DR. MUTTER’S MARVELS
Cristin O’Keefe Aptowicz
Cristin O’Keefe Aptowicz
In celebration of the paperback release of Dr. Mutter’s Marvels, Cristin O’Keefe Aptowicz will be in-conversation with Mellick T. Sykes, MD, MA (Anat) FACS, the Archivist from the Texas Surgical Society and a Clinical Professor of Surgery, to discuss the life and times of Dr. Thomas Dent Mutter, founder of the (in)famous Mutter Museum of medical oddities in Philadelphia. Their conversation at BookPeople in Austin, Texas on October 12th at 7 pm, will feature surgical instruments from the oftentimes treacherous (and fascinating) world of medicine and surgery during the early 19th century. The talk will be followed by a brief Q&A and signing.
A mesmerizing biography of the brilliant and eccentric medical innovator who revolutionized American surgery and founded the country’s most famous museum of medical oddities Imagine undergoing an operation without anesthesia, performed by a surgeon who refuses to sterilize his tools—or even wash his hands. This was the world of medicine when Thomas Dent Mütter began his trailblazing career as a plastic surgeon in Philadelphia during the mid-nineteenth century.
Although he died at just forty-eight, Mütter was an audacious medical innovator who pioneered the use of ether as anesthesia, the sterilization of surgical tools, and a compassion-based vision for helping the severely deformed, which clashed spectacularly with the sentiments of his time. Brilliant, outspoken, and brazenly handsome, Mütter was flamboyant in every aspect of his life. He wore pink silk suits to perform surgery, added an umlaut to his last name just because he could, and amassed an immense collection of medical oddities that would later form the basis of Philadelphia’s renowned Mütter Museum.
Award-winning writer Cristin O’Keefe Aptowicz vividly chronicles how Mütter’s efforts helped establish Philadelphia as a global mecca for medical innovation—despite intense resistance from his numerous rivals. (Foremost among them: Charles D. Meigs, an influential obstetrician who loathed Mütter’s “overly modern” medical opinions.) In the narrative spirit of The Devil in the White City, Dr. Mütter’s Marvels interweaves an eye-opening portrait of nineteenth-century medicine with the riveting biography of a man once described as the “[P. T.] Barnum of the surgery room.”
Even in the middle of the ocean, Mütter could not get her out of his mind. He excused himself early from dinner, stopped well- meaning conversationalists mid- sentence, and rushed down to his sleeping
quarters just to hold her face in his hands.
To an American like him, she appeared unquestionably French: high cheekbones, full upturned lips, glittering deep- set eyes. For an older woman, she was impressively well preserved, her temples kissed with only the slightest crush of wrinkles. When she was young, Mütter imagined, she must have been very beautiful, though perhaps girlishly sensitive about the long thin hook of her nose, or the pale mole resting on her lower left cheek. But that would have been decades ago.
Now well past her childbearing years, the woman answered only to “Madame Dimanche”—the Widow Sunday— and all anyone saw when they looked at her was the thick brown horn that sprouted from her pale forehead, continuing down the entire length of her face and stopping bluntly just below her pointy, perfect French chin.
The young Dr. Thomas Dent Mutter had arrived in Paris less than a year earlier, in the fall of 1831. Even for Mutter, who had always relied heavily on his ability to charm a situation to his favor, it had not been an easy trip to arrange. He was just twenty years old when he graduated from the University of Pennsylvania’s storied medical college. To an outsider, he may not have seemed that different from the other students in his class: fresh- faced, eager, hardworking. But he knew he was different— in some ways that were deliberate and in other ways that were utterly out of his control.
Perhaps the most obvious of these was Mutter’s appearance. He was, as anyone could plainly see, extraordinarily handsome. Having studied his parents’ portraits as a child— One of the few things of theirs he still possessed— he knew that he inherited his good looks. He had his father’s strong nose, impishly arched eyebrows, and rare bright blue eyes. He favored his mother’s bright complexion, her round lips, and sweet, open oval face. His chin, like hers, jutted out playfully.
Mutter made sure to keep his thick brown hair cut to a fashionable length, brushed back and swept off his cleanly shaven, charismatic face. His clothing was always clean, current, and fastidiously tailored. From a young age, he understood how important looks were, how vital appearance was to acceptance, especially among certain circles of society. He worked hard to create an aura of ease around him. No one needed to know how much he had struggled, or how much he struggled still. No, rather he made it a habit to stand straight, to make his smile easy and his laugh warm. He was, as a contemporary once described him, the absolute pink of neatness.
The truth was that, financially, he had always been forced to walk a tightrope. Both his parents had died when he was very young. The money they left him was modest, and thanks to complicated legal issues, his access to it was severely limited. Over the years, he grew practiced in the art of finessing opportunities so that he could live something approximate to the life he desired. At boarding school, he was known to charge his clothing bills to the institution and then earn scholarships to pay off the resulting debts. When he wanted to travel, he secured just enough money to get him to his destination and then relied on his wits to get him back home.
