WASHINGTON – Marion Friedman was “a sickly child” in the early 1920s, when the doctor would drop by his house every week to check on him.
Not just any doctor, but the chief pediatrician at the University of Maryland.
Today, “you couldn’t find a doctor of that stature in anybody’s home,” said Friedman, 81, a physician who spent 40 years in practice in Baltimore.
Friedman says there are other problems with medicine today, too, but he acknowledges that there have also been great strides since he started his practice in 1942.
“In those days we could do little for patients except hold their hands and give compassion and reassurance. Patients would come in with complaints you could do very little for,” he said.
Friedman remembers attending a lecture on malaria in the 1940s where the speaker pointed out that anything that could not be cured had to be cut off.
“That was the attitude,” he said. “And people usually went to hospitals to die.”
In the late 1930s and early 1940s, Friedman interned at the old Sydenham Hospital in Baltimore, which was the only hospital in the area treating contagious and infectious diseases.
“We would have to go out to pick people in a special ambulance because others wouldn’t let us use theirs,” he said.
He remembered how upset his family was after he returned home from picking up a meningitis patient one day, “Because in those days meningitis used to be 100 percent fatal.”
Diagnoses were sometimes suspect: Friedman remembers that the death of a family friend was attributed to acute indigestion. Looking back on it today, he thinks it was more likely a heart attack.
But today, medical science makes a lot more possible.
“We’re even able to cure leukemia, which used to be 100 percent incurable back then,” he said. Organ transplants and procedures like bypass cardiac surgery had made it even more possible to save what would have previously been terminal cases, he said.
Not all of the changes have been advances, Friedman said. The economics and politics of medicine have changed many things.
“There is too much demand on the time of doctors,” he said, and doctors and patients no longer share a rapport. “The doctor sends you out to six different people for tests and then puts everything together.”
Another big change has been cost.
“Back then no one had health insurance, and everything cost much less,” said Friedman, who said one patient in the early 1940s paid $158 for an appendectomy. “And that included everything — the ambulance, 10 days of hospital stay, surgeon’s fees, family physician’s fees…”
Still, he said, we are still better off today than we were then. Doctors still cannot cure everything, he said, we are a long way from the 1800s and early 1900s when “doctors practiced through someone else” and surgery meant “getting a person drunk and holding them down while a barber cut off a leg.”
“And we’ve only just begun,” he said.