In most histories of medicine doctors are the heroes. Patients are rarely mentioned by name unless they are famous in their own right, and even then they are almost always presented as grateful (and passive) recipients of medical and nursing care. Our perspective as patients is rarely described, unless it is about our gratitude for the heroic work of the doctor and how the doctor has overcome our fear of treatment and eradicated the terrible symptoms we exhibit. We are rarely seen as active partners in our care and certainly not as contributors to the advancement of medicine or the rest of healthcare. The same or similar treatment of patients appears in almost all histories of other health professions like nursing and pharmacy where there are often vigorous complaints about how their profession is ignored in medical histories. While it is worthwhile to celebrate extraordinary scientific discoveries and the healthcare professionals who achieve them, it may be useful to point out the critical role that we as patients and families have played in the development of modern healthcare. Ignoring our perspective is to lose the great richness of our contributions in the past, our growing participation in the present and the need for our partnership in the future.
No one has so far written a history of medicine from our point of view. Yet we as patients have always been the object of concern and care. What does the history look like from our perspective? Have we really been as passive as the term “patient” implies? How has the view of patients changed over time? Who is a patient? Has this supposed passivity helped us? Has it harmed us? Where and how have we been active participants? Where have we led advances in healthcare? Who have been some notable patients in the past? What have they accomplished? The blogs will explore these issues and more. We will try to shrink this large gap in the history of healthcare and medicine.
As sick people we have often had a role in our own care. Most of us manage our own minor ailments. We often get support from our families and at times we find help in unlikely places outside the formal healthcare system. It is not surprising that a record of these aspects of health care have been neglected in the face of the enormous success of professional medicine. The truth is that as well as family and friends, there has always been a multiplicity of health care providers, and that the virtual monopoly of professional medicine is a relatively recent phenomenon. I will be writing a series of blogs with the view to preparing a book that takes a wider view and looks historically at the roles that we as patients have assumed and the kinds of care that we have chosen (or been subject to) from prehistoric times and what that care has contributed to healthcare today.
When we became so ill that self care was no longer an option, the choice between doctors and other practitioners was at one time a major decision for patients and their families, but it has had little place in the history of medicine. For medical practitioners all non-doctors were always quacks. But as William Osler pointed out, the real trouble with quacks is that their cures work. Osler was arguing for the professionalization of modern medicine and the removal of even the temptation to go to non-professionals. Despite this we as patients have been drawn to a wide variety of treatment and much of it has worked. This book will consider the successes and failures of the choices we make for care and how that has affected the history of medicine. We will also think about the search for magical cures and silver bullets that has always been, and continues to be, part of the patient environment.
Finally many patients have been sacrificed on the altar of progress in medicine, some willingly, some unwittingly, and some despite their protests. This book will look at the history of patients as clinical material throughout history and the role we continue to play as subjects of study with and without our consent.