#William Stewart Halsted

[aperint]

¿Sabías qué?

¿Sabías qué? Cáncer de mama #aperturaintelectual #sabiasqueaintelectual

Cáncer de mama Uno de los grandes mitos que todavía se mantiene, especialmente entre el género masculino, es que el cáncer de mama ataca de manera exclusiva a las mujeres y no hay nada menos cierto que eso. Hace muchos años por la falta de información, esta línea comenzó a cobrar mayor fuerza; sin embargo, desde 1307 el médico militar Jhon de Aderne observó y detalló por primera ocasión que este…

[nyxwolph]

It's okay if you couldn't cut it as a doctor. No sober human was ever meant to.

how cocaine created the residency programs of today

Why did we ever force doctors to learn their profession in this exhausting, sleepless way? The answer originates with the esteemed physician William Stewart Halsted, MD. 

Halsted founded the surgical training program at Johns Hopkins Hospital in Baltimore, Maryland, in May 1889. As chief of the Department of Surgery, his influence was considerable, and his beliefs about how young doctors must apply themselves to medicine, formidable. The term “residency” came from Halsted’s belief that doctors must live in the hospital for much of their training, allowing them to be truly committed in their learning of surgical skills and medical knowledge. 

Halsted’s mentality was difficult to argue with, since he himself practiced what he preached, being renowned for a seemingly superhuman ability to stay awake for apparently days on end without any fatigue. But Halsted had a dirty secret that only came to light years after his death, and helped explain both the maniacal structure of his residency program and his ability to forgo sleep. Halsted was a cocaine addict. 

Early in his career, Halsted was conducting research on the nerve-blocking abilities of drugs that could be used as anesthetics to dull pain in surgical procedures. One of those drugs was cocaine, which prevents electrical impulse waves from shooting down the length of the nerves in the body, including those that transmit pain. Addicts of the drug know this all too well, as their nose, and often their entire face, will become numb after snorting several lines of the substance, almost like having been injected with too much anesthetic by an overly enthusiastic dentist. 

Working with cocaine in the laboratory, it didn’t take long before Halsted was experimenting on himself. If you read Halsted’s academic report of his research findings in the New York Medical Journal from September 12, 1885, you’d be hard pressed to comprehend it. Several medical historians have suggested that the writing is so discombobulated and frenetic that he undoubtedly wrote the piece when high on cocaine. 

Colleagues noticed Halsted’s odd and disturbing behaviors in the years before and after his arrival at Johns Hopkins. This included excusing himself from the operating theater while he was supervising residents during surgical procedures, leaving the young doctors to complete the operation on their own. At other times, Halsted was not able to operate himself because his hands were shaking so much, the cause of which he tried to pass off as a cigarette addiction. 

Ashamed and nervous that his colleagues would discover the truth, he entered a rehabilitation clinic under his first and middle name, rather than using his surname. It was the first of many unsuccessful attempts at kicking his habit. For one stay at Butler Psychiatric Hospital in Providence, Rhode Island, Halsted was given a rehabilitation program of exercise, a healthy diet, fresh air, and, to help with the pain and discomfort of cocaine withdrawal, morphine. Halsted subsequently emerged from the “rehabilitation” program with both a cocaine addiction and a morphine addiction. 

Halsted inserted his cocaine-infused wakefulness into the heart of Johns Hopkins’s surgical program. The exhausting residency program, which persists in one form or another throughout all US medical schools to this day, has left countless patients hurt or dead in its wake—and likely residents, too. Many medical schools used to require residents to work thirty hours. You may think that’s short, since I’m sure you work at least forty hours a week. But for residents, that was thirty hours all in one go. Worse, they often had to do two of these thirty-hour continuous shifts within a week, combined with several twelve-hour shifts scattered in between.

