Two doctors who, like Mütter, were born and raised in Virginia would be elected to two more of the chairs: John Kearsley Mitchell was elected to chair of the practice of medicine, and Robert Huston was given the chair of materia medica (materia medica being the era’s catchall term for “the body of collected knowledge about the therapeutic properties of any substance used for healing”).
Meigs was likely hoping that, of the six doctors up for consideration for the chair of chemistry, Franklin Bache would ultimately be selected. Bache, the great-grandson of Benjamin Franklin, had taught in tandem with Meigs for more than six years. Their long friendship meant so much to each other that they both named sons after the other.
Meigs named his seventh and youngest son Franklin Bache Meigs, while Bache had given Charles’s name to his firstborn—Charles Meigs Bache—who, sadly, passed away shortly after birth. Bache had six children, five of whom were still living when his wife, Aglae, passed away in 1835. Bache, “faithful to her memory,” never remarried.
Meigs and Bache made quite a pair. Bache had a full head of hair, thick bushy eyebrows, and a placid, calm sweetness. Meigs was thin, with sallow visage and a large balding head. But they shared a sense of moral righteousness. Both considered themselves austere, honest, and forthright and could not easily lend themselves to any compromise that might lie between right and wrong.
Benjamin Franklin and his great-grandson Franklin Bache
“If I were to describe Franklin Bache, I would speak of him as an entirely upright man—not merely upright in outward dealings, but in thought and word and deed,” a former student once said of him. “To his mind a matter was either right or wrong, true or false. He could not appreciate, as some do, intermediate shades.”
Meigs shared this rigid vision of morality and took it several steps further. If someone in Meigs’s family was found guilty of “discrediting” the Meigs name, he simply removed all evidence of them from the family Bible, a tradition he asked his children to keep.
“If all men could be induced to preserve their family records, discarding without mercy every member of their blood-line, whose conduct might stain it,” Meigs told his children, “society would derive great security, and virtue a strong support from that course.”
“If it should be deemed unfair to ignore discreditable members of a line,” he begrudgingly added, “then at least let a mark of disapprobation be set opposite their record.”
Unlike Meigs, however, Bache didn’t have the best reputation as a teacher. Some argued that his famous family opened doors that would not have been opened for a lesser-known man of similarly limited talents.
“If as a lecturer [Bache] was dull,” a colleague would later write of him, “he was earnest and faithful; and the students, if at all intelligent and attentive, could not fail to be instructed by him. But it must be confessed that few of them ever displayed much knowledge of chemistry at their final examination.”
But luck was with the old friends, and Franklin Bache—despite stiff competition—was also voted to his position unanimously.
• • •
Mütter was the youngest name to be forwarded to the Jefferson Medical College board. He was thirty years old, having graduated from medical school only ten years earlier.
Mütter’s gifts as a lecturer had been amply demonstrated during the six years he had spent at the Medical Institute, and his reputation—as a surgeon and as a professor—was now firmly established. Still, he faced tough competition with the only other name up for nomination: Joseph Pancoast.
Pancoast was the same surgeon who had beaten McClellan—the founder of Jefferson Medical College—for the coveted chair of surgery. Pancoast was six years older than Mütter and had a reputation as “an extraordinarily versatile man” when it came to medicine. A combination anatomist and surgeon—and prominent in both arenas—he was so skilled across platforms that he was the only doctor to be nominated for more than one chair. In fact, he was nominated for three.
Like Mütter, Pancoast was an innovator. He challenged not only how medicine was taught, but how medicine should be practiced. Among his many innovations, Pancoast could claim:
An early type of cataract surgery (performed while the patient is awake—“a very fine needle, turned near the point into a sort of hook, is introduced three-sixteenths of an inch behind the cornea” );
The invention of the plough and groove, or plastic suture (“in which four raw surfaces, the beveled edges of the flaps, and the margins of the groove cut to receive the flaps, come together”);
A surprisingly “good-looking substitute” for a destroyed eyebrow (“made by raising a flap of the scalp with the soft drooping hairs of the temple, and giving it a long pedicle, to run in a bed cut for it up to the brow”) ;
And a surgical technique (involving “an abdominal tourniquet with a large roller compress over the lower end of the aorta”) that made amputations at or around the hip joint possible, since before Pancoast’s innovation, such amputations were “very fatal from the excessive blood loss.”
Additionally, Pancoast was known as a man of decided convictions, professional, moral, and political; a kind husband and father; a warm friend; and an upright citizen. Mütter admired Pancoast, and saw in him a potential ally in the work Mütter himself was attempting to do. To Mütter, it seemed as if he and Pancoast shared a common vision: to help free medicine from an inherited body of superstition, both with their patients and within the profession.
As a professor, Pancoast was respected by his peers and his students. And while he earned praise of his work with anatomy, it was Pancoast’s surgical prowess that worried Mütter the most.
“He possessed all the attributes of a great operator—quickness of perception, unflinching courage, and rare presence of mind,” another surgeon wrote of Pancoast. “It may truly be said of him that his hand never trembled and his eye never winced.”
