Chilean miners benefit from older doctors

Trapped chilean miner rescuedWe live in a time when almost all doctors – even those who practice in rural areas of the US – rely on advanced technology for diagnosis and treatment. But there are times when knowing the old-fashioned way to practice medicine comes in handy.

Dr. Jorge Díaz, responsible for the team of 15 doctors who monitored the health of the trapped Chilean miners, has been a physician for a long time. As he put it, he “practised medicine before it became as sophisticated as it is today.”

One of the first medical emergencies his team encountered was a miner with a urinary tract obstruction. If the miner had been above ground, imaging technology could have located the obstruction and, if appropriate, a trained professional could have inserted a urethral catheter. Since that wasn’t an option, Dr. Diaz relied on his older, more basic skills.

There was no way to use a catheter or give him an IV. We solved the problem the way we would have 50 years ago, with warm compresses and oral antispasmodics. … It has been very important that the [medical] team include older physicians, like me.

Benjamin Franklin didn’t invent the catheter

Contrary to American mythology, Benjamin Franklin did not invent the urinary catheter. He did oversee the construction of a relatively flexible catheter — by a silversmith — for his brother John. Franklin describes this at length in a fascinating letter dated 1752.

This Machine [the catheter] may either be cover’d with a small fine Gut first clean’d and soak’d a Night in a Solution of Alum and Salt in Water, then rubb’d dry which will preserve it longer from Putrefaction: then wet again, and drawn on, and ty’d to the Pipes at each End.

The use of catheters for medical purposes goes back to the ancient Syrians, who used reeds, and to the time of Hippocrates (c. 460 BC – c. 370 BC), who used metal. More flexible catheters were devised in the Middle Ages, and the 19th century introduced rubber catheters.

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The art and science of medicine
Palliative care: Lost and recovered
Still useful after all these years: The gall bladder

Resources:

Image source: Reuters

Barbara Fraser, Chilean miners see the light at last, The Lancet, October 23, 2010, Vol 376 Issue 9750, p. 1379

Edward David Kim, MD, FACS, et al., Urinary Tract Obstruction, Medscape, October 31, 2008

Benjamin Franklin, A Flexible Catheter, The History Carper, December 8, 1752

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3 Responses to Chilean miners benefit from older doctors

  1. Fascinating and very interesting. Modern medicine is a marvel. But maybe sometimes the less invasive treatment may be best. But it is hard to find doctors who believe this any more. I am sure law suits have something to do with this.

    I have even read that leeches have come back into vogue for some medical problems.

    • Hi Roberta – Ah yes, leeches have made a comeback. Today they’re used for a different reason than in the past, however. Medicine went through a transition in the mid-19th century, from understanding illness as an imbalance in the four humors (blood, phlegm, black bile, and yellow bile) to the modern scientific medicine we know today. In the humoral theory, if a body was red, this was a sign of excess blood. Leeches were one form of bloodletting.

      Today leeches are used in microsurgery, such as plastic and reconstructive surgery. When a surgeon reattaches a finger, ear, or eyelid, it’s important to restore good circulation. Leeches consume excess venous blood, which helps prevent congestion in newly attached veins, and they secrete an anticoagulant that keeps blood from clotting. The use of leeches is called hirudotherapy, after the anticoagulant in leech saliva, hirudin.

      A similar treatment making a comeback today is the use of maggots to clean wounds (debridement). Maggots only eat dead flesh and can be much more effective than surgically cleaning a wound. The practice goes back to antiquity, but was also rediscovered many times during wars, including the Civil War. Doctors noticed that soldiers whose wounds contained maggots had a better chance of surviving. These days they put sterile maggots in a mesh bag, so they can’t crawl around wherever they want.

      Is this suitably scary for the Halloween season? Or just slightly disgusting.

      • As to being scary, if I needed that kind of treatment go right ahead. Just put me under for the duration; like when I have some dental procedures.