Louisville Medicine Volume 63, Issue 11 | Page 11

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