Patient’s Position, Hospital Bed & A Misnomer

1861, Long Island, Jamaica. A thirteen-year-old boy joined as an apprentice in his father’s railroad repair shop. Five years ago, he came to Jamaica with his family from New York City. His father was a master mechanic and established the railroad repair shop. The boy was learning telegraphy and other jobs in his father’s shop. Few years later. A major accident occurred in the repair shop. Few workers became severely injured. The young boy came forward to aid the victims. The incident moved the boy and changed his life. And also the art of surgery.

1866. The boy completed his apprenticeship. His father asked him to join the shop. But the accident already marked his destiny. The young one declared that he wanted to study medicine and become a surgeon.

1871. The boy became a graduate in medicine and started practicing surgery in Brooklyn. He was one of the first to adopt Joseph Lister’s antiseptic methods.

1887. At just 39, the young surgeon was appointed chief of surgery at the newly opened New York Methodist Hospital, Brooklyn. By that time, appendicitis had become “one of the darkest chapters of surgical pathology,” causing a considerable number of deaths. The young surgeon became more inclined to find out the solution: the management.

1893. In between, the chief of surgery performed the world’s first Thoracoplasty.

1894. The 46-year-old surgical artist gifted the medical world its first historical “Treatise on Appendicitis,” which changed the diagnostic and surgical approach towards the management of appendicitis. The book was a compilation of his series of articles that were published in the Annals of Surgery. And it contains 35 amazing real-time medical illustrations and five plates of appendicitis.

But the most notable year was 1900. The veteran surgeon published an article in The Medical Record, New York. Published as “Diffuse septic peritonitis, with special reference to a new method of treatment, namely, the elevated head and trunk posture, to facilitate drainage into the pelvis, with a report of nine consecutive cases of recovery”. The article gave a whole new dimension to the management of septic peritonitis. Thus, the medical world got its ideal patient bed position for various medical and surgical complications: FOWLER’S POSITION, named after this gifted surgeon, GEORGE RYERSON FOWLER, MD. The Fowler’s position, which is divided into three different positions – high-Fowler (90 degrees), semi-Fowler (30–45 degrees), and low-Fowler (slightly elevated head) – has become so important in patient management that hospital beds are still sold as Fowler’s Beds.

And that’s a complete misnomer, because there is NOTHING called Fowler’s Bed. Rather, the modern 3-segment adjustable hospital bed with adjustable side rails is actually called the GATCH BED, named after another surgeon, Willis Dew Gatch, chair of the Department of Surgery at the Indiana University School of Medicine. Gatch invented the adjustable bed in 1909, three years after Dr. Fowler’s death. Dr. Gatch observed that a postoperative patient did not have the luxury of sitting upright in bed or draining his wounds correctly. The initial patent was registered in 1874 by the Cincinnati mattress company Andrew Wuest and Son for a type of mattress frame with a hinged head that could be elevated, the predecessor of the Gatch Bed. Hence, it was the combined inventions of GR Fowler (position), WD Gatch (bed), and Andrew Wuest and Son (mattress), without which today’s medical world can’t imagine treating a patient. Tragically, appendicitis was responsible for the death of Dr. Fowler in 1906.

Yesterday, Drs. Fowler and Gatch sent their pre-birthday gift to another unknown, unheard ailing physician of another part of the world. Their gift gave the latter so much comfort that he slept last night after almost three weeks without any pain or discomfort.

Shuvo Janmodin (Happy birthday), Baba!

Today’s hospital bed is a combined invention of GR Fowler (position), WD Gatch (bed) & Andrew Wuest and Son (mattress).

More information at: https://archive.org/…/treatiseonappend…/page/14/mode/1up

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