Book Review

Operations That Made History

N Engl J Med 1997; 336:143January 9, 1997

Article

Operations That Made History
By Harold Ellis. 135 pp. London, Greenwich Medical Media, 1996. (Distributed by Oxford University Press, New York.) $57.50. ISBN: 1-900151-15-4

Anyone interested in surgery or drama will enjoy this small, highly readable book. The author, not surprisingly a surgeon, has assembled accounts of operations that represented major breakthroughs (e.g., the first ovariotomy, the first gastrectomy, and the first renal transplantation) or innovations (e.g., Paré's abandonment of boiling oil for wounds and Lister's use of carbolic acid on a compound fracture) or involved famous patients (e.g., Edward VII, treated for an appendiceal abscess, and George V, treated for empyema). Edward VII and George V fared better than did Queen Caroline about 200 years earlier, who died of a strangulated umbilical hernia that her surgeon had lanced. Although someone else might have compiled a different list of operations, those that Ellis chose are all important and do reflect the title of his book.

That surgery has contributed to the remarkable progress of medicine seems too evident to mention. Yet painfully long-standing, at least to those of us who operate, has been the stereotype of the surgeon as having better hands than brain, in supposed contrast to our medical counterparts. The distinctions between surgery and medicine, always artificial, have become more blurred in the past few decades. Operations are not what they used to be. Less traumatic and less invasive procedures — for example, endoscopy — are being performed by surgeons and nonsurgeons. Recently, a relative with unremitting angina underwent angioplasty and the insertion of a stent by a radiologist. Asymptomatic, he left the hospital in two days. As someone who has been a patient, I know that it matters little “whence cometh my help” as long as it arrives.

Ellis asks what might be the theme of a future book. He postulates that it may describe the first operation in outer space or “the first famous operation by a female surgeon.” I hope we will do much better and will think in terms of preventing or relieving deformity and suffering as well as forestalling death without resorting to the use of knives.

Robert M. Goldwyn, M.D.
Harvard Medical School, Boston, MA 02115