The implant revolution had its roots in the founding of the genius societies
in the 17th century, the birth of scientific surgery in the 18th century, and
the reworking and perfection of the microscope in the early 19th century;
the revolution gained steam with the genesis of chemistry, the
solidification of germ theory, and the revelation of the organ basis and
cellular basis of disease. In the half century between the first elective
operations for hernia and the introduction of penicillin in 1941, the first
(failed) attempts at implantation occurred.
Two world wars flanked the invention of health insurance, preceding a
postwar boom of hospital construction, financed by the US government. In
an incredible concentration of developments, polymer sciences,
transistors, modern alloys, and antibiotics were industrialized, thus
necessitating the feedback loop of insurance and Medicare. Implant
materials, the money to pay for them, gleaming new operating rooms, and
the antibiotics to make the surgeries safe launched the revolution.
After seventy-five years of revolution, there are still glaring flaws in
the delivery of medicine in America, and every country. But the dramatic
improvement in the treatment of arthritis, heart disease, stroke, abdominal
organ disease, scoliosis, urinary incontinence, hearing loss, Parkinson’s,
cancer, and hundreds of other conditions was built upon the foundation of
implants. While often dramatically effective, these interventions are
exceptionally expensive compared to the old-fashioned “benign neglect”
of 18th century medicine, and it is still all too common that implants are
not evaluated with enough scientific rigor.
Charles Darwin, in his iconoclastic On the Origin of Species,
summarized his project in a striking final paragraph:
Thus, from the war of nature, from famine and death, the most
exalted object which we are capable of conceiving, namely,
the production of the higher animals, directly follows. There
is grandeur in this view of life, with its several powers, having
been originally breathed by the Creator into a few forms or
into one; and that, whilst this planet has gone cycling on
according to the fixed law of gravity, from so simple a
beginning endless forms most beautiful and most wonderful
have been, and are being evolved.^17