developed “a manner of dealing with animal experiments that soon
became the national standard,”^20 his second major contribution to surgery
in Baltimore in an amazingly brief time.
Welch had petitioned President Gilman’s tolerance of Halsted’s poor
reputation; such was Welch’s esteem of his New York companion. The dog
surgery, gainful basic science research, positive reception at Harvard—by
all appearances William Halsted was finally righting the ship, except he
wasn’t. Soon after his Boston presentation, Dr. Halsted checked himself
into Butler Sanitarium again, this time for nine months. Over a twenty-
two-month-long stint, “William Stewart” (his assumed name at Butler)
spent sixteen months at the sanitarium, accomplishing nothing
scientifically in the prime of his surgical career. No one taking bets at that
time would have predicted he would ever resume surgical practice again,
let alone assume the mantle of the most significant surgeon in American
history.
Halsted clandestinely returned from his sophomore recuperation at
Butler in December 1887, and quietly returned to work at the Pathology
Building. The bachelor surgeon faithfully dined and socialized at the
Maryland Club near his Baltimore dwelling, fastidiously researching by
day with Welch and the young coterie of physicians. The previously
energetic and gregarious surgeon had adopted a protective carapace, his
old-fashioned pince-nez eyeglasses perched on his nose, shielding a dark
secret of combined addiction to cocaine and morphine. Perhaps only
Welch ever knew (for sure) that Halsted was an unrelenting, unrepentant,
and partially incapacitated user.
In the classic German legend of the scholarly alchemist Faust, the
malcontented intellectual makes a pact with the devil, exchanging his soul
for unlimited knowledge and worldly pleasures. There is no doubt that
Halsted’s cocaine use started innocently, but he rapidly was bewitched by
its powers. Prescribed morphine at the sanitarium, the Greek god of
dreams, Morpheus, also entranced Halsted. Sadly, a pervasive personality
change gripped Dr. Halsted to his grave. Serious, secretive, ashamed, and
vulnerable, he retreated into a cocoon that few could break into. By our
nature, surgeons are “control freaks,” and the powerlessness must have
tortured Halsted.
The routine at the “Pathology” had been comforting to William Stewart
Halsted, and by early 1889, he had begun seeing patients and operating at