How could Mütter, who was still young both in age and in his career, compete with such a man?
• • •
So despite Mütter’s growing reputation, it was nonetheless a surprise that when the votes were cast, it was Mütter, not Pancoast, who was unanimously elected chair for the principles of surgery.
Pancoast was instead elected the chair of anatomy.
And in a surprising move, the college decided to elect a separate chair for the practice of surgery. It was the first time in the institution’s history that the study of surgery would be divided in such a way. Pancoast too was up for that position but lost it to Dr. Jacob Randolph, the son-in-law of Philip Syng Physick, whose own work in late-eighteenth-century operating rooms was so profoundly innovative and important that Physick was dubbed the “father of American surgery.” But Randolph was utterly unsupportive of splitting the chair of surgery in such a way, and swiftly declined what he saw as a weakened position.
After hearing Randolph’s response, the board decided not to split the chairs after all. Instead of having two surgical chairs—one for the “principles” and the other for the “practice” of surgery—they voted to reinstate the one powerful position of chair of surgery. And they voted to give that chair—and the incredible platform it provided—to their youngest and least- tested professor: Thomas Dent Mütter.
Shortly after the election, Philadelphia’s frigid weather broke. The thaw was so quick and so great that Philadelphia’s Schuylkill River overflowed, flooding into the city almost two full city blocks on each side.
It was equal parts calamity and miracle, for as difficult as the flood was, the city that had felt too long held hostage by the drawn-out winter, finally felt ready for change—no matter the wreckage.
CHAPTER EIGHT
THE NEW JEFFERSON MEDICAL COLLEGE
Portrait of a Jefferson Medical College Student
THE PHYSICIAN MUST BE AN INDUSTRIOUS MAN
Without habits of ind
ustry, the finest talents are, for the most part, lost.
Each day adds something new to the general stock of medical lore,
and it is your bounded duty to diligently and carefully investigate
the nature and worth of these additions, and endeavor at the same time
to contribute your own might towards the elucidation of difficulties,
or the improvement of your art.
Up, then, young men!
You, to whom a future generation has to look for the decisions of the questions which the feeble light of our day prevents us from determining.
THOMAS DENT MÜTTER
The advertisements announcing the new faculty of Jefferson Medical College began running that summer, and attempted to lure new students in periodicals like The Boston Medical and Surgical Journal and The New York Medical Gazette:
JEFFERSON MEDICAL COLLEGE.
Session of 1841–42.
The regular Lectures will commence on the last Monday of November.
On and after the first of October, the dissecting room will be open, and the Professor of Anatomy will give his personal attendance thereto. Clinical instruction will likewise be given at the Dispensary of the College.
During the course, ample opportunities will be afforded for clinical instruction; Professors Dunglison, Huston, and Pancoast being medical officers of the Philadelphia Hospital; Professor Meigs of the Pennsylvania Hospital; and Professor Mütter, Surgeon to the Philadelphia Dispensary.
Professor Dunglison will lecture regularly on Clinical Medicine, and Professor Pancoast on Clinical Surgery, at the Philadelphia Hospital, throughout the course.
Added to these facilities, the Museum of the Institution affords essential aid to the student, by its various anatomical, pathological, and obstetrical preparations and drawings, as well as by the diversified specimens of genuine and spurious articles, and plates, drawings, &c. for illustrating the materia medica. These, with the numerous and varied specimens that have been recently added from the private collections of the members of the faculty, render the Museum and Cabinets more rich and effective for the purpose of Medical Instruction than they have ever been.
ROBERT M. HUSTON, M.D., Dean of the Faculty.
The New Jefferson Medical College. That is how the board hoped people would refer to it once the illustrious names of their newly appointed, hand-selected faculty were revealed.
Up until now, the strength of Jefferson had always lain in the personal power of its faculty, and the refined, scholarly Dunglison hoped these men—evenly split between old and new, Northerners and Southerners—would usher in a new era for the vanguard medical institution. And furthermore, that these men would help shape a bolder, more ambitious, more unified vision for what American medicine could be during an important and precarious time in history.
But for now, they had to survive their first year, this brilliant collection of physicians, all with strong personalities, fixed opinions, and the kind of robust, prideful egos that come from making a career of saving people’s lives. Now this same group had to compete for resources, attention, and respect from their new peers, their new board, and their new students—and all without bitterly and publicly imploding as other faculties before them had.
• • •
For the returning students of Jefferson Medical College that year, much of their routine seemed the same as it had been in years past . . . at first.
In the morning, the students would enter the Ely Building, the main lecture hall of the college, located on the southwest corner of 10th and Sansom Streets. Recently remodeled to better suit the school’s ever-growing population of students, it boasted two “capacious” lecture rooms that could comfortably seat 450 (and seat 550 uncomfortably), as well as two additional large halls in the rear of the building.
The first hall would be the territory of Dr. Pancoast, used exclusively for dissecting.
