get this straight and childhood immunization will become the standard again; but this may take another generation who will know better.

At the beginning of the second half of the 20th Century, medical insurance became available. Originally it was to cover hospitalization. All other medical conditions were treated by physicians and were on a fee-for-service basis. Most physicians charged the patient what they considered to be fair. Some bartered and payment might have been in the way of produce or other items of value. Some charged wealthier patients more to make up for losses from those less fortunate. After a decade or so, mostly through employment, patients pushed for insurance coverage for diseases not requiring hospitalization. Insurance was well underway as the means of payment for medical care. As new diagnostic methods were developed, costs increased, as did the costs of new drugs, and various surgical procedures. Life spans increased significantly as a result of scientific advancement, and patients and many in their national government now believe that industry or government should be responsible for their health care. We are evolving in that direction.

Which leads to this: If you want your fellow man/woman to be responsible for your health care you have to take some responsibility yourself.

What does that mean? It means you must adopt healthy health habits for yourself and your families and forsake substances and habits that lead to poor health. It is not new thinking, but this current generation has two major health problems: obesity and smoking-related diseases. The former results from our children giving up physical activities for the intrigue of the computer, cell phone and texting. All require no physical activity except bending the elbow of the predominant arm while the other arm is feeding the face. Where are the games of tag, hide-and-go-seek, softball and football that took up the child’s time after school was out for the day? It could be hard for the parent to get the child to come in for dinner and complete homework for the next day. In our day, smoking was so glamorous. Everybody did it in the movies and that behavior transferred onto the street. Smoking is addictive, and difficult to quit once one has started.

I started in high school, as kids do today, and felt sophisticated. After I got into surgical training and saw what cigarette smoke did to lungs, plus the knowledge that it increased the risk of lung cancer, stopping that habit was a no-brainer. I’m not saying it was easy. Not many smokers are as fortunate as I to have had that experience. Also, your mind and behavioral patterns are not completely developed until you are well into your 30s. By that time, one is really addicted. The easiest way to break the habit is to never develop it in the first place.

Now, are you asking your fellow man to cover your health costs when you have habits that are known to increase your health risks? The only good thing that could happen would be for your risks to result in an early demise and less cost to the health care industry and those that offer insurance to cover them.

What is your responsibility to your fellow man, if not yourself?

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