Since the dawn of time, man has had to deal with illness, disease, recovery and death; that will never change. However, medical theories and practices do change. I have been privileged to witness many changes in the practice of medicine and nursing. Nurses no longer wear starched white uniforms and caps and doctors no longer are expected to take Wednesdays off to play golf. Nurses are now in the front lines of health care as independent medical providers of care in all aspects of medicine whether it is in primary care or specialties like cardiology, neurology or oncology, etc.

It is not that I am that old; rather, changes are occurring at lightening speed. For example, skin adhesive for the treatment of minor lacerations has been available only within the last few years. Ten years ago, if you had sustained a superficial laceration you would have demanded to speak to a surgeon if the ER doc had made the loony suggestion of closing your wound with glue. But today, savvy and informed patients actually request skin adhesive.

The why of illness and disease, or etiology, has also changed. The discovery of germs and viruses in the 19th century finally put to rest the notion of evil spirits and "bad humours" as the cause of afflictions. Recently, other causes are coming to light, namely complex psychoneuroimmunologic causes and genetic etiologies. Religion also has influenced the evolution of medicine and continues to do so. During the middle ages, the quest for medical knowledge was restrained because of the ban on dissection and autopsy. However, the care of the sick and infirm owes much to the early monasteries and religious orders that established the forerunners of hospitals.

In an ironic twist, medical advancements owe much to warfare. There are accounts of Gladiators in Roman times relying on primitive skin grafts to wounds and crude iron prosthetics in Medieval times for soldiers; all for the sole purpose of returning the combatants to the front lines. Most of us are aware how World War II provided the impetus for rapid development of antibiotics. What advancements will we be the recipients of as a result of current conflicts?

Nature has always been intricately intertwined with illness and healing. Pre-historic man knew which plants and herbs to use to his benefit and which to avoid. Even today, many medicines have their origins in nature; aspirin, digitalis, morphine, quinine, cyclosporine and vinblastine are a few that come to mind.

The more things change, the more they stay the same. Persons who are ill, diseased or dying are no different today than 100 years ago or 1,000 years ago or a millennium ago. We may have different theories and different treatments in the 21st century; what will always remain constant, however, is the need to bring humanness and caring to the patient's bedside.

Agnes Oblas, APRN, is a certified adult nurse practitioner. Her primary care practice, New Paths to Healthcare, LLC, is in Ahwatukee Foothills, 13838 S. 46th Place, Suite 340. Reach her at or (602) 405-6320

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