By Bernadine Healy, M.D. Medicine is a mighty
presence in American life. It commands some 15
percent of our economy, employs 1 in 10 workers, and
is a favorite topic on the lips of our citizens. The
wonders of medicine touch us virtually every day.
From the tiniest baby struggling to survive in a
neonatal intensive care unit to the oldest of the
old warding off memory loss, we are a nation with
boundless faith in the ability of medical research
to translate into the relief of suffering and the
prevention and cure of disease. No surprise that we
invest almost $30 billion a year in the National
Institutes of Health.
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It was not always this
way. Medicine's ascent to prominence was a late
20th-century phenomenon, and the discipline is
mostly absent from the 100 National Archives papers
culled from the period 1776 to 1965. Nonetheless,
the same forces that have powerfully shaped our
nation from its birth also led to the eventual
prominence of medicine in our society: the
dedication to individual freedom and human dignity
and the energetic pursuit of free ideas. Witness the
Declaration of Independence.
Prescient. Four
physicians signed this founding epistle. The most
prominent was Benjamin Rush, only 30 years old at
the time and a rebel when it came to medicine too.
He lectured and wrote tirelessly on his own theories
and practice of medicine. Though his belief in
bloodletting and purging failed the test of time,
much of his scholarship was extraordinarily on
target: He concluded that tobacco caused lip cancer
and excess alcohol harmed the liver and brain; that
the marshes and even mosquitoes were tied somehow to
the deadly yellow fever epidemics that swept the
colonies. Rush avidly pursued studies of the mind,
including mind-body interactions, gaining him the
lasting title Father of American Psychiatry. Despite
his prominence in political circles, Rush had no
problem being "politically incorrect."
With medical gravitas he championed women's
education as a solution to the miseries in many
marriages; fought slavery based on the equality of
black and white; and raised alms to vaccinate the
poor against smallpox. In a brief stint as surgeon
general, Rush confronted none other than George
Washington because of shabby and unhygienic military
hospitals. But before he resigned his post in
protest, he promoted what we now call the "GI
haircut"--the close crop that saves time,
prevents lice, and relieves the nuisance of wet hair
while facing the elements. There is virtually no
American medical figure who surpassed Rush in the
first years of our Republic.
Though his work may
now seem primitive, Rush personified what made
American medicine progress--the courage to think
freely, challenge, and innovate; and the willingness
to spend government money on science. Rush weighed
in on what was very likely the first federally
funded science project, the expedition of Lewis and
Clark. In his secret 1803 message to Congress asking
for $2,500 to support the effort, Thomas Jefferson
avowed the need to "enlarge the boundaries of
knowledge by undertaking voyages of discovery."
Thanks to Benjamin Rush, that discovery also
included some medical science. Rush outlined the
data that Meriwether Lewis should collect on the
Indians they encountered, including their heart
rates, hygiene, medicines, and women's and
children's health. The historian Stephen
Ambrose noted that Rush wrote to Jefferson after
meeting with Lewis, "May its advantages prove
no less honorable to your administration than to the
interests of science." That tie between the
interests of government and science became a
recurrent theme in American history.