— Why We Sleep by Matthew Walker, PhD 

[uniformmanufacturerofficial]

Medical Uniforms of the Past: Examining Historical Garb in Healthcare

Throughout history, medical professionals have donned various forms of attire, reflecting not only the practical needs of their profession but also the prevailing cultural norms and beliefs of their time. In this blog, we'll journey through the evolution of medical uniforms, exploring the styles, materials, and significance of historical garb in healthcare.

Ancient Beginnings: In ancient civilizations such as Egypt and Greece, healers and physicians often wore simple robes or tunics, emphasizing cleanliness and modesty. These early medical uniforms were typically made from linen or cotton, prized for their breathability and ease of washing.

Medieval Medicine: During the Middle Ages, medical practitioners adopted more distinctive attire, often incorporating hooded robes or cloaks to denote their profession. These garments, usually made from wool or rough linen, served practical and symbolic purposes, providing warmth and protection while signaling the wearer's role as a healer.

Renaissance Reforms: The Renaissance period saw significant advancements in medical knowledge and practice, accompanied by changes in uniform attire. Physicians and surgeons of this era favored more tailored garments, often featuring elaborate embroidery or embellishments to signify their status and expertise. Leather aprons and gloves were also commonly worn for protection during surgical procedures.

Victorian Era Elegance: In the 19th century, medical uniforms took on a more formal and stylized appearance, reflecting the Victorian era's emphasis on decency and decorum. Male physicians favored dark suits with high collars and waistcoats, while female nurses wore long dresses or uniforms with crisp white aprons and caps. These uniforms conveyed a sense of professionalism and authority, as well as adherence to strict hygiene standards.

Modern Innovations: Medical uniforms underwent further transformations with the advent of modern medicine and healthcare professionalization in the 20th century. The introduction of standardized scrubs, pioneered by Dr. William Stewart Halsted in the early 1900s, revolutionized the field by providing practical, easy-to-clean attire for surgical staff. Today, medical uniforms come in a variety of styles and materials, ranging from traditional white coats and nurse uniforms to colorful scrubs and specialized protective gear.

Conclusion: The evolution of medical uniforms reflects changes in healthcare practices and shifts in societal attitudes and cultural norms. From ancient robes to modern scrubs, these garments have played a vital role in defining the identities of medical professionals and instilling confidence in patients. As uniform manufacturers continue to innovate and adapt to new challenges, the legacy of historical garb in healthcare serves as a reminder of the enduring importance of professionalism, hygiene, and tradition in the medical profession.

Housekeeping Uniform Manufacturer

[shaaknaa]

Yeah... if I remember correctly the guy who invented residency was a firm believer in cocaine.

Like... this might be a stretch, but I don't think we should've let someone addicted to cocaine judge how long a non-addict should be awake and learning.

“After thirty years of intensive research, we can now answer many of the questions posed earlier. The recycle rate of a human being is around sixteen hours. After sixteen hours of being awake, the brain begins to fail. Humans need more than seven hours of sleep each night to maintain cognitive performance. After ten days of just seven hours of sleep, the brain is as dysfunctional as it would be after going without sleep for twenty-four hours. Three full nights of recovery sleep (i.e., more nights than a weekend) are insufficient to restore performance back to normal levels after a week of short sleeping. Finally, the human mind cannot accurately sense how sleep-deprived it is when sleep-deprived.”

— Matthew Walker PhD, Why We Sleep: Unlocking the Power of Sleep and Dreams (via themedicalstate)

[thephilosopheroftheboudoir]

William Stewart Halsted

[pocketgalaxies]

my new icon is william stewart halsted

[yougobunny]

Tech loved his friends. 

When he found Ace on his knees in the training room, palms pressed into his eyes and groaning from the pressure pounding in his skull, Tech had a pair of goggles ready for him before dinner. When Ace went to his room that night he found it shrouded in midnight, a type of darkness that Ace had never experienced before even after the meteor crash took out the power supply in Acmetropolis. The blackout screens that Tech had installed over dinner blocked out any possible light source, and when Ace woke up the next day it wasn’t from the migraine that has stolen sleep from his eyes for what feels like a lifetime. 

