Medical education itself was becoming more standardized, though major reforms would accelerate after Susan’s training.

This meant Susan was not simply applying a fixed body of western knowledge.

She practiced while medicine was reinventing itself.

Some treatments available to her would now be considered ineffective or dangerous.

Antibiotics did not exist.

Tuberculosis remained a major killer.

Influenza could be devastating.

Childbirth remained risky.

Smallpox and other infectious diseases required vaccination and prevention rather than easy cures.

Travel delays could turn manageable conditions into emergencies.