- American Surgery: An Illustrated History
Over the course of approximately the past decade, the adverb “arguably” has increasingly crept its insidious way into scholarly literature. Trotted out to qualify what should be a declaration of confidence about some statement, its very appearance weakens the certainty that the writer or speaker would seem intent on conveying. That, of course, is its purpose: all bases are thus covered. It is a bit like a surgeon saying that he can “virtually” guarantee that a particular operation will be successful.
There is no need to invoke “arguably” in the following sentence: Ira Rutkow is the world’s foremost authority on the history of American surgery. Had he not already asserted his hegemony over the field by a series of perceptive and [End Page 539] illuminating journal articles, his two-volume History of Surgery in the United States, 1775–1900 (1988 and 1992) has firmly established his oeuvre as the finest source of information on the evolution of the profession in our country. And now—as impossible as it sounds—he has outdone even himself, with American Surgery: An Illustrated History.
Potential readers should not be led astray by the second half of the title. This is hardly a picture book, although it does contain some of the most informative and even extraordinary images (some of them published for the first time) in any current or past academic work of history. The clarity of their reproduction is unsurpassed. Those many readers who have seen any of the book’s illustrations elsewhere will find details here that had escaped them in all but a few previous printings. Many of the photographs come from the archive of Stanley Burns, the ne plus ultra of such things.
Rutkow’s approach is chronological. His first four hundred pages consist of a clearly written and thoroughgoing narrative, beginning with a fascinating description of the much-neglected topic of Native American surgery. It is an indication of the comprehensiveness of the book’s entire text that the author provides a careful differentiation between the practices of various tribes. Much the same plenitude of attractively presented information characterizes the following eleven chapters, in which the era-by-era story is told, beginning with the first decade of the seventeenth century. Attention is paid to the social, political, and economic issues that were part of the process of development, and the broad cultural context of American history is interlarded in a variety of ways, including the use of timelines to introduce some of the chapters. Brief biographies of the leading figures of each period comprise a useful addition to the text. Throughout, the underlying theme—Rutkow calls it the leitmotif—is the professionalization and specialization of American surgery.
To round out the history of these fundamental matters, the last third of the book contains a series of chapters in which the development of the various surgical subspecialties is traced, along with biographical sketches of the prominent contributors. The history continues right up to 1997, and it is a telling commentary on the current situation of American medicine that the last chapter of the main history is entitled “Socioeconomic and Political Transformation, 1975–1997.”
This is the first all-encompassing volume ever written about the history of American surgery, a study that Rutkow calls “a great adventure” (p. 395). It will take readers on that great adventure with the excitement of a cowboy movie and all of the visual thrills. “American surgery has a distinguished heritage that is in danger of being forgotten,” Rutkow says (p. 395)—but this monumental work ensures that it will not only never be forgotten, but will attract a growing number of enthusiastic acolytes from the many people who are sure to read Rutkow’s enthralling and hugely important account.