Two Hundred Fifty Years of American Medicine: What We Built, What We Lost, and What Must Be Restored

Introduction: What We Built and What We Lost Along the Way

The story of American medicine is not just the story of physicians, hospitals, discoveries, and institutions. It is also the story of the American patient: the mother caring for a feverish child at home, the family waiting for a doctor to arrive at their bedside, the patient consenting to a treatment they barely understood, and the individual trying to determine whom
to trust when illness, fear, and uncertainty enter their life. Over the course of 250 years, medicine has repeatedly asked individuals to place their bodies, their families, and their futures in the hands of those who claimed to know what was best. Sometimes that trust was rewarded. Sometimes it broke.

In 1776, medicine in America did not constitute a system. It was not even a profession in the contemporary sense. Rather, it was a calling: messy, imperfect, frequently ineffective, yet profoundly human. Physicians had limited means to offer. They performed bloodletting and purging, often relying on conjecture rather than knowledge. Nevertheless,
they remained present and bore witness to suffering in its most unmediated form. That mattered.