Brian T. Maurer
Cell 2 Soul. 2006 Spring; 2(1):a7
Photographer: Barry Penchansky
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I recently had the good fortune to attend an evening lecture on 18th and 19th century New England ship-building.1
As early as the mid-17th century Great Britain was exploiting New World forests, harvesting all types of trees used in the construction of wooden ships — tall white pines for masts, pitch pines for tar used in caulking hulls, oak for keels and futtocks (those curved ribs forming the frame) and "knees" (angular braces to strengthen the frame).
A typical mast required a white pine at least 120 feet in height and 4 feet in diameter at the base. Such trees were felled by axe or two-man draw saws. Afterward they were transported down rivers and hauled by horse-drawn wagon to ship yards where they were planed, tapered and rounded to form the final product.
Compass wood — large curved branches strengthened by the weight of winter snows — was prized for the production of futtocks. Angular knee braces were cut from the base section of the tree, using the butt of large roots for strength and support. Spars and bowsprits were fashioned from smaller trees.
The completed vessel was, in effect, the forest gone to sea.
In addition to materials, it took a lot of know-how to build a ship, from selecting the proper trees to honing the individual pieces before assembly. Shipwrights were in demand in colonial New England.
The land was eventually clear cut; the trees harvested. When the steam engine and steel finally replaced the wooden ships and canvas sails, the shipwright became a dying breed.
When I first learned the skills of physical diagnosis, we students relied on simple tools — the stethoscope, the reflex hammer, the pneumatic otoscope — and recognition of certain signs on exam. We were introduced to a myriad of maneuvers, many of which had strange and exotic nomenclature: McMurray's sign, the Valsalva maneuver, the Allen test, pulsus paradoxus.
Somehow we were expected to integrate the objective information we gleaned from the physical exam with the historical information provided by the patient to arrive at a diagnosis — quite a challenge, even on a good day.
Eventually medical technology provided us with all sorts of wonders — first CT scans, then MRI's, radionucleotide studies, echocardiograms — to allow us to look inside the human body with greater ease and proficiency.
Cases are discussed on morning rounds; tests are ordered and interpreted; fluids are adjusted; medication is prescribed — and the untouched patient is largely ignored.
At my own recent visit to a local hospital emergency room, my blood was drawn, an IV line placed in my left arm, a urine sample obtained, and I had a helical CT scan of my abdomen — all before a rather harried attending physician poked her nose through the curtain to announce that, although a small kidney stone had lodged at my right uretero-vesicular junction, I would undoubtedly pass it after all. That was the closest she got to my body.
Perhaps, like those early shipwrights, the medical clinician has become a dying breed.
Perhaps one day we too will attend an evening lecture at the Medical Historical Society, awed and amused by the set of skills possessed by our forbearers, now largely forgotten.
References:
1 Presented by Walt Landgraf, Forest Naturalist, The Stone Museum, Pleasant Valley, CT