largest children’s hospital), the University of Texas M.D. Anderson Cancer
Center (the world’s largest cancer hospital), the Texas Heart Hospital, the
Methodist DeBakey Heart Hospital, the DeBakey Veterans Hospital,
Shriner’s Hospital, and many more. There are over 100,000 employees and
10 million patient encounters per year, with 750,000 emergency visits per
year, and 25,000 births per year. The TMC is the eighth-largest business
district in the world, with a Gross Domestic Product of $25 billion (ahead
of many countries).
The two square miles that the TMC occupies is a technological and
logistical spectacle, particularly when one considers the seed money
originated from a bachelor who lived unostentatiously in downtown
Houston hotels. (The MDAF has donated more than $81 million to Texas
Medical Center institutions^5 and more than twice that outside the TMC.)
From a broader context, the labyrinth of buildings has one description: A
Medical Industrial Complex. In Houston, and in other prominent places
like Boston, New York, and Rochester, Minnesota, the obvious visual
representations of the industrialization of medicine is breathtaking. But
every American city and hamlet is dotted with clinic buildings, labs,
hospitals, rehab centers, therapy offices, surgery centers, and business
offices.
Another, more powerful way of contemplating the reach of the medical
industrial complex is to consider the number of patients who have been
treated, and the most salient question is how many Westerners have
received, in their body, an implant? In other words, instead of thinking
about hospitals and medical complex buildings, how many humans have
pieces of the medical industry in their own bodies?
First: what constitutes an implant? In this book, implants are either
temporary or permanent. For centuries, catgut and silk sutures were the
mainstay in primitive surgery, and both of these sutures rapidly degrade in
the human body. Weeks after placement in the body there is no evidence of
their presence due to rapid degradation and destruction by the immune
system. Obviously, these types of suture are temporary implants, and are
clearly not the main thrust of this work. Permanent implants are the focus
of this book, and every medical specialty utilizes implants that are meant
to stay in the body till death. The simplest form of a long-lasting implant
is “non-absorbable” suture, typically made from synthetic polymers (e.g.,
polyester or polyethylene). Almost anyone who has had an operation