Museums and Medicine

You may be curious why I see connections between heart medications and explosives. This perspective can be traced back to my childhood, where my mother frequently took me to various museums. My explorations included New York's Museum of Modern Art, the Metropolitan Museum of Art, and the Yale Gallery.

Last week, during a visit to New York, my first stop was the Whitney Museum located in Manhattan's Meatpacking District.

You might wonder how this relates to my academic background at the Yale School of Medicine. The institution offers a workshop aimed at enhancing observational skills for first-year medical students. This initiative encourages them to scrutinize unfamiliar artifacts—like an 18th-century British painting—and draw pertinent insights.

Why Yale Medical Students Visit Museums

Irwin M. Braverman, M.D., a professor emeritus of dermatology and the course's creator, reflects on the traditional medical education: "[Looking at artworks] is worlds apart from our training," he noted. "We were instructed to identify existing patterns."

Shadows on an X-ray exemplify this type of learning. However, what happens when a physician faces an unfamiliar situation? They lack a reference point.

Dr. Braverman asserts that developing the skills to solve medical mysteries takes about a decade, and his aim is to give students an early advantage. "Essentially, [studying art] mirrors a patient examination," he explains, where the exhibit hall acts as the examination room and the artwork becomes the patient.

The Value of Museum Visits

Engaging with art enhances our observational abilities. At Yale, students spend 15 minutes independently analyzing an assigned painting, gathering as many details as possible. They then share their observations in group discussions.

Dr. Braverman emphasizes that 18th- and 19th-century British paintings are particularly suitable for this exercise, as they often narrate real historical events. Yet, akin to patients with obscure symptoms, they frequently present ambiguous or conflicting details.

A visit to your local museum or gallery could sharpen your observational skills. The experience of viewing paintings, sculptures, and performance art encourages me to pause and reflect.

This year, for the first time, Dr. Braverman replaced the usual post-workshop evaluation with a specific question: what insights have you gained about yourself as an observer? Many medical students admitted that, although they believed they were attentive observers, the workshop revealed their previous superficiality. The course has equipped them to perceive both their environment and their patients more profoundly.

I view my museum visits as moments of mindfulness—easier for me than practicing vinyasa flow yoga.

The Nobel Prize

When you hear the name Alfred Nobel, what comes to mind? For me, it’s the prestigious Nobel Prize.

For over a century, these awards have celebrated remarkable human accomplishments across various fields, including literature and science. The Nobel Prize is awarded "to the individual who shall have accomplished the most significant work towards fraternity among nations, the abolition or reduction of standing armies, and the promotion of peace congresses," as stated in Alfred Nobel's last will.

The announcement of the 2023 Nobel Prizes is scheduled from October 2nd to 9th.

The Dark Side of Innovation

However, there is a darker aspect to this narrative, filled with destruction and loss. To provide some context, Alfred Nobel's father, Immanuel Nobel, was responsible for developing the first operational sea mines for the Russian Czar during the mid-19th century's Crimean War. Alfred Nobel's invention of dynamite was not intended for military use, but we know how that story unfolded.

Dynamite found its way into the Franco-Prussian War, initially used by the Prussians and later by the French.

Alfred Nobel: The Merchant of Death?

While many link Nobel with peace initiatives, it remains ambiguous whether he endorsed the military application of dynamite. Following the death of his brother Ludvig in 1888, a journalist mistakenly published Alfred’s obituary, denouncing him as a man who profited from mass destruction.

The obituary labeled him "the merchant of death," describing how he amassed wealth through methods that accelerated killing.

Upon reading this, Nobel was compelled to reshape his legacy. A year before his passing in 1896, he established a will that allocated the majority of his fortune to fund five Nobel Prizes, including one for peace.

The Journey of Nitroglycerin

Returning to the peculiar saga of heart and erectile dysfunction treatments: were you aware that nitrate-based medications can trigger airport bomb detection systems? They also attract the attention of explosive-sniffing dogs, reminding us of their explosive origins.

In 1847, Ascanio Sobrero in Turin discovered nitroglycerin while collaborating with Theophile-Jules Pelouze. Alfred Nobel recognized nitroglycerin’s potential in 1851 and began manufacturing it in Sweden, overcoming its handling challenges with his patented detonator. Interestingly, Nobel experienced severe angina but declined to use nitroglycerin for treatment.

The Medical Use of Nitroglycerin

Today, nitroglycerin is utilized as a powerful drug that dilates blood vessels. It is commonly administered sublingually to both relieve and prevent angina attacks caused by reduced blood flow to the heart.

Dr. Ferid Murad, who passed away on September 4th at his home in Menlo Park, California, was a key figure in this narrative. He shared the Nobel Prize in 1998 for his discovery of nitric oxide—an air pollutant and a byproduct of nitroglycerin—which plays a critical role in relaxing blood vessels.

Dr. Murad's exploration of nitroglycerin dates back to the 1970s, when he began investigating its properties. The history of nitroglycerin as a medicinal substance traces back to the 1900s when workers at Nobel's factory noted an unexpected side effect: inhaling nitroglycerin vapors alleviated their work-related chest pains. Subsequently, physicians began experimenting with it for angina, hypertension, and other cardiovascular conditions.

Although nitroglycerin became a standard treatment for heart issues, it wasn't until Dr. Murad's research at the University of Virginia that the mechanism of action was understood. His elegant experiments revealed that nitroglycerin releases nitric oxide, which relaxes smooth muscle cells.

Nitric Oxide and Erectile Dysfunction

Dr. Murad's pivotal discovery also paved the way for the development of Viagra, a medication that assists in achieving erections by enhancing blood flow to the penis. Additionally, Murad's findings have benefited many premature infants whose underdeveloped lungs require stimulation.

Dr. Murad's contributions to medicine are profound, and his legacy will endure.

Disclaimer: The information provided in this blog is intended for educational purposes only and is not a substitute for professional medical advice. Always consult a healthcare provider for medical concerns or treatment.

Thank you for engaging with "The Fascinating Journey of Heart and Erectile Dysfunction Treatments."