Invasion of the Body : Revolutions in Surgery

In 1913, the Peter Bent Brigham Hospital in Boston admitted its first patient, Mary Agnes Turner, who suffered from varicose veins in her legs. The surgical treatment she received, under ether anesthesia, was the most advanced available at the time. At the same hospital fifty years later, Nicholas Tilney—then a second-year resident—assisted in the repair of a large aortic aneurysm. The cutting-edge diagnostic tools he used to evaluate the patient’s condition would soon be eclipsed by yet more sophisticated apparatus, including minimally invasive approaches and state-of-the-art imaging technology, which Tilney would draw on in pioneering organ transplant surgery and becoming one of its most distinguished practitioners.In Invasion of the Body, Tilney tells the story of modern surgery and the revolutions that have transformed the field: anesthesia, prevention of infection, professional standards of competency, pharmaceutical advances, and the present turmoil in medical education and health care reform. Tilney uses as his stage the famous Boston teaching hospital where he completed his residency and went on to practice (now called Brigham and Women's). His cast of characters includes clinicians, support staff, trainees, patients, families, and various applied scientists who push the revolutions forward.While lauding the innovations that have brought surgeons' capabilities to heights undreamed of even a few decades ago, Tilney also previews a challenging future, as new capacities to prolong life and restore health run headlong into unsustainable costs. The authoritative voice he brings to the ancient tradition of surgical invasion will be welcomed by patients, practitioners, and policymakers alike. (20110815) In 1913, The Peter Bent Brigham Hospital In Boston Admitted Its First Patient, Mary Agnes Turner, Who Suffered From Varicose Veins In Her Legs. The Surgical Treatment She Received, Under Ether Anesthesia, Was The Most Advanced Available At The Time. At The Same Hospital Fifty Years Later, Nicholas Tilney--then A Second-year Resident--assisted In The Repair Of A Large Aortic Aneurysm. The Cutting-edge Diagnostic Tools He Used To Evaluate The Patient's Condition Would Soon Be Eclipsed By Yet More Sophisticated Apparatus, Including Minimally Invasive Approaches And State-of-the-art Imaging Technology, Which Tilney Would Draw On In Pioneering Organ Transplant Surgery And Becoming One Of Its Most Distinguished Practitioners. In Invasion Of The Body, Tilney Tells The Story Of Modern Surgery And The Revolutions That Have Transformed The Field: Anesthesia, Prevention Of Infection, Professional Standards Of Competency, Pharmaceutical Advances, And The Present Turmoil In Medical Education And Health Care Reform. Tilney Uses As His Stage The Famous Boston Teaching Hospital Where He Completed His Residency And Went On To Practice (now Called Brigham And Women's). His Cast Of Characters Includes Clinicians, Support Staff, Trainees, Patients, Families, And Various Applied Scientists Who Push The Revolutions Forward. While Lauding The Innovations That Have Brought Surgeons' Capabilities To Heights Undreamed Of Even A Few Decades Ago, Tilney Also Previews A Challenging Future, As New Capacities To Prolong Life And Restore Health Run Headlong Into Unsustainable Costs. The Authoritative Voice He Brings To The Ancient Tradition Of Surgical Invasion Will Be Welcomed By Patients, Practitioners, And Policymakers Alike. Three Operations -- The Teaching Hospital -- Evolution Of A Profession -- Steps Forward And Steps Backward -- War And Peace -- The Promise Of Surgical Research -- Operations On The Heart -- The Mechanical Heart -- The Transfer Of Organs -- Making A Surgeon, Then And Now -- Shifting Foundations -- Unsolved Dilemmas. Nicholas L. Tilney. Includes Bibliographical References And Index. Contents ......Page 8 Introduction ......Page 12 1. Three Operations......Page 18 2. The Teaching Hospital......Page 46 3. Evolution of a Profession ......Page 63 4. Steps Forward and Steps Backward ......Page 86 5. War and Peace ......Page 108 6. The Promise of Surgical Research......Page 139 7. Operations on the Heart ......Page 178 8. The Mechanical Heart ......Page 211 9. The Transfer of Organs ......Page 238 10. Making Surgeon, Then and Now ......Page 265 11. Shifting Foundations ......Page 292 12. Unsolved Challenges ......Page 320 Notes ......Page 350 Acknowledgments ......Page 370 Index ......Page 372 Introduction -- 1. Three operations -- -- 2. The teaching hospital -- -- 3. Evolution of a profession -- -- 4. Steps forward and steps backward -- -- 5. War and peace -- -- 6. The promise of surgical research -- -- 7. Operations on the heart -- -- 8. The mechanical heart -- -- 9. The transfer of organs -- -- 10. Making a surgeon, then and now -- -- 11. Shifting foundations -- -- 12. Unsolved challenges. A pioneering organ transplant surgeon narrates in gripping detail the revolutions that have transformed modern surgery, and the turmoil in medical education and health care reform as new capacities to prolong life and restore health run headlong into unsustainable costs. Tilney's stage is the famous Boston teaching hospital, Brigham and Women's