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Doctors Of The Frontier
Underschooled and ill-equipped, the men who attended the pioneers practiced a rugged brand of medicine—but they made some major advances all the same
April 1963 | Volume 14, Issue 3
The sufferer had to choose between the probability of death at once, and the certainty of death a little later. She had to weigh her responsibilities to her four small children. And she must have thought a lot about the sheer physical ordeal which a decision in favor of surgery entailed. It was winter, and Danville lay about sixty miles away over steep and twisting trails. Every mile would be an agony in her condition, but in that direction only lay life. On a December day she made her decision. Leaving her husband, Thomas, in charge of the children, she set off on horseback, resting her swollen abdomen on the pommel of the saddle. The details of her heroic journey are now clouded by legend, but somehow she made it. At Danville, Dr. McDowell put her to bed for two days’ rest before the operation.
He scheduled it for a Sunday morning, as was his custom in difficult cases, so that the prayers of his church might be with him in his task. On this occasion, however, some of the townsmen thought he was doing the work of the devil. Superstition and sexual taboos contributed to dark murmurs that the doctor was “butchering a woman’; according to some accounts a threatening crowd gathered outside his house. His nephew and medical assistant begged him not to go through with the operation. In vain.
Two assistants and a nurse stood by to help, part of their duty being to hold and comfort the patient. Anesthetics did not yet exist. It was Mrs. Crawford’s turn to seek divine aid now; as pain and fear came, she gritted her teeth and recited the Psalms. A foot-long incision was made, and almost instantly there was a crisis. “The intestines rushed out,” Dr. McDowell reported. “So completely was the abdomen filled with the tumor that they could not be replaced until the massive lesion was removed.” Those who worked with the surgeon said that his face flushed and perspired at such moments, but his hands remained marvelously steady. Quickly he turned the patient on her side, so that the sprawling intestines would not block his view of what had to be done. He cut out a tumor which weighed about twenty-two pounds, removing at the same time much of the Fallopian tube. The task was accomplished in about twenty-five minutes.
Five days later Dr. McDowell looked in on his patient for a morning checkup and found to his astonishment that she was up and about, making her bed. He gave her, in his own dry phrase, “particular caution for the future,” but she was not a woman to lie abed when urgent duties were calling her back to the workaday world. Some three weeks after the operation, this incredibly hardy woman climbed on her horse and rode back to a joyous reunion with her family.
Dr. McDowell repeated the success twice more in the next seven years before he deemed it worthy of reporting to a medical journal. It is a measure of what he had achieved that his account simply was not believed. In Europe especially, the medical authorities thought it impossible that this unknown man in a raw, new country had achieved something beyond the grasp of the most renowned surgeons of London, Paris, and Berlin. British physicians deplored the operation as “dangerous to the character of the profession,” and the French dismissed it as “among the prerogatives of the executioner.” The reception in this country was not much better. Dr. McDowell did not argue the point but went his way, repeating the feat when circumstances required, achieving eight successes in thirteen attempts. About half a century later medicine caught up with him, and he was recognized, posthumously, as a giant of his time, the first man to perform an ovariotomy. A memorial to him stands at Danville today. As for tough Mrs. Crawford, she lived to be seventy-eight.
Dr. William Beaumont was another who gained fame with the help of an almost indestructible patient. Beaumont was a United States Army physician assigned to a fort and trading post on Mackinac Island in Lake Michigan during the 1820’s. Several thousand Indians and French-Canadian voyageurs swarmed through the post each year, bringing pelts from the wilderness. These trappers were a rough lot; knife and gunshot wounds figured prominently in the doctor’s busy practice. One of these, in 1822, resulted in a now-famous chapter in medical history. A nineteen-year-old voyageur named Alexis St. Martin was all but torn apart by the accidental blast of a shotgun. The shot poured into his stomach at three-foot range, the flash from the muzzle setting his clothes afire.
The prospect of success was dim. Dr. Beaumont found “a portion of the Lungs as large as a turkey’s egg protruding through the external wound, lacerated and burnt, and below this … a portion of the Stomach which at first view I could not believe possible to be that organ in that situation with the subject surviving.” Further examination revealed a stomach puncture large enough to admit a finger. Said Dr. Beaumont: “I proceeded to cleanse the wound and gave it a superficial dressing, not believing it possible for him to survive twenty minutes.”