Like most inventions, port wine has a rich history and surprising backstory. The fortified wine received its name in the second half of the 17th century from the Portuguese city of Oporto (now Porto), where the product was primarily brought to market or exported. Although wine was being made in Portugal for centuries, port was discovered much later, once a certain set of circumstances aligned.
In the 1660s, tension between England and France led to the blockading of French ports, boycotting of French goods, and a near-instant shortage of French wine in England. British merchants looked to Portugal as an alternative source. Upon discovering that the quality of wine they sought was not readily available there, the British decided to oversee production themselves. Traveling inland along the Douro River, they found more robust red wines in the Douro Valley, home to a distinct mix of climate, schist-filled soils, and grape varieties. Unfortunately, these wines took longer to transport to England, posing problems with preservation.
To stabilize the wine for shipping, British merchants added brandy to the wine barrels to halt fermentation, thereby yielding higher levels of alcohol and residual sugar and giving port its signature sweet taste. The fortified wine was quickly favored by the British and grew even more popular after the 1703 signing of the Methuen Treaty, which reduced taxation on Portuguese wines imported into England. Ultimately, the discovery, production, and popularity of port wine hinged on a perfect combination of factors, both organic and manufactured.
Innovation occurs in an ecosystem. For better or for worse, the right conditions are required for an idea to be conceptualized, for a product to be developed, for a new approach to be tested, for third parties to recognize value, for experts to embrace change, for consumers to gain access, and so on. In health care specifically, a system of checks and balances is undeniably essential, but it sometimes seems like the obstacles to innovating are insurmountable.
In this issue of GT, contributors discuss a range of threats in the interventional glaucoma landscape. From innovation to daily practice, several areas of glaucoma care are made significantly more challenging by politics and policies. Despite this, physicians keep at it, seeking to push the boundaries, challenge the status quo, and advance the space. Although daunting, sometimes great discoveries are made against all odds.
