The Old Operating Theatre

It's 19 April 1824. Elizabeth Raigen (aged 60) is walking merrily along a busy street in London, minding her own business, when suddenly she is struck down by a passing heavy horse-drawn carriage, which promptly runs over her leg, sustaining a compound fracture of her tibia and fibula and an extensive wound, just above the ankle.  She is swiftly (in horse-drawn carriage terms) taken to St. Thomas' Hospital (now Guy's) where she receives emergency medical treatment (emergency treatment consisting of her wound being patched up as much as possible with some adhesive straps and her leg laid on a pillow). 

That night, Elizabeth can't sleep, is restless and complains that her leg is very hot. Some evaporating lotion (to cool it down) is applied. The next day, blood has started to ooze from the wound and she is given some Tincture of Opium to relieve the pain. Elizabeth's pulse starts to slow down during the following night, although manages to get some sleep. She hasn't been to the toilet (number two) since she arrived at hospital so is given some castor oil to get things moving. Elizabeth is in pain and to make things worse, pus starts to ooze from the wound. Suppuration takes place (squeezing the pus out). Thanks to the castor oil, the next day she's able to go to the toilet two or three times. Unfortunately the oozing pus is getting worse and blisters have started to appear on the front of her foot. She's given more opium to relieve the pain.

Another restless night follows, her tongue has become dry and brown and her pulse is weak and quick. The strappings on her wound are removed due to the large amount of pus, it is packed out with a piece of lint soaked in nitric acid and a poultice laid over it. She is given some wine and as much food as she can take.

A few days later, her symptoms have continued to increase, and she is weaker.  Elizabeth is feeling low, weak and is no longer speaking.  The wound is now much worse, has started to smell and gangrene is setting in.  The wine isn't helping.  Elizabeth is now on death's door and the decision is made to remove her limb altogether, her only chance of survival.  In desperation, Elizabeth consents to the operation.  The operation goes ahead the following day at 1:00 pm in the female operating theatre, London Bridge.  Usually she would never be able to afford the attentions of such experienced surgeons, but on this occasion, she agrees to be used as a teaching aid.  Elizabeth is wheeled along the corridor of the women's ward, and then hoisted up a floor between the stair case to the Operating Theatre, where the amputation takes place.  Observed by as many students as the theatre can possibly accommodate.  Without anaesthetic.

So, viewers, this is where you find us on this bright sunny day.  Standing here in the very same operating theatre where Elizabeth (and countless other women) suffered the effects of surgery without anaesthetic, nor advanced knowledge of medicine, with an audience of medical students observing the whole thing.  

Now, before I tell you more about the Operating Theatre itself (sorry to sidetrack momentarily), first I must tell you that this was our second attempt at visiting.  The first attempt failed due to the Theatre being too full with tourists, so we were turned away.  Quite disappointing as you can imagine, but, intrepid explorers that we are, we found other things to entertain ourselves with meanwhile.  Just to keep you in the loop - these included a refreshment stop at Vinopolis wine bar in Borough Market (sorry, no photographic evidence), and a wander around Guy's Hospital grounds to find an elusive piece of the old London Bridge.  Thankfully, we found it without much of a kerfuffle (I love that word).

The gent you can see perched on the far left is a sculpture of John Keats (whose history I won't go into now, but worth a look if you have time on your hands, poor chap).  This part of London Bridge is in fact one of the old arches under the bridge - there are four left, dotted around London haphazardly.  One being here in the grounds of Guy's.  Worth a mention I think.

Also worth a quick mention regarding the failed first trip - the Shard once again glared down at us from the realms above and we couldn't help but notice the crazy fools hanging around at the top!!

Operating Theatre & Shard

Anyway.  On with the task at hand.  So this time we were in!  After a climb up a windy staircase above St. Thomas' Church, barely wider than our shoulders (not for the faint-hearted) we arrived in the Herb Garrett, used by St. Thomas' apothecary to store and cure herbs.  Looking around, we saw quite a few stomach churning things....

The narrow staircase

 We quite liked the ornate Nurse's Chatelaine - attached to the belt of her dress with suspended useful items

 Until 1846, surgeons had no recourse to anaesthetics, so the use of some of these instruments may have been slightly painful.... The obstetrics cabinet was especially shudder-inducing...

  Amputation kit

Notice the doctor's walking cane (at the bottom) which doubled up as gag to hold the patient down - there are still bite marks visible

After gazing pukingly at various instruments of torture, we emerged into the light of the Operating Theatre itself.  We couldn't help but feel the melancholia saturating the room.  We live in times of bionic super medicine, where after 10 seconds, clever surgeons are able to induce us into a peaceful sleep, whereupon we wake up after all the gory stuff has happened, patched up neatly, feeling chirpy and ready to run a marathon.  Pre-1846 they weren't so lucky.  Anaesthetic consisted of getting the patient drunk enough to hold down on the table...

Seeing the table was quite sobering.  At that moment we could see Elizabeth being wheeled into this very space, writhing in agony, about to endure the most horrific experience of her life.  Thankfully, the surgeons were skilled enough to get things done quickly.  A limb could be removed within a minute. Unfortunately, such aggressive surgery could result in terrible shock, which oftentimes killed the patient anyway.  The lack of understanding about the causes of infection greatly increased the risk of death also.  Although cleanliness was a moral virtue, descriptions suggest that a surgeon was as likely to wash his hands after an operation as before.  The old frock coats surgeons wore during operations were, according to a contemporary, 'stiff and stinking with pus and blood'.  Beneath the table was a sawdust box for collecting blood.   

Medical students could crowd around the spectacle, getting their first taste of a life in medicine.  A description of students packing the theatre to witness an operation by John Flint South, Surgeon: "the first two rows... were occupied by the other dressers, and behind a second partition stood the pupils, packed like herrings in a barrel, but not so quiet, as those behind them were continually pressing on those before and were continually struggling to relieve themselves of it, and had not infrequently to be got out exhausted.  There was also a continual calling out of "Heads, Heads" to those about the table whose heads interfered with the sightseers".  

It was a very sobering experience for myself and my E.A.A.C. (although not so anonymous anymore, as previous blogs will testify), a part of history that seems too gruesome to believe.  We take our advanced knowledge of the human body for granted, our ancestors were not so lucky.

You might be wondering what happened to Elizabeth.  It took 20 minutes in the Operating Theatre to remove her limb.  She drifted in and out of consciousness, although brandy and wine kept her awake somehow.  Despite coming around from the ordeal, unfortunately Elizabeth passed away from the trauma of it all, just two weeks after the accident.  A sad tale, and one that makes us appreciate advanced medicine in all its glory today.

If you are ever in the vicinity of London Bridge, we recommend you stop by the Operating Theatre for a visit.  Maybe stop for lunch AFTER though...