Tech invented near-indestructible gloves for Rev for the speedster’s baking endeavours. Earmuffs for Lexi to mute out the world, at least temporarily. For a few weeks when Duck had demanded to add a cape to his suit, Tech sketched designs using the same material from their suits, the ones that he had already designed to be bulletproof after Slam constantly tore through the first few designs, after Ace had gotten shot. 

A few weeks after meeting her, Tech asked Sapphire for her phone over dinner and returned it a few minutes later while they were digging into dessert. Sapphire was still dressed in her butterfly scrubs, Tech could still smell the antiseptic that clung to her like a second skin at this point. “I’ve upgraded it, there’s an app right on the home screen now,” he turned the screen towards her and pointed at an icon designed to look like a sleek rendition of HQ from afar, “if you’re ever in trouble just click on this and we’ll get an alert no matter where we are.”

“Thank you,” Sapphire’s eyes flickered between Tech and the screen, her pavlova forgotten for a few heartbeats. She reached for the phone, finger hovering over the app. A distress call. A message in a bottle. “Lexi told me to just scream if I ever need help and she’d hear me.”

“I stand by that!” Lexi called out from the other side of the room, eyes not leaving the screen from whatever game she and Rev were battling out for the night. 

Tech grinned, fingers tapping on the table, “Think of this as back-up.”

Sapphire dropped her phone back into her bag, “Do you know who William Stewart Halsted is?”

Tech nodded, not perturbed in the slightest by the change of topic. He’s gotten used to it with Rev. “The inventor of the rubber gloves.”

“Do you know why he did it?”

“Necessity?”

“You could say that,” Sapphire laughed, “He was the first chief of surgery at the hospital and he loved a nurse there, she became his wife later on.” She grabbed her spoon and began digging into the pavlova once again as she talked, “He noticed that the skin of her hands had developed a bad case of dermatitis from her work at the hospital, so he introduced rubber gloves that she could wear to protect her hands. Soon everyone wore them too.” She took a bite of the dessert, swallowing before speaking once more, “It’s the great romance of medicine.”

Tech glanced down at Sapphire’s hands, then glanced around the room to where his friends were sprawled. Slam had Ace and Duck captivated with his commentary of a wrestling match on the screen that Tech had upgraded after Slam had accidentally sent the remote crashing through it once in his excitement. Lexi let out a whoop of joy, tossing her controller aside and backflipping over the couch in a celebratory lap after beating Rev. She had broken two controllers before Tech had fixed them. 

Tech loved his friends. He loved them to the point of reinvention.

[thequeeninyellowlace]

Fun fact from a medical professional: The insane, work-until-you-drop-or-else-you’re-not-a-real-doctor residency schedule, which routinely drives student doctors to suicide, was invented by a guy who could do it because he was a massive cocaine addict! True story!

[allieinarden]

I knew that story about William Stewart Halsted inventing rubber gloves to help his wife and it’s actually so much better than the version I’ve seen going around. 

Caroline Hampton wasn’t his wife at the time, she was a nurse working at his hospital. Because of her bad allergic reaction to the antiseptic (note that Halsted was one of the earliest surgeons to enforce the standards of cleanliness we take for granted today, meaning that it wasn’t a problem she would have encountered at any old hospital), she almost left her job. He came up with the concept of thin rubber gloves and had his buddy at Goodyear Tires make her a pair so that she could stay right where she was. Your call whether her marrying him later was related. 

[rschmidth]

PDF Doctors: The Illustrated History of Medical Pioneers PDF -- Sherwin B. Nuland

Doctors: The Illustrated History of Medical Pioneers - Sherwin B. Nuland

READ & DOWNLOAD Sherwin B. Nuland book Doctors: The Illustrated History of Medical Pioneers in PDF, EPub, Mobi, Kindle online. Free book, AudioBook, Reender Book Doctors: The Illustrated History of Medical Pioneers by Sherwin B. Nuland full book,full ebook full Download.

