Recently, a friend of mine posted the following status update on Facebook: “ [I just] finished Team of Rivals: The Political Genius of Abraham Lincoln by Doris Kearns Goodwin.1 What a glorious read. Why was history so blah in high school, when in fact it is rich with fabulous characters and intrigue.” Yet Dr. Goodwin’s book is far more than simply an intriguing story well told. It is extensively researched and is drawn from the work of other authors writing about Abraham Lincoln’s cabinet as well as new finds from primary archival sources. It is the synthesis of this research that generates new insights into the character of Lincoln, the members of his cabinet, and, to some extent, ourselves.
Unfortunately, my friend’s experience with high school history is all too common. History is taught with an emphasis on testable material: names, dates, and major occurrences. This misses the real substance of history, the “why?” It also misses the fundamental point of history: what does it mean to be human? Of what are we capable? Both good and bad? We learn about ourselves by studying human behavior throughout history. When done properly, such as in Dr. Goodwin’s book, history becomes the story of real people faced with decisions and playing a part in momentous events. It is both their and our story.
In this issue of Anesthesia & Analgesia, Dr. Rajesh Haridas has created a similarly interesting story surrounding the first images of William Thomas Green Morton’s inhaler.2 On October 16, 1846, Morton anesthetized Gilbert Abbott for the removal of a jaw tumor. The surgery was performed by Massachusetts General Hospital (MGH) surgeon and Harvard Professor John Collins Warren. It is from this demonstration of the power of ether to render a patient insensible to the noxious effects of surgery that the news of surgical anesthesia traveled. Letters from Boston crossed the Atlantic by steamship to Great Britain and France, the leading countries in medical science. It was in Great Britain and France that Morton’s discovery was rapidly validated and incorporated into the clinical practice of medicine.
Despite the often-told story and its origins here in the United States at a very prestigious institution, MGH, there are details yet to be discovered. Charles Thomas Jackson, a physician and geologist, who was Morton’s landlord at the time, claims to have told Morton about the powers of ether and suggested that he use it to anesthetize patients in Morton’s dental practice. After October 16, 1846, Jackson claimed credit as the discoverer of surgical anesthesia and sought to have his claim recognized in Europe over Morton. This is why Jackson wrote the letters that Dr. Haridas quotes in his excellent monograph.
What is the story behind the story? Like other good historians, Haridas started with questions about the discovery of anesthesia. One of the most intriguing issues centers on Morton and Jackson. They knew each other well because Morton rented rooms in Jackson’s house. Yet Jackson was not present in the amphitheater at MGH that October morning. How did he justify credit for the discovery? In seeking an answer to this question, Dr. Haridas spent some time reading the original source material: Jackson’s letters from the archive of the Smithsonian Institution in Washington, DC.
Having studied the question for some time, and having looked through the finder’s guide to the Jackson letters online, Haridas went to read the actual correspondence for himself. Undoubtedly, there was a momentary pause as Dr. Haridas, paper in hand, realized he was holding a letter actually written by the historical figure he had researched. Carefully reading the letter, he noticed a small doodle in the corner of the sheet of paper and recognized, from the date of the letter, and his knowledge of the existing documents, that this was the first known illustration of Morton’s ether inhaler. Heart racing from the thrill of discovery, Dr. Haridas rushed to make a copy of the illustration and to figure out what was the best way to share this discovery with the rest of the world.
The “ah ha!” moment of discovery links historical, clinical, and basic science research. All are driven by questions generated in the mind of the investigator, who demands answers. Seeing the data firsthand that confirms the hypothesis is a very special reward. For historians, touching the past through original documents, and in them finding bits of information missed by others, is a special treasure.
Yet after discovery is the next challenge, communicating the results to the world. In both basic science and clinical studies, the format of communication is very well delineated with introduction, materials and methods, results, and discussion sections. For the historian, the challenge is to express the new data in a compelling narrative that holds the reader’s interest. The “story” is integral to the “history.” Without a standardized format for historical papers, the academic historian is faced with the demanding task of composing an account that fully communicates the magnitude of the discovery within the confined structure of a scientific biomedical journal. However, it must be done. The joy of discovery is not complete until the historian has experienced the pleasure of telling the entire story.
Does history make a physician better at his or her chosen specialty? Perhaps. When we learn about the actions, behaviors, and motives of the founders of our specialty, we also learn something about ourselves. We care for patients daily, guiding them through the anxious, yet precious, moments before they drift into the anesthetic state. We must quickly establish trust and rapport if we are to shepherd our patients through this critical and, sometimes, life-altering event. Knowing the struggles of the past, and learning from them, allows physicians to be better humanitarians. If our feet are firmly planted in the past, anchored in the knowledge of who we are, and how we arrived, then we are better able to know who we are today. We are grounded, so we can reach for the stars.
Historians like Dr. Haridas spent hours, days, weeks, and even years in musty archives, seeking fragments of knowledge from scraps of paper. Dr. Haridas has literally touched our past. In the process, he ensures our future.
Name: Douglas R. Bacon, MD, MA.
Contribution: The work is mine alone.
Attestation: I attest to the integrity of the original material.
This manuscript was handled by: Steven L. Shafer, MD.