- Virginia Johnson
Some people today fear going under the surgeon’s knife. It’s mostly a dread of the unknown. What might happen while they are knocked out, unaware of what is going on around them. They may not realize how fortunate they are. In Dr. Mütter’s Marvels, readers are swept back in time to a period before anesthesia was generally used. A good surgeon was a swift, careful cutter who could make the operation as mercifully short as possible for his wide-awake patient. He might even do some good for the patient in the process.
A patient would be asked three times if he were determined to go through with the operation. Once he gave his permissions, there was no backing out. He (or she) would be cut, even if screaming in protest, held down by as many as five assistants. In the case of teaching hospitals, he would be cut while horrifically awake in full view of eagerly watching students who were taking notes.
This was the way of it, especially in America. Surgeons were more about the brawn and strong will to finish what they had begun than about caring for patients’ outcomes. Once the operation was complete, a patient would be put in the hospital’s carriage, probably bloodied from its last occupants, and carted home, with no hospital stay.
Dr. Thomas Mütter had an important hand in changing all that. Born Thomas Mutter and orphaned at an early age, he was taken in by Robert Carter, a member of one of the wealthiest and most influential families in Virginia—but that doesn’t mean he had access to money. Even as Thomas Mutter was sent to John Lewis’ Llangollen preparatory school in Spotsylvania County, he had his eye on further horizons.
A stylish and brilliant young man, he learned to finesse his circumstances to his best enjoyment, such as winning scholarships to cover his clothing expenditures. Trained as a doctor, he wanted to practice the most difficult surgical arts, and for that, he believed he needed to study in Paris. He also added an umlaut to his name for prestige, becoming Mütter instead of plain Mutter.
He arranged his passage by working his way over as a ship’s doctor. Once there, he absorbed everything, coming to specialize in what became known as plastic surgery. In the 1800s, the need for this surgery was dire. Women and children in particular were prone to something called “hearth death” from falling into the flames of open fires. If they weren’t killed outright, they were maimed for life, particularly in the face. Mütter’s technique for swiftly correcting the horrifying damage to the skin was revolutionary.
He also insisted on treating his patients with kindness, getting to know them well before operating so that they would have less to fear. Probably one of his greatest innovations at Philadelphia’s Thomas Jefferson University was insisting on having a ward where patients could be cared for by medical students and nurses after their operations.
He was a rebel in another very important way as well. In a time when surgeons routinely used the same instruments from operation to operation without cleaning them or wearing fresh clothing, Mütter insisted on better hygiene which naturally led to better patient outcomes.
A brilliant mind who gave much to the world during his relatively short life, one of Mütter’s legacies was his collection of unusual medical specimens, intended to enrich the knowledge of surgeons. The Mütter Museum of the College of Physicians in Philadelphia may still be visited today, and its website is fascinating.
By reading Dr. Mütter’s Marvels, you can get to know this extraordinary person whose philosophy, genius, and fortitude did so much to evolve American surgical techniques. The much-loved doctor, who died at a young age, passed on his humanitarian principles to his students. They continued to improve surgical techniques in the decades to come, even as the drumbeat sounded for the Civil War, where surgeons, North and South, would be needing every bit of skill and principle they possessed.