And now that Mutter had achieved his long time goal of graduating from one of the country’s best medical schools, he focused on his next goal: Paris.
Paris was the epicenter of medical achievement: the medical mecca. Hundreds of American doctors swarmed to the city every year, knowing that in order to be great, to be truly great, you must study medicine in Paris.
And that had always been Mutter’s plan: to be great. More than that: to be the greatest.
Getting to Paris, however, was not an easy endeavor. He knew— as all gentlemen of limited means did— that sailing as a surgeon’s mate with a U. S. naval ship in exchange for free passage to Europe was an option open to him, but competition was always considerable and fierce. Mutter spent months submitting letters and applications to the secretary of the Navy, trying to use charm, logic, and bravado to secure a position. He even implored his guardian, Colonel Robert W. Carter, to ask prominent men close to President Jackson to write letters on his behalf, explaining, “[I] am afraid that I shall not be able to obtain an order unless I can get my friends to make some exertions for the furtherance of my plan.” Despite all the effort he expended, no position ever materialized.
Mutter could only watch as the wealthier members of his graduating class departed for Europe with financial ease. Others returned to their hometowns with their new degrees, bought houses with their fathers’ money, and started their practices using their families’ connections. Mutter remained in Philadelphia, and his hopes remained fixed on Paris.
Mutter felt his luck about to change when he read about the Kensington in a local Philadelphia paper. For months, the Cramp shipyard had been building a massive warship. The rumor was that it was being built for the Mexican Navy, and that upon seeing its immense size— and cost— they opted to back out of purchasing it. However, the most recent update was that the giant ship had sold after all, to the Imperial Russian Navy.
Mutter saw an opportunity. He went to the Cramp shipyard and asked if the American crew in charge of sailing the Kensington to Russia was in need of a surgeon’s mate. That he was just twenty and only a few months out of medical school was a minor detail. He hoped that being present, able, and willing would be enough. Luckily for Mutter, it was. A few weeks later, he boarded the ship (later to be renamed the Prince of Warsaw by Tsar Nicholas himself ), and left America for the first time.
The ocean was like nothing Mutter had ever experienced: vast and wild and so incredibly loud. He had hoped the enormity of the newly built warship— with its four towering masts and immense spiderweb of rigging— as well as its extensively trained crew would offer him comfort during the weeks at sea, but the experience was more taxing than any book or anecdote portended.
He did not anticipate that whether he was holed up in the bowels of the ship or clinging to the aft railing, his body would be trapped in a relentless cycle of emptying itself. That his stomach would never become accustomed to the rolling blue- black swells of the sea. Nor did he realize how intimate he would become with the ship’s beastly stowaways— bedbugs and fleas,
and rats. He would wake to bugs crawling in his hair and mouth, and fall asleep to sounds of the rats chewing through his clothes, attempting to suss out even the smallest morsel of food. And then there were the storms, the nights when he felt certain the vessel would break in two as mountainous waves crashed over it, the ship itself painfully groaning with each hit. The ocean seemed nothing but a frothing black maw, hungry to devour him.
When the sea was calm and the sky bright and blue, he forced himself to stand on the ship’s deck and look toward what he hoped was Europe. He tried to enjoy these moments, but he didn’t know true relief until the crew pointed out birds appearing in the sky, a sign that they were approaching land, after more than a month at sea.
When Mutter finally arrived in Paris, it immediately reminded him of the ocean; it too was vast and wild and incredibly loud. Unlike at sea, however, in Paris he felt perfectly at home.
Its streets were packed, people and buildings in every direction. His world was suddenly and delightfully filled with new sounds, new scents, new music. There were colorfully dressed women sweeping the streets, and strapping men carrying enormous bundles on their heads. There were strange- looking carriages that seemed like relics of a barbarous age, which were in turn being pulled by enormous and brash horses. Even the food being eaten at street- side cafes seemed strange and exotic to Mutter. The city avenue was a vast museum of wonderful new sights to gawk at, and it seemed that the French wanted it that way. They loved to look, and to be looked at. It was true what Mutter had heard: Those French who could spare the time would flamboyantly promenade every day. And on Sundays, absolutely everyone did.
Once Mutter had secured modest student housing, he set out to promenade himself. He’d been sure to pack his finest clothes for the journey: suits cut close to his slim frame (his natural thinness being perhaps one of the only benefits he’d gained from the illnesses that had plagued him since childhood) and made from the most expensive fabrics he could afford in the brightest colors in stock. Years earlier, a schoolmaster once wrote to Colonel Carter, Mutter’s guardian, that his pupil’s “principal error is rather too much fondness for a style of dress not altogether proper for a boy his age.” Clearly, that schoolmaster had never been to Paris.
