Musings in the Auditorium

Two days ago I was at a national medical conference, sitting in an auditorium watching a live cardiac procedure on a large video screen. The procedure was being performed on a patient many miles away and I was seeing the operation as it was being performed.

Additionally, the procedure was a replacement of the patient’s aortic valve using a relatively small device being placed in the “heart” through a small incision in the patient’s upper leg. No opened chest, no general anesthesia, no heart-lung pump, no cardiac surgeon.

I truly believed I was in some sort of alternative or parallel universe. How was all this happening? When did we actually have the madness to believe we could replace heart valves without opening the chest?

This incredible experience led me to think — an often dangerous activity for me.

Four days ago I began my 27th year of practicing medicine and cardiology. When I graduated from medical school over 31 years ago, we had never heard of HIV. We were only dimly aware of some odd and strange cases of infections seemingly associated with immune deficiency in adults that were being seen in some of our hospitals. 50% of people having a heart attack would die either before they made it to a hospital or while in the hospital. Stomach and intestinal ulcers were treated by a surgeon in the operating room. Kilogram babies could not survive outside the womb. Hip replacements were amazing surgeries and only a few orthopedic surgeons did them. I had never heard of anything called “percutaneous transluminal coronary angioplasty”.

I thought I wanted to be a neonatologist.
Or maybe a pediatric surgeon.
Or maybe a pediatric cardiovascular surgeon.
Or maybe a neuroophthalmologist.
Or maybe a traumatologist.
Or maybe . . .

I NEVER thought I wanted to be a military officer!

What things I have SEEN! What skills I have acquired. What things I have done to make people well, better, cured or more comfortable.

Where have all those years gone? How is it I have lived through all this amazing progress and technological revolution in medicine?

Yet, I still rely on my stethoscope, my hands, my old brain. They seem to have done well by me and my patients. Indeed, many times they have succeeded when all that technology failed or was not there.

I wonder what Sir William Osler, arguably the father of “modern” North American medicine, would say about all these things that have happened to his beloved profession in the last century? Would he be pleased or thrilled or saddened or angry?

It has been a great career for me over these three decades.

Do I have one more decade left in me?


About Michael Therrien

Physician, teacher, administrator, military officer -- and a few other roles just thrown in to make it interesting!
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