AUDIE CORNISH, HOST:
If you think of a doctor, you think white coat, scrubs and a stethoscope around the neck. The first stethoscope was invented 200 years ago. Now some say the tool is becoming obsolete. From WHYY's the Pulse in Philadelphia, Taunya English reports.
TAUNYA ENGLISH, BYLINE: For hundreds of years, doctors put an ear up to a patient's chest and listened, but then, in 1816, things changed. The story goes that 35-year-old Paris physician Rene Laennec was caring for a young woman who was apparently plump with a bad heart and large breasts. Obstetrician George Davis, who collects vintage stethoscopes, says the young doctor didn't feel comfortable pressing his ear to the woman's bosom.
GEORGE DAVIS: So he took 24 sheets of paper and rolled them into a long tube and put that up against her chest and listened to the other end. And he found that not only could he hear the heart sounds very, very well, but it was actually better than what he could hear with his ear.
ENGLISH: It also could've been the lack of hygiene in the 19th century that kept him away from his patient. Regardless, Laennec went home, crafted a wood cylinder with a hole down the middle, and that became the first stethoscope. It took a while for auscultation, the art of listening to the body, to catch on. But over the years, the stethoscope has helped doctors better hear the sounds of a healthy heart...
(SOUNDBITE OF HEARTBEAT)
ENGLISH: ...And distinguish the offbeat cadence of a problem.
(SOUNDBITE OF ABNORMAL HEARTBEAT)
ENGLISH: Doctors in their 60s and 70s say they used to get praise if they had the ear to hear those subtle sounds, and medical schools still teach the art of listening. Allison Rhodes is a third-year student at the University of Pennsylvania School of Medicine.
ALLISON RHODES: I think it's absolutely still relevant. I had a patient that had a left-lower-lobe pneumonia. It was really wonderful to be able to listen to her and say, you know, this is what I think it is and then later see on a chest X-ray that that's exactly what it was.
ENGLISH: But in the digital age, Dr. Bret Nelson says the stethoscope is becoming less useful.
BRET NELSON: It's time has come.
ENGLISH: Nelson is an emergency medicine doctor at Mount Sinai Hospital in New York. He says clinicians now get a lot more information from newer technology. An ultrasound, for example, turns sound waves into moving images of blood pumping and heart valves clicking open and shut. Those visual cues are easier to interpret than muffled murmurs. Nelson admits that the stethoscope has been an icon for physicians for hundreds of years, but he doesn't buy the argument that if you lose the stethoscope, you lose the tradition of healing touch. Nelson, who's 42 and graduated from medical school just 16 years ago, says these days, there are other ways to bring patient and physician together.
NELSON: Pulling on ultrasound machine out of my pocket or wheeling the cart over next to the patient, talking through with them exactly what I'm looking for and how I'm looking for it, the fact that they can see the same image on the screen that I'm seeing strengthens that bond, I think, more than anything in the last 50 years.
ENGLISH: And another thing that's changed in the last 50 years - medical costs. Obstetrician George Davis says imaging scans should be back up.
DAVIS: How much do those ultrasound machines cost? I can get a good stethoscope for less than $20.
ENGLISH: He listens with his stethoscope first, and that helps him figure out which patients need additional testing.
DAVIS: We're not going to sit there and do an echocardiogram on every patient who walks through the door.
ENGLISH: Davis worries that a whole generation of physicians is learning to rely on expensive technology, but Bret Nelson's not worried. That's just the future. He says prices will come down, and machines will become more portable. Just like...
NELSON: ...A slide rule, a calculator, a flashlight, a phone, a modem, a computer terminal and 36 videogames.
ENGLISH: Which is what we all have on our smart phones. For NPR News, I'm Taunya English in Philadelphia.
CORNISH: This story is a reporting partnership with NPR WHYY's program the Pulse and Kaiser Health News.
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