Digging Up the Dead: Uncovering the life and times of an extraordinary surgeon, by Druin Burch, Chatto & Windus, 拢20 (ISBN 9780701179854)
In the days before anaesthetic, a good surgeon was indifferent to the screams of his patients and might well have learned his trade on corpses stolen from graves. So how did surgery become a scientific profession in the early 1800s, asks Sam Kean
You don鈥檛 often read about the poet John Keats鈥檚 fascination with gouging out bats鈥� eyes, but that is the fun of Druin Burch鈥檚 Digging Up the Dead. The gore in this account of the early days of surgery is slasher-movie quality, the torture as voyeuristic as any in Dante.
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Besides being disgustingly entertaining 鈥� active readers will make dozens of exclamation points in the margins for all the times someone is strapped down for 鈥渞outine鈥� surgery 鈥� the book succeeds in making something mundane, the human body, seem a cavern of disease and despair. 鈥淣othing is quite so strange as that which is half familiar,鈥� Burch writes, in what could be the book鈥檚 motto. He does the same in exposing the profession鈥檚 unseemly past. Surgeons had to learn their art by dissection and relied on bodysnatchers to serve up a constant supply of cadavers: only executed criminals could be cut up legally. When corpses were in short supply, some even turned to thuggish entrepreneurs who drummed up more using chloroform and clubs.
鈥淲hen corpses were in short supply, thugs drummed up more using clubs鈥�
Today, these shocking stories are valuable history. Burch captures the era through the life of one man: Astley Cooper, in his day (1768-1841) the world鈥檚 pre-eminent surgeon, who, for reasons that remain a mystery, also used his eminence to advance the teenage Keats鈥檚 soon-abandoned medical career.
Burch proposes three qualities that contributed to Cooper鈥檚 renown. First, his incredible technical skill, gained through an obsessive devotion to dissection: at different points, he slices up kangaroos, a whale beached in the Thames and a pile of eels before church on Sunday. Bloody work, but Cooper believed that an intricate knowledge of bodies was vital for surgeons. Given the butchery his less devoted colleagues pulled off, he may have been right.
Cooper鈥檚 second 鈥渟kill鈥� was the ability to believe what was convenient. Once a passionate democrat (he admired the French revolution, even after visiting Paris during the Terror), he regularly ignored his principles to advance his career. Other demerits included a taste for execrable puns and pranks such as hiding monkey bowels in a friend鈥檚 make-up kit. Burch calls him a 鈥渧ain, egotistical, nepotistic and rather wonderful old man鈥�.
The third quality was more ambiguous: a chilly indifference to screams of pain that was, in the days before anaesthetics, an advantage to a surgeon. Cooper鈥檚 animal vivisections fall into the same category: he was constantly tying off rabbit arteries or puncturing dog testicles just to see if the subjects recovered.
The cruelty involved in these and other experiments is obvious, but they provided surgeons with the knowledge they needed for surgery to emerge as a legitimate discipline in the early 1800s. Surgery combined, says Burch, 鈥渢he flexibility of the arts, the technical knowledge of science [and] the sense of purpose of the church鈥� 鈥� an attractive combination for the ambitious.
As a doctor himself, Burch evokes the tensions between brutality and beautiful science by informing the historical narrative with his own memoirs. For example, he draws parallels between his own and Cooper鈥檚 experience of inflicting, and ignoring, pain. Digging Up the Dead is also full of pithy writing that reflects his medical experience: one man鈥檚 fluid-filled lungs crackle wetly with every breath.
Burch also shows how the emergence of professional surgery and of democracy in the UK in the 1820s were linked. The British government greatly expanded voting rights in 1832 but eviscerated any goodwill among the common people by immediately passing the Anatomy Act, which granted surgeons the right to dissect unclaimed bodies. A shortage of bodies had become a crisis by then, and hundreds of new surgeons needed practice. The problem was that only paupers ended up on the dissection table, never aristocrats 鈥� and because of a literal belief in the 鈥渞esurrection of the body鈥�, as stated in the Christian Apostles鈥� Creed, the thought of entering heaven minus eyes or toes was terrifying. Anatomy became a civil-rights issue.
Digging Up the Dead may be a valuable social history but it is also memorable for its freak-show moments: surgeons slicing open cavities with fingernails; babies putrefying inside women; a man with an ulcerous penis who pees over his left shoulder. Burch twice compares biography to dissection, and this wide-ranging biography, his first book, adorns historical insight with the gloriously gruesome detail of an anatomy textbook.
