William Pancoast, the Son of Joseph Pancoast, in the Center of Jefferson Medical College Dissection Room
William Goodell, Class of 1855, knew he wanted to be an obstetrician when he entered the Jefferson Medical College. And while he took ample notes during Meigs’s lectures, he followed Mütter’s philosophies about creating clean environments for all medical procedures. The son of missionaries, Goodell was elected to be the first physician in charge of the newly established Preston Retreat in Philadelphia (“a lying-in hospital for indigent married women”), and his insistence that the hospital and staff follow Mütter’s principles of asepsis and antisepsis was praised for leading to the hospital’s astonishing success rate. Of the 2,444 deliveries recorded during Goodell’s time there, only six ended in death.
• • •
The ripple effect of Thomas Mütter’s years of teaching would echo through an entire generation of doctors; and through his students—their work and their influence—Mütter’s philosophies and approaches would become an instrumental part of the development of what we now see as the era of modern medicine.
But as Mütter watched his final class of students graduate, he knew none of this. He simply applauded loudly and sincerely as each name was read, and then said his good-byes.
• • •
On May 19, Mütter finally wrote the letter he had been dreading and mailed it. It read:
Philadelphia May 19th, 1856
I am compelled by the condition of my health to take the most painful step of my life.
I refer to the resignation of the chair in the Jefferson Medical College with which your board honored me some years since.
In requesting you to lay before the trustees my resignation, I’ll aim to refrain from expressing my high appreciation of their uniform kindness to myself and their untiring devotion to the interests of the institution over which they preside.
For sixteen years, trustees and faculty have strived together in harmony and kind feeling towards the accomplishment of one great end and the result proves how richly their efforts have been rewarded.
To leave such trustees and such colleagues occasions me the most poignant regret, and nothing but a firm belief that my life would fall a sacrifice to another winter’s work could induce me to tender my resignation.
Please present my warmest regards to each member of the “boards” and that he who “orders all things aright” may continue his protecting influence to us all, shall be the constant prayer of one who is truly and sincerely, your firm friend . . .
Gentlemen, I hereby resign the chair of surgery in the institution over which you preside.
WITH HIGH RESPECT AND ESTEEM, I REMAIN YOURS,
THOMAS D. MÜTTER
• • •
The Jefferson Medical College board of trustees received the letter “with deep regret” and gave “their assent to his request Solely on the ground of his impaired health” and fervently hoped that “a cessation from the arduous professional duties in which he had been engaged may lead to a restoration of his health” so that he might return to his “long career of eminent usefulness.”
The board unanimously voted that “as a mark of the high estimation in which the Board of Trustees hold the distinguished service of Professor Mütter during his long connection with the Institution” he be named emeritus professor of surgery, the first time ever that such an honor was bestowed by Jefferson Medical College.
One would think receiving such an honor and leaving on such a high note would be enough for Mütter . . . but there was one more thing he knew he must do before his time on earth came to an end.
CHAPTER TWENTY-SIX
LEAVE NOTHING UNDONE
Anatomical Specimens from the Personal Collection of Dr. Thomas Dent Mütter
With his resignation accepted, Mütter began the difficult process of leaving the city he loved so much. He gave volumes of books from his personal library to his favorite students, whittling down his enormous collection to one that was “very small, not exceeding seven or eight hundred volumes, and of these many were obsolete.” He then gave his unique and impressive collection of surgical tools and tool kits to fellow doctors, so that the tools did not see a day of waste. He donated his piano to the Pennsylvania Hospital for the Insane. He agreed to rent his house, fully furnished, to Samuel D. Gross—the outspoken doctor whom Jefferson Medical College had voted to replace Mütter. He began to write his last will and testament.
But there was still one responsibility he had to fulfill: to find a home for his extensive collection of unusual medical specimens.
Like his idol, Dupuytren, in Paris, Mütter had amassed a large collection of pathological marvels, many extremely unusual. There were “the usual osseous, nervous, vascular, muscular, ligamentotaxis, and other preparations for anatomical demonstration,” but his collection also contained a large number of wet preparations (specimens in jars); diseased bones and calculi; an extensive series of paintings and engravings, representing healthy and morbid parts, fractures, dislocations, tumors . . . and the surgical operations that are necessary for their relief; as well as graphic models of medical conditions in wood, plaster, and wax.
Throughout his career, Mütter had always been on the lookout for “fresh acquisitions” and was always sure to tell anyone who asked that his collection was created solely for demonstrations in class, for it was so well curated for “illustrating the various branches taught in the school.”
But in truth, to Mütter, it was more than that. Unusual specimens—or medical oddities, as they are sometimes called—were always an attraction to the general public, and it seemed a cruel irony to Mütter that people who suffered so greatly during their life were also stripped of their rightful humanity after their death. One could scarcely imagine a more cruel rejoinder to a life of painful forced isolation than to have one’s corpse paraded in a sideshow.
