NOVEMBER 17, 2014
WHEN I WAS IN HIGH SCHOOL, my biology teacher took our class to the Mütter Museum, a medical museum in Philadelphia housing specimens that were odd, curious, and often grotesque. Visiting the museum was a rite of passage for students in the Philadelphia area; we wandered from glass case to glass case, eyeing the collection of dozens of skulls, gawking at a human colon the size of a sofa, and crowding around the “Soap Lady” — a woman whose body had turned into a waxy, soap-like substance after she had died.
I don’t remember what the trip had to do with our biology class — we might have been studying human anatomy — but the museum had a profound effect on me. I saw how radically people’s bodies could change, seemingly for no reason whatsoever. Organs could inflate without end, eyes could weep blood, and hearts could harden into stone. (Or at least something stone-like.)
When I started writing poetry seriously, I wrote a poem about the museum. It was specifically about the set of drawers — open for inspection to visitors — filled with things swallowed whole by patients over the decades.
No doubt Cristin O’Keefe Aptowicz, author of six collections of poetry, could have written a seventh about the Mütter Museum, but I’m glad that she didn’t. It’s a site that practically screams project book — but Aptowicz didn’t listen to that siren call. Instead, she took a wonderfully straightforward approach, and wrote about the museum’s namesake, Philadelphia surgeon Thomas Dent Mütter. Her largely unknown subject was ripe for a biography, and her prose vividly recreates the dramatic and often bloody world of 19th-century medicine.
Mütter’s personal history seems ripped from the pages of a comic book. His father, mother, and brother died (of an illness unnamed by Aptowicz, likely due to the scarcity of historical records), leaving him an orphan when he was only seven years old. The boy was taken in by a wealthy Southern family, despite his terrible lingering cough.
The young Mütter was almost universally well liked by his peers and his teachers. He excelled at school and developed a dandy’s taste for well-tailored, ostentatious clothing, much to the chagrin of his caretaker, who resented that the boy’s inheritance had not been enough to pay all of his expenses. Nonetheless, Mütter was able to attend medical school at the University of Pennsylvania, and, after graduation, traveled to Paris where he studied with the finest doctors and soaked up every bit of knowledge he could about a new field of surgery called les opérations plastiques, used to help patients who had been horribly disfigured by trauma or disease.
In the early 19th century, as Aptowicz describes, any surgery was a brutal endeavor:
The first incision usually brought the patient’s first scream — the first scream of many. Soon came the blood, the struggle, the shock. The patient would beg the surgeon to stop, plead and shout, and yell to the students to come save him, his voice cracking, tears streaming down his face. The surgeon was expected to ignore it all, to move forward swiftly and surely, and to hope that his assistants were strong men with equal resolve. Every student had heard stories of patients who were able to struggle free, who leapt off the table and attacked their doctors — often with the surgeon’s own instruments! — before running out of the room, leaving a trail of their own blood behind them.
But Mütter was not daunted by the challenges of the work. And he held some rather unorthodox views for the time: he was notoriously tidy during surgery (speed, not neatness, was prized before the advent of anesthesia, and an overly clean surgeon was thought of as unnecessarily fussy); he believed in being completely honest with his patients about the possible risks and outcomes of various procedures; finally, he advocated extensive post-surgery care, a rarity in an age when patients were sent home in carriages down cobblestone streets immediately after their operations were completed. Eventually, Mütter’s talents in and out of the operating room led to his appointment as professor of surgery at the new Jefferson Medical College.
With a flair for narrative, and having researched extensively, Aptowicz chronicles the ascent of Mütter’s career and his numerous surgical breakthroughs, most notably a technique for skin transplantation (still known today as the Mütter flap), which uses a piece of skin from the back to restore the faces of patients who have suffered severe burns:
He kept cutting through the skin — swiftly and confidently but deeper and deeper — as he moved strips of the scarred skin from her neck and placed them in a basin out of her field of vision. When he thought he had cleared all the scarred skin he could afford, he told the assisting doctor holding her head to help raise it into its proper position.
Despite the throbbing, shocking pain the young woman experienced, Mütter could see the gratification on her face. Without the thick webbing of scar tissue dragging her face down, she was able to blink her eyes easily and painlessly. She was able to close her mouth. She could turn her head for the first time in more than two decades.
Mütter’s surgery was critically important for the women of the era, who disproportionately suffered from disfiguring burns because of their highly flammable clothing and the ubiquity of open-flame cooking.
Aptowicz’s description of the Mütter flap surgery is precise and clear, but she also has the feel for making each scene vivid and immediate:
As with his work on the front of her neck, he was mindful not to cut too deeply. But despite his best efforts, one small vessel was opened. For the rest of the surgery, a steady stream of blood dripped onto the floor, ticking like an insistent clock.
It’s in sections like this one that the reader is aware of Aptowicz-the-poet. The particular paragraph isn’t necessary to the description of the operation. But that image — dripping blood “ticking like an insistent clock” — functions on at least two levels, to show that Mütter isn’t infallible, and to add an extra element of suspense to the scene. Aptowicz’s prose works the same way Mütter did — with speed, elegance, and tactile accuracy. In her capable hands, Dr. Mütter’s Marvels is a biography of a scientific innovator that conjures, more vividly than it otherwise might, the atmosphere of the often terrifying and swiftly transforming field of medicine in the 19th century.
Meanwhile, Mütter himself is such a paragon — an artist in his own right — that he needs some sort of obstacle, narratively speaking, to drive his own story. In the new television show The Knick, Clive Owen plays Dr. John Thackery, another brilliant, though fictional, surgeon. But Thack, for all his brilliance, is arrogant — a drug addict, and a racist. Even so we can’t help but watch him — and root for him — because of his unabashed commitment to medicine, his art.
Mütter had no such flaws of character. We have nothing to forgive him. He was loved by his students and colleagues (save for the few that clung to outdated medical practices). He became one of the most widely respected surgeons of the time. He championed the use of anesthesia during surgery. He established a clinic at Jefferson Medical College to treat his patients. However — that lingering cough from his childhood never went away. The noted surgeon died at the age of 48.
For most people, Mütter is simply the namesake of a funky Philadelphia museum. But in Dr. Mütter’s Marvels, Aptowicz reminds us of his rightful place in the pantheon of American medicine, offers a window into a time of revolutionary scientific change, and takes a hard look at the temperament and resolve of a pioneer whose influence continues to be relevant today. Yet we know from the first page of the prologue that Mütter will die before his time; that the blood drip “ticking” during his famous surgery is the clock running down on his life. It’s Mütter’s childhood disease, then, that serves as the driver of Aptowicz’s narrative. How much, the reader wonders, can the doctor accomplish before he dies? Really, that’s all artists — surgeons and poets — can do: they make their art until their bodies give way. Death is always waiting, and the work is never done.