613: Surgery

A Thousand Things to Talk About
A Thousand Things to Talk About
613: Surgery

Have you ever had surgery?

Full episode script

Up until the time effective and reliable anesthetics were discovered around the 1800s surgery existed but definitely was not considered a solution of first resort for, well, just about anything. While researching the history of surgery, what was particularly illustrative, for me, of how surgery was approached was this quote from the UK Science Museum:

Women could not become physicians [during the middle ages], but surgery, considered a lesser profession, was open to them. Surgeons did not go to university to study, but were apprenticed to practising surgeons to learn through observation. Women continued to train as surgeons throughout the 1500s and 1600s, often treating the poor. In fact they were not pushed out of surgical practice until the 1700s, when surgical training moved to the universities – from which they were banned.


Once speed was no longer the most important skill for a surgeon to possess and anesthetic was in more common usage, surgery became more essential for treating a wide number of conditions — and became more popular for elective reasons, too.


But how common is surgery? That’s a surprisingly difficult question to answer. To quote extensively from a 2016 World Health Organization paper:

Surgical care is essential for managing diverse health conditions – such as injuries, obstructed labour, malignancy, infections and cardiovascular disease – and an indispensable component of a functioning health system. International organizations, including the World Health Organization (WHO) and the World Bank, have highlighted surgery as an important component for global health development. However, surgical care requires coordination of skilled human resources, specialized supplies and infrastructure.


As low- and middle-income countries expand their economies and basic public health improves, noncommunicable diseases and injuries comprise a growing proportion of the disease burden. Investments in health-care systems have increased in the last decade, but the effect on surgical capacity is mostly unknown.


Based on modelling of available data, it was estimated that 234.2 million operations were performed worldwide in 2004. The majority of these procedures took place in high-income countries (58.9%; 138.0 million), despite their relative lower share of the global population.


We estimate 266.2 to 359.5 million operations were performed in 2012. This represents an increase of 38% over the previous eight years. The proportion of caesarean delivery were higher in Member States with lower surgical volume.

This script may vary from the actual episode transcript.