Empire of the scalpel The history of surgery

Review by Publisher's Weekly Review

"The history of surgery is a series of awe-inspiring, discrete triumphs," according to this smart survey from historian and surgeon Rutkow (Seeking the Cure). He begins in the Stone Age, when individuals successfully cut open skulls for unknown reasons, then brings the story forward by elucidating the four most important factors necessary for successful surgery--understanding human anatomy; controlling bleeding; minimizing the risk of infection; and reducing pain. "If a pantheon existed to honor the surgical greats," Rutkow writes, those who made breakthroughs on those four issues would sit "in the front row." This includes Andreas Vesalius, who in the 16th century studied human anatomy despite the threat of being burned at the stake, and Joseph Lister, who pioneered surgical antisepsis practices in the 19th century. Rutkow does a good job of discussing the cultural issues surrounding surgery: war, for example, "has always posed moral dilemmas for surgeons," given how much they learned treating wounds on the battlefield. He's at his best when delving into the stories behind specific breakthroughs--as with his colorful description of the first surgery that used anesthesia, in 1846 Massachusetts. The result is a unique take on the history of medicine. (Mar.)

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Review by Library Journal Review

Surgeon and medical historian Rutkow (Surgery: An Illustrated History) writes a chronological history of surgery (primarily in Western societies) that begins with "Stone Age surgeries," evidenced by 10,000-year-old human skulls bearing manmade holes, which have been unearthed around the world. Rutkow's history links surgical advances to concurrent social and scientific developments: in medieval Europe, "barber surgeons" who dared to attempt invasive procedures were looked down on by physicians--who were doing their own primitive, often-futile procedures, unsupported by science. Only with the gradual emergence of anesthesia, antisepsis, hospitals, antibiotics, and professional accountability did surgeons begin their rise to respectability, Post writes. Advances came at a cost, and grisly battlefields became field labs. Rutkow's book is interspersed with depictions of significant, largely Western figures in the history of surgery and experiences from his 40 years as a surgeon. He touches on Eastern medicine but says that his focus is Western surgical developments, as they came to dominate globally; he also discusses the women and people of color who are less represented in the contemporary surgical field. VERDICT This is a well-documented and jargon-free work, aimed at helping laypeople better understand surgery and its practitioners.--Richard Maxwell

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Review by Kirkus Book Review

A veteran surgeon and historian of American medicine charts the development of effective surgery. Rutkow, who has written multiple books about surgery, offers both useful historical context and deserved recognition to the key figures. The author notes that the first evidence of surgery goes back millennia--there are skulls from the Neolithic period with holes in them caused by a method called trephination, which relieves dangerous pressure on the brain--but he also acknowledges that for centuries, surgery was a last-resort procedure, almost as likely to kill the patient as save them. In fact, some of the early surgeons were barbers, presumably because they owned sharp blades. Rutkow sets out the parameters for successful surgery as we now know it: a profound knowledge of anatomy, a capacity to stem blood loss, access to anesthesia, and a precise understanding of infection and how to combat it. He shows how each of these elements has been addressed and provides biographical sketches of the physicians and researchers responsible. Modern developments such as X-rays and blood typing helped to turn surgery into a more exact science, reflected in increasing professionalization and specialization in the field. The first kidney transplant, in 1954, was a remarkable achievement, marking the way ahead for operations of increasing complexity. Rutkow also adds some vignettes about his own surgical experiences, which gives the book an added dimension of personal connection. The author avoids jargon, arguing against the idea of surgeons as a quasi-priestly elite and emphasizing that surgery is, ultimately, about saving lives rather than building reputations. In the concluding section, he examines the impact of robots, 3-D organ printing, and artificial intelligence systems on surgical practices, changes that will require new skills from surgeons. These advancements are all positive, writes Rutkow, but a knowledge of history provides a crucial element of humility for the profession and understanding for the public. A fascinating, well-rendered story of how the once-impossible became a daily reality. Copyright (c) Kirkus Reviews, used with permission.

Copyright (c) Kirkus Reviews, used with permission.

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