Lister had pioneered antiseptic surgery a quarter of a century prior to
the naissance of Johns Hopkins Hospital. It had started with sponge
dousing of carbolic acid to a surgical site, and then evolved to the use of
an atomizer to spray the acid into the air. Next, the surgeons’ hands were
approached with special indignity, with application of strata of acids,
oxidizing agents, and amalgams. Scrubbing, dipping, coating, and painting
was consigning everyone’s hands to becoming reddened and inflamed, if
not purified. In particular, a well-to-do Southerner, nurse Caroline
Hampton was troubled with dermatitis of her hands.
Welch had brought rubber work gloves back from Germany, using them
for autopsy duty. They were too thick and clumsy for surgical work, so
Halsted had another thought: could an American company help him
develop a product better suited for the operating room? Halsted later
recalled, “As she [Caroline] was an unusually efficient woman, I gave the
matter my consideration and one day in New York requested the Goodyear
Rubber Company to make as an experiment two pair of thin rubber gloves
with gauntlets. On trial these proved to be so satisfactory that additional
gloves were ordered.”^23 It took a few years for everyone in the operating
room to adopt Caroline’s gloves, but the “single greatest advance in the
history of sterile technique”^24 had occurred because of Halsted’s concerns
for his nurse, who, just a few months later, became his wife. Almost forty
years old, Halsted broke the bonds of bachelorhood, with Welch (forever
single) serving as best man.
Before his arrival in Baltimore, Halsted had performed a series of
“firsts” that were simultaneously courageous and bizarre. He was the first
surgeon to remove gallstones, performing the operation in the home of a
privileged and elderly woman suffering a life-threatening gallstone attack.
The patient happened to be his mother. Later, he performed the first blood
transfusion, using the new implements of hypodermic needles and tubing.
The patient was suffering from postpartum uterine bleeding, but her life
was spared after the transfusion. The donor? Dr. Halsted himself. The
recipient? Halsted’s own sister. He also performed the first appendectomy,
but tamely not on a relative.
The surgeon-in-chief Halsted quickly settled into a routine of bold
surgical innovations with assistant surgeon J.M.T. Finney and his first
resident Fred Brockway. Gerald Imber, in his book, Genius on the Edge,
poignantly captures the first breast cancer operation performed at Johns