Throwback thursday| 2019-11-07 Ortó Eszter

Dr. Robert Liston, “the fastest knife in the West End”

Surgical procedures still fill people with fear even today- imagine what they must have felt back in the day, before the invention of anesthesia, when surgery looked like something straight out of a horror movie. Today a surgeon’s greatest value is precision but that wasn’t always the case. Back then speed mattered a great deal more – the faster the surgeon was, the less pain the patient felt and the less likely they were to bleed out.

So what was surgery like in the 19th century? Sterilization and disinfection were unknown concepts, just like analgesia and anesthesia. Hospitals did exist even then, of course, but doctors performed surgeries anywhere they could, without a second thought – in tents, taverns or in the middle of lecture halls. Before the procedure the surgical assistant tried to get the patient drunk so they’d be dull and numb, then they pressed the patient to the table as hard as they could. Then the surgeon made the incision, clamped the vessels, sawed through the bone and finally closed up the wound.

The fastest doctor in London could carry out this long and complicated procedure in less than 2 and a half minutes. Dr. Robert Liston (1794 -1847) Scottish surgeon was well known for his speed; a skill that earned him the nickname ’the fastest knife’. He was admired by his colleagues as well due to his fantastic mortality rate- only one-tenth of his patients died. Today this seems like a horrible ratio but back then it was considered miraculous. Liston wasn’t hiding his talent – he often performed surgeries in public, in front of crowds. Before the procedure, he often asked the viewers to count the minutes he needed to carry out the surgery out loud.

His speed often came at the expanse of precision though. He sometimes injured previously healthy body parts and he once accidentally removed a patient’s testicles. He is also said to have performed the only surgery that resulted in a 300% mortality rate. During that fateful surgery, he severed his assistant’s finger and accidentally cut the coat of a spectator as well. The viewer, terrified that the knife struck a vital organ, died of shock on the scene; the assistant and the patient both died of sepsis later.

Liston wasn’t only known for his speed though. He was the first to use ether during surgery in 1846 (American dentists had been using ether as an anesthetic before him). The procedure was successful and it became the milestone we consider to be the beginning of anesthesia in Europe. And even though ether -believed to be a miracle drug back then- wasn’t exactly a perfect solution, it was still an important stepping stone to discovering today’s anesthesia.