Transaction. Early in my career, radical mastectomy was the gold standard for treating breast cancer, and I remember saying it would be my choice if I had this disease. Gradually, through large and expensive clinical trials, this body-deforming operation was almost entirely replaced by early detection and minimal surgery, often followed by radiation and chemotherapy, while survival rates soared. .
Likewise, I have witnessed major improvements in surgery to remove cataracts (now an outpatient procedure); replace hips, knees, shoulders, elbows and even finger joints crippled by arthritis; and prevent heart attacks and strokes by bypassing clogged arteries. Not to mention the possibility of transplanting organs between genetically different people, even from animals to humans. Today, most heart and lung transplant recipients achieve long-term benefits.
Pediatric surgeons now operate to correct or minimize major life-threatening defects, including spina bifida and obstructed airways, while babies are still in the womb. Intrauterine gene therapy, currently being tested on fetal animals, is likely next. And bariatric surgeons can now safely facilitate substantial weight loss in adolescents and adults with health-threatening obesity when dietary changes aren’t enough.
Sexuality and gender. Our understanding of human sexuality has also undergone a cataclysmic shift toward medical and cultural acceptance of lesbian, gay, transgender, and queer people. It may shock you to learn that an article I wrote in 1971 suggested that psychotherapy could help homosexuals become heterosexual, an idea that I, along with medical professionals, now despise as abusive.
Medicine now recognizes and accepts a wide range of gender and sexual identities. Increasingly, people who identify as transgender, for example, are able to adopt a gender identity or gender expression that differs from what is typically associated with the “male” or “female” sex that they was assigned at birth.
Mental Health. The closing of most psychiatric hospitals and the deinstitutionalization of people with severe emotional disorders during the 1950s and 1960s lit a fire in long-needed efforts to develop better therapies for mental illness. There are now many effective medications and other treatments for common conditions, including bipolar disorder, depression, anxiety, attention deficit hyperactivity disorder, post-traumatic stress disorder, and psychosis.
Recognition of autism as a spectrum disorder promotes a better understanding of children and adults with this condition. Leaders in their field, like animal scientist Temple Grandin and actor Sir Anthony Hopkins, who have spoken openly about being on the spectrum, help others find acceptance in society.
More than anything else, what has driven me to write past 80 is the feedback I’ve received from readers with heartwarming personal stories of lives transformed by the information and advice provided by my column. . May my successors derive as much satisfaction as I do from researching and writing about whatever the future holds.