Dr: Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine by Cristin O’Keefe Aptowicz
Published September 2014 by Gotham Books
Hardcover; 371 pages
Genre: Non-fiction, Biography, History, Science, Medical
Source: Personal Collection
Imagine undergoing an operation without anesthesia performed by a surgeon who refuses to sterilize his tools—or even wash his hands. This was the world of medicine when Thomas Dent Mütter began his trailblazing career as a plastic surgeon in Philadelphia during the middle of the nineteenth century.
Although he died at just forty-eight, Mütter was an audacious medical innovator who pioneered the use of ether as anesthesia, the sterilization of surgical tools, and a compassion-based vision for helping the severely deformed, which clashed spectacularly with the sentiments of his time.
Brilliant, outspoken, and brazenly handsome, Mütter was flamboyant in every aspect of his life. He wore pink silk suits to perform surgery, added an umlaut to his last name just because he could, and amassed an immense collection of medical oddities that would later form the basis of Philadelphia’s Mütter Museum. [Via Goodreads]
My mother is a surgical nurse. She has been my entire life and so it isn’t uncommon for us to discuss unseemly things across the dinner table– diagnoses, incisions, accidents requiring surgical intervention, how certain parts of the body work and how a surgery is performed. I am no stranger to surgical talk and I think that may have played a part in why this book was so fascinating and important to me.
In the early 1800’s, at the dawn of modern medicine, there was no anesthesia. Surgical proceedings were not only viewed by onlookers both looking for educational credits but also gawkers with an interest in the macabre and the patient, well, they did the best they good on sips of strong wine and the physician operated as quickly and efficiently as possible. Additionally, there was no cleaning of surgical instruments before or after an operation. The operating table was often covered with blood from a previous poor sap. Physicians wore their blood spatters like badges of honor. What’s more is that once the operations were complete, a patient was sent on their (un)merry way with absolutely no post-operative care or follow up. It goes without saying that a lot of procedures were hit or miss given the contamination of the operating room, tools, even hands of the physicians as well as the lack of follow up care. Infection ran rampant and some physicians mistakenly thought a pus covered wound was a good sign of healing. Oh, boy.
Then, comes Dr. Thomas Dent Mütter. Though there were many physicians who paved the way for modern medicine to become what it is today, in my opinion, Dr. Mütter’s is the most important. He advocated for the cleanliness of surgical instruments to safeguard against infection and even created his own post-op wing where patients could be monitored closely and recover fully before being transported anywhere. In addition to this, he taught each of his students that being a good physician was about taking care of the patient properly–which included treating them like a human. People with serious disfigurements in the 1800s were not treated kindly. The term for them was “monsters” and many physicians only cared about performing the procedure and very little about outcomes or how it affected the patient. Mütter advocated compassion to his students.
He taught them that the patients who flocked to the clinic for care were not to be defined by their diseases, or their injuries, or their deformities. They were not mysteries to be solved, or cases to add to the docket. They were people, humans. They had names and families, and–maybe if they doctors did their jobs right–they would each have a future too. A good future–one made better by the help these gentlemen should feel privileged to provide.
But this book is so much more than just the account of Dr. Mütter’s additions to the medical community, it discusses some of his colleagues, predecessors, and students along the way–like George McClellan who founded the Jefferson Medical College in 1824 and insisted that all students must take an active part in the care of patients. Up until this point, education had never been hands-on. Students took what information they could glean from lectures and watching procedures and, upon graduation, had often never laid a finger on a single patient! Shortly after, the medical community began to rethink the standards of receiving a medical degree. Did you know that at the time, each test you took was different? One school may be easier, another more difficult and both of them could be entirely inaccurate due to lack of standardization of the materials being covered? It’s true.
In addition to McClellan, there was Edward Robinson Squibb who designed the first ether apparatus to deliver a uniform strength of ether and thereby standardizing the dosage of ether given to patients. (Until this time, it had been fairly willy-nilly and depending on what brand you purchased some might be stronger–and could kill a patient, and some might be too weak–requiring the poor patient to undergo more ether anesthesia.) He went on to found E.R. Squibb & Sons, a pharmaceutical company, known today as Bristol-Meyers Squibb. He became an advocate for transparency between patient and health-care provider and between doctor and medicine supplier. Because of this, he was instrumental in the movement that gave us the first federal Pure Food and Drug Act in 1906. It was the first in a series of consumer protection laws that required drugs to be labeled with their active ingredients.
Another student, Francis West Lewis went on to create the Children’s Hospital of Philadelphia that began as a tiny, twelve bed hospital and has continued and grown to this very day. Meanwhile Jonathan Letterman earned the “father of battlefield medicine” title thanks to the innovations he developed while a Civil War surgeon. He introduced a concept you may find yourself familiar with if ever in need of visiting the emergency room: triage–a system of organizing patients into groups of those who will live regardless of their wounds and those who would surely die because of them.
Dr. Thomas Dent Mütter’s legacy lives on in many ways today, most especially at the Mütter Museum located in Center City Philadelphia. Originally opened in 1863 to house his vast collection of medical oddities collected during the course of his works it has grown in size enough to move locations and remains open today.
For me, as someone who has grown up in the healthcare industry, this was an incredibly fascinating read about the development of innovative ideas that have helped make modern medicine what it is today. It is not for the faint of heart (or stomach, I suppose) but if you enjoy history, medical things and maybe just a little bit of the macabre, I think you will enjoy this too.