making scientific history at the nondescript hindmost of the university
grounds.
At Bellevue in 1885, Halsted had overseen the construction of an
operating room tent, but at Hopkins (for the first fifteen years), all surgical
procedures were performed in the basement of Ward G, in a makeshift area
lit by gaslight. All of the early anatomical and surgical theaters throughout
Europe and America were at the top floors of academic buildings,
harnessing the natural light streaming in from skylights and large building
windows. Unglamorously, Halsted operated under improvised conditions
in the women’s ward near the Pathology building.
Halsted had an old German operating table from the Franco-Prussian
War, equipped with a central trough that drained blood and the deluge of
caustic preparatory solutions. On the table was stationed a stretcher that
also served as the implement for patient transport. Instead of the classic
black wool Prince Albert frock coat favored by surgeons, Halsted selected
white duck cotton operating suits, with high collars and short sleeves,
topping off the ensemble with a little cotton skull cap. Indeed, the garb
was still primarily worn to protect the surgeon’s finery beneath, but it was
still a dramatic improvement over the blood-caked and detritus-covered
coats.
There in the basement, dressed in white, incorporating what he had
learned in Vienna, Berlin, and Würzburg, Halsted cobbled together a
surgical practice from scratch. Having pioneered regional anesthesia and
scientific animal experimentation, Halsted initiated a series of innovative
changes that resonate in every hospital and academic institution to this
day. In the opening years of the Johns Hopkins Hospital there were no
trees, no medical students, and few surgical colleagues. “Halsted was a
complex and isolated man, forbidding and nurturing; rigid, proper, and
secretive; compulsive and negligent; stimulating and reclusive; addicted
and abstemious; oblivious and solicitous; and always concerned with
advancing the science of surgery.”^22 If Halsted’s story is familiar, it may
be that you have seen The Knick, the television series whose central figure
is Dr. John Thackery, a character who is very much based upon William
Stewart Halsted. Forever burdened with his drug impulses, he pushed on,
his revolution beginning almost immediately at Hopkins, starting with his
care of a nurse’s chafed and inflamed hands.