Let’s open our latest post with this little attention grabber;

“The horror of great darkness, and the sense of desertion by God and man, bordering close on despair, which swept through my mind and overwhelmed my heart, I can never forget, however gladly I would do so. During the operation, in spite of the pain it occasioned, my senses were preternaturally acute, as I have been told they generally are in patients in such circumstances. I still recall with unwelcome vividness the spreading out of the instruments: the twisting of the tourniquet: the first incision: the fingering of the sawed bone: the sponge pressed on the flap: the tying of the blood-vessels: the stitching of the skin: the bloody dismembered limb lying on the floor.”

The preceding is a patient’s account of an amputation performed in 1843, before the time of anesthesia – and is part of Two Hundred Years of Surgery, one of a series of articles marking the 200th anniversary of the New England Journal of Medicine.

Written by Dr. Atul Gawande, author of Complications: A Surgeon’s Notes on an Imperfect Science and Better: A Surgeon’s Notes on Performance (both available thorough our on-campus and virtual bookstores), Two Hundred Years looks at the evolution of this invasive branch of the healing arts – from violent procedures of frequently dubious value, to the mercifully more refined practices in use today.

(Not to say all the problems have been solved of course. Even as Gawande records the advances in patient outcome that came with anesthesia and antisepsis, his accompanying video notes that survival rates after surgery are still worse than those after traffic accidents, and that the simple addition of a ‘pre-flight’ checklist in the operating room can significantly increase the patient’s chances.)

The video, article, and an accompanying interactive timeline combine for an engaging presentation – of interest to surgeons and the lay reader (not to mention potential future patients from both groups).