Book review: ‘Dr. Mütter’s Marvels,’ by Cristin O’Keefe Aptowicz
November 30, 2016
Modern medicine is taken for granted by most in the developed world, with the remarkable discoveries and innovations of the past two centuries woven into the highly technical and advanced system we know today. But, there are many unsung greats from days long gone, men and women who, through trial and error and persistent hard work, profoundly changed the landscape in which they worked, and which, in turn, framed the forward march of medical progress into the future. One of those unfamiliar figures has been pulled very handily from the ether of oblivion by author Cristin O'Keefe Aptowicz in her exceedingly palatable book, "Dr. Mütter's Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine."
Born into a time when even the most common ailment could cause deadly complications, Dr. Thomas Dent Mütter challenged the conventional thinking within the medical community of the early 19th century, and turned the discipline on its head, exhibiting a commitment to the underserved and shunned members of society, those most disadvantaged in a world where any physical deformity meant a life of ridicule and degradation. Sickly himself throughout his short life, Mütter was drawn to medicine to improve life's lot for others. Aptowicz describes him as exceedingly brilliant and though he battled with his own health, "he continued struggling under the oppression of the severest bodily infirmities to elevate the science to which he was devoted and to relieve the miseries of others."
Europe, Paris in particular, was seen as the epicenter of medical research, both academic and practical, and it was there, in his early career, that Mütter discovered "la chirurgie radical" or "radical surgery," from which modern day plastic surgery evolved. The new techniques were all the rage in the French capital, with the goal being to provide ostracized individuals, who were labeled "monsters" by society, a chance at a normal life. Mütter saw the new medical frontier as an opportunity to fill a neglected niche in treatments back in his home city of Philadelphia.
The early 19th century was a tough time to be a patient. Doctors could practice without a license, so "quacks" were a real problem, and those who knew what they were doing had to manage in challenging conditions, with a lack of basic knowledge of the human body and no awareness of the pathogens eagerly lurking in the unhygienic settings that were so common. Surgeries were done by lamp or candlelight, and, worst of all, anesthesia was not yet in use, so the most intense pains had to simply be endured, though it did lead to an overuse and abuse of alcohol, laudanum and opium.
Because patients were awake and the pain was immense, Mütter trained himself for speed. Too quickly, and mistakes could be made, too slowly, and the patient might lose consciousness, which could increase some hazards, like choking. Also, Mütter was unique for the era, in that he was highly aware of the suffering of those who came to him, so much in need that they were willing to risk their lives to alleviate their misfortunes.
Aptowicz deftly paints the grim backdrop of Mütter's steady rise through the staid and structured medical hierarchy of Philadelphia, which was deeply steeped in tradition and profoundly resistant to change. Scattered throughout the book, among the fascinating details of Mütter's life, both professional and personal, are an astonishing number of illustrations, photographs and drawings, which truly help to bring to life the formative era in which Mütter established his reputation as a medical pioneer.
Though unaware of the existence of germs, Mütter demanded a clean operating room, and he advocated for post-op recovery rooms, which were non-existent. Above all, he was determined to present a gentle bedside manner, which he believed fostered a more receptive patient and a speedier recovery. He also became a champion for women's health in a world and era run by men who were simply not interested in it.
As Aptowicz says, "Mütter's philosophies and approaches would become an instrumental part of the development of what we now see as the era of modern medicine. … One hundred and fifty years after his death, Thomas Dent Mütter's legacy does not rest. It lives on in the surgical techniques he created and which are still being used today." Aptowicz, with her engaging and deeply researched book, has recalled Mütter to his rightful place in the history.
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