Thursday, September 29, 2011

Surgical Anaesthesia as a Metaphor for Liberalism

The invention of surgical anaesthesia is an incredibly gloomy story in which ordinary scientific squabbling over who gets credit for a discovery was raised to an abnormally high pitch, until practically everyone involved had met a tragic and in some cases rather gothic end.

One character turns to drugs, throws sulfuric acid at a whore on the streets of New York, and commits suicide by opening his femoral artery in his jail cell -- after self-administering a vial of chloroform he had smuggled in.

Our hero spends most of the mid-19th century trying to make money from his invention, but he can't so much as get credit for it thanks to the connivances of a monomaniacal nemesis, who ruins our hero's reputation, foments petty lawsuits against him, and robs him of a $100,000 reward that Congress had for decades told our hero he could expect to receive from them any day. And just when our hero finally gives up the fight -- having lost his patent, his practice, and his last dime -- our villain places a gloating article in a New York medical journal, claiming the invention of anaesthesia for himself. Our hero flies to New York, in order to convince the medical journal to print his rebuttal, but drops dead in the frenzy of writing it.

His nemesis falls victim to the curse soon thereafter: When he spies a monument erected to our hero, he falls into a four-day raving fit and is finally committed to a Massachusetts asylum, where he lives out his few remaining years.

It reminds me of a heist movie where everything goes wrong (except for the last act of the story where our hero and villain die, which is not a heist movie but the plot of Amadeus in bizarrely accurate detail): The prospect of a big pay-off drives everyone to extremes and some to insanity, and in a fit of greed and madness they pick each other off until one man, at most, is left standing.

Every heist movie has the same moral: Gold, in sufficient quantity, is guaranteed to drive ordinary men to hysteria. Which is where the metaphor for liberalism comes in. Is it possible that the prospect of abolishing pain is just as much an invitation to obsession and madness as the prospect of stealing a million dollars from a bank? The men in this story didn't just think they were developing a chemical that would facilitate surgery; they thought they were abolishing suffering. (Books on the anaesthesia controversy include such titles as Triumph over Pain, Victory over Pain, and 'We Have Conquered Pain'.) Maybe that delusion is where they went wrong, and where a certain type of politics goes wrong, too.

Our first test case is Horace Wells, the man who disfigured a whore in broad daylight and then killed himself after being arrested for it. He had two reasons to consider himself the inventor of anaesthesia, which he was not: He had shared a dental practice with the real inventor, our hero William Morton, several years before Morton came to prominence; and he had in his youth experimented with laughing gas in dental surgery, even giving a demonstration in Boston of its efficacy as an anaesthetic. The demonstration failed, which both embarrassed him and put an end to his experiments. (It is pictured in the cartoon above. The puking man is most definitely not anaesthetized.)

The author of this book on this story says that when Wells heard of Morton's invention, he progressed from "I could have invented that" to "I should have invented that," and finally to "I did invent that." Upon convincing himself of that conclusion, he moved to New York to start conducting experiments with chloroform, which he hoped would supplant Morton's ether, and to make friends with journalists who could push his claim.

I have mentioned that Wells became a drug addict. It is perhaps more important to explain that he developed his addiction through his experiments with chloroform -- he was using himself as a guinea pig to determine the right dosage, and the habit grew on him. Wells wasn't facing a surgeon's scalpel, but he had left his family behind in Connecticut, lost his livelihood, and, in his view, been robbed of the fame he deserved. Why shouldn't chloroform ease his pain as well as the pain of his patients?

It did, well enough, until the side-effects of his addiction led to his bizarre assault on a prostitute, landed him in prison, and drove him to suicide. (His farewell note was addressed to his wife: "My character, which I have ever prized above everything else, is gone. My dear, dear wife and child, how they will suffer. I cannot proceed. My brain is on fire.") And when he had settled on suicide, chloroform made it painless. The abolition of pain had unforeseen consequences.

Our villain is the most interesting character in the story, as usual. Dr. Charles T. Jackson (pictured above) might be familiar to you as the man who famously sued Samuel Morse for allegedly stealing his idea for the telegraph. I assume that the Morse lawsuit was a real education for Jackson in how to steal a man's invention, because by the time he got around to claiming credit for ether, he was a real pro at it -- he scarcely put a foot wrong in his tussles with Morton. His most ingenious ploy was stealing the ledger from Morton's dental practice and then sending bills to all Morton's patients, even the ones that had already paid. Morton lost all his customers and gained a reputation for crookedness, which robbed him of his source of income as well as, of course, diminishing his credibility in the anaesthesia fight.

Jackson then scoured every medical journal he could find for articles on ether and visited the authors personally to convince them to press their claims in Congress, which had decided to give a $100,000 reward to the inventor of anaesthesia -- partly in compensation for voiding the patent on it in order to make anaesthesia available to army surgeons in the Mexican-American war. Morton had already filed his patent on ether at the time Congress invalidated it, but he didn't contest Congress's action, out of a sense of patriotic duty. (This came back to bite him later, when he tried to claim the congressional reward: If you invented ether, why didn't you sue us back in 1846?)

At one point, in 1849, Congress seemed ready to grant the $100,000 reward to Jackson, but Jackson made what he called a "fine gesture of renunciation" and told Congress that he didn't want the money, just the credit. In the end, his gesture raised more suspicions than it suppressed and ultimately undermined his claim, but it does suggest that his preoccupation with ether was less self-interested and more purely obsessive.

Jackson ended up an addict, too, but not to chloroform, just alcohol -- he was drunk when he saw the monument to Morton that pushed him over the edge. But the principle is the same: If a medicine kills pain, why not use it all the time?

Our hero Morton is more sympathetic than Jackson or Wells, but no less obsessive -- which is all the more surprising given that he was a very ordinary man, the furthest thing from a tortured genius you could imagine. But anaesthesia worked its alchemy on him, too -- even when every possibility of reward had been closed and he had settled into life as an impoverished gentleman farmer, with his pawned equipment and his house donated by a well-wisher, he was frantic to rebut Jackson's claim to the credit. He worked on his rebuttal with such a frenzy that it killed him. Surely that indicates something beyond the usual desire of a scientist to go down in history.

I certainly don't mean to say that the desire to ease pain is in and of itself pathological -- though it is entertaining to read the statements of the doctors who did feel that way at the time. A member of the French Academy of Sciences, when told of Morton's innovation, wrote that "the new method conflicts both with sound reason and with moral sensibility," and compared it to operating on "people dead drunk" and then to operating on corpses. The man who first gave chloroform to women during childbirth was a Scotsman, and his fellow Calvinists condemned him for violating Genesis 3:16 ("In sorrow thou shalt bring forth children"). Eventually the man, James Young Simpson, resorted to exegesis himself: "The word used in the Hebrew, and translated by 'sorrow' in the 16th verse . . . means 'toil, labor and trouble,' not 'physical pain.'"

What I do mean to say is this: A long time ago, James Poulos described liberalism as the idea that "the purpose of politics [is] to reveal and institutionalize the needlessness of human suffering." While it seems to me that liberals have given up on the perfectability of man, they still cling to the related idea that all suffering is needless. You can detect it in their rhetoric all the time -- if someone is suffering somewhere, there must be something we can do about it. I'm not yet sure what that means, but if the first men who ever felt that they had the abolition of pain within their grasp went utterly mad from the attraction, it must mean something.

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