Foreword: “The Most Difficult Puzzles Ever Devised”

C harles Best, one of the pioneers in the search for a cure for diabetes, once explained what intrigued him so about medical research: “It’s not just the gratification of knowing one is helping people,” he confided, “although that probably is a more heroic and selfless motivation. Those feelings may enter in, but truly, what I find best is the feeling of going toe to toe with nature, of trying to solve the most difficult puzzles ever devised. The answers are there somewhere, those keys that will solve the puzzle and make the patient well. But how will those keys be found?”

Since the dawn of civilization, nothing has so puzzled people—and often frightened them, as well—as the onset of illness in a body or mind that seemed healthy before. Being unable to reverse conditions such as a seizure, the inability of a heart to pump, or the sudden deterioration of muscle tone in a small child, or even to understand why they occur was unspeakably frustrating to healers. Even before there were names for such conditions, before they were understood at all, each was a reminder of how complex the human body was and how vulnerable.

While our grappling with understanding diseases has been frustrating at times, it has also provided some of humankind’s most heroic accomplishments. Alexander Fleming’s accidental discovery in 1928 of a mold that could be turned into penicillin has resulted in the saving of untold millions of lives. The isolation of the enzyme insulin has reversed what was once a death sentence for anyone with diabetes. There also have been great strides in combating conditions for which there is not yet a cure. Medicines can help AIDS patients live longer, diagnostic tools such as mammography and ultrasounds can help doctors find tumors while they are treatable, and laser surgery techniques have made the most intricate, minute operations routine.

This “toe-to-toe” competition with diseases and disorders is even more remarkable when viewed in a historical continuum. An astonishing amount of progress has been made in a very short time. Just two hundred years ago, the existence of germs as a cause of some diseases was unknown. In fact, less than 150 years ago a British surgeon named Joseph Lister had difficulty persuading his fellow doctors that washing their hands before delivering a baby might increase the chances of a healthy delivery (especially if they had just attended to a diseased patient)!

Each book in Lucent’s Diseases and Disorders series explores a disease or disorder and the knowledge that has been accumulated (or discarded) by doctors through the years. Each book also examines the tools used for pinpointing a diagnosis, as well as the various means that are used to treat or cure a disease. Finally, new ideas are presented—techniques or medicines that may be on the horizon.

Frustration and disappointment are still part of medicine because not every disease or condition can be cured or prevented. But the limitations of knowledge are constantly being pushed outward; the “most difficult puzzles ever devised” are finding challengers every day.