What Did Surgery Feel Like Before Anesthesia? — Transcript

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1. 0:00At some point in your life, there's a
2. 0:01good chance a surgeon will cut you open.
3. 0:03You'll count backwards from 10, make it
4. 0:05to about 7, and then wake up in a clean
5. 0:07bed with the whole thing already over.
6. 0:09For almost all of human history, that
7. 0:12mercy did not exist. If you needed
8. 0:14surgery in 1842, you walked into the
9. 0:16room awake. You watched them lay out the
10. 0:18knives, and you stayed awake for every
11. 0:20second of what came next. So, what did
12. 0:22that actually feel like? We know the
13. 0:24answer because survivors wrote it down.
14. 0:26And what they described is worse than
15. 0:28anything you're imagining. Let's put you
16. 0:29there. London, 1842. 3 days ago, a cart
17. 0:33wheel crushed your lower leg, and the
18. 0:35broken bone tore through the skin. Now,
19. 0:37the wound has turned dark, and it smells
20. 0:40sweet and rotten at the same time. The
21. 0:42surgeon examines you for less than a
22. 0:44minute. Then, he gives you the only two
23. 0:46options that exist. The leg comes off in
24. 0:48the morning, or the infection reaches
25. 0:50your blood and kills you within the
26. 0:51week. That was the math of surgery
27. 0:54before anesthesia. Nobody went under the
28. 0:56knife for a bad knee or a lump they
29. 0:58could live with. You climbed onto the
30. 0:59table for one reason, because death was
31. 1:02the alternative. And plenty of people
32. 1:03still chose death. Surgeons of the era
33. 1:06wrote about patients who refused the
34. 1:07operation and took their chances with
35. 1:09the rot. And about others who said yes,
36. 1:11then had to be carried in when their
37. 1:13legs gave out. So, you say yes. And that
38. 1:15night, you don't sleep. In the morning,
39. 1:18two assistants walk you up the stairs
40. 1:19because the operating theater sits at
41. 1:21the top of the building under a
42. 1:22skylight. Surgeons needed daylight to
43. 1:24cut by, and the word theater is literal.
44. 1:28Wooden galleries rise around the table
45. 1:29in a horseshoe, packed shoulder to
46. 1:31shoulder with medical students who came
47. 1:33to watch you. The table is plain wood,
48. 1:35stained by everyone who came before you.
49. 1:37Underneath it sits a fresh box of
50. 1:39sawdust. You understand immediately what
51. 1:40the sawdust is for. They give you what
52. 1:42the era has to offer, a glass of brandy,
53. 1:45a dose of opium if you're lucky, and a
54. 1:47strip of leather to bite down on.
55. 1:48Everyone in the room knows none of it
56. 1:50will touch the pain. The brandy is
57. 1:52mostly to keep your legs working long
58. 1:54enough to reach the table. Then, the
59. 1:55assistants take hold of you, one for
60. 1:57each limb. Their entire job is to stop
61. 2:00you from tearing free because patients
62. 2:02always fought, not from cowardice. The
63. 2:04body simply tries to escape the knife,
64. 2:06whether you agreed to this or not. And
65. 2:08we know exactly what happens next
66. 2:10because the patients wrote it down
67. 2:12themselves. In 1811, the novelist Fanny
68. 2:14Burney had her breast removed by
69. 2:16surgeons in Paris with nothing over her
70. 2:18face but a thin handkerchief. Through
71. 2:20the fabric, she watched the polished
72. 2:22steel come down. She wrote, "I began a
73. 2:24scream that lasted unintermittingly
74. 2:26during the whole time of the incision. I
75. 2:29almost marvel that it rings not in my
76. 2:31ears still, so excruciating was the
77. 2:33agony." When the blade reached bone, she
78. 2:35felt it scraping against her breastbone,
79. 2:37and she described that, too. The
80. 2:39operation took about 20 minutes. She
81. 2:41fainted twice from the pain, and both
82. 2:43times she woke back up into the middle
83. 2:45of it. Months passed before she could
84. 2:47write about it without falling ill. She
85. 2:49carried the memory for another 29 years.
