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Davis, California

Tuesday, April 23, 2024

Column: Good medicine

Four years ago, I felt like I was going to die.

I had an acute case of appendicitis. It felt like someone was stabbing a knife into my belly button. There was lots of pain and lots of barfing.

After a day of agony, surgeons removed my appendix. Today, I’ve just got a faint scar and a gross story.

I only felt like I was going to die, but 200 years ago, I probably would have bitten the dust. A ruptured appendix can cause an infection of the abdominal cavity, leading to a blood infection and death. Appendectomies didn’t gain popularity until a doctor named Reginald H. Fitz published a paper describing the disease back in 1886. (Avoid this paper unless you want lengthy descriptions of gangrene and “fetid, purulent fluid.”)

I like to think about how modern medicine saved me whenever I run across stories about our dangerous modern world.

An article in last week’s Cleveland Daily Banner quoted a doctor who said, “Modern life is hurting us … Our lifestyles have created many of our health problems.”

Indeed, recent headlines tell me that cell phones could cause brain cell damage, chemicals in plastic bottles could cause breast cancer and some babies’ car seats contain carcinogens.

I hate cancer. I want my brain to work, and I want babies to be safe. But I disagree with anyone who thinks the modern world is becoming less and less healthy.

For background information, I decided to talk with Catherine Kudlick, a UC Davis history professor who teaches courses on the history of medicine and public health.

“I am a 22-year-old woman. In previous centuries, what would have been the biggest threats to my health?” I asked her.

“It would of course depend on your social class, race and location,” Kudlick said. “If you were a well-off white woman living comfortably in rural U.S. or Western Europe, a big danger until the 20th century would be childbirth plus infections and diseases – different ones in different historical moments.”

For example, I could have faced the bubonic plague in the Middle Ages or the influenza pandemic of 1919. The East Coast faced a terrible yellow fever outbreak in 1793. Typhoid fever epidemics sprang up in the western world from the times of the ancient Greeks to the early 20th century.

Today, these diseases rarely make headlines in the U.S. We wear bug repellant, we wash our hands and we encourage each other to get flu shots. All these steps help stop diseases.

The idea that bacteria and viruses cause disease wasn’t even accepted until the late 19th century.

“In western medicine until the 19th century, advanced medicine worked from a notion of keeping four basic humors in balance,” Kudlick said. “If someone was hot, you’d cool them down; dry, you’d increase fluids. There was a lot of bleeding using leeches, which often either did nothing or even killed a person.”

Early doctors weren’t idiots. It is a good idea to lower the temperature of a person with a fever, and a patient with dehydration should definitely be given fluids. But I’m glad doctors today also have CT scans, MRI machines, antibiotics and tools for blood analysis.

I believe strongly in the benefits of modern medicine, but Kudlick warned me not to get too Rah-Rah-Y2K.

“I try to wean students away from a March of Progress narrative because you give a false sense of our own era as some great triumph. Sure, in many ways we live far better than before, but there’s a lot of problems we’re not facing because of a false sense of security,” Kudlick said.

A sense of security in the western world can make us forget diseases in other countries. HIV still spreads across the globe, and we still don’t have a cure for malaria. I may be safe from typhoid fever here in California, but 214 people died during a typhoid fever outbreak in the Democratic Republic of Congo in 2004-05.

HIV and malaria are terrible, but advances in western medicine are also helping less fortunate regions; at UC Davis, there are several labs dedicated to understanding and preventing those diseases.

Medicine in 2011 is more effective than in any other era. Eventually, I will die. But, thanks to modern medicine, it won’t be appendicitis that gets me.

MADELINE McCURRY-SCHMIDT learned a new word while writing this column. Fecalith (noun): a stone formed by fecal waste and a common cause of appendicitis. Madeline has decided that fecaliths were definitely not what caused her appendicitis. If you were Madeline’s surgeon, do not e-mail her at memschmidt@ucdavis.edu.


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