Marrow of Tragedy- Final

First off, I found the final chapters of this book extremely hard to focus on because of the 'attitude' (I don't know if that's the best term) that the author seemed to have when talking about Samuel Preston Moore. While comparisons are important in understanding the differences between the medical care systems, I felt that the author did not give the southern system a change to participate in the 'race' for the best system. She constantly compared even the smallest details. I don't know if I was the only one who read it that way, but I felt it was very hard to focus on what she wanted to teach with her personal opinion in the way.

A major fact that stood out to me was the infant mortality rate. It seems like such a waste of life when the methods were there to lower the rate, but each side seemed almost too ignorant and wrapped up in themselves to think of how it affects the people. When I think of healthcare and doctors and nurses, I think of people who always put the needs of others before their pride.

I find it very interesting that the north and the south still participate in this competition for the best. Wether it sports teams, education, city popularity, and being from Boston with a sister in Houston, medicine too. Hospitals in different areas have different specialties, and still today many of those come from what is in demand in that place like the 'Southern illness of malaria'. My sister in Houston was shocked to see the number of obesity, diabetes, and gastric bypass specialist there are in every hospital. This is the new 'Southern Medicine', while places like Boston have major children hospitals and oncology departments.

Marrow of Tragedy 4-6

The first chapter of this section focused on the start of the USSC and the new "efficiency, organization, and expertise" it provided for medical care. What I found rather funny is the USSC is essentially just a strict 'mother' that was missing from essentially a frat house of young men. Details like "cleaning undergarments once a week" and going to the bathroom only in dedicated ditches seem like basic behaviors expected from men, but I guess if there is no 'mother' to nag and remind you it doesn't happen. Things like clean sheets were cleaned by 'mother', balanced meals were cleaned by 'mother', and disapproving behaviors with alcohol and stealing were not tolerated by 'mother'. Like last week, it was difficult to read how little details that were not thought out before war hospitals came about could have made life so less miserable then it was. Things like scurvy plaguing troops because they forgot to ensure that citrus fruits could reach the men before it set in. Especially now, it is hard to think of a medical system that wasn't sterile or safe, or even have an ambulance system to transport you comfortably. I also found it interesting how much distrust there was in a health system for the public with concerns about corruption, rights, and dependability. Because we still today have the same issues but with healthcare. Maybe it's American tradition to not want help out of some fear that we'll one day not be able to support ourselves.   I was very impressed by the first hospitals of Philly. Since the trial and error had already been done in homes for centuries, and practice in the military hospitals, the description of the logistics of a hospital were amazing for it to be so early on.

Marrow of Tragedy: 1-3

Major Facts:
killed more than a million Americans
major influence was Christianity blended with American culture
2:1 Illness to battle wound death ratio
Movement from care in home to care in hospital
Design and architecture of new hospitals
Gender issues in professional medicine
Lack of consistent medicine


A very interesting idea that came from the introduction was the idea of preachers changing their sermons to justify the war. I feel like for us today, a similar thing occurs with our politicians while religious leaders change their sermons on social issues.
There was no knowledge about how to organize the number of wounded and sick during the war. It's so sad to think of how many lives in history could have survive if the importance of good sanitation was understood. So many survived the battle but not the bunkers. Women, the main providers of care at home, emerged as one of the most valuable assets to war. While at the time no one saw women as having any contribution to battle, they gained recognition for cleaning up after the battles so that men could go on to fight the next one. The realized the importance of "will"  and gave the men more than medical attention, but encouragement. The smallest things, like dysentery, were the most lethal. The ideas of straws to drink water or IV fluids with electrolytes, Imodium pills and Gatorade could have saved people. With amputations, I was surprised that they knew about blood infections, but not to heal some basic wounds. The idea that hospitals before this time had never seen affluent patients made me think that care before in hospitals was not real care at all. I presume that the poorer patients were sometimes seen as lesser humans, but not anymore. It seems to me that medical progress could have been decades more advanced had people accepted the skills of women and learned from them rather than ignored them. I love the recognition the author gives women in that they were promoted socially and professionally.

Before the 20th century, the care of the sick was driven by trial and error. Although there were dedicated to heath the sick, from wise elders with knowledge of natural remedies to professionals with tools and drugs, most of their knowledge was from experiences and not science. Before the establishment of the Germ Theory, there was little scientific understanding of why, how, when, and where illnesses stemmed from. The idea that the body needed balance in order to be healthy was true in some sense, as one must balance relaxation and work for stable mental health. But this theoretical kind of balance was not the biggest issue at the time. As time passes, people learned what worked best with a fever, what herbs were dangerous, and that filthy homes are no place to raise children. The scientific findings sped up the process of finding the reasoning behind how illnesses manifest themselves in people and animals.