No faculty member added greater distinction in these years than Dr. Valentine Mott, who would go on to found NYU Medical College and become an indispensable part of Bellevue’s future. Historians of American medicine regard Mott as the premier surgeon of his time. Contemporaries went even further. “The boy was father to the man,” an admirer wrote worshipfully of Mott’s upbringing. “Docile, obedient, pure in mind, cautious in speech, neat in dress, erect in person, walking as one who reverences God, and who respects the rights and feelings of his fellows: in a word, a perfect gentleman.”
Born in 1785, the son of a Quaker physician from Long Island, Mott had apprenticed with Dr. Valentine Seaman, a leading New York City surgeon, before traveling to England for further study. Superbly trained, with an impeccable pedigree, he returned home to become a professor of surgery at P&S. At a time when European medical opinion scoffed at the skills of American “knife-men,” Mott remained the conspicuous exception. He was among the first surgeons to amputate successfully at the hip. He performed hundreds of lithotomies, extracting “the largest [gall] stone ever removed from the living body,” a friend wrote, “its weight being seventeen ounces and two drachms.” Mott revolutionized vascular surgery by placing ligatures within inches of the heart. “He cut firmly and boldly,” it was said, “yet with a certain gentleness, too.” And he was perfectly ambidextrous, working fluidly with either hand. In the words of Sir Astley Cooper, England’s leading surgeon: “Valentine Mott has performed more of the great operations than any man living.”
Among Mott’s favorites was a procedure he devised to relieve the “exquisite suffering” of a man whose testicles “had been drawn up by a gradual contraction of the surrounding muscle.” (When dealing with “malignancies,” Mott, by his own count, had removed “over a bushel of testicles, some of them weighing more than a pound.”) The case at hand had baffled numerous “surgeons of eminence” because the patient, while forced to find a “more harmless” line of work, still enjoyed “a reasonable amount of pleasure” in the bedroom. Upon examination, Mott “decided to cut down, divide the spermatic nerve and remove a larger portion of the cremaster muscle.” This caused the testicles to descend and the pain to disappear. The result, it was said, “unfolded new truths…in alleviating the afflicted.”
Much of his success came before the introduction of anesthesia. “In Mott’s early days,” a colleague recalled, “stout arms held down the writhing man; firm violence was requisite to keep quiet the shrieking child [whose] trachea must be cut to save her life. What nerve, what firmness, what determination were the attributes of him.”
Mott loved the operating theater, and he didn’t come cheap. For private patients, he charged as much as $1,000 for a complicated procedure—an immense sum at that time—and never lacked for business. For charity patients, he charged nothing; their role was to provide the raw material needed for clinical instruction. When lecturing his students, Mott stressed two basic rules: Never perform an operation that you, the surgeon, would refuse to undergo yourself. And never attempt a procedure on the living without first practicing it on the dead.
Not everyone bowed to his genius. The cranky New York diarist George Templeton Strong described Mott as something of a fraud. Strong’s uncle had suffered from a painful facial neuralgia that Mott apparently promised to relieve. There followed a “very severe operation” that failed the patient but produced a sizable bill. “The Hercules that finally vanquished the Hydra—that all Dr. Mott’s science wasn’t up to—was a preparation of rather quackish origin,” Strong explained, “an ointment prepared by rubbing down five grains of aconitine [an extremely toxic plant] and applying it twice a day….It effected an immediate cure.”
Failures, though, seemed few and far between. A more typical Mott story, told and retold by his many students over the years, involved a memorable performance in the dissection of a cadaver. “The scalpel slipped and a portion of [Mott’s] own finger was cut off and fell on the table,” a witness recalled. “Perhaps now he who had…never flinched when those around him were groaning under operations might become unnerved…dismiss the class…and retire to his room.”
Not so, Dr. Mott. “Putting his finger in his mouth, he sucked the wound, then wrapped it in his handkerchief, shrugged his shoulders…and went on lecturing till the gong sounded. I had my eye on that piece of surgical flesh…but being detained to assist in bandaging the Professor’s finger, a brother doctor slipped into the lecture-room and secured the prize. He now can boast of Dr. Mott in alcohol.”