 Read / Download Doctors: The Illustrated History of Medical Pioneers

DESCRIPTION BOOK : National Book Award-winner and surgeon Sherwin B. Nuland tells the extraordinary story of the development of modern medicine through compelling studies of the great innovators and pioneers. Artfully selected illustrations bring the history of medicine to life as never before. This brilliant collection of life portraits of physician scientists shows how their deeds and determination paved the way for future breakthroughs in medicine. Ranging from the legendary father of medicine, Hippocrates, to Helen Taussig, the founder of pediatric cardiology, the book is filled with the spirit of ideas and the thrill of discovery.Other medical pioneers profiled include Galen, Andreas Vesalius, Ambroise Par�William Harvey, Giovanni Morgagni, John Hunter, Ren�aennec, Ignac Semmelweis, Rudolf Virchow, Joseph Lister, and William Stewart Halsted. Artwork and photography are married to Nuland's vivid narrative here for the first time, turning a "reading" book by a bestselling author into a treasured

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Author : Sherwin B. Nuland

Pages : 480 pages

Publisher : Black Dog Leventhal

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ISBN-10 : 1579127789

ISBN-13 : 9781579127787

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[qsycomplainsalot]

Marcille is the isekai reincarnation of William Stewart Halsted.

i hate when people call marcille a girlfailure btw like SHE ISNT. and shes not a ”girlboss” either. this is a neurotic and Permanently On The Edge of a Breakdown overachiever late 20s virgin just out of her phd program with permanently shaky hands from an addiction to overly sugary coffee and a deep desire to be crushed to death under falins giant jugs no matter the cost. the only thing shes ever ”failed” at is going to theraphy

[esoutherngolf]

