I remember the early trials of thrombolytics; not for stroke but for MI. During my residency, we were still comparing tPA with streptokinase. It was pretty incredible stuff. Now we’ve moved beyond that positively “medieval” method of treating heart attacks and have advanced to incredible interventions in coronary and cerebrovascular disease.
Furthermore, we are able to rescue more and more people from the brink of death with advanced medications and with techniques, like ECMO, that our medical forebears couldn’t even imagine. These days, people can say things like: “I had severe sepsis last year, but I recovered,” or “A few years ago I nearly died of stage 4 cancer, but here I am!” Fifty years ago, twenty years ago, their families would have told their stories with sadness.
What we do is amazing. The science behind our saves, coupled with our training and passion, make medicine all but miraculous. I am proud of what I know, proud of what I do. I am so impressed with my colleagues. And I am often awestruck by the scientists and engineers, without whom we would be apes poking bodies with sticks (good-looking apes in scrubs, mind you).
If we could, at the end of our lives, look back at the gifts we gave to the sick and injured, we would see that they far outweigh our errors and mistakes, our losses and failures. And yet, for all our modern innovations, we have limits. We can ask and answer a constellation of questions, and we can fix untold numbers of problems. But there are questions that defy us, and problems that leave us shaking our heads.
In spite of our pride in science, and our common dismissal of all that is “unscientific,” suffering remains, and we can’t answer why. Who knows this better than those of us who have dedicated ourselves to emergency care?
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