Patient-in-Chief
Happy Presidents’ Day!
Among the great powers of the presidency is the ability to shape the national conversation on health care. Which got us thinking: the story of medical innovation can be told through the American presidency.
We’re dusting off our history books today to review a few Patients-in-Chief.
First in War, First in Peace, First in Excruciating Pain
In honor of the holiday formerly known as Washington’s Birthday, we start off with a piece from PBS NewsHour’s Dr. Howard Markel on “the excruciating final hours of President George Washington.”
Dr. Craik entered Washington’s bedchamber at 9 a.m. After taking the medical history, he applied a painful “blister of cantharides,” better known as “Spanish fly,” to Washington’s throat. The idea behind this tortuous treatment was based on a humoral notion of medicine dating back to antiquity called “counter-irritation.” The blisters raised by this toxic stuff would supposedly draw out the deadly humors causing the General’s throat inflammation.
Today, doctors would have likely swapped those “Spanish flies” for antibiotics. Score one for medical innovation.
Two Presidents Suffer Remedies Worse Than the Disease
Within twenty years, two American presidents were arguably felled, not by an assassin’s bullet, but 19th century medical techniques.
President James A. Garfield lived for 11 weeks after being shot by an assassin in 1881. As a patient, he experienced a 19th century remedy that was worse than disease. “Garfield had such a nonlethal wound. In today’s world, he would have gone home in a matter or two or three days,” says Dr. Ira Rutkow, a professor of surgery at the University of Medicine and Dentistry of New Jersey and a medical historian.
That nugget comes from Amanda Schaffer’s New York Times piece, “A President Felled by an Assassin and 1880’s Medical Care.” Rather than the bullet itself, Garfield was felled by his doctors using unsterilized equipment. Although Joseph Lister pioneered sterilization in Britain in the 1860s, it wasn’t common practice in the United States until years later.
Alexander Graham Bell supplied Garfield’s medical team with an improvised metal detector. There’s no clear reason why the metal detector failed to locate the bullet. One school of thought blames the metal coils in the president’s bed, while another group of historians believes the search was limited to one side of his body.
Edison’s Attempt to Save the Day
President William McKinley was touring the latest technological innovations at the 1901 Pan-American Exposition in New York, when fatally shot by anarchist Leon Czolgosz.
According to the U.S. National Library of Medicine, “A worried McKinley aide sent word to inventor Thomas Edison to rush an X-ray machine to Buffalo to find the stray bullet. It arrived but wasn’t used.
Blogger David J. Kent notes, “At the autopsy, physicians found that the unrecovered bullet did not cause the death of the President through loss of blood and resultant shock. Instead, gangrene had developed along the path of the bullet, and McKinley died of septic shock due to bacterial infection.”
Both Garfield and McKinley were on the edge of potentially life-saving medical inventions – a metal detector and X-ray machine.
It’s Morning Again in Alzheimer’s Research
There’s plenty of reason to share Ronald Reagan’s trademark optimism about advances in Alzheimer’s research.
With more than 500 clinical trials underway at ClinicalTrials.gov, Alzheimer’s cures are now a race, a point reinforced by WAAY 31’s Andy Devine. We’ve identified the proteins that cause the buildup. Now, the trick is figuring out how to stop it.
Carter’s Breakthrough Therapy
Here at Patients Rising, we’ve written extensively on how breakthroughs in cancer treatments have saved the life of Jimmy Carter, who saw melanoma spread to his liver and brain. Dr. Charles Balch and John M. Kirkwood also wrote about this recently in Newsweek.
Carter was treated with a newly approved immune system drug that has shown to also have positive treatment effects in some cases of melanoma. It targets gene activity called PD-1 and PD-L1, and the interaction between them can prevent some tumors from being detected and neutralized by the body’s immune system that naturally prevents cancer from spreading.
These medications that allow immune cells to fight back – called immunotherapy – are helping patients in ways unimagined just a few years ago.
How can a 91-year-old man, no matter how vigorous, undergo extensive cancer treatment and infusion? The answer is, we have to adjust our thinking about what is possible. Carter’s breakthrough therapy can be given in 30 minutes with no nausea side effect. So he can take this treatment, and it can enhance his life. That is why the FDA gives accelerated approvals for breakthrough therapies. We need more of them.