Thursday, October 28, 2021

Veterinary bibliotherapy: The Chloroformist, by Christine Ball


The Chloroformist by Christine Ball, pictured here with a stinger anaesthetic machine.

Have you ever wondered what the experience of undergoing surgery would be like without anaesthesia? In The Chloroformist, written by anaesthetist and Woodford Library Museum history of anaesthesiology laureate Christine Ball, provides some vivid descriptions as she tells the compelling story of anaesthetic pioneer Joseph Clover.

As part of my PhD research, I’ve been researching advances in veterinary care and associated ethical challenges (you can read more about that here). 

One of the most important advances in healthcare – of humans and animals – is anaesthesia. It is difficult for most people to comprehend surgery without anaesthesia, particularly major surgery. Aside from causing patients fear, anxiety and distress, it increases the risk of infection (it is very challenging to maintain a sterile field if the patient is trying to escape) and injury (to the patient and/or operators). Lack of anaesthesia means that surgeons must operate much faster, with less time to attend to finer details, and increased risk of error.

Clover, a surgeon, developed an interest in anaesthesia, and become one of the most highly skilled and renowned experts in its delivery – particularly chloroform - during his lifetime.

According to historical records, the first major surgery in a human patient involving an anaesthetic occurred in 1846. Prior to the routine use of anaesthesia, surgery was brutal. For example, Ball documents the surgical treatment of men with bladder stones. 

Bladder stones I removed from a dog via cystotomy, performed under a full general anaesthetic.

Having removed these from animal patients – all under full general anaesthetic, and all treated with post-operative analgesics – it is hard to contemplate doing so on a conscious being. As I read this book, I could not help but reflect on the history of veterinary medicine, and be grateful that I work at a time when anaesthesia and analgesia are utilised routinely (and are of course still being refined).

Clover, a breathtakingly conscientious doctor and scientist, described by an equally breathtakingly conscientious Ball, kept detailed records of his anaesthetics. He was known for his gentle manner, reassuring patients (fear may have increased the risk of anaesthetic complications), as well as his commitment to careful patient monitoring. As someone who had trained as a surgeon, Clover was able to cultivate close working relationships with surgeons, improving outcomes for patients. When anaesthetic complications occurred, he would trouble-shoot these, and he invented and refined various devices for administering anaesthetics safely to patients.

The book will appeal to anyone interested in the history of medicine, anaesthesia, analgesia and surgery, and animal experimentation – an unregulated practice at the time.

The Chloroformist is meticulously researched and beautifully constructed.

The brief, final chapter is a surprising masterstroke. I found myself crying on the bus as I turned the last page. Someone please turn this into a television series!

Reading this book has left me with a desire to take a tour of the Geoffrey Kaye Museum of Anaesthetic History when it reopens. What an extraordinary resource.

The Chloroformist, by Christine Ball, is available from Melbourne University Press, RRP $34.99.