Today, we cut into a human body. The University of
Houston's College of Engineering presents this
series about the machines that make our
civilization run, and the people whose ingenuity
created them.
I've been thinking about
ancient surgery -- in the stone age, in
Mesopotamia, in all the shadowy past of our
cuttings into the human body. Now: if you've ever
watched an operation, one moment stood out over all
others. It was the first incision.
Can anything be as willful or terrifying as
consciously breaking into another person's body?
Yet healers have been cutting into the body since
long before recorded history.
I have trouble visualizing the state of mind that a
person has to achieve to do that for the first
time, or for the hundredth, with or without
anesthesia. So, for
guidance, I turn to contemporary surgeon, Richard
Selzer. In his book, The Exact Location of the
Soul, Selzer addresses that question.
"With a blend of arrogance and ignorance, the
surgeon makes his incision ... ," he says. Later in
the book, he elaborates:
I am still struck with a kind of dread that it
is I in whose hand the blade travels ... that yet
again this terrible steel-bellied thing and I have
conspired for a most unnatural purpose, the laying
open of the body of a human being.
If that's the voice of a modern
surgeon, when did we first undertake this
unnatural laying open of the body. Historian
of ancient medicine, Guido Majno, offers two
candidates for the first surgery. Both appeared about
the same time as agriculture. One was done, not on
humans, but on bulls. Castration turned bulls into
oxen, which then became practical beasts of burden.
The other early operation is a huge surprise. It is
no less than brain
surgery. Majno traces a twelve-thousand-year
history of surgeons cutting through the human skull
-- in Europe, Africa, Asia and the Americas. These
operations, once written off as ceremonial magic,
were likely used most often to vent serious head
wounds.
That's not to say magic was absent. I expect it
took a belief in magic to undertake anything so
radical. As one reads Selzer, the line between
magic and technology is still blurred. When he
gives advice to young surgeons, he tells neophytes
to be in awe -- awe of what they're doing and awe
of the older surgeon.
But Selzer chiefly tells the new surgeon to be in
awe of the scalpel -- of the mystical act
of making that first cut. The
four-thousand-year-old code of Hammurabi, on the
other hand, merely stipulates steep payments for
eye surgery, and punishments for bungled operations
-- no talk of magic there.
It is Selzer, speaking from the present day, who
says, "Poised above the patient the surgeon is
like a priest." But he also makes a remark
that reflects his connection to the patient:
"when a surgeon makes an incision," he
says, "it is a self-inflicted wound."
Thus my search for Neolithic origins of surgery
brings me to the modern surgeon. Whatever doctor,
whatever age -- when the first cut is made, all
surgery might as well be the first surgery.
I'm John Lienhard, at the University of Houston,
where we're interested in the way inventive minds
work.
(Theme music)
G. Majno, The Healing Hand: Man and Wound in the
Ancient World. Cambridge, MA: Harvard University
Press, 1975,
R. Selzer, The Exact Location of the Soul: New
and Selected Essays. New York: Picador USA,
2001.
I am grateful to Seattle actor Megan Cole and
Roberta Bivins from the UH History Department, for
suggestions and counsel.
Nineteenth-century surgery with early use of
anesthesia
(clipart image)
The Engines of Our Ingenuity is
Copyright © 1988-2002 by John H.
Lienhard.
