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Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century

How did use of medical technology such as urinalyses, blood tests, and x-ray machines change patient care in early-twentieth-century American hospitals? To what extent was the use of new machines influenced by the ideas of scientific medicine and to what extent by the availability of newly structured facilities and trained personnel? Drawing on the medical treatment of more than 2,000 patients in Pennsylvania and New York hospitals, Howell traces the ways in which medical technology was used, not merely how it was talked about. He utilizes a wide range of sources—including medical texts, popular literature, and the visual arts—to explore how technology came to be such a central feature of medical care.
Howell also shows how changes in medical practice raised issues of gender, culture, and economics. Howell's analysis is especially timely in light of the ongoing debate over U.S. health care reform, a debate in which a central topic is the use and expense of medical technology. In a concluding chapter he applies the book's historical insights to medical practice today—asking why, for example, modern diagnostic tests have not been used to give doctors more time to spend with patients.

Amtrak Dormitory-Baggage car # 540, a former U.S. Army Hospital car recently acquired by Amtrak was located in the SCL (former ACL) railroad yard on an overcast day at Saint Petersburg, Florida, during 1974. These US Army Hospital cars were numbered in the # 89500 series, and originally built by the SSCC (St. Louis Car Company), during 1952-1953. The Amtrak car number # 540 was obtained by droping the 89 from the Army car number. Many of these cars were rebuilt by Amtrak in 1973, from their hospital car configuration into a baggage-dormitory car. They were later painted in the Amtrak scheme and placed into the # 1400 series. Eventually, some of these cars were rebuilt again with full HEP pass through cabling and numbered into the # 1600 series. It appears that this car provides some basic HEP cable connections so it can be used with Amfleet equipment when in service on the Northeast Corridor. During the various rebuildings, some of the cars were reconfigured to have only one baggage door on each side. One interesting feature of these cars is the trucks on which they ride, an early model of the GSC (General steel Casting) outside swing hanger truck design, very similar to the trucks placed under the Osgood Bradley streamlined American Flyer cars used on the New Haven Railroad. These GSC trucks did have outside swing hangers, bolster anchors, snubbers, roller bearings, but were designed to use convention clasp shoe brakes. The later GSC outside swing hanger designed trucks incorporated the use of disc brakes, and that was something Amtrak wanted to have on all their trucks when possible. You may notice the end diaphram and the use of a strong diaphram support anchor rod and a tight-lock coupler, of course. This car still retained it's US Army olive drab paint scheme with a light colored roof. I find the window configuration used on these dormitory-baggage cars to be interesting, as compared to the more standard configuration used on cars that were originally built for this purpose. There is one final item to mention and that is the pair of air horns mounted high on the car's vestibule end outside bulkhead.

[Photo provided by a member of the photo-posting public.]

This is a rare look along the vertical axis of one of Flickr's GPS resolvers. Think for a moment what is inside those colorful balls. Then stop thinking about it because you don't have a need to know. Flickr's technicians know what is inside because it is their job to service the equipment therein. But they are sworn to secrecy to protect Flickr's cutting edge technology from being stolen by competitors. Anyone caught "spilling the beans" will be punished severely (without violating the Geneva Convention). What can be revealed about this installation is that without it, geotagging would be compromised in a way that would cause much embarassment and resulting finger-pointing by spouses and significant others.

The photographer who took this image is one of those spiritual kooks who seeks unity with the universe. After he took this picture, he placed his hands on the column to "become one spiritually" with Flickr's mission. Later, after being released from the hospital, he explained that he could feel the calculations of GPS coordinates being made---inside his body! Struggling for the proper words, he described it as being akin to staring into a blinding white light. We're pleased to report that his hands have finally healed and that he has learned to respect signs that say "DANGER OF INJURY---DO NOT TOUCH THIS STRUCTURE UNDER ANY CIRCUMSTANCES!"

This handbook gives readers practical advice, guidelines, and strategies for writing concise, clear, and accurate EMS quality assurance reports. The guide covers basic principles of EMS documentation ... hands you three approaches for writing prehospital medical reports ... supports current philosophy on documentation from a medical and legal standpoint ... provides example formats of several types of incidents ... and tips for report construction. Useful for all rescue unit personnel, basic EMTs, seasoned paramedics, and nurses. A Brady book.