Trying new things in medicine

February 15, 2018

My classmate in medical school, Eric, only became a medical student because his father insisted. Eric wasn’t happy about this until he discovered he loved ophthalmology. He went on to perform brilliantly as a resident and built an extremely successful and fulfilling practice. Eric’s story is not unique.

 

My classmate in medical school, Eric, only became a medical student because his father insisted. Eric wasn’t happy about this until he discovered he loved ophthalmology. He went on to perform brilliantly as a resident and built an extremely successful and fulfilling practice.

Eric’s story is not unique.

Claudius Galenus, also known as Galen, was born in 129 A.D. to a well-to-do Greek family in Pergamum. His father arranged for his son to have a first-class education to prepare him for a prestigious career as either a philosopher or politician. Then his father had a dream in which the Greek god of healing, Asclepius, ordered him to make his son study medicine.

So, a star was born. Galen went to Alexandria and studied every medical text available. His big break came in 157 A.D. when he was appointed physician to the gladiators in Pergamum. This allowed him to become an expert in the management of injuries, and the death rate among his gladiator clientele plummeted.

He showed the value of ligating bleeding vessels. His vivisections of monkeys and other animals (the dissection of human cadavers was forbidden) shaped his insights into anatomy and physiology. Galen eventually moved to Rome and became physician to the emperors.

 

Galen gave public demonstrations of his medical skills and made no effort to conceal scorn for his physician-colleagues in Rome, whom he regarded “as either incompetent or avaricious and always unscientific.”

While many physicians may say they don’t like to write or find it difficult to find the time or motivation, Galen was remarkably prolific. More than 80 of his treatises survive, compromising more than half the entire corpus of ancient medical writing and a substantial proportion of all the ancient Greek literature that exists. His medical texts were translated into Arabic and Latin and remained in use by medical students for more than 1,300 years.

In one of his treatises, That The Best Physician Is Also A Philosopher, he makes the point that only through constant questioning and scientific study of new treatments can medicine advance.

Among his many observations, Galen described the circulation of blood, the generation of the voice by the larynx, the difference between motor and sensory nerves, the concept of muscle tone, and the difference between agonists and antagonists. He understood that the crystalline lens was in the anterior portion of the eye and not the center. He figured out that psychiatric problems somehow originated in the brain, and one of his works is the first description of psychotherapy to treat psychological problems.

 

 

Sound familiar?

Here’s the important part: he was also an accomplished cataract surgeon.

Galen was apparently mocked by many of his physician colleagues who thought it ludicrous to draw conclusions about human health based upon studies of animals. After proving himself correct and his detractors wrong time and again and in very public fashion, he finally had generated so much envy and hatred directed his way that Galen-fearful he would be poisoned by other doctors (there had been precedents)-left Rome. He died in Sicily around the age of 80.

It’s hard to believe a cataract surgeon would not be universally admired by his or her fellow physicians. Even in ophthalmology there have been radical new ideas that, despite scientific support, have met with fierce resistance. But doctors poisoning other doctors with whom they disagree is probably going a bit too far. 

 

Reference

Hall, E. (2014) Introducing the Ancient Greeks. New York: W.W. Norton & Co., pp 233-236.