Mutter enjoyed the moment, peacocking on Parisian streets for the first time, a master of his fate. The lines between Mutter’s starting points and his destination were not often straight, but he took pride and comfort in knowing that he always got there. And the next morning, he would begin the next phase of his mission, his true goal in Paris: to learn everything he could about modern medicine until his money, or his luck, ran out.
In 1831, over a half million people called Paris their home, and by royal decree, each French citizen was entitled to free medical treatment from any of the dozens of hospitals within the city limits. The hospitals were typically open to any visiting doctors, provided one could show them a medical degree and, when necessary, place the right amount of coins into the right hands.
Studying medicine in Paris became so popular that guidebooks were written just for the visiting American doctors. Nowhere else in the world, one wrote, could “experience be acquired by the attentive student as in the
French capital . . . where exists such a vast and inexhaustible field for observation. . .”
And it was true. Where else but Paris would there be not one but two hospitals devoted entirely to the treatment of syphilis? Afflicted women were sent to the Hôpital Lourcine, a hospital filled with the most frightful instances of venereal ravages. The men were sent to the Hôpital du Midi, which required that all patients be publicly whipped as punishment for contracting the disease, both before and after treatment.
Hôpital des Enfants– Malades was a hospital for ill children, and was nearly always filled to capacity. It had a grim mortality rate— one in every four children who came for treatment died there— but the doctors on staff assured visiting scholars that this was because most of the patients came from the lowest classes of society and thus were frequently brought to the hospital already in a hopeless or dying condition.
Doctors specializing in obstetrics could visit Hôpital de la Maternité. It served laboring women only, and averaged eleven births a day. Some days, however, the numbers rose to twenty- five or thirty women, each wailing in her own bed, as the doctors and midwives (called sages-femmes) rushed among them. New mothers were allowed to stay nine days after giving birth, and the hospital even supplied them with clothing and a small allowance, provided they were willing to take the child with them. Not all of the women were.
So the Hôpital des Enfants– Trouvés for abandoned children was founded. Newborns arrived daily from Hôpital de la Maternité from women unable or unwilling to keep their children, as well as those infants whose mothers died while giving birth, as one in every fifty women who entered Hôpital de la Maternité did.
The Hôpital des Enfants– Trouvés also allowed Parisian citizens to come directly to the hospital and hand over a child of any age. The hospital encouraged families to register and mark the children they were leaving so
they might reclaim them at a later date, but the families who chose to do so were few. In fact, the vast majority of the children there had arrived via le tour.
Le tour d’abandon (“the desertion tower”) was merely a box attached to the hospital, constructed with two sliding doors and a small, loud bell. An infant was unceremoniously placed in the box, the door firmly closed behind it, and the bell was rung. Upon hearing the bell, the nurses on duty would go to le tour to remove the infant, replace the box to its original position, and wait. Every night, a dozen or so infants were received in precisely this way.
For a while, it had been in vogue for wealthy, childless individuals to adopt children from the Hôpital des Enfants– Trouvés to bring up as their own, but the practice had long since fallen out of fashion. At the time of
Mutter’s visit, more than sixteen thousand children were considered wards of the Hôpital des Enfants– Trouvés, and of those, only twelve thousand would live to adulthood.
There were hospitals for lunatic women and for idiot men, hospitals for the incurable, for the blind, for the deaf and dumb, and even for ailing elderly married couples who wished to die together— they could stay in the same large room provided that the furniture they used to furnish their room became the property of the hospice upon their deaths.
And perhaps most astonishing to the visiting American doctors, Paris had the École Pratique d’Anatomie, which provided any doctor, for six dollars, access to his own cadaver for dissection. In America, cadaver dissection was largely illegal. Many doctors resorted to grave robbing to have the opportunity to examine the human body fully. In Paris, twenty doctors at a time would whittle a human body down to its bones— provided they could stand the smell and the ultimate method of disposal of the dissected corpses: At day’s end, the decimated remains were fed to a pack of snarling dogs kept tied up in the back.
However, more than any single hospital, what most attracted Mutter to Paris were the surgeons: brilliant and daring men who were to him living gods, redefining medicine and at the zenith of their renown.
You know what biographies I actually enjoy reading? The ones that don’t read like the typical sources you used in grade school to do a book report on some famous person in history. Aptowicz does a masterful job of pulling you into the gruesome 19th century world of medicine with her fiction-like narrative, while providing you with loads of facts (just in case you actually are writing a book report). Each chapter opens with an excerpt written by the great Dr. Mutter, and you can tell right away that you are dealing with a sound intellectual. The diagrams of some of his procedures included in the work coupled with Aptowicz’s vivid descriptions are grotesque yet fascinating. As I read a few choice paragraphs aloud to my husband, he asked, “How are you still reading that?!?” I answered that it was so amazing that I wished they had videos of his work online. I probably couldn’t sleep much afterward, but I think it would be worth seeing the magic.