Mott seemed the closest thing to a celebrity doctor that early-nineteenth-century America could produce. A physically imposing man—“fully six feet with broad shoulders, and a fine muscular development”—he lived with his wife and children at One Gramercy Park, a four-story Italianate mansion known as the finest dwelling in New York. The Motts entertained “in a style of magnificence which we have not witnessed for a long time,” wrote a guest at one of their galas for visiting royalty. The doctor’s net worth hovered somewhere around a million dollars, feeding juicy gossip in the press. “He daily rose at 7 o’clock, breakfasted at 8, and dined at 5,” a friend noted, “rarely taking anything in the interval, except perhaps, a glass of water….At 9 o’clock he went into his office, and except when interrupted by his college lectures or a call to attend some urgent case, remained at home until 1 o’clock.” Afternoons were filled with surgical operations and visits to his patients. “His horse and carriage were always in perfect order and never driven beyond a slow, dignified pace….His evenings were always spent in his library, reading, writing, or conversing with friends.”
In 1835, “overcome by the fatigues of his pursuits,” Mott fled New York City to travel the world. His published thoughts, popular at the time, are best left to the ages. “He is humorous only about the smell of vagrant Greeks, the large-sized bed-bugs on the plains of Marathon, and the obesity of women in Asia Minor,” a critic observed. Stopping in Constantinople, Mott removed a growth from the head of reigning sultan Abdul Medjid, earning a knighthood and, one suspects, a hefty fee.
While in Europe, Mott had corresponded with friends about starting a medical school at New York University, an institution chartered only a decade before. Mott knew that his name would be solid gold. His plan mimicked the arrangement between Columbia College and P&S: the medical school would offer a degree through the university but otherwise be self-sufficient. And, as with P&S, the students and faculty would have full access to the clinical riches of the Bellevue Establishment—an arrangement, negotiated by Mott himself, that virtually guaranteed the school’s survival. In 1841, Mott and five other physicians bought an impressive granite building on lower Broadway. The group included Surgery (Mott); Chemistry (John Draper); Anatomy (Granville Pattison); Materia Medica (Martyn Paine); Theory and Practice of Medicine (John Revere); and Diseases of Women and Children (Gunning S. Bedford).
Though few doubted the need for a second medical school in America’s largest city, the rank commercialism of the project raised some eyebrows. Mott and his colleagues planned to admit just about any white male student able to afford the costs. Rigorous standards jeopardized the public’s health by excluding those who would go on to be doctors anyway, they explained. Better to have some schooling than none at all.
The enormous entering class of 271 included almost everyone who applied. Only blacks, women, and complete illiterates were rejected. Who, save the utterly ignorant, would prefer “this rotten and disgraceful concern” to the “dignified and meritorious” College of Physicians and Surgeons? a critic sniped. “Heaven only knows what is to become of all the Doctors ground, or rather bolted, out of the innumerable [diploma] mills from Maine to Texas.”
Tuition was $105 per term, plus a $5 “matriculation” fee, a $10 “broken” fee (for damaged equipment), and a $20 “anatomical” fee (for fresh cadavers). With four terms required to graduate, plus a $30 “graduation” fee, the total for each student ran to $550, a hefty sum. Accordi
ng to the ledger books, the faculty split close to $40,000 a year after expenses.
Handpicked by Mott, the faculty was eclectic, to say the least. John Draper, the Bone Bill man, preached the virtues of modern science, while Martyn Paine, a traditionalist, taught the old ways of calomel and the lancet. (To pass one of Paine’s examinations, it was said, required but a single answer to every question: “The treatment is blood-letting, sir.”) John Revere, the youngest son of colonial patriot Paul Revere, was among Mott’s closest friends. A gifted writer—his Treatise on Medicine was a standard text in that era—Revere would die from typhus in 1847 while tending to one of his students.
