Newtown Health Care:

 A Look At The Past –

A Glimpse Of The Future

By Thomas F. Draper, MD

The dawning of a new century provides an impetus to reflect upon some of the health issues confronting the Newtown of today in contrast to those concerning the community just prior to World War II. In so doing we can learn something of the dramatic transformation which health care has undergone during this century and anticipate, perhaps, something of the health care scene in the new millennium. To assist in this endeavor I reviewed issues of The Newtown Bee of 1939, and recalled conversations which I had over the years with the late Dr Benton Egee who was a family physician in Newtown at that time.

The issue of The Bee of January 13, 1939 notes that 36 babies had been born to Newtown families during the preceding year, 19 boys and 17 girls. According to Dr Benton Egee, virtually all births occurred at home, delivered by a family physician assisted by a visiting nurse. The 1938 Vital Statistics of Connecticut indicate that babies born during that year could anticipate living an average of 64 years, but that 37 out of 1,000 would die in the first year of life, most often from an infectious disease.

The 1939 Winter issues of The Bee reflect some of the health concerns of the population at that time. The Foundation for the Prevention of Infantile Paralysis (polio) was launching its annual campaign concurrent with President Roosevelt’s birthday. There was an outbreak of flu. Mrs Fanny Edwards was “recovering from a severe attack of the prevailing grip (sic) which has kept her confined to her home on Queen Street for the past two weeks.” According to Benton Egee, then a Newtown family physician, most patients with “the grippe” or “flu” as we have come to know it, would care for themselves at home using such traditional remedies as aspirin for fever, Browns mixture for cough, mustard plaster for the chest pain of bronchitis. If the doctor was called at all it would be for the severely ill. In such cases the doctor would travel to the home, evaluating the patient for a complicating pneumonia which could incur a stormy course from which some might not recover.

The January 27 issue notes that “George Walker is recovering in the hospital from an appendix operation.” A 6-year-old child in Oxford “who underwent an operation for acute appendicitis 2 weeks ago,” after coming home, suffered a relapse with a streptococcal infection, “the poison having settled in her throat and kidneys.”

The February 2  Bee tells us that “20 out of 24 children in the South Britain school are out with measles.” February 17: “Dr. W.H. Kiernan is caring for a 15-year-old girl who splintered her leg in a school yard accident – he put her leg in a plaster cast and she will be taken to Danbury in a few days to place the leg under an X-Ray light so as to determine the exact injury.”

The March 2 issue of The Bee includes an editorial by Paul Smith urging support for the committee appointed to expedite the building of a sidewalk  from Newtown Street (Main) to Sandy Hook “to protect walkers from injury by automobiles.”

Illness, Births At Home

In the late 1930s Newtowners were using hospitals largely for surgery: bad fractures, appendicitis, diseased gall bladders, hernia repair. Most illness was managed at home. Birth occurred at home; most deaths took place in the home. Between doctors and the families they served there existed a close trusting relationship of neighbor and friend. In the nation at large the leading causes of death in 1939 were pneumonia, tuberculosis, heart disease, stroke and accidents.

In 1996, 332 babies were born to Newtown families, 10 times the number of nearly 60 years before, virtually all delivered in a hospital by a trained obstetrician. These babies could anticipate living an average of 76 years, 12 years longer than their counterparts of 1938. Only 6 out of 1,000 would die in the first year of life compared to 37 in the earlier generation. What happened in health care in the last 60 years of the century may provide some insight into what we may anticipate in the new millennium.

Looking at the spectrum of health care in these last days of the century we see that a sea of change has occurred. Major infections which afflicted Newtown in 1939 are submissive to antibiotics or prevented by vaccines. The six-year-old Oxford child critically ill with “poison settled in her throat and kidneys” would likely be quickly cured today by penicillin. Most of the pneumonias which caused weeks of illness and often death in 1939 now resolve in a few days. Hospitals built just to treat tuberculosis of the earlier generation are now closed, no longer needed. Dr Kiernan’s X-Ray light of 1939 has given way to elaborate imaging systems, CT scans, MRIs, permitting diagnostic examination of the deepest regions of the body. In our modern hospitals, highly trained doctors repair hearts and blood vessels, transplant healthy organs of one person to replace the diseased organs of another, defective joints are reconstructed or replaced. A seemingly endless array of pharmaceuticals have been developed, coping with all kinds of disturbances in the human physiology.

The Newtown resident of today has become far more reliant upon the hospital for care than was the generation of the 1930s. When there is emergent need to reach that hospital, a volunteer ambulance service stands ready to transport the sick or injured, its skilled technicians trained to initiate critical therapy at the home or accident site. Today’s Newtown parent does not live in fear that paralytic poliomyelitis will afflict a child or that an epidemic of measles will close the school.

Genetic Engineering

While the latter half of this century has witnessed dramatic progress in the effort to combat disease, the new millennium promises new and exciting developments in science and technology. Genetic engineering and gene replacement therapy, now in its infancy, offer the possibility for cure of diabetes, cancer and a range of maladies. New vaccines to prevent infection will become available. The pharmaceutical industry will manufacture more potent and perhaps safer drugs to combat disease.

As we laud the progress, it is well to recognize that this century has seen the emergence of new and serious problems which will sorely challenge the future. AIDS has appeared as an infection previously unknown to mankind. Intertwined with drug abuse, it has spread throughout the globe. In the United States it is a major killer of young people and its cure has yet to be found. Not only have new infections appeared, but bacteria causing older infections such as pneumonia and tuberculosis are developing resistance to previously effective antibiotics as a result of overuse. Perhaps most ominous to health in the new millennium is the threat of Biological warfare and terrorism. The very discoveries that enabled control of infectious diseases may be subverted to cause lethal epidemic.

Not least of the problems with which the new millennium must contend is the ever increasing cost of health care. Fueled by the development of increasingly expensive technology and drugs, health care costs are threatening the budgets of industry, government and private citizens. The specter of possible Medicare insolvency worries the aged and challenges the political process. Many leading hospitals caring for an older, sicker and often poorer population are operating at deficit; some are bankrupt. Much of the population lacks any health insurance or the funds for needed care. Significant moral and ethical dilemmas have arisen in determining the allocation of expensive medical resources for limited benefits, particularly at the end of life in the settings of hospital intensive care.

It is our hope that technologic innovations and scientific discovery will continue to benefit the health of Newtown. But the future challenge to the health of our town and our world may well be determined by how wee behave as a people. We do live longer; but we eat more, exercise less, and our obesity generates fat in our arteries, high blood pressure, heart disease, and more expensive health care. Judicious use of drugs may bring benefit, but abuse and addiction destroy the spirit. Increasing dependence on the automobile contributes to the pollution of our air, the loss of protective ozone, and decay in physical fitness.

As the century ends, Paul Smith’s sidewalk from the flagpole to Sandy Hook has yet to be completed. It is conceivable that we could do more for the health of Newtown in the new millennium by investing in walkways and paths permitting us to emerge from the isolation of our houses, walk or cycle in safety, exercise our bodies, meet our neighbors, and renew the community which has served us so well.

(Dr Draper retired this year after 40 years of service as a local pediatrician and a former chief of pediatrics at Danbury Hospital. He is health advisor to the Town of Newtown and the Borough of Newtown.)