How medicine has changed with the Monarchy ?

I woke up to the news last Friday that the longest reigning monarch, the queen of England had passed on to her heavenly abode. A reign of 70 years and almost 100 years living on the face of the earth seemed incredible.She had been the queen of England for all my life and it must be true for most us as well. So it truly feels like an end of an era and curtain call of an eternity. While reading her memoir I came to know that she had lived through 2 world wars, met 15 prime ministers of the United Kingdom and travelled to 117 countries! Impressive feat and what an achievement. In all this I can’t help but wonder how she would have felt as the days were slowly but surely slipping past her.How medicine has changed in the modern world during this time period is very significant when you look back in time.

I often have this thought when in solitude that having been born in the late 80s I am very fortunate to witness the most technological advancements there is to see. I had been in an era when sending postcards and greeting cards on Christmas was a cherished family tradition and receiving telegrams on important occasions was commonly practiced. I used to have a pen friend somewhere in the US whom I used to keep in touch with. Then came the landline phone and all the excitement with it. I still remember our neighbours coming home to speak on the phone with their relatives. When my uncle took out a huge cordless phone from his bag one day excitedly talking about it’s features I really thought it was a new toy. That was the first time I saw a mobile phone or a cordless phone as it was called then. I remember going to a cyber cafe to check my 12th board exam results as that was the one of the few options in Bangalore which had internet for general public. While in college I had the trustworthy Nokia button phone and have spent so many hours on it playing the snake game. Then the internet boom and advent of smartphones sped up my life and others like me. I now have this phone to educate, entertain and motivate me, to connect me to my friends and be my spiritual guide, my nutritionist and exercise partner!

While this was just my journey over the years about technology and its advancement, I’m sure even health care and the practice of medicine has had a profound change over the years. So this week as the world mourns the loss of a very prominent leader figure who was with us for almost a century let us look back in time and see what how medicine has changed in the last century.

Discoveries and inventions that changed the course of medicine:

1. Discovery of Penicillin- Sir Alexander Fleming’s discovery of penicillin in 1929 has changed the course of medicine. Up until then infections were treated using herbs from the garden, sometimes chemicals like iodine and bromine and even by blood letting! This fascinating process involved letting out the blood from artery or veins using syringes or even leeches. After penicillin was discovered came the discovery of a slew of other antibiotics and many serious and life threatening illnesses like tuberculosis finally had some cure!

2. The first blood banks- It was during World War I(1914-1918) that the first blood banks were set for the wounded soldiers. Women also held prominent position during this time and played vital roles as nurses saving millions of lives. This ultimately led to a social change and women obtained rights to vote in Britain in 1920 after the war. This can be considered a significant way in which medicine has changed.

3. The Pap smear (1920s) – did you know that the now routinely performed test for detecting cervical cancer was only a chance discovery made by Papanicolou? While observing the cellular changes of vaginal fluid during the menstrual cycle of women subjects, he happened to note that one participant who had uterine cancer showed abnormal cancer cells in their smear. Since then this simple test has helped greatly in screening and early detection of uterine and other cancers.

4. Insulin- Endocrinology was at its nascent stage when this hormone was discovered by Banting and Best in the early 1920s. Up until then a diagnosis of diabetes was a certain death knell for the patients. Following its discovery, diabetics could not only survive the disease but also live long healthy lives! The fact that it had to be injected daily subsequently sparked the search and development of several oral hypoglycaemic agents.

5. The defibrillator(1940s) was a miraculous invention by Beck a cardiovascular surgeon who apparently ‘brought back a young boy to life’ during heart surgery he performed! Today this device continues to save millions of lives sand marks more than 70 years since the new era in cardiac life support began.

6. Discovery of the DNA- the double helix that rules our lives was not discovered up until 1953 when James Watson and Francis Crick put forth their theory. This landmark discovery for which the two gentlemen received Nobel prizes in 1962 led to the rise of modern Molecular Biology. Now we know how diseases can be passed on from parents to their offsprings. Genetic sequencing helped identify abnormal genes and now gene therapy and genetic counselling might give a new lease of life to those with genetic diseases in the future.

7. Organ transplantation- can you believe the first organs transplantation was performed was a kidney transplantation way back in the mid fifties? Even before modern imaging techniques like the CT scan and MRI were found. Later on several other organ transplantation surgeries involving the liver and heart also were successfully performed in the 50s and 60s.

8. The Oral Rehydration Salt solution (ORS) (1960-70)- one of the most commonly prescribed medication to treat a variety of gastrointestinal conditions like loose stools, vomiting and abdominal pain. This wonder powder was actually invented in collaboration with the American researchers at Calcutta, India. This was at a time when several lives where lost very quickly due to the dreaded cholera and India lacked intravenous fluids to rehydrate them quickly. All this changed with the advent of ORS which continues to save lives even today.

9. Another invention which transformed the lives of countless women was the Oral Contraceptive pills! It allowed women to plan their families and enter the workforce like never before and was given the FDA approval in the 1960s. Commonly known as the first ever lifestyle drug something not for treating an illness but provides a better lifestyle. This single invention is credited to be the symbol of the ‘sexual revolution’ of the 1960s and 70s.

10. Imaging marvels- MRI and CT scans (1980s)- this invention has revolutionized medicine to such an extent that even minute growth can be caught early and has led to faster detection of deadly illnesses like cancer and bleeds. Please read here to learn more about medical imaging

These were certainly not the only discoveries that come to my mind. The dawn of the vaccine age, complex surgeries like angioplasty and heart lung bypass, the ventilator, kidney dialysis machines and even new treatment for diseases like HIV and cancer have all been discovered this last century!

Peek into the future.

If what has been achieved seems phenomenal what is yet to come will be even more exceptional. For one, technology will continue to have a huge impact on health care. We are expected to grow by leaps and bounds in genetics and gene therapy might actually come within the reach of the common man. Robotic surgeries and artificial intelligence assisted scans and reporting will probably become the way forward. Will the health care professional a.k.a the doctor and nurses become completely redundant and replaced by AI or robots remains to be seen.

With the advent of space travel and more manned missions to outer space, there would be a need for medical equipment which are portable and can work in a different gravity setting able to withstand harsh/hazardous environments. Also, there would be a need for medical professionals/physician astronauts trained to work in outer space/human colony in another planet.

Personal health devices like smart watches, smart weighing scales, BP machines etc are going to get much smarter and would read many vital signs and could communicate with a healthcare provider in real time to provide alerts to the user.There would also be multiple variants of advanced human implants that would support humans in stabilizing/monitoring various body functions. Also, nano robotics would help to assist in diagnosis and performing surgeries that need laser cut precision. How medicine has changed with the help of disruptive technology is something that needs to be seen in the future.

What changes do I envisage in public health since that is so close to my heart? Well there might be greater health mapping of people especially in developing countries and use of modern data analytics tools to arrive at disease patterns and behaviours. We might have more one shot vaccines that prevent a multitude of illnesses together much like the pentavalent vaccine we have now. Health screening might be taken more seriously by the populations and to know more about health care packages do read on here: 

Telehealth and tele-consultations might continue to decrease the rural urban divide and make healthcare more accessible to the masses. Diseases will be diagnosed earlier, treatments will be much cheaper, scans will become more precise and man will hopefully live longer. 

Years later when you sit and ponder about how time flew and how medicine has changed, who knows you might be  part of the history in the making!