The Story of Surgery: An Historical Commentary (review)

The Story of Surgery is a throwback to an earlier era in the writing of medical history, when storytelling reigned supreme and the yarn-spinners were physicians. These practitioners told of the great triumphs of their ancestors, and of how mankind was made safe by the indubitable achievements of medicine. Impressed with the profundity of their profession, doctors read the tales and were dutifully inspired to carry on their vocation's grand traditions. The public was similarly captivated, but for different reasons: to the general audience, an understanding of medicine's progress provided future comfort for one's inevitable days as a patient, and confirmed the worthiness of the caretakers. In those days of old, medical history was hagiography at its finest, and readers were enthralled by the written efforts.

In more modern times, however, as medicine draws ever closer to paralleling the pathways of contemporary society, most scholars would agree that the penning of medical history must go beyond the simple narration of a doctor's life or the straightforward understanding of the development of clinical techniques. It is no longer acceptable or appropriate for medical history to be depicted as little more than an unrelated series of contributions by individual physicians. Rather, the writing of the history of medicine must involve not only clinical content but cultural, ethical, political, and socioeconomic elements as well. This being said, the modern telling of medical history does not have to manifest itself as the bland and boring, albeit analytically superb, texts that compromise many present-day accounts. The engrossing views of yesteryear that made medicine's story so entertaining still need to be incorporated into contemporary efforts; otherwise, the medical historians' audience will be confined largely to their peers. Such a myopic consequence is unhealthy for the discipline, and deprives the lay readership of an appreciation of the majesty of the advance of medical science.

The Story of Surgery, having gone through several metamorphoses, now incorporates both hagiography and historical commentary, which makes it an interesting mix. Originally published in 1958, in the United Kingdom, under the title The Surgeon's Tale, the book slowly wended its way across the Atlantic Ocean and arrived in the United States in 1964, slightly revised, as The Story of Modern Surgery. Four years later, sporting an introduction by Michael De Bakey, it resurfaced as Surgery: Old and New Frontiers. Nearly four decades later, Robert Richardson decided to breathe new life into his earlier creations by adding material (mostly on cardiac, transplantation, and vascular surgery) and providing an extensive list of bibliographic sources. How well has he succeeded in his stated goal (p. vii) of tracing "in broad outline the evolution of modern surgery, including details as required or as they took my fancy"?

This work serves up a smorgasbord of surgical sagas. It is all here: almost every organ, almost every surgeon, and almost every story. And, like all buffets, it has its strengths and weaknesses. There is a lack of organization, and of narrative momentum: the tale zigzags from one event to the next, but without a cogent storyline. However, Richardson has achieved what he set out to do: he manages to provide a large amount of information and elucidate the fascinating progress of surgery. True, most of the stories end in the 1950s, and the historical commentary is sophomorish, but Richardson shows what a magnificent adventure surgery is. He neatly demonstrates that there is no way to separate today's surgeons and their craft from the experiences of all the surgeons who have preceded them.