Gunning Bedford, a visionary of sorts, had a gift for attracting publicity, much of it bad. Honored today for opening one of the first obstetrical clinics in the United States, he was best known in the 1840s as a crusader against abortion. Bedford aimed to replace the midwife with a physician trained in both the medical and moral aspects of childbirth—someone who saw the fetus as fully equal to the mother. He thus opposed all procedures that endangered the infant, the most common being the craniotomy, which reduced the skull in order to fit it through the birth canal; and he regularly employed cesarean section, explaining that it saved babies in distress (though it put the mother at greater risk of deadly infection).
Critics portrayed Bedford as a fanatic and a fraud. His unfortunate habit of lifting the writings of others—what we call plagiarism today—was well noted in the press, which mocked him as “a Psychological and Literary Phenomenon!” Yet his advantages were clear. Immigrants were pouring into New York, and Archbishop John Hughes, a friend of Bedford’s, had declared that Catholics, whenever possible, must patronize doctors who satisfied the teachings of the Church. Bedford provided a bridge between the new medical school and the city’s foreign-born population. His Obstetric Clinique would soon be treating ten thousand patients each year.
Even more controversial was Mott’s choice of the eccentric Granville Sharp Pattison, whose most notable talent, aside from teaching anatomy, lay in creating ill will almost everywhere he went. Born in Scotland, Pattison had held and lost a string of medical posts before coming to the United States—the reasons ranging from an indictment for grave robbing to an affair with a senior colleague’s wife. Taking a position at Philadelphia’s Jefferson Medical College, he fought a duel with General Thomas Cadwalader, a local hero, over a family insult, leaving the general with an arm withered for life. A notorious reveler, Pattison gulped down mercury—the common “cure” for syphilis—in copious doses. What brought him to Mott’s attention were his undeniable pedagogic skills. “As a lecturer on anatomy,” a student recalled, “he almost made the dead body before him speak.”
At first, Pattison and Mott worked well together—so well that the newspapers took to covering their exploits. In the summer of 1841, the pair performed an amputation at Mott’s Surgical Clinique in Bellevue Hospital, where several hundred doctors and students gathered each Saturday afternoon to watch the master at work. Done in an era before anesthesia or antisepsis, the operation required incredible speed to keep the patient from dying of shock. On the table this day was a fifteen-year-old boy with a horribly infected upper leg. “One professor [Mott] felt for the femoral artery, (and) had the leg held up…to ensure the saving of blood,” the New York Herald reported. A tourniquet was placed on the artery, with the body secured by the boy’s father and an assistant. “A little wine was given to the lad,” who appeared “pale but resolute.”
Then it began. Pattison took a “long, glimmering knife, felt for the bone,” and opened the flesh. “Tears ran down the father’s cheeks—the blood gushed by the pint—the sight was sickening—the screams were terrific—the operator calm.”
Out came the saw. The screams grew louder, and several spectators fled the room. “The father turned pale as death—the boy’s eyes fastened on the instrument with glazed agony—grate—crush—once—twice—and the useless limb from the toes to the center of the thigh was quietly dropped into the tub under the table.” With that, the father “fell senseless to the floor.”
Two months later, the boy was said to be doing well. “When he was placed on the operating table he seemed [to be] sinking from the effects of hectic fever,” Pattison reported. “He is now in vigorous health—the stump has healed beautifully—and the lad is a living illustration of the blessings of scientific skill.”
Pattison and Mott soon took to feuding. The reasons are unclear—some blamed Mott’s princely share of the tuition money—but the two drifted icily apart. In 1853, Mott retired from NYU to accept the post of “consulting surgeon” at Bellevue. The move spurred talk about creating a third medical school there, placing pedagogy within a hospital—something America had not yet seen. Meanwhile, enrollments at the NYU Medical College dropped off, owing, most agreed, to “the withdrawal of Dr. Valentine Mott…then the foremost surgeon of the country [and] a magnetic attraction to the school.”
—
Calls for a medical college at Bellevue had been circulating since the late 1840s, when the hospital separated from the almshouse. Physicians and medical students from across the city now flocked to attend the Saturday clinics and demonstrations in its glass-domed operating theater. Contained within Bellevue was “every disease mankind is heir to,” a doctor marveled. “I have seen Lascars and Chinamen, Indian mixed breeds, Spaniards from South America, lying side by side with natives of every nation in Europe, and of every state in the Union.”