86. 2:52A Scottish chemist named George Wilson
87. 2:54survived an ankle amputation a few years
88. 2:56before anesthesia arrived, and his
89. 2:58account might be worse because he
90. 2:59remembered everything with terrible
91. 3:01clarity. His senses, he said, were
92. 3:03preternaturally acute. He heard the
93. 3:05instruments being spread out. He felt
94. 3:07the twisting of the tourniquet, the
95. 3:09first cut, and what he called the
96. 3:11fingering of the sawed bone. But the
97. 3:13line people never forget isn't about
98. 3:15pain at all. He wrote of the black
99. 3:17whirlwind of emotion, the horror of
100. 3:19great darkness, and the sense of
101. 3:20desertion by God and man, bordering
102. 3:23close upon despair, which swept through
103. 3:25my mind and overwhelmed my heart. That
104. 3:28is what surgery felt like, not just
105. 3:30agony, abandonment. The surgeons knew
106. 3:33all of this. Most of them weren't
107. 3:34monsters. They simply had one single
108. 3:37weapon against pain, speed, which brings
109. 3:39us to Robert Liston, the fastest knife
110. 3:42in London. And at University College
111. 3:44Hospital, he turned amputation into a
112. 3:46race against the clock. He could take a
113. 3:48leg off in about 2 and 1/2 minutes, and
114. 3:50students in the galleries pulled out
115. 3:52pocket watches to time him. When both
116. 3:54hands were busy, he clamped the bloody
117. 3:55knife between his teeth. Speed really
118. 3:57was mercy. Less time under the knife
119. 4:00meant less agony and less shock, and
120. 4:02shock killed. Roughly one in six of
121. 4:05Liston's amputation patients died. At
122. 4:07other London hospitals, the figure was
123. 4:09closer to one in four. He was the best
124. 4:12there was, and still the most famous
125. 4:13story about him, one historians argue
126. 4:16over to this day, shows what all that
127. 4:18speed could cost. Racing through a leg
128. 4:20amputation, the legend goes, Liston
129. 4:22sliced through the fingers of his own
130. 4:24assistant. The patient died of gangrene.
131. 4:26The assistant died of gangrene, too. And
132. 4:29a spectator, convinced the flying blade
133. 4:31had stabbed him, dropped dead from shock
134. 4:33on the spot. If it's true, it is the
135. 4:35only operation in history with a 300%
136. 4:38mortality rate. Now, here's the twist
137. 4:41that made this entire world so much
138. 4:43crueler. Surviving the knife was only
139. 4:45round one. Nobody in the 1840s knew
140. 4:47germs existed. Surgeons operated in the
141. 4:50same frock coats for years, stiff with
142. 4:52layers of dried blood, and that crust
143. 4:54was worn with pride as proof of
144. 4:56experience. The smell of the wards even
145. 4:59had an affectionate nickname, the good
146. 5:00old surgical stink. Instruments got
147. 5:02wiped and reused. The sponge that
148. 5:04cleaned your wound had been inside
149. 5:05somebody else's an hour earlier. So, a
150. 5:07few days after the operation, the fever
151. 5:09often came. And when pus appeared in a
152. 5:11healing wound, doctors were pleased.
153. 5:14They called it laudable pus and took it
154. 5:16as a sign of recovery. It was actually
155. 5:17the infection eating you alive. In the
156. 5:19big city hospitals of the era, roughly
157. 5:21four out of 10 amputation patients never
158. 5:24made it out. Most of them killed not by
159. 5:26the operation, but by what came after.
160. 5:28The surgeon James Simpson compared the
161. 5:31odds to war. A man on a hospital
162. 5:33operating table, he said, faced more
163. 5:35chances of death than an English soldier
164. 5:38at Waterloo. Then a Hungarian doctor
165. 5:40named Ignaz Semmelweis proved, with hard
166. 5:43numbers, that when doctors simply washed
167. 5:45their hands, death rates collapsed. The
168. 5:47medical establishment took it as an
169. 5:49insult. A gentleman's hands, they
170. 5:50insisted, could not possibly carry
171. 5:53disease. Semmelweis was ridiculed, his
172. 5:55career unraveled, and in 1865, he died
173. 5:59in an asylum of an infected wound,
174. 6:01killed by the exact thing he'd spent his
175. 6:03life warning about. That was the deal.
