Book review Gifted hands America’s most significant contributions to surgery Seymour I. Schwartz Prometheus Books. Amherst, New York, USA. 2009. 259 pp. $27.95. ISBN: 978-1-591-02683-9 (hardcover). Reviewed by Kevin J. Tracey Feinstein Institute, Manhasset, New York, USA. E-mail: [email protected] In Gifted Hands: America’s Most Significant its first surgeon, and founder of the New a Nobel Prize for Physiology or Medicine Contributions to Surgery, Seymour Schwartz England Journal of Medicine. At Warren’s for work performed mainly on American reviews the history of surgery in North planned surgery to remove a cervical tumor soil, spent years studying and training in America, covering the evolution and from a young man in his twenties, the first Europe. Whereas entire volumes have been advances in this field from the colonial anesthesiologist, William Thomas Green written about the history and development period to the present. The book chronicles Morton, arrived 15 minutes late, citing last- of individual fields of surgery, here these the stories of individuals who first suc- minute adjustments to the newly invented topics are covered in a few brief chapters. cessfully invaded a body compartment glass ether chamber. His tardy arrival The argument for American preeminence is or developed a life-saving technique that marked an almost comical beginning to a presented with little mention or note about changed the way surgery was subsequently persistent unrequited strain between two the advances in Europe and elsewhere that practiced. The stories contain fascinating professionals in the same theater. Howev- were occurring in parallel. The more mod- detail about not only the surgeons, but er, with the tumor successfully excised, the ern history of surgical advances is rife with also their patients, some of whom were patient reported that he felt no sensation stories of competition to be first, and for full essentially partners in the high-risk exper- of pain, but instead was only vaguely aware press coverage. Those who lived through the iment that would either improve or end of the feeling that a blunt instrument was 1960s and 1970s cannot help but recall the their lives. There is the unforgettable story passing across his neck. Later, Dr. Warren televised daily press conferences reporting of Jane Todd Crawford, the courageous famously noted that this was “the most the health status of the first heart trans- patient who would become forever linked valuable discovery ever made.” Another plant recipients, and the jingoistic fervor to a “daring” surgeon who launched the surgeon, Harvey Cushing, who would later that occurred as international competition field of intra-abdominal surgery in 1809. become known as the father of two fields of erupted to claim the first success. The read- Upon examining Crawford in her home, medicine, neurosurgery and endocrinology, er interested in either the societal context Dr. Ephraim McDowell said that he would developed the first anesthesia record when that undoubtedly fueled American surgical attempt to remove the tumor (which had he was a medical student. He had become advances or the “disdain” for American sur- been incorrectly diagnosed as a growing severely depressed when a patient receiving gery referred to at the outset of the book will fetus) if she could make it to his office. ether anesthesia by his hand succumbed, likely seek additional sources. Crawford traveled alone for days on horse- so he set out to invent a recording chart to None of this detracts from Schwartz’s very back, balancing the tumor on her saddle, document changes in vital signs and anes- descriptive overview of American surgery, but arriving intact for her appointment thesia delivery that, with little modifica- and the captivating stories of some of the with history. The surgical proceedings, tion, continues to be used worldwide. leading doctors and their patient partners. absent anesthesia or antisepsis, are hard Gifted Hands is not a book written “to make The author is himself a leader in American to imagine in the present day. After recu- them come alive without an agenda . .” surgery, with accomplishments that should perating for several weeks, she returned Schwartz has a clear agenda: to convince the be of rights noted in this book, including home by horseback, alone, and remained reader that American surgery has earned a being founding editor of Schwartz’s Prin- very much alive until age 78, having long leadership role within the discipline. The ciples of Surgery, the renowned textbook outlived her surgeon. reader learns of the origin of modern surgi- that formed the basis for educating gen- Schwartz is at his best in presenting cal training programs under William Stew- erations of students and surgical trainees these clinical and timeless descriptions of art Halsted at Johns Hopkins, who sought for decades. Gifted Hands is recommended events that shaped the history of surgery in to provide not only competent practitioners, to students of all ages, to surgical trainees, America. There is the story of the first use but future generations of professors, with and to anyone interested in the history of of anesthesia in an operation performed by expertise in scientific investigation and clin- surgery in America. This great read fills a Dr. John Collins Warren, a founding mem- ical work. Like Halsted and Cushing before void by previous texts that glossed over the ber of the Massachusetts General Hospital, him, Alexis Carrel, the first to be awarded stories of the surgeons and patients. 1790 The Journal of Clinical Investigation http://www.jci.org Volume 120 Number 6 June 2010.