his loving and doting parents and a younger brother. Tragedy struck
early with the death, in rapid succession, of his younger brother,
mother, father and his caretaker maternal grandmother. At age seven,
young Thomas, a perpetually infirm orphan with an unremitting
cough and rather meager inheritance, became a ward of a distant
cousin, Colonel Carter, who provided him shelter, food and money
for his burgeoning habit of acquiring expensive clothes while he
was packed off to a boarding school. Thomas was an academic
wunderkind, a hardworking and scholastically brilliant young man
who excelled in high school and college, and eventually graduated
at age 23 from what was the oldest and most renowned medical
school in the United States, the University of Pennsylvania.
The impetus to become a doctor, first and foremost, was the
suffering and premature death that afflicted several members of his
own family. With sheer determination and perseverance, he wanted
to improve his own lot - both health-wise and financially - as well
as alleviate the suffering of ailing humanity. He had witnessed the
grisly and inhumane “bleed, blister, purge and amputate” practice
mindset of physicians at the time. Because of the paucity of adequate
postgraduate education and lack of opportunities in the United
States, he sailed across the Atlantic and embarked on a year-long
sojourn in Paris, at that time the Mecca of medicine. Parisian medicine was innovative and progressive and blended the brutality of
medieval times and rationality of the Enlightenment. Two horrific
examples include whipping the sufferers of syphilis before and after
treatment and feeding cadaver remains after anatomical dissections
to hungry dogs. The young American physician Mütter watched
the masters of the surgical craft including Jacques Lisfranc, of the
mid-foot “Lisfranc injury” fame, and Philibert Roux, a famous
gynecologist. Among these surgical wizards was the famous and
politically strong Baron Dupuytren, who ruled the largest hospital
in Paris, le Hotel-Dieu, with an iron hand, and was feared and
revered by patients and colleagues alike. He was dubbed “the best
of surgeons, the worst of men.” Dupuytren was ill-mannered and
domineering with a crude and brute demeanor with patients. While
Mütter admired the Parisian surgeon’s creativity, cleanliness and
originality, he deplored his callousness to patients.
and bonded with his patients prior to his surgeries, spending time to
massage and caress the affected areas to desensitize patients, since
operations were performed on fully awake patients. Mütter Ether
Anesthesia was adopted under his supervision for his surgeries, even
though there was strong opposition to its use in the community.
Interestingly, his flamboyance, strict adherence to hygiene, his insistence on hand-washing, and his most unusual habit of indulging in
compassion won him several antagonists, particularly his colleague
at Jefferson medical college, Dr. D. Meigs. Time was running out
for Mütter, however. He developed progressive gouty arthritis and
his breathing difficulties with incalcitrant cough and hemoptysis
compelled him to retire. He was eventually able to strike a deal with
the College of Physicians of Philadelphia for building a museum
for his anatomical specimens. He died prematurely of tuberculosis
in 1859 at the age of 48.
Aptowicz’s narrative, “Dr. Mütter’s Marvels,” is an excellent read
about the life of an uncommon American original and the transformative epoch during which he lived. He had empathy for the
patients, charisma and technical savvy for surgical interventions
and such enviable teaching capabilities that he should be long remembered, and thanks to Ms. Aptowcitz, he will be. Sally and I will
certainly visit the Mütter’s Museum on our next trip to Philadelphia
(no less than part of Einstein’s brain is now on display).
M. Saleem Seyal, MD, practices Cardiovascular Diseases with
Floyd Memorial Medical Group-River Cities Cardiology.
After his return to Philadelphia, he added an umlaut to his name
and was now called Thomas Dent Mütter. Despite his initial difficulty in getting established in private practice, he found his niche
in pioneering and practicing reconstructive surgery on disfigured
patients with previous burn injuries and heavy scarring, who were
pejoratively called “monsters.” He devised the “Mutter flap surgery”
that is still used in reconstructive/plastic surgery. He repaired rather
severe cleft palates and performed other surgeries with excellent
results, particularly with lower incidences of complications and
infections. He was a favorite a