It may not have been Gerald Imber's primary intention, but his recent biography of William Halsted sheds light on how the U.S. developed the world's best-performing clinical care system, and even hints at a better way forward. It started with a group of medical pioneers committed to both research and clinical practice, with a deep respect for repeatable and verifiable scientific findings, and holding themselves and others to high standards. That plus an unfettered market proved a recipe for success.
William Halsted can justifiably be called the Father of Modern Surgery. He pioneered local anesthesia; raised aseptic surgery to a higher level; and invented procedures such as hernia and aneurysm repair. But his overall contribution extends far beyond these technical achievements. Halsted transformed surgery from a brutal act of desperation into a gentle, life-saving art. He and his colleagues at Johns Hopkins not only developed new methods of diagnosis and treatment, they set new standards for physician training and proficiency.
As the title suggests, there is another and quite disturbing side to Halsted. The man was a drug addict. But Halsted did not set out to get high; he became addicted as a result of experiments he performed on himself with local anesthetics. Little was known about treating drug addiction at the time. Though his addiction spanned 38 years of a lengthy career, it did not stop him from performing hundreds of operations and achieving a series of breakthroughs.
It's too bad that our current political leaders are too arrogant to consult history, but if they are truly interested in ensuring affordable health care for all they should study the careers of surgeons such as William Halsted and Harvey Cushing. Both men could and did command exorbitant fees from those who had the means. They could have sat around waiting for the occasional wealthy patient, but they understood that it was in their own interest to treat everyone, regardless of financial means. They charged nothing to the poor, moderate fees to the middle class, and high fees to the wealthy. That allowed them to keep their skills sharp and their coffers full.
Though Imber explores Halsted's personality and personal life, he also describes in detail a number of the medical advances achieved by Halsted and his colleagues. Included are Halsted's gallbladder surgery and Walter Dandy's pneumo-ventriculography for locating brain tumors. These were huge developments in their day. After reading this book, you'll also understand why Johns Hopkins is one of the world's best hospitals--if not the best.