High Hampton - A Favorite Mountain Retreat Reimagined

High Hampton has been serving as a time capsule in the heart of the Blue Ridge Mountains in Cashiers, North Carolina for close to a century, where days consisted of morning walks along the lakefront and waterfalls, and lazy afternoons were spent swimming in the lake or fishing the mountain streams. In the late 1800s, Caroline Hampton Halsted and her husband, William Stewart Halsted, one of the founding surgeons of Johns Hopkins Hospital in Baltimore, purchased the then 450-acre Western North Carolina property and its historic hunting lodge from her aunts, naming it High Hampton. A North Carolina couple, E.L. McKee and his wife Gertrude, converted it to an inn in the early 1920s. Ever since then the McKee family has been welcoming guests seeking relaxation and refuge from the sweltering summers. Today this unique resort and club, listed on the National Register of Historic Places, sits on more than 1,400 pristine acres of Blue Ridge countryside near the Nantahala National Forest. My wife Carol and I spent part of our honeymoon at High Hampton in the fall of 2004, enjoying the colorful autumn leaves, the historical resort, and its warm and cozy four-sided fireplace at breakfast and during the chilly evenings. The golf course was a fun getaway traversing the rolling hills around the resort which needed some TLC. In 2017, a trio of family-run Southern companies, all with ties to the area, purchased the aging Inn and Resort and sought to preserve the spirit of High Hampton while making thoughtful updates that would ensure another hundred years of memories. One of the new owners, Sandy Beall, cofounder of Tennessee's Blackberry Farm and Blackberry Mountain, first visited the storied property with his family in 1982. Sandy tried to buy it then, but the Mckee descendants declined and instead charmed him into purchasing a private home in one of their residential communities. Now Beall and the Blackberry team brought their decades of hospitality expertise to the reworked Inn and its two restaurants, which began welcoming guests again this spring after nearly three years of renovations. "High Hampton is truly a one-of-a-kind property," says Sandy Beall. "We're working to respect that in everything we do including how the Inn will be operated. Independent of our other properties, the food, style and sensibility of the Inn will reflect the charming character of this classic mountain retreat." Working closely with the North Carolina State Historic Preservation Office, the design team updated and enlarged the twelve rooms in the Inn and the forty-seven others in the surrounding cottages with heat and air conditioning, textiles, contemporary lighting and artwork rooted in history, all television free. High Hampton is now a year-round family getaway. At the back of the Inn, the two restaurants were expanded with outdoor dining spaces to take advantage of the views of the lake and Rock Mountain, which turns a brilliant rose gold as the sun sets. Open for lunch, the Tavern is laid-back, serving elevated comfort food like Providence Farm beef tartare with black pepper chips. The upstairs Dining Room no longer  requires a coat and tie, but jackets are recommended for dinner. Instead of the long-running buffet, a talented pair of Blackberry alums- executive chef Scott Franqueza and his wife, pastry chef April-now oversee an a-la-carte Blue Ridge inspired menu, relying on a network of local purveyors for dishes such as benne-crusted trout.  "When the resort was purchased in 2017, it was time to renovate the Inn and golf course for the next 100 years," said Bryan Bowers of Fazio Design. High Hampton was originally designed as an 11-hole layout in 1923 by J. Victor East before it was renovated and expanded to 18 holes by George Cobb in 1956. The routing remained the same until the Fazio team came in. The golf course was reimagined to allow for the expansion of the resort core, with six new holes and 12 others reconstructed in the existing corridors. It is a brand new golf course with every hole reshaped or reconstructed with new infrastructure. The finishing holes, 15 to 18, are framed by Rock Mountain and Chimney Top. They are spectacular. "It was like putting a puzzle together from a design perspective," said Bryan. "We experienced 370 inches of rainfall over the course construction, and it was critical to protect the trout streams, lake and wetlands from erosion. We were required to work in two-acre increments at a time, having to turf the first two acres before opening up new ground." The High Hampton golf course, which is near two other Fazio designs in the Cashiers area, Wade Hampton Golf Club and Mountaintop Golf & Lake Club, now plays as a par 71 extending to 6,900 yards. Other amenities include tennis, pickle ball, lawn games, donkey rides, new swimming pool and spa, 15 miles of hiking trails, canoeing, kayaks and fishing. "Western North Carolina has been my home for the past 40 years, and I'm fortunate to be part of the evolution of golf in the mountains during that time," said Tom Fazio. "The course at High Hampton is truly exceptional. The property is a family environment with landscaping and natural resources unlike anywhere else. With six new holes and the renovated 12, we blended old and new to create a course that is playable, approachable and fun. I look forward to seeing golf continue to thrive at High Hampton for generations to come." To enjoy the Reimagined Retreat, please visit HighHampton.com to make your reservation for a stay and play. Read the full article

[newlimitededition]

Surgical Papers By William Stewart Halsted 1852-1922 (2 Books, Vols. 1 & 2 Limited Edition 1984) http://bit.ly/2W8tOvm

[katarinabrennan]

Initial Research Into Rubber Gloves

Cheap 

Come in a range of materials and thicknesses 

Some are latex free because people are allergic to it

Can be unsupported (rubber only) or supported (rubber coating of textile glove).

Primary purpose is protection of the hands whilst performing tasks involving chemicals.

Rubber gloves can be worn during dishwashing to protect the hands from detergent and allow the use of hotter water.

In 1889, William Stewart Halsted, the first chief of surgery at Johns Hopkins Hospital, invented rubber gloves in order to prevent medical staff from developing dermatitis from surgical chemicals

Range from wrist-length to those that are shoulder-length

Rubber gloves are best worn with a skin tight fit which, while still allowing for the hands to breathe, makes it easier to hold objects and manipulate them.

The palms and fingers usually have a raised pattern which helps provide a good grip when handling objects. 

