Thanksgiving Advent, Day Fourteen: Modern Health

[swan_tower]

When la_marquise_de_ and I were doing the podcast thing at World Fantasy, one of the things that came up was the sheer physical discomfort people used to live with as a matter of course.

Now, I know that there are many people ven now -- possibly some of you reading this -- who likewise live with chronic pain, disease, injury, disability, or other such conditions. I have no desire to trivialize those things. But taking the long perspective . . . my god. Things have improved so much in the last century or so, I can barely even conceive of it.

I'm talking about everything from the major achievements (smallpox used to kill or disfigure vast numbers of people; now it's been eradicated) down to the minor ones (most of us still have all our teeth, and they're probably pretty straight, too). Thanks to vaccinations -- but no thanks to the anti-vax movement, which I won't rant about here because this is supposed to be about thankfulness -- we no longer have to run the gauntlet of measles and mumps and rubella and whooping cough and everything else that used to drop children like flies. We have antibiotics: no more "and by the way he spent the last three years of life with a supperating ulcer in his thigh" for us! We can repair torn ligaments, use hearing aids to combat deafness, replace freaking hip joints, man. If I didn't have astigmatism, or U.S. had approved toric ICLs already, I could get a lens permanently implanted in my eye to correct my vision.

Dude, Beck Weathers lost his nose to frostbite, and they grew a new one for him on his forehead.

So while I extend my heartfelt sympathies to everyone who suffers from ill-health of one kind or another -- my GOD am I thankful for modern health. If you threw me into the European past, I would not want to be treated by any doctor from before maybe 1940 or so. (I don't know enough about the history of medicine in other parts of the world to make judgment calls there, except to say that Europe was late to the smallpox-vaccination party.) I'm sure any number of things we do today will be considered barbaric and dumb by the people of the future, but from where I'm standing, we've made amazing progress.

Comments

[tiamat360.livejournal.com]

Heh, so. Thanks to your post I looked up Beck Weathers on wikipedia, and it turns out that the reason he originally became separated from the rest of the group was due to eye surgery that made his eyes unable to handle light at high altitudes.

And, yes, science/technology/medicine has pretty much exponentially progressed in the last century. Relatedly, did you know that Cleopatra is closer in time to spaceflight than to the beginning of Egyptian civilization?

[mindstalk.livejournal.com]

I hadn't seen spaceflight mentioned per se, but I've noted that "ancient Greece" (particularly Classical, vs. Hellenistic) was 2500 years go. And 2500 years before them was the beginning of Dynastic Egypt and, give or take some centuries of "civilization" (writing, empires) in Mesopotamia and Harappa. The Jewish calendar claims it's about 5700, which is interestingly close to a 5500 year age for writing.

I think 'our' instincts for what's ancient come from the Renaissance and obsession with the Greeks, making it easy to miss that they had stuff that was ancient for them. (And China's got its own depth; I remember mention of medieval Chinese antiquarians.)

Of course, now we know that modern human beings have been around for 60-100,000 years, so that even all of agriculture (10,000) let alone civilization (5000) is a recent novelty...

[swan-tower.livejournal.com]

Yeah, as I said in the reply to tiamat360, I do sometimes put things in the perspective of human evolution. But it's easy to forget there are whole millenia of human civilization that predate even the stuff we think of as "ancient."

[swan-tower.livejournal.com]

. . . wow. I am perhaps oddly prone to viewing things in light of a larger time-scale; I've been known to point out things like how this agriculture thing is a recent fad, in the history of the human species. (Let alone the history of hominid evolution.) But I hadn't thought about that middle scale before.

That's amazing.

[mindstalk.livejournal.com]

Of course, helps that Cleopatra is literally the end of independent ancient Egyptian civilization, such as it was after 300 years of Greek rule, and 500 years after Classical Greece.

