Museums and Medicine

You may wonder why I connect heart medications with explosives.

My mother's influence played a significant role in my interests. During my childhood, she took me to a museum each month, visiting places like New York’s Museum of Modern Art, the Metropolitan Museum of Art, and the Yale Gallery.

On my recent trip to New York, my first stop was the Whitney Museum in Manhattan’s Meatpacking District.

Why mention this? My alma mater, Yale School of Medicine, conducts a workshop focused on observational skills for first-year medical students.

This workshop trains students to examine unfamiliar objects—like an 18th-century British painting—and extract pertinent information.

Why Yale Medical Students Visit a Museum

Irwin M. Braverman, M.D. ’55, the workshop's creator, stated:

> “[Looking at art] is a far cry from what we had,” reflecting on his own medical training. “We were taught to look for pre-existing patterns.”

Shadows on an X-ray represent this type of challenge. However, when doctors face unfamiliar scenarios, they lack a reference point.

Braverman notes that it typically takes about a decade to develop the skills necessary to tackle medical mysteries, and he aimed to provide his students with an advantage.

> “Essentially, [analyzing art] is akin to conducting a physical examination of a patient,” remarked Braverman. The gallery becomes the exam room, and the artwork represents the patient.

You Might Consider a Museum Visit

Studying remarkable artworks enhances our observational abilities. At Yale, students spend 15 minutes closely examining a designated painting to capture as many details as they can.

Following their observations, students engage in group discussions about the narratives depicted in each artwork.

Braverman emphasizes that 18th- and 19th-century British paintings are particularly suitable for this activity because they frequently tell stories about real historical events. Yet, like patients with unexplained symptoms, they often contain ambiguous or conflicting details.

Visiting a local museum or art gallery could enhance your observational skills.

Engaging with paintings, sculptures, and performance art encourages me to slow down. It compels me to stand (or sit, which I find increasingly necessary as I age) and observe.

This year, for the first time, Braverman replaced the standard post-workshop evaluation with a thought-provoking question: what insights have you gained about yourself as an observer?

Almost every medical student reported that while they initially considered themselves competent observers, they recognized that they had previously only skimmed the surface.

The course has helped them learn to view both the world and their patients more profoundly.

Ultimately, I view my museum visits as moments of mindfulness. (And honestly, it's less challenging than vinyasa flow yoga for me.)

The Extraordinary Discovery of Nitroglycerin

Have you heard of nitroglycerin? Nitroglycerin alleviates angina (chest pain) caused by coronary artery disease.

This medication is also effective in relieving an ongoing angina episode.

Nitroglycerin belongs to a category of drugs known as nitrates. Angina occurs when the heart muscle lacks sufficient blood supply.

The drug operates by relaxing and widening blood vessels, facilitating easier blood flow to the heart. However, nitroglycerin cannot alleviate chest pain once it has already started.

It is also not meant to be taken immediately before engaging in physical activities (like exercise or sexual activity) as a preventative measure for chest pain; other medications might be necessary in those situations.

The Nobel Prize

What comes to mind when you think of Alfred Nobel? For me, it's the Nobel Prize.

> “I’m speechless!” was Maria Ressa’s reaction when Olav Njølstad, Secretary of the Norwegian Nobel Committee, presented her with the 2021 Nobel Peace Prize for her “efforts to safeguard freedom of expression, which is crucial for democracy and lasting peace.”

For over a century, the Nobel Prizes have honored remarkable human achievements across various fields, including literature and science.

The Nobel Prize is awarded “to the person who shall have done the most or the best work for fraternity between nations, the abolition or reduction of standing armies, and for the holding and promotion of peace congresses,” as outlined in the will of its founder, Alfred Nobel.

The announcements for the 2023 Nobel Prizes will take place from October 2nd to October 9th.

Alfred Nobel, Dynamite, and More

However, this narrative has a darker aspect, involving death and destruction. Let me provide some background on Alfred Nobel’s father.

Immanuel Nobel developed the first truly effective sea mines on behalf of the Russian Czar during the mid-19th century, amidst the Crimean War.

Alfred Nobel invented dynamite, not intending for it to be utilized in warfare. Naturally, you are familiar with the rest of the story.

Dynamite was soon employed in the Franco-Prussian War, first by the Prussians and later by the French.

Alfred Nobel, Merchant of Death?

Although many associate Nobel with pacifism, it remains uncertain whether he approved of dynamite’s use in military conflicts.

In 1888, Alfred Nobel's brother Ludvig passed away. A journalist mistakenly published Alfred’s obituary, which criticized him as a man who profited from the deaths of others.

A French publication declared, “Le marchand de la mort est mort,” translating to “The merchant of death is dead.” The obituary characterized Nobel as a man who amassed wealth by devising ways to kill more people at a faster rate.

Shocked by what he read, Nobel resolved to improve his legacy. Just a year before his death in 1896, he signed his last will, which allocated a significant portion of his fortune to establish the five Nobel Prizes, including one awarded for the pursuit of peace.

Nitroglycerin Discovery

Returning to the unusual narrative of heart and erectile dysfunction medications, did you know that nitrate drugs can trigger airport bomb detection systems?

These nitrate-based medications also attract the attention of explosive detection dogs, serving as a reminder of the origins of this highly valuable treatment.

Ascanio Sobrero discovered nitroglycerin in Turin in 1847 while collaborating with Theophile-Jules Pelouze.

Alfred Nobel joined Pelouze in 1851 and recognized nitroglycerin's potential. He began its production in Sweden, successfully addressing handling challenges with his patented detonator.

Interestingly, Nobel suffered from severe angina but declined to use nitroglycerin as treatment.

Nitroglycerin in Medicine: Innovation from Tragedy

Today, nitroglycerin is a medication that dilates blood vessels.

This powerful drug is usually administered sublingually to relieve and prevent angina attacks.

Dr. Ferid Murad (1936–2023), a pharmacologist who received the Nobel Prize in 1998 for discovering nitric oxide—a byproduct of nitroglycerin and an air pollutant—was instrumental in the relaxation of blood vessels.

Dr. Murad’s research began in the 1970s when he started exploring nitroglycerin, the substance that Alfred Nobel, the namesake of the prestigious awards in medicine and other fields, used to create dynamite in 1867.

The narrative of nitroglycerin as a medicinal product dates back to the 1900s. Workers at Nobel’s factory observed an intriguing side effect of this explosive compound.

The workers found that their labor-induced chest pains vanished when they inhaled nitroglycerin vapors in the factory. Consequently, physicians began experimenting with it as a treatment for angina, hypertension, and other cardiovascular issues.

Nitroglycerin became a standard remedy for heart ailments, yet it was only when Dr. Murad investigated it at the University of Virginia (USA) that its mechanism of action was understood.

Through meticulous experiments, Dr. Murad established that nitroglycerin releases nitric oxide, which relaxes smooth muscle cells.

Nitric Oxide and Male Erectile Dysfunction

Dr. Murad’s findings were pivotal in the development of Viagra, a medication that promotes erections by dilating blood vessels.

Viagra enhances erections by increasing blood flow to the penis. Murad’s discovery regarding nitric oxide has also benefited many premature infants, whose underdeveloped lungs require stimulation.

Dr. Murad passed away on September 4th at his home in Menlo Park, California (USA), at the age of 86.

The information provided in this article is for educational purposes only and should not replace professional medical advice. Please consult a healthcare professional for medical advice, diagnoses, or treatments. I hold no responsibility for any risks or issues associated with using or acting upon the information in this article.

Thank you for reading “The Unusual Journey of Heart and Erectile Dysfunction Treatments.”