176. 6:05Endure the worst pain a human being can
177. 6:07experience, delivered by the fastest man
178. 6:10you could find, then roll the dice on a
179. 6:12fever that killed nearly half the ward.
180. 6:15And then, on one ordinary Friday
181. 6:17morning, the pain simply ended. October
182. 6:1916th, 1846, Massachusetts General
183. 6:22Hospital, Boston. A young printer named
184. 6:25Edward Gilbert Abbott is brought into
185. 6:26the operating theater with a tumor in
186. 6:28his neck. The galleries are full. The
187. 6:30surgeon is John Collins Warren, 68 years
188. 6:32old, a man who has spent his whole
189. 6:34career cutting into screaming patients.
190. 6:36A local dentist named William Morton
191. 6:38shows up late carrying a glass inhaler
192. 6:40filled with ether vapor. Hardly anyone
193. 6:42in the room expects it to work. Morton
194. 6:44has Abbott breathe from the device until
195. 6:46he goes limp. Warren makes the first
196. 6:47incision, and for the first time in the
197. 6:49history of that room, there is silence.
198. 6:51No one is screaming, and nobody is
199. 6:53straining to pin the patient down. Just
200. 6:54a man sleeping quietly while a surgeon
201. 6:56cuts into his neck. When Abbott comes
202. 6:58around, he says he felt no real pain,
203. 7:01just a dull sensation, as if his neck
204. 7:04had been scratched. Warren, the old
205. 7:06surgeon, turns to the stunned gallery
206. 7:08and says, "Gentlemen, this is no
207. 7:09humbug." The news crossed the Atlantic
208. 7:11by steamship within weeks. On December
209. 7:1421st, Robert Liston himself put it to
210. 7:16the test, amputating the leg of a butler
211. 7:18named Frederick Churchill while the man
212. 7:20lay unconscious. Out of pure habit,
213. 7:23Liston still finished in under half a
214. 7:25minute. Then Churchill woke up and asked
215. 7:26when the operation was going to begin.
216. 7:28He didn't believe it was over until they
217. 7:30showed him the stump. For years, a few
218. 7:32surgeons had chased painless surgery
219. 7:33through mesmerism, trying to hypnotize
220. 7:35patients out of feeling the knife.
221. 7:37Liston buried all of it in one sentence.
222. 7:39"This Yankee dodge, gentlemen, beats
223. 7:41mesmerism hollow." You'd think every
224. 7:43surgeon on Earth celebrated. Many of
225. 7:45them refused. Some argued that pain was
226. 7:47a stimulant, something the body needed
227. 7:49in order to survive an operation. During
228. 7:51the Crimean War, a senior British Army
229. 7:53surgeon advised against chloroform on
230. 7:55the grounds that it was better to hear a
231. 7:57man ball lustily than watch him sink
232. 8:00silently into the grave. Others muttered
233. 8:02that enduring the knife was a test of
234. 8:03manhood and that sleeping through it was
235. 8:05cheating. And in 1853, Queen Victoria
236. 8:09herself took chloroform to deliver her
237. 8:11eighth child. Once the Queen of England
238. 8:13had chosen painless, the objections
239. 8:15started to look ridiculous. The other
240. 8:17killer held on longer. Infection kept
241. 8:19emptying the wards until the 1860s when
242. 8:22a surgeon named Joseph Lister began
243. 8:24attacking germs with carbolic acid and
244. 8:26the fevers finally started to fade.
245. 8:28Tonight, a person is lying on an
246. 8:30operating table with their body open to
247. 8:32the lights and they will remember none
248. 8:34of it. Tomorrow, they'll wake up sore,
249. 8:36press a button for painkillers, and
250. 8:38complain about the hospital food. Fanny
251. 8:40Burney would have called that a miracle.
252. 8:41George Wilson would have called it the
253. 8:43end of the great darkness. For thousands
254. 8:45of years, being saved by the knife cost
255. 8:47more pain than most modern humans will
256. 8:49feel in a lifetime. Then, one October
257. 8:51morning in Boston, the price dropped to
258. 8:53nothing and it has stayed at nothing
259. 8:55your entire life. Counting backwards
260. 8:57from 10 and waking up whole, that's the
261. 8:59entire experience now. The people held
262. 9:01down on those wooden tables would have
263. 9:03given anything to trade places with you
264. 9:05and you never even had to ask.