Empire of the Scalpel: The History of Surgery

by Ira Rutkow M.D.

Overview

From an eminent surgeon and historian comes the “by turns fascinating and ghastly” (The New York Times Book Review, Editors’ Choice) story of surgery’s development—from the Stone Age to the present day—blending meticulous medical research with vivid storytelling.

There are not many life events that can be as simultaneously frightening and hopeful as a surgical operation. In America, tens-of-millions of major surgical procedures are performed annually, yet few of us consider the magnitude of these figures because we have such inherent confidence in surgeons. And, despite passionate debates about health care and the media’s endless fascination with surgery, most of us have no idea how the first surgeons came to be because the story of surgery has never been fully told. Now, Empire of the Scalpel elegantly reveals surgery’s fascinating evolution from its early roots in ancient Egypt to its refinement in Europe and rise to scientific dominance in the United States.

From the 16th-century saga of Andreas Vesalius and his crusade to accurately describe human anatomy while appeasing the conservative clergy who clamored for his burning at the stake, to the hard-to-believe story of late-19th century surgeons’ apathy to Joseph Lister’s innovation of antisepsis and how this indifference led to thousands of unnecessary surgical deaths, Empire of the Scalpel is both a global history and a uniquely American tale. You’ll discover how in the 20th century the US achieved surgical leadership, heralded by Harvard’s Joseph Murray and his Nobel Prize–winning, seemingly impossible feat of transplanting a kidney, which ushered in a new era of transplants that continues to make procedures once thought insurmountable into achievable successes.

Today, the list of possible operations is almost infinite—from knee and hip replacement to heart bypass and transplants to fat reduction and rhinoplasty—and “Rutkow has a raconteur’s touch” (San Francisco Chronicle) as he draws on his five-decade career to show us how we got here. Comprehensive, authoritative, and captivating, Empire of the Scalpel is “a fascinating, well-rendered story of how the once-impossible became a daily reality” (Kirkus Reviews, starred review).

Product Details

ISBN-13:	9781501163753
Publisher:	Scribner
Publication date:	02/14/2023
Pages:	416
Sales rank:	383,291
Product dimensions:	5.40(w) x 8.30(h) x 1.20(d)

About the Author

Ira Rutkow is a general surgeon and historian of American medicine. He also holds a doctorate of public health from Johns Hopkins University. Among Dr. Rutkow’s books are several encyclopedic works on surgical history: Surgery: An Illustrated History, named a New York Times Notable Book of the Year; American Surgery: An Illustrated History; and a two-volume bibliography, The History of Surgery in the United States, 1775-1900. He is the author of three other books, Seeking the Cure, James A. Garfield, and Bleeding Blue and Gray. Dr. Rutkow and his wife divide their time between New York City and a farm in the Hudson Valley.

Table of Contents

Author's Note ix

Prelude 1

Part I Beginnings

1 Genesis 15

2 Exodus 23

3 Prolific Pens 29

4 Darkness, Then Daylight 37

Part II Foundations

5 The Human Road Map 51

6 To Stop the Flow 65

7 The Circle 79

8 Emergence 89

9 Transition 103

Part III Revolutions

10 Pain-Free 119

11 They're Alive 135

12 Scientific Progress 155

13 The Shock of Technology 169

Part IV Baptisms

14 Mass Appeal 185

15 Professionalization 207

Part V Triumphs

16 The Blood of War 231

17 The Center of Things 253

18 Out with the Old 273

Part VI The Present and the Future

19 Changes 295

20 Prospects 317

Acknowledgments 325

Notes 327

Bibliography 347

References 353

Photo Credits 383

Index 385

Editorial Reviews

"By turns fascinating and ghastly. . . . [Readers] will learn that the history of modern surgery is the history of the rise of the modern world, with all that has involved—not just science and technology but also politics, architecture, demographics and institutions. . . .[Empire of the Scalpel] shows how the history of surgery is about so much more than just science and new surgical procedures. All human life is there.” —New York Times Book Review, Editors' Choice

“Unexpected and fascinating perspectives not only on the operating table but also on war, science, society, and human behavior, as well as the biggest questions of all: how we die, how we kill, how we heal, and how we cure.” —The American Scholar

"Rutkow has a raconteur’s touch, and he is especially good on the rugged, difficult, obstinate characters that propelled the field’s advance during a heroic age of medicine.” —The San Francisco Chronicle

"Empire of the Scalpel is a complex history of giant steps made in surgery and a heads-up for what to expect next." —Winnipeg Free Press

"Rutkow, who has written multiple books about surgery, offers both useful historical context and deserved recognition to the key figures. . . . A fascinating, well-rendered story of how the once-impossible became a daily reality." —Kirkus (starred review)

“[A] smart survey from historian and surgeon Rutkow. . . . 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.” —Publishers Weekly

"A well-documented and jargon-free work, aimed at helping laypeople better understand surgery and its practitioners." —Library Journal

From the Publisher

02/01/2022

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

Library Journal

★ 2021-12-15
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.

Kirkus Reviews