Most of his collection had come from the world of medicine. Mütter had kept and preserved unusual specimens from his own practice. He had solicited strange material from hospitals or fellow doctors whom he knew. And, in the case of the anatomical models, he had sought out expert craftsmen, usually in Europe. But Mütter tried to rescue specimens wherever he found them—taverns, alehouses, sideshows. Sometimes this proved to be an arduous task. The owners would resist, refusing to part with the specimen for any price, no matter how doggedly Mütter used his charms or how wide he opened his wallet. These specimens held too much potential to shock or titillate, which in turn would earn their owners a few extra dollars a year. Mütter always noted that the men never kept the piece for emotional reasons. It was never the case that the specimen couldn’t be purchased because it had been plucked from the body of the owner’s own family. But Mütter’s determination—and the ever-loosening strings of his substantial purse—ensured that more often than not, he obtained the object of his desire.
To Mütter, the marvels he had so carefully gathered deserved more respect than to be scattered to the four winds upon his death. He wanted to find his collection—his entire collection—a worthy home, and vowed that he wouldn’t leave the city until it had one.
• • •
Mütter’s first choice was, of course, Jefferson Medical College. He was sure that the board of trustees would welcome the collection. After all, the school’s anatomical museum had served as home for many of his more eye-catching pieces during the fifteen years he’d worked there. Mütter offered to donate his collection—which now consisted of about two thousand specimens—to the school if the institution agreed to give it a permanent home.
Jefferson Medical College refused.
The college simply didn’t have the space to house such an immense collection, the board explained, nor was it willing to spend the money to build such a space. Mütter was crestfallen, but John Kearsley Mitchell, his longtime friend and fellow faculty member, had an idea. He su
ggested that Mütter offer his collection to the College of Physicians of Philadelphia.
The College of Physicians was not a school. Rather, it was the nation’s oldest professional medical organization, founded in 1787 with a clearly defined objective: “to advance the science of medicine and to thereby lessen human misery.”
Mitchell believed that the College of Physicians—which always wanted to be seen as a place for medical professionals and the general public alike to learn about medicine as both a science and an art—might be open to receiving Mütter’s impressive collection, and encouraged Mütter to pen a detailed description of what his gift would entail . . . and what the College would be required to provide in exchange for it.
Mütter spent days working on the proposal, and together, Mitchell and he broached the idea with the board of fellows at the College of Physicians of Philadelphia.
Mütter offered to give the organization his complete collection—all two thousand specimens. In addition, he would give them thirty thousand dollars “for the services of a curator, for an honorarium for a yearly lecturer and for enlarging and maintaining the museum.”
In exchange for these two gifts, Mütter had only one condition: that the college provide a fireproof building for his collection, which needed to be built within four years.
Much to Mütter’s relief, the College of Physicians was interested, but since Mütter’s offer required building an entire museum, they told him they would need more time than he allotted. They explained that they had been interested in sometime constructing a new home for the organization—and had started a building fund in 1849—but despite their efforts, they could not secure sufficient funds to begin building even a traditional structure . . . let alone the fireproof one that Mütter demanded.
Mütter was disappointed, but he understood. He offered to postpone his return to Europe until their decision could be made. He spent one last summer in the sweltering heat of Philadelphia, waiting. But once an autumn chill began to enter the air, Mütter—and his “rapidly failing health”—could wait no longer.
He met with the board of the College of Physicians of Philadelphia one last time, and explained to them that, even though he was too ill to stay in the city longer, he didn’t want them to think he was abandoning his negotiations with them.
Instead, he provided them a copy of his will, which stated that he would bequeath all his property of every description—“everything which I possess, or to which I may have any claim”—to his “beloved wife, Mary W. Alsop Mütter,” with the sole exception of his storied collection of medical specimens, his marvels.
That collection, the will clearly stated, would be given to the College of Physicians of Philadelphia, but only if they carried out “the arrangements entered into, but not completed, at the time of [his] departure for Europe.” He expressed his faith and hope that the organization would rally and the museum would be built, but then warned them that if they had not agreed to his terms by the time of his death, the collection—and the money associated with it—would be offered to other medical institutions. Failing that, it would be given in full to his wife, to be handled as she saw fit.
It was the best Mütter could do.
Shortly after that, Mütter handed over the keys to his house to Samuel D. Gross, his successor at Jefferson Medical College, and left.
“It was better to relinquish quickly one’s own terms,” Gross would remark about the swiftness of the exchange with Mütter. Upon entering the house, it soon became clear to Gross that Mütter’s curt brevity was not a sign of rudeness on the part of the departing professor. Rather, when Gross and his wife entered the house, they were moved by Mütter’s thoughtfulness, even during this time of his personal suffering.