Wearing gloves protects the hands from harsh detergents and other cleaning products which are used in the home and elsewhere.

https://en.wikipedia.org/wiki/Rubber_glove

[julianova44]

William Stewart Halsted, one of the two fathers of modern medical residency, did a lot with regards to making newly available anesthetics the norm. To do this, he and his students experimented on themselves- specifically first with cocaine and later with morphine. He developed an addiction to cocaine.

There’s a dark joke that this cocaine addiction is why the modern American residency schedule is the way it is- after all, you’d have to be on some amazing stimulants to stay awake that long.

Fucking hell why are we making people in hospitals who are responsible for the health and wellbeing of everyone work 12 hour shifts with no breaks I feel like I'm going insane does no one else see the problem here??

[explain-like-i-am-five]

ELI5: Why do many doctors work in crazy 24-36 hours shifts?

The most common answer that was given to me during my training was that working an extended shift allows one to see and understand the evolution of an acute disease process through the patient's initial presentation and progression through therapy. The more of that illness you are physically present for and participating in, the greater the learning and reinforcement in your mind.

I was never really satisfied with that answer, and it's partially BS - some of it has some credence. But in reality, the real answers are multi factorial. I'll list some of the reasons here.

Medicine has a very strong sense of tradition. It is a hierarchical structure and is deeply committed to the preservation of standards. I found it to be very much like the military. The "father" of the American medical training system, William Stewart Halsted was known to work exhaustively and expect the same of his trainees - men like Cushing and Dandy. Later on, brilliant surgeons such as Michael Debakey continued to promote the necessity of 100% devotion to the patient in the form of grueling work hours and little to no time off. There are countless war stories of these men and their often brutal treatment of their trainees. I remember one apocryphal story about Debakey taking the new interns to the main hospital lobby doors and telling them they wouldn't go through those doors for the next year.

There is also an ingrained culture of "I trained this way, and you must also in order to be a competent physician". If I had a dollar for every time during training that I was told the ACGME work hour restrictions were creating terrible doctors, I'd be able to pay of my student loans before the next millenium. Since the dawn of time, old crusty docs have been bemoaning how easy the residents of today have it.

Nobody becomes a physician without at least some sense of altruism, even the most craven among us. When there are sick patients to be seen, it's really hard to mentally justify "going home to go to sleep" when someone or some family is having the worst day of their life. It sounds trite, but when someone is sick and needs my help, I have a really hard time assigning a higher priority to my own rest. (That's probably partially my Catholic guilt). Human misery is endless and does not rest.

Medicine is not a 9-5 job. People will always get sick at odd hours, and someone will always need to be available to do an emergent thoracotomy at 2am. You can't work shifts as a trauma surgeon. There just aren't enough of them, and I doubt there ever will be. The training is too long and arduous to ever expect to get to a supply of trauma docs (or Ob-Gyns, or Pediatricians) where every little hospital in the US has enough of them to staff rotating shifts like nurses.

There is an enormous amount of work to be done in today's hospital, and so much of it is clerical. Services need to be covered with residents, call schedules, back up call schedules, vacations, clinic hours, etc. Those 24 or more hour shifts allow residents to have some precious days off once in a while.

-Finally, and I know may people will howl at this point, but I do feel working 28 hour shifts made me a better doctor. I know it did. Specifically, it taught me to think on my feet, prioritize, and overcome (to a degree) fatigue. I am not claiming I am immune to fatigue or that I am as effective after hour 26 as I am after hour 4. The ACGME and many others like to make a big deal about work hour restrictions during residency, but what never gets talked about is that for many of us docs, life after residency can be even harder. And there are ZERO restrictions on the hours attendings work. In my past job (which I quit) after working all day in the office and rounding in the hospital, I was expected to take phone calls for ED admissions and for moronic patient questions all night long, every 4th night. I did that for 5 years.

Explain Like I`m Five: good questions, best answers.