Sweet Dreams Are Made of This

Before everything changed one day in Boston—the morning of October 16,

1846, to be exact--surgery held horrors a modern person cannot fully

imagine. Here’s a glimpse, provided by British writer Fanny Burney in an

1812 letter to her sister, describing her mastectomy nine months earlier.

[When] the dreadful steel was plunged into the breast—cutting through

veins—arteries—flesh—nerves—I needed no injunctions not to restrain my

cries. I began a scream that lasted unintermittingly during the whole time of

the incision—and I almost marvel that it rings not in my Ears still! so

excruciating was the agony. When the wound was made, and the instrument

was withdrawn, the pain seemed undiminished, for the air that suddenly

rushed into those delicate parts felt like a mass of minute but sharp and

forked poniards, that were tearing the edges of the wound—but when again I

felt the instrument—describing a curve—cutting against the grain, if I may

so say, while the flesh resisted in a manner so forcible as to oppose and tire

the hand of the operator, who was forced to change from the right to the

left—then, indeed, I thought I must have expired.

This was the state of medicine before that fall morning, when patients were

often held down on the operating table by men whose only purpose was to

ignore the shrieks, pleadings, and struggles so that the doctor could do his

job, and opium and alcohol were the only agents still considered of any pain-

reducing value. Sadly, the large amounts of alcohol required to bring on

stupefaction usually caused vomiting and even death, while opium was

typically not powerful enough to blot out the sear of the knife.

Even the doctors could barely stand the experience. Looking back in 1897,

one elderly Boston surgeon compared it to the Spanish Inquisition,

remembering “yells and screams, most horrible in my memory now, after an

interval of so many years.” A British surgeon was preparing to amputate a

leg when the terrified patient jumped off the table and ran away; instead of

chasing him down to complete the operation, the doctor was heard to say,

“By God! I’m glad he’s gone.” And as Edward Everett, a Massachusetts

orator and governor, observed, “I do not wonder that the patient sometimes

dies, but that the surgeon ever lives.”

There was, in the words of Julie Fenster, author of Ether Day, “an aura of

constant dismay” around the world of surgery, which is why all eyes were

on William Morton as he strode into the operating theater at the

Massachusetts General Hospital on the day of her book’s title, a strange apparatus

under his arm and what some would call America’s greatest

medical discovery on the cusp of revelation.

Morton was not a doctor but a dentist, and his arrival in the great domed

room at the top of the Charles Bulfinch-designed hospital was the

culmination of many years of false starts and missed opportunities by others,

some of whom might have beaten him there. There was Joseph Priestley, the

British chemist who synthesized nitrous oxide in 1772, or his countryman

Humphry Davy, who became addicted to so-called laughing gas, but not

before noting that it might be useful in surgery, a note no one apparently

read. There were the countless attendees at mid-19th-century public

demonstrations and private “frolics” that showcased and indulged in the

gas’s hilarious properties, events soon joined by affairs featuring the vapors

of sulfuric ether, a liquid that had been around for centuries and which

produced similar effects. There was even Horace Wells, Morton’s erstwhile

dentistry teacher and partner, who’d observed nitrous oxide’s numbing

abilities and had been using it to offer “painless” tooth extractions in

Hartford, Connecticut, for a number of years prior to Morton’s big day. His

mistake had been demonstrating an extraction in front a bunch of Harvard

medical students without hitting quite the right dose. When the patient

groaned, cries of “Humbug!” arose from the crowd, and Wells retreated in

defeat.

That was not to be Morton’s fate. Through a complex series of actions that

some would call chicanery and others entrepreneurial pluck, he had finessed

the use of ether as an inhaled anesthetic, performing his own tooth

extractions from an office in Boston and catching the attention of the

eminent physicians at Mass General. First among them was the hospital’s

chief of surgery, John Collins Warren, the dean of American surgeons, who

invited Morton to demonstrate his technique at 10 a.m. on October 16. The

unsuspecting patient was 20-year-old housepainter Gilbert Abbott, with a

tumor under his jaw in need of removal.

Morton rushed in with seconds to spare, having only just picked up an

elaborate glass, brass, and leather inhaler he’d commissioned for the event.

Word had spread that something important was about to happen, and the

dome’s five tiers were packed with medical students and doctors. Warren,

who had been about to proceed with the operation without Morton, stepped

back and said, “Well, sir, your patient is ready.” After three or four minutes

of breathing ether vapors, Abbott fell into a deep sleep. “Your patient isready, sir,” said

Morton, and Warren made his incision, “about three inches long,” he recalled, “and began

a dissection among the important nerves and vessels of the neck, without any

expression of pain on the part of the patient.” After his work was complete, he stepped

back and turned to the audience. “Gentlemen, this is no humbug.” History had been made,

and the Ether Dome was born.

In the ensuing years, says Mass General archivist Jeffrey Mifflin, some

8,000 operations occurred under the dome, with ether performing its miracle

and the horrors of surgery fading into memory. A new operating theater

opened elsewhere in the hospital in 1867, and the dome became a nurse’s

dormitory and eventually a storeroom. Its historicity was finally recognized

in 1896, the 50th anniversary of Ether Day, and the hospital preserved its

tiers of wooden benches until the 1930s, when the current steel seats went in

for fire safety reasons. The wooden dome itself, with its magnificent north-

facing skylight, was replicated in copper. The room was declared a National

Historical Landmark in 1965.

Open to the public when not in use for faculty meetings, the dome holds a

skeleton and an Egyptian mummy, constant fixtures since its earliest days,

along with a display of surgical instruments and a magnificent portrayal of

the 1846 operation, painted by artists Warren and Lucia Prosperi and posed

for by current doctors and staff in period clothing and facial hair, courtesy of

Emerson College’s performing arts department. Look closely and you will

see, in the calmness of Gilbert Abbott, the dawn of a new age.