Literature DB >> 21677796

A 'sense' of history and pediatric cardiology.

Shyam S Kothari.   

Abstract

Entities:  

Year:  2011        PMID: 21677796      PMCID: PMC3104524          DOI: 10.4103/0974-2069.79614

Source DB:  PubMed          Journal:  Ann Pediatr Cardiol        ISSN: 0974-5149


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We, the people involved in the care of children with heart disease represent a sort of tribe with certain characteristics. And like every tribe, we should have a sense of our history. Although children with heart disease must have been borne ever since, attempts at understanding the heart disease in children are not more than 3-4 centuries old. The journey of the ‘idea of pediatric cardiology’ from scratch to the significant success as we have today represents an awe inspiring tale; and like most such surreal tales, it must be hiding mysterious secrets in it`s fold. But now that the structures are clarified and diseases classified, treatment standardized and the results posted on the websites with institutions wying with one another for quality matrix, do we need to keep a sense of history? Does it matter that Steno and not Fallot actually described ‘tetralogy of Fallot’, or the courage to operate on the heart emanated from the experience of removing the foreign bodies during the world war 2. Should we remember that in the early twentieth century, every city in the western world had convalescent homes for children with rheumatic fever. Now that the heart lung machine is ubiquitous, is there a point in remembering that even before that, open heart surgery was done with parent of the child supporting the circulation in the child. As late as 1962 (when Thalidomide tragedy stuck), it was thought that drugs given to the mother would have no effects on the fetus. In another vein, it is interesting that Robert Gross ligated the ductus in 1938 (when his chief was on leave), or Frossman catheterized himself (to check if drugs can be given directly) and was fired soon. Not too long ago, Marie Abbot (who described 1000 specimen of CHD when there was no hope of any treatment) was denied admission for being a woman, and Vivian Thomas who played a crucial role in the operation did not find a mention in the Blalock-Taussig shunt for some reasons. There is a plenty of human follies, serendipity, grand play of chance and of course, brilliant human endeavour on display in the study of history of pediatric cardiology.[1-4] A lot of it is fresh like early morning dream. There are several renaissance men and their individual efforts taking the progress to the next level. But one is vulnerable to lose tracks. So often, the tipping points of success are reached by small steps in unanticipated ways. For example, the role of discovery of heparin, of blood groups, of anesthetic agents etc., so central to the final success of the discipline is rarely on the forefront of the mind. Just as memory is essential for human condition, a continuity of collective memory is essential for the psyche of a species or a tribe which is captured in the sense of history. A sense of history is not the chronological memory of events, but a realization that few things happen before others, and that few things happen at certain places and not at others.[5] Historical analysis of ideas and events uniformly brings modesty, widening of horizons and a sense of wonderment.[6] These characteristics are much necessary attributes of a physician. Such a doctor is ‘educated’ and not merely trained, is ‘connected’ to the patients and not only attending, and is more qualified to care for patients in the complex environment of the modern day medicine. Both in History and in medical practice, we deal with uncertainty. This exercise in earnest, generates the creative thrust required for the practice of science. As scientists, we standardize and uniformalise, a sense of history helps us to understand the differences and adds the sense of wonderment to the spirit of enquiry. The sense of wonderment is essential ingredient to both the art and science of pediatric cardiology. And living with the sense of wonderment is living in exciting times. May our tribe always live in exciting times.
  1 in total

Review 1.  A history of pediatric specialties: the development of pediatric cardiology.

Authors:  Jacqueline A Noonan
Journal:  Pediatr Res       Date:  2004-06-04       Impact factor: 3.756

  1 in total

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