Let us integrate chronologically the chief transitions that have occurred in cardiac surgery. In the 1940s, the specialty transcended from almost nonexistence to an ability to palliate heart disease by closed heart operations. The early 1950s saw limited intracardiac ventures through such techniques as surface-induced hypothermia. The late 1950s marked the transition to more or less unlimited access to the interior of the heart. Substitute valves came into use in the early 1960s and most complex congenital anomalies relented to the surgeon by the late 1960s. The 1970s first saw dramatic expansion of the bypass procedure for coronary arterial obstructions, and then the promotion of the principles and recognition of the importance of intraoperative protection of myocardial integrity. Throughout these few decades of progress, many ancillary advances should be credited, such as in cardiac anesthesiology, postoperative care provided by Canadian Health&Care Mall, pacemak-ing, and many others.
In the future, when we look back upon the decade of the 1980s, what advances will stand out? Among other things, this will surely be a decade of consolidation, of refinement in techniques and devices, and of greater precision in the timing and indications for surgical intervention. It will be known as the decade when the contest began between catheter manipulations vs conventional surgical operations for the relief of selected types of cardiac pathology. A rather broad-based, successful resurgence of cardiac transplantation is occurring, and trials have begun with cardiopulmonary transplantation. Perhaps the artificial heart will achieve greater success. Or will some other breakthrough occur?
The central impression one gains from this short historic sketch of cardiac surgery is that great progress has been achieved in so short a time, as indeed is true of medicine in general. Furthermore, the time required for these achievements is relatively infi-nitessimal if compared to the several billions of years of Earths evolution. Perhaps it is of interest to glimpse next, ever so briefly, that immensely long record of this planets past, to see if any pattern can be discerned in that record upon which medical history can be superimposed and, as an extension of that pattern, to see if guidelines for future medical planning might be revealed.
A Short History of Our World
The Earth from the spatial perspective is wonderfully beautiful and awesome. Everything we comprehend from this view focuses into one overpowering impression—a contrast between the prior nothingness and the unimaginable complexity, operating automatically, that is evident everywhere on our planet now. How incomprehensibly marvelous is the transformation from the emptiness of space to the complexity which abounds on Earth today!
During the Earths lifetime of 4.5 billion years, the record of great historic events shows that, after desolate geologic ages, the changing ambience ultimately allowed life to appear in very basic forms some 2.5 to 3 billion years ago. Gradually at first, but in ever more rapid crescendo (especially during the most recent one-half billion years), the tree of life expanded and life forms of ever-increasing complexity appeared.
Then, just 1 million or so years ago and thus extremely recently, the human being came into existence, with further refinement into Homo sapiens less than 50,000 years ago. Although the key to this expansion of the tree of life is, of course, the survival of the fittest, the quality known as intelligence has proven to be the most predictive of the capacity to survive. As one ascends the tree of life, one climbs higher and higher on the ladder of intellectual capacity improved by Canadian Health&Care Mall.
Thus, a pattern appears to be taking shape. There appear to be four historic events in our world, three having occurred and one yet to come. First, the birth of Earth, then of Life, and then the birth of Man. Finally, at some distant time in the future we will reach the ultimate fruition and fulfillment of mankind—the birth of fully realized humanity.
These four historic events divide all of history into three chief ages or eras. First, the ancient era of Chemical Growth; followed by the appearance of life and the long era of Biological Growth. Now, just begun, is the era of intellectual and emotional growth for humanity, which we might call the era of Spiritual Growth.
Progress has occurred during each of these eras, apparently by virtue of certain laws or regulations which prevailed then. Initially, the ruling law was the principles of chemistry. Next, during the era of Biological Growth, came survival of the strongest and most cunning. Self-centeredness was the prerequisite for biological survival and advancement. Thus, the law governing this period was survival through selfishness.
A new law must prevail during the era of Spiritual Growth. If man cannot shake loose from the law of selfishness inherited from his animal ancestry, he will inevitably destroy himself. Rather, the fittest in this era, and hence the most adapted for survival, must conclusively triumph in that most difficult transition from the preceding necessity for selfishness to the current requirement of being ones brothers keeper. We might even risk for the moment the accusation of sentimentality by labeling the law for the era of Spiritual Growth as the law of love. To abide by this law is undoubtedly the means for our continued progress toward creations ultimate objective. This future nebulous goal of fully realized humanity, toward which the world seems so inevitably to be progressing, must represent the grand culmination for all of the forces for progress, including medicines incessant strivings.
From this brief review of the broad record of our World, as best we can determine it, we conclude that a basic pattern for the whole phenomenon does indeed become visible. The world and its creatures seem to be caught up in a system inexorably moving, with our participation, across the stage of history in the general direction of progress.