[mrissa.livejournal.com]

I am very sure that I am far better off with my particular medical concerns in the current state of medicine than I would have been before. Whenever I hear people denigrating their own problems as "First-World problems" (sometimes with justification and sometimes unfairly, I feel), I think, "If I had this and lived in the Third World, I would fall into a cooking fire or a factory machine or something and DIE."

[swan-tower.livejournal.com]

I can pretty much point at my eyes and leave it there. My vision has been going bad since I was seven; I would probably have been run over by a brewer's waggon before I was fifteen, and that would be the end of me.

[mrissa.livejournal.com]

My eyes are pretty much the same, only from nine instead of seven. But I got pneumonia at seven, and when I was born, my mother had a bleeding problem that was a tedious thing for them to handle in 1978 and would probably have killed her in 1878. Would I have survived my first six months without a mother? Some babies did. Many didn't.

Go modern medicine.

[maratai.livejournal.com]

This. I was wearing glasses in kindergarten (when my parents could force me to put them on). The vision issue would have killed me before anything else had time to come into play.

[rosefox]

I was just talking with a doctor about this today! Apparently 18% of women have uteruses that point toward the spine instead of toward the navel, and this is normal and no big deal. But in Victorian England, doctors thought it reduced fertility, and they would put women through massive abdominal surgery (in decidedly non-sterile conditions) just to flip the uterus around and see whether that would make it work better. I'll take present-day medicine, thanks.

I expect a hundred years from now, doctors will be horrified by tumor ablation (also known as setting people on fire for their health), chemotherapy, SSRIs, fatphobia and prescribed dieting, and our general inability to correctly and usefully interpret the output of our extraordinary imaging machines (not least because it takes years to do controlled studies and by then the technology has improved again and the studies of the previous generation of machines are useless). But I will certainly take the present state of treatment for e.g. cancer and mental illness over where they were in 1911.

[swan-tower.livejournal.com]

. . .

<runs screaming>

I'm pretty sure I'm one of that 18%. And while I was sort of at peace with the awareness that my bad vision would be a crippling disability, the notion of that surgery FREAKS ME THE FUCK OUT.

And yeah, I think a lot of twentieth-century psychiatry is going to be seen as quack medicine by the people of the future, while chemotherapy will be put in the same box as mercury treatments for syphilis -- "yeah, it worked, but thank god we have better methods now." Still, we're not conducting icepick lobotomies or (GAHHHH) uterus-flipping surgeries anymore, so that's progress.

[yuuo.livejournal.com]

I will definitely take modern medicine over what used to be. If we went by what used to be, I'd be locked up in an insane asylum, possibly getting a lobotomy.

[swan-tower.livejournal.com]

I might be in an asylum myself, for "female hysteria" or whatever term was current for "being an intelligent and strong-minded woman."

[yuuo.livejournal.com]

Oh, probably. Wanna be my roommate? :Db We can suffer from 'female hysteria' together.

[mindstalk.livejournal.com]

Now now, asylums are barbaric and unnecessary, as was known even in ancient times! Some simple but professional medical pelvic massage will do the trick! And Mr. Newcombe's new steam-powered clockwork vibration machine can bring relief in minutes instead of hours! Buy one from Sears today!

[swan-tower.livejournal.com]

Oh god, am I looking forward to that movie . . . .

[yuuo.livejournal.com]

Oooooo... :O That sounds much more appealing. 8D

[houseboatonstyx.livejournal.com]

I'm sure you're right on most points, but fwiw, I HAD measles, mumps, whooping cough, and chicken pox (tho not at the same time). I didn't drop like a fly, nor did any of my classmates. I remember some aching but overall the discomfort was not as bad as a bad cold or mild flu is now.

[mindstalk.livejournal.com]

Nonetheless, those are all potentially lethal diseases. The cold, not so much.

[swan-tower.livejournal.com]

Though to be fair, I tend to think of the flu as being a mild annoyance, and have to remind myself that it is a) potentially lethal to some people now and b) was lethal, on a massive scale, within the last hundred years.

