Some things don't change

More and more these days, my medical practice in the ER features some of the latest medical gadgets. I use a smart phone stuffed with medical apps to stay on top of the latest medical information. I wheel around a portable ultrasound machine to help me rule out everything from tubal pregnancy to an abdominal aortic aneurysm.

Later this month, WCBA explores medicine's growing dependence on high tech to help us look after you, and how technology changes how we interact with you. In his book 'Technological Medicine: the changing world of doctors and patients' published by Cambridge University Press in 2009, author Dr. Stanley Reiser argues that early inventions such as the stethescope changed the doctor patient relationship in fundamental ways.

Before diagnostic breakthroughs like these, the surest way to learn what ailed the patient was to listen to him or her. That meant long sessions in which the patient was encouraged to talk about symptoms in detail. Once stethoscopes and x-rays became available widely, physicians began almost immediately to bypass the patient's personal account of symptoms in favour of extracting objective data from the body itself in the form of heart sounds and radiological images.

If you've ever wondered how a visit with your doctor ended up being less than ten minutes in length, you have to begin with technological advances such as these.

While medical technology undoubtedly has merit, I think we've taken the idea that we can scan patients for disease instead of listening to them way too far. You can build a machine that takes the most exquisite images of your insides. Still, as a wise mentor once warned me: "if you don't know what you're looking for when you order the scan, you won't find it."


While we're dissing medical gadgets, I thought you'd get a kick out of hearing that in some parts of medicine, we're going forward into the past. Leeches are slimy parasites that feed on blood. The first recorded use of leeches was two and a half millennia ago in Egypt. Ancient healers used them to extract blood from the body to treat a variety of symptoms such as headaches.

This practice - known as "bloodletting" - was extremely common in Europe the mid 1800's. It was so common that in 1833 alone, France imported over 42 million leeches. By the early twentieth century, bloodletting had fallen out of favour as newer treatments came into vogue.

In the mid-1980s, surgeons began to experiment with leeches as a way of improving the success rate following the reattachment of severed limbs. It turns out that leeches, which possess a natural blood-thinning product, can help restore normal blood flow in the transplanted limb.

Recently, I learned first hand the modern benefit of leeches from Isabella Lawson, aka 'The Leech Queen'. Ms. Lawson is a registered nurse in the General Surgery Department of the Toronto Western Hospital, and head honcho of the little critters.

The Leech Queen and her unit's five-foot-long mascot

"Patients are often surprised, but the majority of them accept leeches as part of their treatment," Lawson told WCBA in an interview. "That said, most patients don't want to look at the leeches while they feed. They're too freaked out for that."

You can hear the full interview later this month on WCBA.

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