Stepping Back in Medical History: A Groundbreaking Surgeon’s Battle With the Establishment

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Title: Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine
Author:  Cristin O’Keefe Aptowicz
Publisher: Gotham Books
Publication date: September 8, 2015
Price: $17.00, paperback; 384 pages

In the late 1740s, John Wesley—a British evangelist and cofounder of Methodism—published An Easy and Natural Method for Curing Most Diseases. His tome gave regular people ways to cure themselves by using items they could find in their homes. When in doubt, Mr. Wesley proffered that drinking cold water or taking cold baths could cure most illnesses, including breast cancer.

Although Mr. Wesley’s faith in a cold water cure for breast cancer is a brutally primitive misadventure to today’s oncologists, it is bracing to imagine what it must have been like for those early doctors who were working in a veritable vacuum of medical information. The trial-by-error road leading to the wonders of modern science and technology that contemporary physicians are armed with was painful, wacky, courageous, brilliant, and illuminating. 

Eccentric Physician

In a first-ever biography titled, Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine, Cristin O’Keefe Aptowicz
chronicles the life of the eccentric, groundbreaking physician, Thomas Dent Mütter, MD, who revolutionized surgery and founded America’s first museum of medical oddities. Dr. Mütter, born in 1811, grew up as an orphan in the Antebellum South, an age when death hovered perpetually overhead—a grim fact he was intimate with. By the time he was 7, his mother, father, brother, and grandmother had all died of disease, and he himself was chronically ill as a boy.

Despite his difficult beginnings, he was, by all turns, brilliant, handsome, charming, and ambitious. Since childhood, he longed to become a doctor, and by force of will he worked his way through an undergraduate degree at Hampden-Sydney College in Virginia.

In 1931, he earned his medical degree from the University of Pennsylvania. To get an MD in those years, a student had to attend at least one course of lectures in anatomy, pharmacology, chemistry, and the theory and practice of healing; do a 1-year hospital internship; and be examined by medical trustees and professors. And there were three other requirements for medical students—an applicant had to be at least 24 years old, white, and male.

After receiving his MD, Dr. Mütter left for Paris where he studied radically avant garde plastic surgery under the European masters. It was a career-changing experience, in which he performed surgery on severely deformed patients—people the public at that time classified as “monsters.”

Thereafter, Dr. Mütter became a revolutionary figure whose compassion-based philosophy and innovative surgical ideas and breakthroughs clashed with the medical constraints of the era. Returning from Paris, Dr. Mütter joined the faculty of Jefferson Medical College, where he became renowned for his operations on clubfoot, cleft lip and palate, congenital anomalies, and mutilating injuries.

Details Over Action

Ms. Aptowicz is adept at weaving the narrative through the historical inflection points. However, she occasionally overwrites a section, favoring details over action as if they were equals. In a book about a swashbuckling surgeon, they are not. But that is a small complaint.

Dr. Mütter’s Marvels is based on more than 15 years of research, and Ms. Aptowicz has done a fine job in conflating medical history, clinical procedures, and the major medical personalities of the day into a highly readable book, replete with more than 70 startling illustrations and fascinating period detail.

She also gives the reader a front row seat to the evolution of American medicine: bleedings and leachings, surgeries performed on fully conscious patients, the standardization of medical schools, the institution of pre- and postoperative care, the discovery of anesthesia, and the medical community’s stubborn resistance to antisepsis.

As Ms. Aptowicz points out, doctoring was a tough profession in the early 1800s—not for the faint of heart. She writes, “The simplest thing could end your life: a broken bone from a fall, a leg gouged by a nail, a hand burned by a pot of boiling soup.… Then there was a host of diseases such as cholera in which the affected person retched liter upon liter of fluid that looked like rice water and smelled like rotten fish.” The author is skilled in atmospheric prose that will bring the reader back in time, some of which might be hard to read for those with a sensitive stomach.

Put yourself in this patient’s situation: “On one occasion, a Jefferson Medical College professor attempted a daring removal of a patient’s upper jaw, using marvelous speed to incise and rip out bones with a huge forceps. But the surgery was perhaps too much to witness by the gallery. Doctors who were present would later recall the spectacle of it;  the patient spat out blood, bones, teeth, while unnerved students in the audience vomited and fainted in their seats.”

A Riveting Saga

What makes this an interesting read for The ASCO Post audience—especially surgical specialists—are Dr. Mütter’s brave innovations and the battles he waged against the medical establishment’s dogged resistance to change, even if that change had proven benefits for the patient.  It is a riveting saga that runs deep through medical history.

Another compelling narrative thread is the struggle Dr. Mütter led to treat patients, notably the poor, with compassion and dignity, a medical principle way before its time. For urging compassionate care, his fellow doctors publicly mocked him.  One of the more compelling examples of Dr. Mütter’s character and courage was his public chastising of one of medicine’s prominent superstars: a misogynist (by today’s standards) named Charles D. Meigs, MD, who routinely humiliated women during his gynecologic lectures in front of all-male classes.

The author writes:

‘Women posses a peculiar trait—it is modesty. But scan her position in civilization, and it is easy to perceive her intellectual force is different from that of her master and lord.… She is still in bonds, manacled by her own inferiority to man,’ said Dr. Meigs as he casually positioned the female patient for maximum exposure. Much to his credit, Dr. Mütter, at great professional risk, publicly challenged Dr. Meigs, calling his ideas, ‘lazy, often inaccurate, callous toward patients, some which are outright harmful, such as his tendency to not only positively deny the contagious nature of the diseases he came across, but to ridicule anyone who opposed him.’

Then there is the sensational aspect of Dr. Mütter’s vast collection of medical oddities, turned into a museum that to this day is a major attraction. There you can view the conjoined liver of the famous Siamese twins, Chang and Eng Bunker. It is also the only place where members of the public can view slides of Albert Einstein’s brain.

There is much more, but it is a mere sideshow to the main event. In the end, Dr. Mütter was a great doctor, one who deserves to be praised for his courageous innovations and his humanity toward his patients. Even today, health-care professionals can learn from and be motivated by his legacy. Dr. Mütter’s Marvels is highly recommended. ■