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Anesthesiology:
doi: 10.1097/ALN.0b013e3181f56044
Education: Mind to Mind

Apollo: God. . . and Anesthetist?

Pelavski, Andrés D. M.D.*

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A
AS OCCIDENTALS, we are the heirs of Ancient Greek civilization. Given that the practice of anesthesia is considered less than 200 yr old, it seems hard to believe that the unusual idea of putting someone to sleep during a painful medical procedure was actively discussed and intricately imagined more than 25 centuries ago. Yet the Greek myths tell us of a Homeric warrior named Philoctetes who was anesthetized and operated on by the gods.
During the expedition to Troy, Philoctetes was abandoned at the island of Lemnos because of his painfully infected foot. The noxious odor of the wound was the reason the famous and cunning Odysseus convinced the Greeks to banish him. Other versions of the story hold that Philoctetes was abandoned because of his cries of pain, which endangered the would-be heroes because the noise desecrated their preparatory rituals and sacrifices. In any case, not until 10 yr later did the Greeks realize through a prophecy that they could not defeat Troy without Philoctetes' special bow. Then they began to remember him sympathetically, and eventually Odysseus returned to Lemnos to find him.
How Philoctetes was convinced to rejoin the people who had rejected, scorned, and abandoned him is the subject of Sophocles' tragedy by that name. In his dramatic retelling of the story, Sophocles (better known for writing “Oedipus,” on which Freud based his famous Oedipus complex theory) highlighted the importance of sleep in the healing process.1 In addition, playgoers find that Philoctetes made good use of his time at Lemnos, learning to treat pain with herbs. As a result, the play and the story on which it was based address the practice of anesthesia and pain management thousands of years before they became standard practice in patient care.
Philoctetes eventually agrees to go to Troy, use his bow, and become a hero. One version of the story has it that, after his arrival on the battlefields of Troy, Philoctetes is put under deep hypnosis by Apollo while a son of Asclepius, the god of medicine, cuts the dead tissue with a knife, washes the wound with wine, and heals it with a secret plant his father had given him.2 The Greek god Apollo can therefore be seen perhaps as the first anesthetist.
The myth of Philoctetes has puzzled and stimulated the clinical imagination of many doctors. In fact, many have attempted to retroactively diagnose his strange wound.3–5 However, the main goal of the current article is to call attention to the fact that the idea underlying any anesthetic procedure was already present in ancient Greece.
Although it now seems completely natural that patients are put to sleep for operations and procedures, it was an idea that was not so readily evident 25 centuries ago when medicine was struggling to develop as a scientific discipline. Just as the myth of Icarus and the sketches of Leonardo da Vinci are considered forerunners of the airplane, the practice of anesthesia has its own foundation in the poetic realm of Greek myth through the story of Philoctetes.
There is a beautiful hymn dedicated to “The Sleep” in Sophocles' tragedy. In an era where the role of the anesthetist often fades into the background of the common imagination—largely as a result of the insignificant role it is provided in many television medical dramas—it is extremely validating for me, as an anesthetist, to imagine a chorus of fellow citizens singing and dancing praises to “The Sleep” as if it were a god—and to envisage an audience moved to the point of catharsis by the refrain:
Sleep, innocent of pain, and of hurt, Sleep;
like a soft breeze come over us
breathing contentment, oh lord,
keep in his eyes
this radiant glow, that now is spreading
Come, Healer, come.6
The author thanks Jaume Roigé i Solé, Ph.D. (Head of Anaesthesiology Department, Vall d′Hebron Hospital, Barcelona, Spain), and Maite Clavo Sebastián, Ph.D. (Professor of Greek Philology, Department of Classical Greek, University of Barcelona, Barcelona, Spain).
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References

1.Jouanna J, Le Sommeil Médecin: Théâtre et spectacles dans l'antiquité: Actes du colloque de Strasbourg, 5–7 November 1981. Strasbourg, Université de Sciences Humaines, 1983, pp. 49–62

2.Grimal P: Diccionario de mitología griega y romana, Barcelona, Paidós, 1981, pp. 200–1

3.Grassi W, Farina A, Cervini C: The foot of Philoctetes. Lancet 1999; 354:1256

4.Urso C, Farella V: An inquiry on Philoctetes's disease. Am J Dermatopathol 1996; 18:326

5.Johnson HA: The foot that stalled a thousand ships: A controversial case from the 13th century BCE. J R Soc Med 2003; 96:507–8

6.Sophocles. Fabulae. Commentary by Hugh Lloyd-Jones and Nigel Guy Wilson. Oxford Classical Texts. Oxonii: E Typographeo Clarendoniano; New York: Oxford University Press, 1990

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