Dr. David E. Hogan, Vice President of Educational Development and Chair Emerging Infectious Disease Taskforce
As the United States approaches its 250th anniversary, it is worth reflecting on how medicine has evolved alongside the nation itself. At TeamHealth, where clinicians care for patients across communities nationwide, we are continually reminded that today’s practice of medicine is built on centuries of innovation, challenge, and progress.
To help tell that story, we asked Dr. David Hogan, Vice President of Educational Development, to share his perspective on the milestones, innovations, and defining moments that have shaped American medicine over the past two and a half centuries. In this first installment of a two-part series, Dr. Hogan examines a pivotal moment during the Revolutionary War when a medical intervention helped shape not only the future of healthcare, but arguably the future of the nation itself.
Part One – The Vaccination That Helped Save a Nation
It is the winter of 1777. After losing the city of Philadelphia to the British, Washington has retreated 20 miles north to Valley Forge. The winter is unusually harsh, preventing supplies from reaching the camp. Although most troops are loyal, numbers are dwindling due to exposure, typhus, dysentery, pneumonia, and expiring enlistments. In this setting, word reaches Washington that an outbreak of smallpox is starting.
Washington is very familiar with smallpox. It kills up to 25% of its victims. Those not killed are often left blind or disfigured. Only a year prior, an attack on Quebec ended in an American defeat, largely from a decimating outbreak of smallpox in the Continental Army. Washington knows most colonial soldiers are farm boys with no natural immunity to smallpox. The British troops however are largely immune. A smallpox outbreak in the colonial Army now, will end the rebellion.
Washington also knows that 56 years prior, during an outbreak in Boston, an enslaved man taught a clergyman and physician the crude process of African smallpox vaccination. This saved multiple lives and ended the outbreak. The General takes a bold gamble. In consultation with his Chief Medical Officer, he mandates that all colonial soldiers undergo vaccination. The death rate among colonial soldiers drops from 20% to 1% within weeks and the outbreak stops. The Army survives the winter, reorganizes, retrains, and lives to fight on.
Vaccination and the development of vaccines has done more to save lives and improve the human condition than any other single advancement in medicine in the last 250 years. You could say that things are as American as apple pie and vaccination, because without those Valley Forge vaccinations, it is debatable if America would even exist.
More so than specific medical developments, there are four things that American medicine has been good at. These four things have been the driving factors taking American medicine from a backwards art to the foremost in medicine globally over the last 250 years.
A Legacy of Innovation and Care
The Valley Forge story highlights a defining characteristic of American medicine, the willingness to embrace innovation in the face of enormous challenges. Over the past 250 years, countless discoveries, technologies, and treatments have improved and extended lives. Yet the rise of American medicine cannot be attributed to scientific breakthroughs alone. It is also the result of several enduring strengths that have fueled progress across generations.
Those same qualities continue to shape healthcare today. At TeamHealth, our clinicians build upon the lessons of those who came before them, carrying forward a tradition of advancing care to meet the needs of patients and communities.
Click here for Part Two of this article where Dr. Hogan explores four key factors that helped transform American medicine from a field with limited scientific understanding into a global leader in healthcare innovation and patient care.
