From Questions to Routine: How Medical Innovation Learns to Heal

Introduction

Most genuine medical innovation has faced the same paradoxical path: celebrated as a miracle by some, condemned as a danger by others. Rarely does a new therapy or technology enter clinical practice without scepticism, resistance, or even outright rejection. The story of progress in medicine is not one of straight lines but of steep learning curves.
 
Innovation must prove itself in practice. It must survive the early phase of sub-optimal use, and it must mature through evidence, refinement, and experience. In this process, one truth has consistently emerged: medical innovation is most effective when applied to the right patient, at the right time, in the right dose. Defining those three conditions is never instantaneous—it requires courage, persistence, and the willingness to learn from failures as much as from successes.
 
The following case studies, drawn from different eras of medical history, illustrate how groundbreaking ideas moved from suspicion to standard practice. They show how opposition shaped innovation, and how each generation of clinicians has ultimately learned to trust new tools—once their optimal use became clear.
 
Anesthesia: The Battle Against “Unnatural Sleep” (1840s)
 
In October 1846, dentist William T. G. Morton demonstrated the use of ether for surgical anesthesia at Massachusetts General Hospital. The event became famous as the “Ether Dome demonstration,” a milestone that changed surgery forever.
 
At first, the reaction was euphoric. For the first time, patients could undergo surgery without the agony that had defined the field for centuries. Yet almost immediately, resistance arose. Some physicians and clergymen argued that pain was a divine necessity, not something to be artificially suppressed. Others feared the safety of ether and chloroform, noting unpredictable dosing, respiratory complications, and even deaths.
 
One of the most vocal critics was the London obstetrician Charles Meigs, who declared that “pain is no evil, if it be necessary.” In the United States, religious leaders warned that anesthesia in childbirth interfered with God’s will. Even among surgeons, many were hesitant to embrace the practice, citing the risk of explosions, suffocation, or malpractice.
 
Over time, however, the benefits were impossible to ignore. Techniques for administration improved, and safer anesthetic agents were developed. Within decades, anesthesia became inseparable from surgery. The early fears, though understandable, had given way to one of the greatest humanitarian advances in medical history.
 
The lesson was clear: only through repeated attempts, refined dosing, and the personalized utilisation based on every patient’s individual physical constitution could anesthesia transition from a dangerous experiment to indispensable tool.
 
Insulin: From Crude Extracts to Lifesaving Precision (1920s)
 
Before 1921, a diagnosis of type 1 diabetes was essentially a death sentence. Patients – often children – could only be managed temporarily with starvation diets. That year, Frederick Banting and Charles Best, working in Toronto, isolated insulin and successfully treated diabetic dogs. Their discovery quickly moved into clinical practice, with the first human injection administered in 1922.
 
The results were astonishing: children near death regained weight, energy, and life. Newspapers hailed insulin as a miracle. But the early years were not without complications. The first insulin preparations, derived from animal pancreases, were impure and often caused painful reactions or abscesses at injection sites. Dosing was extremely difficult, with episodes of severe hypoglycemia sometimes proving fatal.
 
Some physicians were hesitant to adopt the therapy, worrying that it was too unstable and dangerous. Others pointed to the challenges of mass production and questioned whether the results could be reliably reproduced.
 
Despite these obstacles, the trajectory was unstoppable. Improvements in purification and later the development of recombinant human insulin transformed treatment. Over time, long-acting and rapid-acting analogues allowed fine-tuned regimens tailored to individual patients.
 
The principle held true: finding the right dose for the right patient was the key to turning a crude and risky therapy into a cornerstone of modern medicine. Today, insulin stands as one of the most powerful examples of how persistence through a steep learning curve can yield extraordinary, life-saving results.
 
Contemporary Lesson: mRNA vaccines and robotic-assisted surgery
 
The same cycle is not confined to history – it continues today.
 
mRNA vaccines, developed over decades, were long dismissed as unrealistic. Critics argued they were too unstable, too experimental, and impossible to scale. Yet when COVID-19 struck, the technology rapidly proved itself, delivering safe and effective vaccines in record time. While initial public skepticism and resistance were widespread, accumulating real-world evidence established mRNA vaccines as a new platform with potential far beyond the pandemic.
 
Robotic-assisted surgery has faced similar scrutiny. When first introduced, many surgeons argued that the machines were unnecessarily complex, too costly, and inferior to human skill. Outcomes in the early years were mixed, reinforcing doubts. Yet as experience accumulated, specific indications emerged—such as prostatectomy and gynecological procedures—where robotics offered real advantages. Today, robotic surgery is steadily expanding, not as a replacement for surgeons, but as a refined tool when applied to the right patient at the right time.
 
Both examples highlight how, even in the 21st century, innovation must pass through the same learning curve of skepticism, refinement, and eventual trust.
 
Conclusion: The CytoSorb Journey
 
From anesthesia to insulin and, most recently, mRNA vaccines, the pattern is unmistakable: every medical breakthrough has faced resistance, not because of ignorance or malice, but because true progress demands careful testing, refinement, and proof.
 
CytoSorb is not different from other great innovations in medicine: it has followed the same learning curve. Early on, results were inconsistent because the right patients, timing, and dosing had not yet been fully realized. That does not mean the therapy does not work – it means we were still learning how to best use it. Today, with more than 1,000 publications in our literature database, nearly 300,000 treatments with no reported safety issues, tools like CytoScore, and our recently updated guidelines, we can define patient selection and timing much more clearly.
 
The key is to recognize that CytoSorb, like other advancements in medicine before it, unfolds its full power only when used in the right patient, at the right time, and in the right way. What once caused uncertainty is now turning into confidence – as this is the natural path of every true medical innovation.
 
But our journey is not finished. We know far more now than we did ten years ago, and with the right utilization we are achieving better and better results more consistently. But learning in medicine never ends. The next decade will bring deeper insights, broader clinical experience and evidence, and new tools to guide therapy. History suggests only one direction: more clarity, more confidence, and more patients helped at exactly the right, often the most crucial moment.