Medical Education in Ohio

Before the 1800s, medical education in Ohio was apprentiship-based training, where aspiring doctors learned from practicing physicians.  During this period medical care was basic, and the understanding of the etiology of diseases was limited. The importance of sanitation played in the health of the people was totally ignored.  All this changed with the establishment of Medical Schools. 

The founding of the Medical College of Ohio was the beginning of a new era.  Daniel Drake, a prominent figure in the 19th-century American medicine, known for his work as a physician, scientist, educator and author found it.  He was the first President of the Medical College of Ohio in 1819, which later changed its name and it is now known as the University of Cincinnati College of Medicine.  

A stimulus towards the establishment of formal medical education was the Cincinnati cholera of 1849.  Cholera is an infection of the small intestine. The classic symptom is watery diarrhea. Patients get cholera from drinking water or eating food contaminated with feces from infected patients. The severe dehydration causes the body to take a blue-gray tone, thus it was called "Blue Death". Treatment requires rehydration, orally or intravenously and a course of antibiotics. Although the cholera of 1849 spread throughout Ohio, the city worst hit was Cincinnati, the "Queen City" where some 6,000 Cincinnatians died from cholera that represented 6% of the city's population. In fact during the pandemic Cincinnati suffered more deaths than New York and London combined.  Today, an estimated 1 to 4 million people get cholera and between 20,000 and 140,000 die.  Although this number is unacceptably high, let's keep in mind that nowadays, all around the world, an overwhelming majority of children reach adulthood.  For much of history, almost half did not. Getting were we are required improved nutrition; riding drinking water of sewage; the discovery of antibiotics and vaccines with the last two being among the major advances in medicine of the last 100 years.  

Over time, other institutions like The Ohio State University College of Medicine and Case Western Reserve University also played significant roles in shaping medical education in Ohio.  In 1846, the Willoughby Medical University of Lake Erie moved to Columbus and became the Starling Medical College, which later merged with the Ohio State University.

Several medical schools emerged in Cleveland, including those associated with Saint Vincent Charity Hospital, Western Reserve College and Ohio Wesleyan University. 

The Medical College of Ohio (MCO) merged with the University of Toledo in 2006, forming the University of Toledo College of Medicine and Life Sciences.

Ohio University became home to Ohio's only college of Osteopathic Medicine also known as the Heritage College of Osteopathic Medicine. The college was created to address a shortage of family physicians and train doctors for underserved areas.

The Ohio State University College of Medicine implemented several innovations such as an independent study program in 1970s, later reverting to a four-year curriculum.  In the posts to follow, I will describe individuals who played key roles in the education of the students and care of the patients and about the OSU Department of Radiology's staff, faculty and innovations during the time, I was Radiology Department's Chairman.   

The text was authored by D G Spigos, MD PhD Professor Emeritus at the                                       Ohio State University.

This post is dedicated to the early doctors in the State of Ohio who took care of patients with care, even risking their lives, during the "time of the Cholera" in 1849. 

Corona virus; a review and projections of the pandemic.

Since its beginning in December 2019 in Wuhan city in Hubei province of China nearly 860,000 cases and 42,000 deaths due to Corona virus have been reported worldwide as of April 1st, 2020 8:00 GMT.  During this period, confirmed cases in select countries, are as listed in round numbers; US 190,000, Italy 105,000, China 82,000, Germany 71,000, France 53,000, Sweden 4,500, Greece 1,300, S. Korea 9,900 and Japan 2,200.  

During the same time the deaths per million of inhabitants in the above-mentioned countries are; US 12, Italy 200, China 55, Germany 10, France 58, Sweden 18, Greece 5, S. Korea 3 and Japan 0.5.  Interestingly, while China enacted strict quarantine of the 60 million inhabitants of the Hubei province, Japan and Holland lets individuals and businesses continue as in pre Covid-19 time expecting "herd immunity" will deal with the epidemic in a similar way as the annual flu.  S. Korea and Singapore have performed widespread testing of their populations, Sweden instituted social distancing only while the remaining countries enacted lockdown schemes of different severity. 

The first case in Greece appeared on February 25, 2020 and was related to an individual who had travelled to the north of Italy, as well as members a group of pilgrims who had travelled to Israel and Egypt.  

