The 1980s were not just about the end of disco


Herb Fred does it again. In a prior blog, I mentioned the great teacher’s wonderful and informative column in the Texas Heart Institute Journal. Recently, he described what life was like in medicine and cardiology when he was starting out in the late 1940s and early 1950s (Tex. Heart Inst. J. 2013:40:508-09). It made me think about the 1980s when I was in medical school and in training (I am likely two generations removed from Dr. Fred).

When I mention some of these to our young house staff, they look at me as if I were from the Stone Age:

• For a while, the cause of AIDS was not known to be a virus and various odd explanations were posited.

• The big debate in acute myocardial infarction care was whether tissue plasminogen activator was better than streptokinase.

• We gave the first dose of a new prescription of an ACE inhibitor (captopril) to outpatients with hypertension in the waiting room to gauge whether they would get hypotensive.

• We admitted patients the night before a cardiac catheterization and kept them overnight after the procedure.

• Heart transplantation was novel, and we really did not know a whole lot about what we were doing.

• The first implantable cardioverter defibrillators were implanted by thoracotomy and the generators were huge in size.

• Beta-blockers for heart failure were discussed sparingly until the early 1990s (when I recall Bill Colucci telling me that "this is going to work!").

• A night float meant that we were going out late to get a milk shake or related dessert.

• We were on duty every third night (and sometimes every other in the units).

• As in Dr. Fred’s early era, there was a small lab for the house staff to perform Gram stains and spin hematocrits, but as house officers, we surely did not perform liver biopsies, pleural biopsies, or sternal bone marrow aspirations!

Dr. Fred’s last two entries certainly applied to my generation as well (and these are direct quotes):

• "Trainees, faculty members, and practitioners considered it a privilege to be a doctor."

• "Everyone understood and firmly believed that medicine is a calling, not a business, and that the patient comes first, always."

Back in the 1980s, when disco was dying, we had our naysayers who told us that the best days of medicine were behind us. While it’s tempting, I do not want to sound the same alarm. As a consequence, I am holding on to the belief that we will still see the commitment to medicine that I saw in my elders and among many of my contemporaries. I’ve even made a few house calls in my time. May our trainees take note.

Dr. Hauptman is professor of internal medicine and assistant dean of clinical-translational research at Saint Louis University and director of heart failure at Saint Louis University Hospital. He is an associate editor for Circulation: Heart Failure and blogs while staring out his office window at the Arch.

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