Dr Michael Brown (Roehampton University)
Teaching Compassion – Surgical Education and the Inculcation of Moral Values in Early Nineteenth-Century Britain
It is often generally assumed that the practice of operative surgery in the pre-anaesthetic era was dependent upon the cultivation of a dispassionate and detached attitude towards pain and suffering, what William Hunter famously described as a ‘necessary inhumanity’. By performing dissections on cadavers and witnessing painful surgical procedures, it has been suggested, surgical pupils learnt to harden their hearts and act with cool rationality in the face of profound emotional distress. However, a closer reading of the historical sources suggests that the reality was more complex than this.
In fact, contrary to this established narrative, the early nineteenth century saw the flowering of a rich language of compassion as, shaped by the cultures of sensibility, surgeons began to conceive their relationship with patients in terms of emotional intersubjectivity. As Astley Cooper put it: ‘In the performance of our duty one feeling should direct us; the case we should consider as our own and we should ask ourselves, whether, placed under similar circumstances, we should submit to the pain and danger we are about to inflict’.
Much of the evidence for this culture of surgical compassion can be found in lectures and other such pedagogic materials. This paper therefore considers the importance of the lecture theatre as a space for the shaping of a new surgical culture. It demonstrates how certain lecturers sought to promote the values of restraint and responsibility in contrast to the imagined brutality of earlier periods. Hence it also explores how this new surgical identity was linked to surgery’s self-conscious social and professional ‘improvement’ in the early decades of the nineteenth century.
Dr Michael Brown is a Senior Lecturer in History at the University of Roehampton.