Saturday, June 12, 2010

Epilogue: The man in a red canoe who saved a million lives

Mostly we commute to work each day driven by motives we would rather not look at too deeply. But one renal physician used a red canoe to commute each day from his house boat to the hospital. He could have been a very rich man, but instead Belding Scribner gave his invention away, and continued his modest existence.

He invented the Scribner shunt- a U of Teflon connecting an artery to a vein, and allowing haemodialysis to be something which could be repeated as often as needed. Before Scribner, a glass tube had to be painfully inserted into the blood vessels, which would be damaged by the procedure and haemodialysis could only be done for a few cycles.

Clyde Shields was his first patient with chronic renal failure to receive the shunt on 9 March 1960, and said that his first treatment “took so much of the waste I’d stored up out of me that it was just like turning on the light from darkness”.

Scribner took that was something 100% fatal and overnight turned it into a condition with a 90% survival. In doing so, he founded a branch of bioethics because not everyone could have the treatment immediately. This is the branch of ethics that is to do with who gets what- ie distributive justice. In Scribner’s day, this was decided by the famous ‘life and death committee’ which had the unenviable job of choosing who would survive by placing people in order precedence.

Scribner said that his inventions sprang from his empathy for patients, including himself. ‘I was a sickly child’ he said, and at times he needed a heart-lung machine, a new hip, and donated corneas. He was the sort of man whose patients would inspire him to worry away at their problems during the day- and then to awake at night with a brilliant solution.

On 19 June 2003, his canoe was found afloat but empty- and like those ancient Indian burial canoes found at Wiskam which have been polished to an unimaginable lustre by the action of the shifting sand around the island of the dead, so we polish and cherish the image of this man who gave everything away.

source: Oxford Handbook of Clinical Medicine.