In the days before anesthesia, speed was at least as important as accuracy when doctors were performing surgery. The longer a patient had to endure the pain of being cut open and cut apart, the less likely he or she would survive the procedure.
With that in mind, surgeons trained to perform their ministrations as quickly as possible. One noted surgeon, Robert Liston (1794-1847), could amputate a limb in under a minute. Once he removed a 45 pound scrotal tumor in four minutes. Prior to the surgery, the owner had to carry it around in a wheelbarrow.
There is a fine line, however, between expediency and recklessness. Once, while operating on a patient’s leg, Dr. Liston, in his haste, cut off the fingers of his assistant. He also slashed through the clothing of a spectator. Not only did his patient die, but the assistant and the observer both developed infections from their injuries and died, resulting in the only known medical procedure with a 300% mortality rate.
On another occasion he amputated a man’s leg in a mere 2.5 minutes. His precision was a little off, though, so he also managed to remove his patient’s testicles.
One time he noted a pulsating red spot on a boy’s neck. Convinced that it was nothing more than an abscess, he pulled a knife from his pocket and lanced the spot right there, puncturing the carotid artery. The boy died within seconds, but if you want to see the artery, it is on display at the University College Hospital in London as Specimen No. 1256.
Liston made quite the sport of his speedy surgery. One of his surgical scenes was described thusly:
He was six foot two, and operated in a bottle-green coat with wellington boots. He sprung across the blood-stained boards upon his swooning, sweating, strapped-down patient like a duelist, calling, ‘Time me gentlemen, time me!’ to students craning with pocket watches from the iron-railinged galleries. Everyone swore that the first flash of his knife was followed so swiftly by the rasp of saw on bone that sight and sound seemed simultaneous. To free both hands, he would clasp the bloody knife between his teeth.
Liston’s legacy is preserved through the Liston Medal, awarded by the Council of University College for achievements and original observations in surgery.