Destiny of the Republic - Candice Millard [81]
Not only did many American doctors not believe in germs, they took pride in the particular brand of filth that defined their profession. They spoke fondly of the “good old surgical stink” that pervaded their hospitals and operating rooms, and they resisted making too many concessions even to basic hygiene. Many surgeons walked directly from the street to the operating room without bothering to change their clothes. Those who did shrug on a laboratory coat, however, were an even greater danger to their patients. They looped strands of silk sutures through their buttonholes for easy access during surgery, and they refused to change or even wash their coats. They believed that the thicker the layers of dried blood and pus, black and crumbling as they bent over their patients, the greater the tribute to their years of experience.
Some physicians felt that Lister’s findings simply did not apply to them and their patients. Doctors who lived and worked in the country, away from the soot and grime of the industrialized cities, argued that their air was so pure they did not need antisepsis. They preferred, moreover, to rely on their own methods of treatment, which not infrequently involved applying a hot poultice of cow manure to an open wound.
Even those doctors willing to try antisepsis rarely achieved better results than they had with traditional practices. Their failure, however, was hardly a mystery. Although they dipped their instruments in carbolic acid, they used wooden handles, which could not be sterilized, and they rested them on unsterilized towels. If the surgical knife they had carefully sterilized happened to fall on the floor during an operation, they would simply pick it up and continue to use it. If a procedure required both hands, they would hold the knife in their teeth until they needed it again.
In the midst of the arrogance, distrust, and misunderstanding that characterized the American medical establishment’s attitude toward Lister’s theories, there was a small but growing bastion of doctors who understood the importance of practicing antisepsis, not halfheartedly but precisely. A young surgeon in New York would later write that he and his colleagues had watched with helpless horror the progress of Garfield’s medical care. The president’s life might have been spared, he wrote with disgust, “had the physician in charge abstained from probing Garfield’s wound while he lay on a filthy mattress spread on the floor of a railroad station.”
Even as far west as Kansas, Lister’s followers sought to intervene on the president’s behalf. In a letter to Lucretia the day after the shooting, Dr. E. L. Patee, a highly respected surgeon from Manhattan, Kansas, warned her that she must shield her husband from potentially harmful medical care. “Do not allow probing of the wound,” he urged. “Probing generally does more harm than the ball.” Although he lived far from what was then considered the center of medical thought in the United States, Patee had read carefully Lister’s work and understood its importance. “Saturate everything with carbolic acid,” he begged the first lady. “Our whole state is in … great grief. God help you.”
Unfortunately, young, inexperienced surgeons and rural doctors had little hope of being heard. The morning after Patee wrote to Lucretia, two surgeons arrived at the White House, summoned there by Bliss. David Hayes Agnew, the chief of surgery at the University of Pennsylvania, and Frank Hamilton, a surgeon at the Bellevue Medical College in New York, were “old men,” an American doctor would write, “and not likely to be pioneers in a new field of surgery.” Both men had attended Lister’s talk at the Centennial Exhibition, and both had made it clear that they distrusted his ideas. So vigorously had