I was fortunate in the very busy weeks leading up to Christmas to get a weekend free with which I was able to go on a whistle stop gallivant around London with a few compatriots. We try and organise a trip to London at least once a year whether it’s for something specific like seeing a play or just to go on a G&T bar hop. This time was to be a little different however, decidedly more educational than we were used to! There was the customary Cava on the train down and once we’d pushed through the throngs at Euston and made it out into London proper we started heading towards Guy’s Hospital in Southwark.
One of the oldest hospitals in London, the eponymous Thomas Guy founded it in 1721, Guy’s still retains some of its original features and theatre areas; kept in a state of preservation by the foundation. Think London Dungeons but with better intentions. What was perhaps most immediately striking about the theatre itself was the size of the whole enterprise. It was more like a broom cupboard with seating than a professional surgical theatre. Rising up in tiers to enclose the operating area were cramped wooden benches that really brought home the origin of the now ubiquitous term “theatre”. Back in the 18th century there was no colloquial sense to this word; going and watching someone be operated on was truly a spectacle to behold. With no television to slake the thirst of every human’s daily requirement of schadenfreude the operating theatre was poised to provide it instead. Think of the Colosseum (but with better intentions.) Roll up! Roll up! Come and See! No Anaesthetic! Is It A Tumour or a Cyst!? You Decide! You could practically hear the screams that had soaked into the wood panelling over the years.
There was a particular reason for coming to Thomas Guy’s beyond simple morbid curiosity; it was this very operating theatre that saw a procedure performed that became the basis for the first recorded medical malpractice claim. The year is 1828 and Stephen Pollard is anxiously awaiting his slot in theatre for a routine, even for that time, gall stone removal. He is called up and taken in. Over 200 pairs of eyes watch from the gloom as he is strapped down into place to prevent his body contorting in pain. Anaesthetic was still a ways off yet. The surgeon, Bransby Cooper, was known to be an ungifted and somewhat mediocre practitioner but if your uncle is the King’s physician then don’t let a lack of skill stop you from professionally maiming people! Cooper first sliced open Pollard’s perineum and then attempted to fish out the gall stone with a pair of forceps. After nearly an hour of being unable to find the stone with a variety of instruments, Cooper then played his ace-in-the-hole: a human finger. Rooting around as though he were trying to extract a particularly irksome bogey from his nose, Cooper was soon brought to a halt by the cries of Mr Pollard. Not to be deterred however he simply wiped the digit clean then asked if anyone had a longer finger than he. Presumably the aghast looks of those around him shocked him out of his idiocy as he returned instead to the forceps and was able, after a little bit more jimmying, to extract the stone.
The gruelling procedure was too much for Stephen Pollard and he died the day after from the trauma of surgery and repeated finger pokings. The incident was brought to the attention of the nation after Thomas Wakley published an article in The Lancet decrying the barbaric, even for the times, nature of the operation. This by itself would probably not have been enough for a public spectacle but Dr Cooper took umbrage with this version of events and sued The Lancet for libel. This then set the stage for a public and much needed debate on the standards people could expect from surgical operations. The Pollard case served as a catalyst with which these issues were brought into the national consciousness. Clearly there was a long way to go as Dr Cooper eventually won due to Wakley being deemed unable to have demonstrated clear and prolonged negligence. By the standards of the time a messy surgery, even one as gruesome as Pollard’s, was still not out of the realms of professional possibility. But even so the foundation was set for a nationally applicable standard of care & practice that medical practitioners must adhere to.
Leaving the theatre to emerge blinking into the sunlight it felt like we had been catapulted back into the 21st century. From a perforated perineum to Pret a Manger in a single staircase. I’m not sure the rest of the party quite enjoyed it as much as I did with one vowing to never leave me in charge of the group activity again. But I like to think that a tiny exposure to past horrors every once in a while is good for the conscience; it at least makes us a little more self-aware of how terrifically lucky we are. If you grow up thinking your local A & E department is to be taken for granted as you sit in there nursing a broken ankle sustained from some daring stunt or another then I think you’d benefit from a trip to Guy’s Hospital. It’s only through the oft messy trial and error surgery of the last couple of centuries that we now live in a country with one of the most comprehensive medico-legal frameworks in the world. The reason that you can now fight for accountability of improper medical care is because of the horror and misery experienced by Stephen Pollard and countless others. And for that we at least owe them a few minutes of our time.
Dictated by Sally Gordon, written by George Gordon