Friday, November 15, 2013

Hsieh PJM OpEd: Will Tomorrow’s Medical Innovations Be There When You Need Them?

PJ Media has just published my latest OpEd, "Will Tomorrow’s Medical Innovations Be There When You Need Them?"

My basic theme is that we must protect the freedoms necessary for the advancement of medical technology.

I start with a pair of vignettes:
How much has American medicine changed in the past 30 years?

Let’s turn the clock back to 1983. A middle-aged man, Dan, is crossing the street on a busy midday Monday. An inattentive driver runs a red light and plows into Dan at 45 mph, sending him flying across the pavement. Bystanders immediately call for help. An ambulance rushes Dan to the nearest hospital. In the ER, the doctors can’t stabilize his falling blood pressure. They prep him for emergency surgery. The trauma surgeon tries desperately to stop the internal bleeding from his badly fractured pelvis but is unsuccessful. Dan dies on the operating table.

The surgeon gives Dan’s wife the sad news: “I’m sorry, but your husband’s injuries were too severe. We did everything we could. But we weren’t able to save him.”

Fast forward to 2013. Dan’s now-grown son Don suffers the same accident. But within minutes of his arrival in the ER, he’s sent for a rapid trauma body CT scan that shows the extent of the pelvic fractures — and more importantly, shows two badly torn blood vessels that can’t be easily reached with surgery.

An interventional radiologist inserts a catheter into the femoral artery in Don’s right leg. Watching live on the fluoroscopy screen, the radiologist skillfully guides the catheter through the various twists and turns of the arterial system and positions it at the first of the two “bleeders.” From within the blood vessel, he injects specially designed “microcoils” into the torn artery and stops the bleeding. He then guides the catheter to the second bleeder and repeats the procedure. Don’s blood pressure recovers. The surgeons now have time to repair Don’s pelvic fractures and other internal injuries.

The surgeons give Don’s wife the good news: “Your husband’s injuries were pretty bad. But we were able to fix everything. He’ll still have to go through recovery and physical therapy. But he should be back to normal in six months”...
For more, read the full text of "Will Tomorrow’s Medical Innovations Be There When You Need Them?"

(The material for the opening vignettes was drawn from a pair of excellent talks presented last month at the 2013 annual meeting of the American Society of Emergency Radiology. )

Update #1: A great example of medical innovation coming from unexpected places was this 11/14/2013 New York Times article describing how an Argentinian car mechanic saw a Youtube video on how to extract a stuck cork from a wine bottle and realized it could also be used to help extract babies stuck in the birth canal.

His idea will be manufactured by Becton, Dickinson and Company and has already undergone initial successful safety testing in humans. It could save the lives of many babies in Third World countries and also reduce the need for Caesarean section in industralized countries.  (Via Gus Van Horn.)

Update #2: For those interested in the real-life technology used in the fictional scenario I discussed, here's a nice medical slideshow from UCLA interventional radiologist Dr. Justin McWilliams, "Life-saving Embolizations: Trauma and GI bleeding"