The second hall would be used as an “anatomical museum”—a storage space where professors could keep the physical materials they used in their lectures: models of human faces or body parts made of wood, or wax, or plaster; actual bones, limbs, and organs preserved in jars; and realistic anatomical illustrations, as seen in both paint and pen. It would also be the place where students could view unusual medical specimens and artifacts; for instance, a strange wax model of a French woman with a thick horn growing from her head, donated by the curious new professor of surgery.
Over the years, Mütter had amassed an ambitious collection of unlikely, abnormal, and extraordinary material—intestines pulled from cholera victims; a human heart that had been slowly transforming into bone; cancerous livers, lungs, kidneys, and spines; a cancerous testicle so enlarged by its disease that a special case had to be built to contain it; tumors sliced from noses, throats, eyeballs, and breasts; a finger so brutally ripped from its hand that only a flexor tendon remained attached; a human foot showcasing a horrific compound fracture of the ankle, which had been dried and prepared so that it looked like a wax model . . . but wasn’t; the withered heart of a ten-year-old boy whose limbs turned blue because of his body’s inability to hold on to oxygen; a wax cast of a hermaphrodite; and much, much more.
“He surrounded himself richly with materials of illustrations,” a fellow professor would later write, “to excite, surprise and [inspire] wonder.”
Mütter was thrilled to finally have a place to properly store and display his collection. And the students reveled in the chance to examine specimens and artifacts that—up until the moment they fixed their gaze upon them—they had assumed could only be the impossible product of a wild imagination.
• • •
For six long hours each day—in frigid cold and relentless heat—students sat upon hard benches in Jefferson’s overcrowded lecture rooms, listening to their professors intently while taking notes with journals balanced on their knees, the nibs of their pens dipping often into small pots of ink positioned perilously on the corners of portable writing desks.
Some professors allowed for questions at the end of each lecture, but for the most part, they were largely one-sided affairs. It was the job of the professor to share what he knew, and the job of the student to “task to the utmost [his] powers of memory and analysis.”
When evening finally came, the exhausted students would retire to their rented rooms to eat small meals of potatoes, oysters, beer, and bread, and “trim [their] lamps for a toilsome study.”
“Many a time, in the midnight rambles of my medical duty, I have looked up from the street to the pale light of the student’s room,” later recalled John Mitchell, a fellow Jefferson faculty member, “and heaved a sigh at the thought, that one so young and playful should there be thwarting the gentle instincts of his nature.”
This was a pattern that would last for months, or even years, as medical students were encouraged to take two yearlong sessions of courses prior to their final examination. At this point, it was the tradition, and the students entering Jefferson Medical College had no reason to think it would change when they first entered Mütter’s lecture hall in November of 1841.
• • •
Mütter stood at the lectern and watched his students enter the lecture hall. Novembers were (and are) typically frigid months in Philadelphia, and this one was no exception. The young men stumbled in, looking nearly identical in brown and black coats, their hats pulled down to cover their foreheads and the frozen tips of their exposed ears.
The students hailed from all over the newly formed country: Virginia, New Hampshire, Pennsylvania, Delaware, Ohio, Kentucky, New York, Tennessee, Mississippi, Connecticut, Maryland, Georgia, Maine, Alabama, and South Carolina. There were even men from Canada and Ireland who had traveled all the way to Philadelphia to learn medicine in this institution and from these men.
Mütter greeted each one loudly as they walked in, catching many by surpri
se. Surely, they thought, this gregarious young man at the lectern must be playing a prank of some sort. After all, it was customary for the professor to wait until the room was full before making his entrance, lest their learned, lauded, and in-demand instructor waste even one second of his precious time.
So who was this strange gentleman—small in stature and delicately framed, with a clear blue eye, high forehead, and thick black hair—who waited for them at the lectern, greeted them ardently, and asked them their names?
The experience only grew odder with Mütter’s lecture. He began by speaking about the state of medicine, as the other professors had done before him. He was a charismatic presence from his first utterance, possessing a wonderfully musical voice, which, even in its lowest notes, could be distinctly heard throughout any of Jefferson’s large lecture halls. His gestures were relaxed and comfortable, and his speech was smart and sharply prepared.
But while his speech was buoyed often by the great charm of his enthusiasm, it seemed oddly marred by long stretches of silence, when Mütter peered into the audience with a curious, expectant smile.
This behavior made no sense to the students. Mütter seemed so confident, and yet, when he came to a question in his speech—whether it was theoretical in nature, or steeped in known facts—he would stop, as if he were actually inviting the students to answer the question.
Finally, one student took the bait. From the depths of the lecture hall, a clear voice broke the silence and offered up an answer to one of Mütter’s questions.
The students froze as Mütter quickly turned to locate the source of that clear voice and locked his eyes with the young man’s. Mütter smiled brightly and thanked him for his contribution, before adding that he hoped more students would follow his lead and be so bold.
It was a strange beginning to what would be an equally strange year.
Dr. Mutter's Marvels Page 8