“On our arrival we were not obliged to go to a hotel, everything being in readiness for our accommodation,” Gross wrote, astonished. “In fact, even dinner was awaiting us.”
• • •
Mütter and his wife left for Europe shortly thereafter, deciding that their best option was to go to France, where he could spend the winter in Nice. Despite everything, Mütter held out hope that he might recover—even including a clause in his proposed contract with the College of Physicians of Philadelphia that if his health returned, he would be granted full access to his collection to use in future lectures and classrooms.
When he arrived in Nice, it seemed that if God were to bless him with a place to heal, this would be it. The Mediterranean Sea was a bright, hopeful blue, and sparkled in the region’s golden sunlight. His small house was nestled into a vine-covered hillside, where Mary—with whom he had recently celebrated a twentieth wedding anniversary—could pluck olives from the trees if she wanted to. He felt relaxed, finally, his lungs filling with the warm sea air that found its way up the gentle slope of the hill.
But unfortunately for Mütter, the winter of 1856 was one of “unusual severity” in Europe. “His old malady renewed its attacks,” it was written by a fellow doctor, “with its customary frequency,” and he and Mary made their way back to Paris so that he could convalesce under the care of the best doctors he knew.
But Philadelphia—and the promise of a museum for his collection—was never far from his thoughts. Mütter learned, however, that he was being called insincere in his offer to give his collection to the College of Physicians of Philadelphia—after all, if he were serious about it, why would he have left the country before an agreement could be formally struck? So he wrote an open letter to the College of Physicians, which he would additionally publish in the popular journal Medical News to ensure his message was heard.
In the letter, he defended what he considered to be a “grave charge” made against him about his departure from Philadelphia, which he felt was “both unjust and uncalled for.” He explained that his ill health had forced him from the country but that, before he left, he gave the organization all the information necessary to form “the basis of a future contract between the College” and himself, and furthermore that these propositions were made “advantageous to both parties” in the hope that it would help accelerate the process. In this way, Mütter wrote, he left Philadelphia feeling that he and the College of Physicians were united in their efforts to see his museum built.
“It will be seen from the foregoing that I have in every way attempted to carry out my promise to the College,” he wrote. “I would leave nothing undone to accomplish the chief object of my professional life.”
• • •
Under the care of his physician friends in Paris, Mütter was able to extend his life for another year, although it was clear that, while his heart beat and his lungs took in air, the life he lived trapped in his pain-racked body was not an easy one. When asked by concerned friends what they might be able to bring Mütter and Mary to help them, Mütter would quip, “Linen for Mary, Laudanum for me!” referring to the powerful opiate that doctors would prescribe only for patients who were suffering severely.
Mütter spent several seasons in Europe, growing more and more “weary with the endless torture of disease.” He realized that his protracted residence abroad brought “no relief to the malad[ies]” plaguing him. Although his friends were keeping him alive, he was no longer living what could be considered a good life.
He came to the dark—but true—realization: The “only remedy [to his condition] was to be its own last and fatal attack.”
Mütter finally understood how all those patients begging for his help had felt, those who had come to his office door in wretched states and said they were happy and willing to risk their lives on his surgical table if such a risk held the promise of change. He finally knew what it was like to welcome death over continuing to live the life you were forced to live.
Mütter decided that if he was going to die, he did not want to die in Paris. He was an American; he wanted to die and be buried at home, on his native soil. And those close to him sensed a
growing impatience about the fate of his collection. He did not want to die without knowing what would happen to it. After saying good-bye to Paris and to his much-loved friends there, Thomas and Mary Mütter set sail for home for the last time.
• • •
In October 1858, Thomas and Mary returned to Philadelphia. Mütter, “feeble and dejected, with the graven lines of pain furrowed deeply on his brow,” was a shadow of his former self and a shocking sight to his friends and former colleagues.
“Conspicuous from his bright and manly bearing, which frequent and severe suffering had not yet been able to change,” Joseph Pancoast would write about his friend’s final visit to the school where he had long taught, “his hair blanched prematurely to almost a snowy whiteness, he stood among you, admired and honored, like a tower partly ruined and fallen, yet unspeakably attractive from its lingering charms and former associations.”
While in Philadelphia, the gout in Mütter’s hands finally subsided enough for him to write a letter in his own handwriting to Colonel Carter, his old guardian, who Mütter was sad to hear had recently lost a child.
“My dear old friend,” Mütter wrote. “Ever since my arrival in this country I have been very ill and am still suffering severely. Up to this period, my hands have been nearly useless, hence my delay in writing you. Armistead [Carter’s cousin] had informed me of the death of your darling child. From my whole heart you have my sympathy and were I able to undertake the journey I would go to you at once.
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