On May 1st the World count of confirmed Corona virus according to Johns Hopkins site was 3,330,000 cases and the death count was 235,000. The U.S. reported 1,100,000 cases and 64,000 deaths.  Next the two most affected countries were Spain with 240,000 cases and 25,000 deaths and Italy with 205,000 cases and 28,000 deaths.  Two countries that have done well are  Germany with 163,000 cases and 6,600 deaths and Austria with 15,500 cases and 585 deaths.  The Greek CDC reported 2,590 cases and 140 deaths.   The majority of those who died (70%) were older than 65 and had pre-existing conditions.  In my opinion, it is the deaths per million of inhabitants, is a useful indicator and points on how and if the countries' health systems cope with the stress of the pandemic.  The deaths per million for select countries are as follows: US 80, Spain 532, Italy 467, France 240, UK 409, France 364,  Sweden 260, U.S. 194, Germany 267, Austria 41 and Greece 14.  S. Korea  has 5, Japan has 3 and Taiwan's has only 0.3 deaths per million.

As of June 1st, 2020, 35,553 patients have been diagnosed with corona virus in the State of Ohio and 2,162 have died, which corresponds to 185 deaths per million.  Ohio and Greece have approximately 10 million inhabitants and have near identical land masses of 50,000 square miles and although geographically distant and with health systems which are distinct, both enacted early lockdowns and both had adequate number of ICU beds fare different when it comes to deaths per million for reasons I cannot explain other than obesity is more prevalent in Ohio. The State with the worst toll is New York with 379,902 cases and 29,918 deaths that corresponds to a death rate of 1,528 deaths per million. 

The Institute of Health Metrics and Evaluation (IHME) of the University of Washington estimates a total of 84,000 deaths for the United States.  Because we know that the deaths per million in Hubei province were 55 per million and because it is the only country that the epidemic has completed its course, I thought we could estimate the death toll in different countries but it turn a grossly inaccurate metric.  As of today, US has 316 deaths per million, UK has 584, Spain has 577, Italy 557, Germany 103, Austria will likely have higher death rates to the projected ones, Germany and Austria 74 and Greece 18.

Four Asian countries have very low death rates and are;  Taiwan with 0.3 deaths per million, Singapore 4, S. Korea 5 and Japan 7.  

Epidemiologists and others are using different models and have and will advance theories why the death rates will differ among countries.  I believe that the estimates of 100-240,000 deaths in the US  are very high while the IHME projection of 84,000 deaths will be closer to the real number at the end of the pandemic.  I also feel Spain's and Italy’s death rate will stay significantly higher than the projected ones while Germany’s, Austria's, Sweden’s, Greece’s, S. Korea’s, Japan’s and especially Taiwan's will be well below projections. In my opinion Greece’s and the State of Ohio death totals will be between 200 and 500 at the end of the pandemic.   I also believe the number of deaths of the United States will be approximately 60,000, which incidentally was the death toll CDC reported for the 2017-2018 flu season.  We will only know the exact number(s) at the completion of the pandemic in August 2020. 

The present was posted at 8:30 GMT on April 1, 2020. I decided I will update the incidence and death numbers  weekly in order for visitors to know the most recent tally of the coronavirus pandemic.

Boogie Woogie

Jeanette Smith describes the painting Boogie Woogie by Paul Chidlaw (1900-1989), a native of Ohio, in Art of JAMA. 

Chidlaw attended the Art Academy of Cincinnati from 1919 to 1923 and in 1927 moved to Paris, which at that time was the epicenter of experimentation in modern art.

He returned to the United States in 1935, and initially painted murals for the Works Progress Administration.  

In Boogie Woogie, a cheerful inundation of colors reminds the exuberance of the genre that became popular in the late 1920 and visually suggests a torrent of bright streamers and confetti drifting down from the winter sky at New Year’s celebrations. Although each and every color is stimulating in itself, the work in aggregate is even more motivating because of the effect of the contrasting hues and shapes.

Although Chidlaw’s eyesight was diminishing in his late years, he retained his creativity and spirit of artistic adventure and created paintings with colors combining as in a joyful symphony.