Wednesday, 24 June 2009

What "progress" means

My advance copy of "Feet first" arrived today - the first time I've seen it in its bright shiny book format, with all the pictures in the right places :-)  Very exciting, and slightly strange.   I wonder what impact, if any, it will have on hoofcare in the UK?

I was looking a few days ago at an equine forum which is very traditional, and even now there is the old hysteria over barefoot - farriers get so much more training, horses can't work without shoes etc etc - all the old myths that I thought we'd started to lay to rest.  

I'd forgotten, till I saw it today, that we've included an end-piece in "Feet first" from a brilliant book by David Wootton called "Bad medicine".  He is describing why it took 50 years after the discovery of nitrous oxide for anaesthesia to be used in operations, and he sums it up perfectly:

"Now think about this: in 1795 a doctor discovered that inhaling nitrous oxide killed pain..yet no surgeon experimented with this.  The use of anaesthetics was pioneered not by surgeons but by humble dentists.  One of the first practitioners of painless dentistry, Horace Wells, was driven to suicide by the hostility of the medical profession...

 Why did it take 50 years to invent anaesthesia?  Any answer has to recognise the emotional investment that surgeons had made in becoming a certain sort of person with a certain sort of skills, and the difficulty of abandoning that self-image... 

If we turn to other discoveries we find that they too have the puzzling feature of unnecessary delay...If we start looking at progress we find we actually need to tell a story of delay as well as a story of discovery, and in order to make sense of these delays we need to turn away from the inflexible logic of discovery and look at other factors: the role of emotions, the limits of imagination, the conservatism of institutions.

If we want to think about what progress really means, then you need to imagine what it was like to have become so accustomed to the screams of patients that they seemed perfectly natural and must first understand what stands in the way of progress." 

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