[juliet]

My eldest uncle died of flu, aged 2 or so, some 70-80 years ago. (In Aberdeen, Scotland.) (And on your point a: I had the flu jab this year as I'm pregnant, and it can be very serious indeed for pregnant women, among the other risk groups. So, yeah, still a serious thing in some circs.)

Several of what-used-to-be-standard childhood diseases (chicken-pox, mumps, etc), many of which I also had as a kid (25-30 years ago, pre-MMR), may be (usually) a mild nuisance to otherwise-healthy & well-nourished kids, but the same is surely not necessarily true of kids for whom that's not true?

[swan-tower.livejournal.com]

Yes, the very young, the very elderly, the immuno-compromised, and the pregnant are all at-risk groups for the flu. And this gets into the "herd immunity" thing, too; there are always people who for one reason or another can't be vaccinated, who can only be protected by surrounding them with enough people who have been that the disease is unlikely to get anywhere near them.

[swan-tower.livejournal.com]

They were less lethal in living memory because of other improved aspects of medicine, before we got to the point where we could vaccinate against them. But life expectancy in the past -- by which I mean before 1900 or so -- wasn't so appallingly low because people rarely lived past 40; it was low because vast numbers of children died before the age of 5. The hard part was making it out of toddler-hood alive (and then surviving pregnancy and childbirth, if you were female). After that, your odds got better.

Even with improved medicine, though, a lot of those diseases still killed, or left the sufferers with lifelong consequences.

[mindstalk.livejournal.com]

Probably also less lethal because of better nutrition and lower parasite loads. Medicine doesn't get all the credit; regular food, clean water, and oh yeah, not actively killing each other as much all contribute to long lives.

Fun idea: going by simple game theory, a germ or parasite that has a host all to itself should take it easy, reproducing over time without killing the host. Two types of parasite though are in a Prisoner's Dilemma, where the incentive is to race for grabbing as much of the host as possible, even at the expense of its life. Ditto for one parasite in an otherwise dying host; no sense in conserving the dead. So there might be a phase transition in parasite behavior, being relatively nice to healthy humans and vicious to the already sick.

I don't know if there's any evidence to support this, I think I got the idea from a discussion of evolution and adaptation. But it's an intriguing idea.

Won't get into the health effects of social status independent of economics, or of stress...

[http://users.livejournal.com/la_marquise_de_/]

You were probably well-nourished, living in conditions that were clean, draught-free, warm, and vermin-free, and allowed to take time out to rest and recover. And you weren't subjected to medical practices that served mainly to weaken you further. Measles wiped out all but one of the heirs of Louis XIV towards the end of his reign -- the sole survivor was the infant Louis XV, who only survived because his nurse would not let anyone else near him. And that was at the most privileged end of the scale. Measles also blinds, causes heart weakness and can develop into pneumonia. Same with the others. Whooping cough, in particular, was a real killer because children literally choked to death. We haven't seen bad cases of these in many many years, so we forget how severe they can become -- and how easily.

[kurayami-hime.livejournal.com]

In class today, we had to make sample sentences involving "if I had a time machine," and all I kept thinking was "GAH! DISEASE! GAH! NO PLUMBING!" The point was to practice new grammar involving suppositions, so I'm pretty sure I was doing it wrong.

In only tangentially related news (my specialty), your Kevin Bacon Six Degrees fun fact for the day: the one time I went to camp, I went to camp with Beck Weathers' son. Who is also named Beck, so I always have a moment of confusion whenever Everest is brought up.

[swan-tower.livejournal.com]

Oh, c'mon, that totally works. "If I had a time machine, I would be careful to take antibiotics with me." "If I had a time machine, I would make sure my vaccinations are up-to-date."

And the Beck Weathers thing is just further proof there aren't six billion people on this planet; there's only about six thousand or so. <>