community. The two most popular instructors were Halsted and his good
friend William Welch, two years the surgeon’s senior. The two trailblazers
were both Yale and P&S graduates, gregarious and gifted educators who
inspired devotion to this new form of medicine.
After accepting the offer to become the founding physician at Johns
Hopkins University, Welch departed for another expedition to Europe in
- He had spent seven years as a pioneering physician at Bellevue, but
his Gotham contributions would be dwarfed by his future work at Hopkins.
Granted an eighteen-month sabbatical to revisit the leading medical
centers, Welch was also leaving his close friend, Halsted, who was
transforming medicine metropolis-wide as a surgeon, anatomy prosector,
quizmaster, and experimental scientist.
By 1884, Halsted was on staff at five hospitals (including Presbyterian,
the New York Hospital, and the prestigious Bellevue Hospital), but his
dream of a “modern” operating room with comprehensive antiseptic
facilities was unmet. Raising money from friends and family, Halsted
organized the construction of the most state-of-the-art operating room in
the country, an elaborate standalone tent replete with maple floors,
skylights, running water, gas for lighting, and sterilization facilities. In
1885, this was likely the most advanced operative theater in the Western
Hemisphere.
Halsted’s operating room bivouac at Bellevue Hospital was a utilitarian
version of the operative theaters he had seen in Austria and Germany,
while hovering over the shoulders of luminaries in Vienna, Leipzig, Halle,
and Kiel. His most famous exemplar surgeon was the sensitive and
melancholy physician-poet Theodor Billroth, the self-styled “sentimental
North Sea herring.”^4 For twenty-five years, Billroth was professor of
surgery at the University of Vienna following his training under Bernhard
von Langenbeck in Berlin (1853–60).
Langenbeck contributed significantly to the development of surgery at a
time of great philosophical upheaval. He received postgraduate training in
surgery in London in the 1830s (predating anesthesia by more than a
decade), serving under Astley Cooper and Benjamin Brodie; thus linking
the German school of surgeons to John Hunter (1728–1793).
Langenbeck’s clinical career was interrupted several times by war,
including the Schleswig-Holstein Wars (1848–52 and 1864), the Austrian
War of 1866, and the Franco-Prussian War of 1870.^5 Battlefield medicine