Few doubted that Bellevue would soon get a medical school. The hard question was: Exactly what kind? Americans had grown weary of the excruciating treatments of orthodox medicine, often centuries old, which rarely seemed to work. This had led to a search for alternatives, some imported from Europe, others homegrown. In the early 1800s, a self-trained New Hampshire physician named Samuel Thomson became immensely popular by promoting the “vegetables of our own country” as the cure for most ailments. Thomson had a bone to pick with traditional medicine, having seen his mother copiously bled and purged by local doctors following their diagnosis of “galloping consumption.” “They galloped her out of the world in about nine weeks,” Thomson recalled, adding: “Much of what is at this day called medicine, is deadly poison.”
Thomson went by a simple slogan: Heat is Life; Cold is Death. A healthy body generated warmth through the food it consumed, much like a furnace burning firewood. Problems arose, however, when the digestive system became clogged. “This causes the body to lose its heat,” Thomson explained. “Then the appetite fails; the bones ache, and the man is sick in every part of the whole frame.”
Thomson relied on spicy botanicals—hot peppers, cayenne, and lobelia, a plant commonly known as “puke weed”—to cleanse the system. In doing so, he tapped into the public’s growing dread of bleeding and purging, especially with violent mineral laxatives like calomel. Commonsense medicine came from “studying patients, not books,” he liked to say, from “experience, not reading.”
The appeal lay partly in the milder remedy. An enema of pukeweed was a bed of roses compared to the lancet or mercury-laden drugs. But even more important to Thomson’s success was the nation’s changing political landscape. “Thomsonianism” took root in the expanding democratic culture of Jacksonian America, with its suspicion of entrenched elites. Many state legislatures in this era abolished all restrictions on who could become a doctor or a lawyer in order to discourage “monopolies.” Thomson insisted that ordinary people, using common sense, could effectively heal themselves. His goal, he stressed, was “to make every man his own physician.”
While Thomsonianism declined rapidly following its founder’s death in 1843, it did signal a revolution at hand. Alternatives to traditional medicine were flourishing, the most popular being homeopathy, brought to American shores by the disciples of a German doctor named Samuel Hahnemann. Like Thomson, Hahnemann believed in herbal cures. Unlike Thomson, Hahnemann held a college medical degree and had taught at the prestigi
ous University of Leipzig. His goal was not to turn every man into his own physician, but rather to turn every physician into a homeopath. In the United States, at least, he seemed to be gaining ground.
Hahnemann viewed bleeding, purging, and even surgery as barbaric relics of the past. Careful study had convinced him of two things: First, a drug that produced specific symptoms in someone who was well could cure the very same symptoms in someone who was ill—a process he called similia similibus curantur. Thus, a certain herb or bark that caused a fever or a high pulse rate in a normal patient could also relieve that fever or high pulse rate in a sick patient. Furthermore, these drugs worked better when given in minute doses—the logic being that highly diluted solutions served to replace the patient’s stronger symptoms with weaker ones, giving the body a better chance to respond.
Hahnemann forged a different base of support. Where Samuel Thomson’s followers were mostly rural and poorly educated, Hahnemann’s included the likes of Henry Wadsworth Longfellow and Harriet Beecher Stowe. One observer wryly described it as “the radicalism of the barnyard” versus “the quackery of the drawing room.”
By the late 1840s, homeopathy claimed somewhere between 5 to 10 percent of New York City’s doctors, the numbers rising steadily with German immigration. This led traditional native-born physicians to create organizations like the American Medical Association to separate “regular from irregular practitioners.” A showdown was inevitable. In 1857, a number of Hahnemann’s prominent followers, including Horace Greeley, editor of the New York Tribune, demanded that the wards at Bellevue Hospital, a public facility, be split evenly between “homoeopaths” and “allopaths” (the term for those who practiced regular medicine). The pressure grew so intense that Bellevue’s Medical Board agreed to study the matter—a move quite unthinkable just a decade before.
Bellevue Page 9
