Article written by Sandra L. Bloom, MD
In 1881, President James A. Garfield was shot by an assassin—one bullet to his arm and another to his back. Physicians rushed to care for him, believing that he had survivable injuries. The discovery of microbes as the origin of infectious processes was still new, and although Joseph Lister’s pioneering work in antisepsis was known to American doctors, and Lister himself had visited America in 1876, few doctors had confidence in it, and none of the advocates of germ theory were among Garfield’s treating physicians. As a result, no sterile procedures were used to treat his wounds. No hands were washed, no instruments were boiled in probing his wound. He died 2 months later after a grueling decline as a result of massive infection (Millard, 2011). The recognition—finally—that microbes were the etiological agents behind the major killing diseases of earlier centuries brought about a radical change in the way health care is delivered and gave birth to the whole field of public health prevention, from antibiotics and vaccines to clean water, healthy food, and decreased poverty. Germ theory was the paradigm shift in knowledge and understanding that provided the basis for individual, local, national, and global changes in practice andpolicy and initiated the modern era of public health intervention and prevention.
Almost exactly 100 years later, in 1980, the American Psychiatric Association defined posttraumatic stress disorder, and shortly thereafter, in 1985, the field of traumatic stress studies was propelled forward by the formation of the International Society for the Study of Traumatic Stress with an initial focus on combat veterans, disaster victims, and other survivors of adult trauma (Bloom, 2000). Not long thereafter, the organization that is now known as the International Society for the Study of Trauma and Dissociation was formed with a focus on dissociative disorders and the treatment of what are now considered the complex disorders that follow on the heels of childhood exposure to overwhelming stress. In 1998, the Adverse Childhood Experiences Study was published, clearly demonstrating that there is a strong positive association between the amount of exposure to toxic stress that children experience and a wide variety of health, social, mental health, and substance abuse problems that unfold interactively across the life span (Felitti et al., 1998). Epigenetic research is demonstrating that these effects may be transmitted to subsequent generations (National Scientific Council on the Developing Child, 2010). These recent advances in knowledge—each of which highlights a broader and deeper knowledge base that has accumulated across two centuries—represent the consolidating of a massive paradigm shift in how we understand human health, human pathology, and human nature.
[For more of this article written by Sandra L. Bloom, MD. go to http://www.tandfonline.com/doi...5299732.2016.1164025]
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