Friday, 21 August 2009

The surgeon gets to work

I began this blog at the beginning of the year as I was bored. The boredom was provoked by having to hang around the house: I've been ill on and off for over a year now, work and trips providing occasional punctuations. Nothing life-threatening or totally incapacitating, just something uncomfortable, debilitating and frustratingly stubborn.

Anyway, I've now exhausted all pharmacological avenues in the search for health and tomorrow will go under the knife, the first of three operations. Radical but, I'm assured, a sort of cure. I therefore forecast very light blogging for the next week. Very light everything in fact.

However, I'm casting my mind forward to that glorious day of feeling entirely well and wondering what will become of the blog. Well, having begun it merely to fill time, I appear to have stumbled across something which has really shocked me in its enjoyableness. I can hardly express how much fun it has been to write up my various musings and observations. And it's been a pleasant bonus that there are some out there willing to regularly read them, and even occasionally comment. So, I'm expecting blogging to continue, at least for as long as I have a thought in my head.

First, though, the op. I'm pretty squeamish, but surgery is something that surely holds intrinsic interest for everyone (literally, I suppose). Some of the best passages in Claire Tomalin's superb biography of that proto-blogger Samuel Pepys, concern his surgery for the 'stone' (a stone in the bladder, formed through the agglomeration of minerals in the urine, which if not voided becomes progressively more painful).

The preparation for the operation was really quite pleasant:
The sick person was advised to cultivate a calm frame of mind and to avoid anger or sadness; he should feel confidence in the surgeon, even affection (all this modern-sounding advice comes from contemporary manuals). And surgeons were encouraged to give their patients an honest account of what they were to undergo. Wine was not allowed during the preparatory weeks, only sweet drinks made from almond, cucumber and melon, and a diet of fresh meat, chicken, pigeon, eggs, butter, barley and water-gruel. In the days before the operation Pepys would have been given warm baths - possibly an unprecedented experience - and kept in a warm bed. His belly would be rubbed with unguents, he would be bled in the arm and given gentle purges, until the final day, when he was left in peace and simply served with a good meal.
On the day of the surgery a lightly boiled egg was recommended...He had a last bath, was dried, told to take a turn or two around the room and offered a specially prescribed drink made of liquorice, marshmallow, cinnamon, milk, rosewater and the whites of fifteen eggs - six ounces to be swallowed with an ounce of syrup of althea and other herbs, a large dose for a nervous man to swallow.
Then things turn rather less pleasant:
After this he was asked to position himself on a table, possibly covered with a straw-filled bag into which he could be settled while the process of binding him up began. Some surgeons thought it wise to say a few reassuring words at this point, because the binding was terrifying to many patients. They were trussed like chickens, their legs up, a web of long linen strips wound round legs, neck and arms that was intended to hold them still and keep their limbs out of the surgeon's way. The instructions for the binding alone take up several pages of one manual; and when it was done the patient was further bound to the table. He was shaved around his privy parts, and a number of strong men were positioned to hold him fast: 'two whereof may hold him by the knees, and feet, and two by the Arme-holes and hands... The hands are also sometimes tyed to the knees, with a particular rowler, or the knees by themselves, by the help of a pulley fastened into the table'. Meanwhile the surgeon lubricated his instruments with warm water and oil or milk of almonds: the catheter, the probe, the itinerarium, the specular, the pincers, small hooks and so forth; he also had powder to stop bleeding, sponges and cordial waters to hand. There were no anaesthetics, and alcohol was certainly not allowed to a patient undergoing surgery to the bladder.
Finally, the unpleasantness really gets underway:

The surgeon got to work. First he inserted a thin silver instrument, the itinerarium, through the penis into the bladder to help position the stone. Then he made the incision, about three inches long and a finger’s breadth from the line running between scrotum and anus, and into the neck of the bladder, or just below it. The patient’s face was sponged as the incision was made. The stone was sought, found and grasped with pincers; the more speedily it could be got out the better. Once out, the wound was not stitched—it was thought best to let it drain and cicatrize itself—but simply washed and covered with a dressing, or even kept open at first with a small roll of soft cloth known as a tent, dipped in egg white. A plaster of egg yolk, rose vinegar and anointing oils was then applied.

I'm grateful that today we can rely on more than a sponging of the face and the application of eggs for relief. (Reminds me of how you were advised to temporarily patch up a leaking car radiator in the old days: drop in a raw egg). But what was it with all the eggs? A couple of dozen of them figure, at least. After all that, I'm not sure I could look an egg full in the face ever again.

The stone was described as 'very great': the size of a real tennis ball, with a diameter a little over two inches. Pepys had a little display case made for it and intended to celebrate the operation annually, on 'Stone Day'. The excellent surgeon, a Mr Hollier, was attached to St Barts, a medieval charitable foundation set up by the City of London. My surgeon has the same affiliation, another of London's continuities.

But thank God for the odd discontinuity! We really are very lucky to live when we do. Anyway bon chance et bon courage! (French always sounding devil-may-care when shouted with sufficient gusto).

10 comments:

Gadjo Dilo said...

Bon courage, mon brave! Glad you enjoy the blogging; it's something that's kept me in touch with people with a sense of humour and culture for a year and a bit now, though I fear I may hve to slacken off soon as my 8-hour working day at a computer on top of the blogging time is making my eyes hurt not a little.

worm said...

god, reading that made my eyes cross in sympathy!

Good luck with the op, and hope to see you back soon!

worm said...

PS, received the Tomalin Pepys book in hardback just now - it's quite a weighty tome! might take me a while to get through that one! Looking forward to it!

Brit said...

Dear me. Good luck old boy.

Nige said...

Good luck Gaw! Hope all goes smooth as smooth.
I know what you mean about the shock of finding how enjoyable blogging is - I never thought I'd take to it at all.
Look forward to having you back.

Gaw said...

Thanks all! Much appreciated.

Bunny Smedley said...

That egg business is enough to convince even me of the merits of 'progress'!

More to the point, though, here's hoping that the ops go perfectly and that as soon as can be you'll be enjoying that 'glorious day of feeling entirely well' you mentioned above - all worth an interlude of light blogging, as much as we'll all miss you.

ghost of elberry said...

A sterling blog, hope the op goes well.

Brit said...

Elberry, you drama queen!

ghostofelberry said...

Ghost of Elberry, if you please.