The Department of Medicine at the Albert Einstein College of Medicine, Final Thoughts

The medicine we knew at the school’s beginning in 1955 was almost unrecognizable at the end of the twentieth century. The science, the knowledge base, the organization, and the funding of health care had all undergone dramatic changes. Fifty years ago, we thought we might be able to conquer infectious diseases. Now we are facing rampant ‘new’ diseases such as Human Immunodeficiency Virus (HIV) and Severe Acute Respiratory Syndrome (SARS), and are witnessing the development of resistance to antibiotics by many microorganisms, including the previously highly sensitive pneumococcus. Fifty years ago, cardiac surgery was still in its youth, and mitral commissurotomies were high points of surgical endeavor. Now, rheumatic heart disease is very uncommon in the United States (although still common in parts of the third world). Fifty years ago, we had only primitive antihypertensive drugs, which were difficult for patients to tolerate. Now, antihypertensive drugs are far more effective and better tolerated by patients. Fifty years ago, the structure and mechanism of replication of DNA had just been described by Watson and Crick. Now, we are using therapeutic agents manufactured by recombinant techniques, and are beginning to see clinical applications of gene transfer therapy.