"Never More Than 15 Feet From the Respirator": Housestaff Research During the 1955 Boston Polio Epidemic.

Abstract

In July 1955, a devastating polio epidemic struck Massachusetts only 3 months after the licensing of the Salk vaccine. One of the last major polio epidemics in the United States, it overwhelmed the local health care system. At Massachusetts General Hospital, 2 assistant residents-the equivalent of today's postgraduate year 2 trainees-were assigned to oversee a hastily organized polio ward and a rising second-year medical student was charged with setting up and running an adjoining laboratory. There, they and other residents conducted original patient-oriented research while providing round-the-clock care for patients, most in iron lungs, under crisis conditions. Their work was facilitated by a strong preexisting culture of bedside research at the hospital. Extremely long work hours ensured constant, close patient observation. A lack of role boundaries between the physician as researcher and as clinician and an absence of formal requirements for patient consent to research in that era also facilitated the studies, which were of similar methodological sophistication and ethical consideration to contemporaneous studies of other diseases. There is evidence that this experience influenced their subsequent careers. The autonomy granted these trainees contrasts sharply with the restricted roles permitted to medical students and residents during the initial surge of the recent COVID-19 pandemic.