Sunday, January 19, 2014

Invention of the Day: Anaesthesia.

October 16, 1846 is the official birthday of anaesthesia, the art of preventing a surgery patient from feeling pain. On that day, surgeon Dr. Warren publicly demonstrated a painless tumor removal at the operating theater of the Massachusetts General Hospital. To anaesthetise the patient, Dr. Warren used the method invented by dentist William T.G. Morton. Under the invention, the patient was rendered unconscious by inhaling ether, an organic compound known to people since the 8th century, but never used in medicine before. The invention of practical anaesthesia (along with methods to prevent wound infection) created the world of modern surgery. The 1846 invention was a breakthrough that allowed people to control one of the basic biological experiences - pain.

Morton's US Patent 4,848 on the medical use of ether was never enforced due to public outcry.

Although pain is the most unpleasant experience in life, it is also a life saver. You yank your hand back when you touch a hot stove and (barring immediate danger) you avoid running when you broke your foot. The feeling of pain allows us to avoid aggravating injuries, letting the body to try and heal itself. People who don't feel pain don't live long because they burn their limbs and re-injure their bodies. In short, pain is unpleasant, but in many cases it helps prevent death.

Unfortunately, when it comes to surgery, pain results in the worst of both worlds: it not only feels horrible, but also prevents the surgeon from fixing the problem. Alcohol, opiates, and other painkillers that help us deal with chronic pain don't help here because they either don't render the body insensitive enough for a precise surgical intervention, or cause addictions and other lasting side-effects. Ideally, pain should be turned off completely just for the duration of the surgery in the exact body area that requires a surgical intervention. It doesn't make sense to knock somebody completely unconscious when all they need is to have their tooth pulled. For an effective surgery, we have to have complete control over the patient's pain experience, both during and after the surgery.

The invention of practical anaesthesia — like any other breakthrough invention — created a new world, with its own time, space, and opportunities for inventing new ways of doing things (actions).

Before, the surgeons could only do simple operations that lasted a short period of time - tooth extraction, limb fixation and amputation, etc. The time frame for an operation was determined by the patient's ability to bear pain. (Note that the word "patient" is derived from "patience"). After, the surgeons were able to increase the complexity and "depth" of their interventions into the human body. The skill and knowledge of the surgeon became the determining factor in the duration of a surgery. Moreover, surgeries became a frequent event, producing a community of experienced doctors. As the result, the pace of innovation in the newly created field of surgery increased dramatically.

Before, surgeries were performed in places where people could tolerate blood, gore, and immense human suffering. After, the modern hospital with clean specialized operation rooms emerged as a dominant design in the system for delivering medical care to large populations. Regular, reliable surgeries demanded new hygiene and antiseptic practices, which the sciences of medicine, biology, and chemistry began delivering at a rapid pace. In sharp contrast, the old world of gore and human butchery turned into a pristine domain where highly trained teams of specialists perform miracles of healing.

Before, the simplicity of skills and tools ruled the day. After, newer and newer techniques could be developed, including diagnostics, exploratory surgery, organ replacement, laser and robot-assisted operations. The new time and space in the world of surgery enabled a high degree of action specialization. This growing range of available actions helped surgeons reach deeper and deeper into the human body: from a part (limb) to an organ (heart) to an element (blood vessel) to a cell (radio nuclear medicine).

As inventors, we should look for anaesthesia-like opportunities for innovation. The pattern we want to see is a fall of a major barrier and the consequent creation of time, space, and broad range of new actions.

P.S. In Scalable Innovation (Prologue) we discuss the breakthrough that Dr. Giovanni Battista Morgagni created in the 18th century when he started treating human diseases as ailments of specific organs instead of the ancient way of looking at an imbalance of four humors. The invention of the anaesthesia in the 19th century enabled surgeons to treat the organs directly.

tags: invention, innovation, medicine, dilemma, trade-off, tradeoff, breakthrough, medicine, control, 10X, scale, space, time, interaction

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