A kind of surgical history

Under the Knife by Arnold Van de Laar

Translated by Andy Brown

I love reading books about medicine in all of its many disciplines, and books about surgery are often amongst the most fascinating. Subtitled “The History of Surgery in 28 Remarkable Operations”, this book promised a interesting take on the subject.

In the introduction, Van de Laar looks at the changing role of surgeons in history, from the butchery and gore of the barber-surgeon to today’s highly specialised and skilled practitioners. Having read Lindsay Fitzharris’ very entertaining book about Joseph Lister and the advent of antiseptics in hospitals, The Butchering Art, earlier this year (reviewed here), one could be forgiven for thinking that surgery before then barely existed, but even in the seventeenth century there were some serious doctors doing operations…

…Charles-Francois Felix de Tassy was by no means a novice, but he had never performed an operation to cut open an anal fistula when Louis XIV consulted him about this complaint. So he asked the kind to give him six months and first performed the operation on seventy-five patients before daring to try it on the king.

We then move on to the operations, each getting a chapter, and following a similar style. Titled by problem to be treated by surgery, we go from asphyxia to peritonitis; from aneurysm to hernia, via castration, varicose veins and more.  Van de Laar spices up the text with stories of historical figures that have undergone the surgery – from Queen Victoria to JFK, from Bob Marley to Pope John Paul II.

The writing style is fairly breezy, and explanatory side boxes explain some of the surgical terms and details, allowing the main text to concentrate on the stories behind the operations. There is rather a lot of jumping about chronologically in the order of the sections, but with each chapter presenting its own history too, this made for a rather bitty read.  The final chapter on ‘electricity’ uses an operation on an electric eel as its main feature – I wasn’t sure about this. Also, I wondered whether ’28’ was a few too many operations. A smaller, rounder number like 20 or 25 may have allowed a little more discussion about today’s surgical techniques, over which the history tended to dominate. There was almost too much history and not enough surgery, and there were no diagrams, which would have been welcome.

The Epilogue, however, was entirely superfluous. In it, the author shares his ten favourite surgeons from science fiction. This, while fun, just detracts from the serious endeavour of the surgeons in the book’s main body.  We all know that Star Trek’s Leonard McCoy faked it with salt shakers as his diagnostic device!  Make this an appendix, but not an epilogue.

That said, Under the Knife was an enjoyable read, particularly from an historical viewpoint. (6.5/10)

Source: Review copy – thank you.

Arnold Van de Laar, Under the Knife (John Murray, 2018), hardback, 368 pages, incl indexes etc.

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