Jones David S, Sivaramakrishnan Kavita
Department of the History of Science, Harvard University, Cambridge, Massachusetts, and the Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts.
Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, New York, and the Department of History, Columbia University, New York City, New York.
J Hist Med Allied Sci. 2018 Jul 1;73(3):303-332. doi: 10.1093/jhmas/jrx059.
On 17 February 1968, Bombay surgeon Prafulla Kumar Sen transplanted a human heart, becoming the fourth surgeon in the world to attempt the feat. Even though the patient survived just three hours, the feat won Sen worldwide acclaim. The ability of Sen's team to join the ranks of the world's surgical pioneers raises interesting questions. How was Sen able to transplant so quickly? He had to train a team of collaborators, import or reverse engineer technologies and techniques that had been developed largely in the United States, and begin conversations with Indian political authorities about the contested concept of brain death. The effort that this required raises questions of why. Sen, who worked at a city hospital in Bombay that could not provide basic care for all its citizens, sought a technology that epitomized high-risk high-cost, health care. To accomplish his feat, Sen navigated Cold War tensions and opportunities, situating his interests into those of his hospital, municipal authorities, Indian nationalism, Soviet and American authorities, the Rockefeller Foundation, and others. The many contexts and interests that made Sen's work possible created opportunities for many different judgments about the success or failure of medical innovation.
1968年2月17日,孟买外科医生普拉富拉·库马尔·森成功移植了一颗人类心脏,成为世界上第四位尝试这一壮举的外科医生。尽管患者仅存活了三个小时,但这一壮举为森赢得了全球赞誉。森的团队能够跻身世界外科先驱行列,引发了一些有趣的问题。森是如何如此迅速地完成心脏移植的呢?他必须培训一组合作人员,引进或逆向研发主要在美国开发的技术和技巧,并开始与印度政治当局就备受争议的脑死亡概念展开对话。这一切所需的努力引发了一个问题:为什么要这么做?森在孟买的一家城市医院工作,这家医院甚至无法为所有市民提供基本护理,而他却在寻求一种代表高风险、高成本医疗保健的技术。为了完成这一壮举,森应对了冷战时期的紧张局势和机遇,将自己的利益与医院、市政当局、印度民族主义、苏联和美国当局、洛克菲勒基金会以及其他各方的利益联系在一起。促成森开展这项工作的诸多背景和利益因素,为人们对医疗创新的成败做出多种不同的评判创造了机会。