So named because of its seasonality, poliomyelitis was the cause of worldwide epidemics in the 1950s. This new book presents a detailed look at the 1952 epidemic (in which I was an unwilling participant) with a focus on its effects in Denmark.
"... until quite recently in medical history, there was no intensive care. Seventy years ago anyone who struggled to breathe, whose heart gave out, or whose kidneys shut down would be kept comfortable and left to die. There were no ventilators, no monitors keeping track of vital signs minute to minute, no expertise of nurses and physicians to keep critically ill patients alive, and no dedicated units in hospitals for the care of such patients... This is the story of how we got from 1952 to now."
The story in Denmark begins at Blegdam ["Blei-dahm"] Hospital in Copenhagen, created in the 1860s as a "fever hospital" for quarantine purposes in a busy port city. Cases of cholera and various febrile illnesses arriving by ship would be sequestered here for isolation until resolution or death. Polio patients came here for "care," but not for "treatment" - which was nonexistent.
By 1952, some iron lungs were in use, especially in the United States, but those devices were immense, expensive, and difficult to use. In response to a massive epidemic which was killing their children, the Danes discovered the utility of "bagging" via an endotracheal tube. But no automated ventilators existed, so medical students were recruited to bag patients continuously, 24/7. Chapter 13 "Student Ventilators" details the development and implementation of this policy.
Nursing care in that era "was rooted in the tradition of a life given over to the work - long shifts, residence at the hospital for life, and no marriage." That also had to change. Analysis of blood gases and arterial pH - never before attempted (or considered) - was also invented, as was the concept of an "intensive care unit," (a term first used in 1958).
This book will not be of interest to everyone. It will have special meaning to current polio survivors, and should be a must-read for respiratory therapy students who want to learn about the invention of their profession and its tools.
Beyond Polio survivors I would think the transformation of hospitals would be of interest to a lot of people. So many changes in our lifestyle happened far enough back in time we'll never know the true details. This is one that happened in the last 70 years so we have living witnesses to all the sordid and funny details.
ReplyDeletexoxoxoBruce
Urgency matters in urgent situations. That's obvious. But a number of years ago, I still recall the painful result of my absolutely torturous pain being addressed without any noticeable rise in urgency. I was in the hospital, and that pain was so bad and relentless, the nurses station actually called me room to see if I was alright. NO!!!
ReplyDeleteIn fact, the nurse who was making the rounds didn't speed up her rounds one bit. She would drop by about every 45 minutes as she made her continued rounds. I got so desperate that, believe it or not, I actually picked up the phone to dial 9-1-1! Then it hit me: What are they going to do? I'm already in the hospital!
This article reveals what happens when people get serious enough about a matter to try to make a difference. Unusual matters are not often addressable by standard procedure. The Danes are owed a massive standing ovation!