Tuesday, November 20, 2007

Personal takes on the history of medicine in Oregon

Since 2003, the OHSU Oral History Program has been acting in cooperation with what was then an already existing project to create a documentary film on the history of medicine in Oregon. This latter project, jointly sponsored by the Oregon Medical Association, Oregon Historical Society, The Foundation for Medical Excellence, and OHSU, and funded largely through the Oregon Medical Education Foundation, has recently been named an official Oregon 150 project. OHSU Historical Collections & Archives, in addition to providing research support and coordinating on interviews for some interviewees of interest to both projects, will eventually become the repository for the materials--video, audio, and paper--created as a result.

To that end, we recently received three transcripts from oral history interviews recorded for that project. As with all oral history, there are wonderful anecdotes and personal opinions included in each of these, samples of which are below:

Oregon Senator Mark Hatfield, interviewed by Roy Payne, M.D., May 20, 2003, on lobbying the legislature for funding:
Payne: Now after you got into the political field, into the legislature, where did you start getting involved there? Was it the dental school issue then?

Hatfield: The dental school was the very first, because it was not in the top level of the consolidated programs for building and higher education that had been developed by the chancellor’s office. So a group of students were helping to lobby for a new building, as well as faculty. And I remember the most, perhaps the most fantastic piece of lobbying that I ever experienced were these dental students saying, “You know, the saliva injector is something we have to pump by our foot while the patient is having his dental work done. And then after a while, something happens, and it reverses itself.”
Well, just the imagery of a saliva injector reversing itself from a common pot, so to speak, it won the day. And we put that dental school right at the top of the list.

Former Oregon Medical Examiner William J. Brady, M.D., interviewed by Matt Simek, May 23, 2007, on winning his first election:
Simek: Would you say that’s unusual, that an opponent would endorse his opponent?

Brady: Well, the whole election that year was very, very interesting and unusual situation. There was a layman who ran, was involved in the Republican primary, didn’t make it. His platform consisted of, ballot slogan, "[name] is dead right," and he was going to adjust the morgue to put a restaurant at the top of the morgue, and he would call it the Top of the Morgue. It was an unusual election. It was unusual. These are all true stories, honestly. [laughs]

Portland anesthesiologist Joanne Jene, M.D., interviewed by Matt Simek, August 23, 2007, on things you never see anymore:
Jene: We’re doing much, much teaching with the medical simulator so that people can get real life experience on a dummy, if you will. And that’s a great enhancement. Because you train to take care of the unexpected or the complication that may occur during a procedure under anesthesia. But you can go through a whole lifetime and never experience that situation.
And I will use as an example malignant hyperthermia, which is an anesthesia-triggered disease. It’s the only one anesthesia triggers. And it’s a combination of a genetic composition of the patient and drugs that you may use which will trigger an automatic release of a hyperthermia, or increase of the temperature of the patient. And usually this is in children. And the temperature could go from 37 degrees or 98.6 to 105 in a matter of minutes. And this is a life threatening anesthesia emergency. And I think that one of the things that we’ve done is develop the fact that Dantrolene is a medication that every hospital and every ambulatory surgical unit must have on hand. But also, it really becomes a team effort to resuscitate and save a patient.
And you may never see this in your lifetime. I had one case. Only one in my lifetime. It was in 1964. And at that time, there was no Dantrolene. We had no pulse oximeters. We barely measured the patient’s temperature. We had no monitors that we have now. And unfortunately, the patient died. I knew that there was a problem. It took time to define what the problem was. And then the only thing that we really had to treat the patient was sedation and ice. That was it. And then they go into a super hyper coagulability situation where the blood all begins to clot and then they begin to bleed.
So it was terrible, but there wasn’t anything. Now we do know how to treat it, how to recognize it. And that’s probably one of the greatest threats and challenges of anesthesia, but one of the biggest rewards that when you make the diagnosis, you can treat it.

Simek: Was that a child?

Jene: It was a sixteen year-old boy.

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