Very few have a biography like that of Dr William Halsted often credited with founding modern American surgery. He was a professor of surgery at Johns Hopkins, and a lifelong drug addict.
Halsted was born in New York in 1852. He chose medicine out of fascination of secrets of the anatomy lab which drew him in, and he fell in love with the complex structures of the body’s interior and their arcane nomenclature.
Once Halsted became a doctor, he joined the New York Hospital. There he’s credited with making his first lasting innovation: the hospital chart.
In 1890, he released word of his new hernia operation. A couple of years later, he published the results of 82 cases. The surgery was a hit and became a relatively safe and effective option for patients. Then he topped himself, writing up 50 cases of a radical operation for breast cancer.
His technique was impeccable, most doctors at the time noted. He tied off every blood vessel, tried not to damage tissue he could avoid and was adamant about cleanliness.
His obsession with cleanliness was to serve him well through his career. But his enthusiasm for the new anesthetics was his undoing. One of the most effective local anesthetics in those days was cocaine, and within a few months of testing it on himself he had a bad drug habit.
He also soon acquired the addict’s other bad habits: he lied, missed work, made endless excuses. Finally, a medical paper he published on cocaine anesthesia was such gibberish that his career in New York was effectively over.
But Halsted, still only 34, was undaunted. After a long European vacation and a stint in the 19th-century equivalent of drug rehab, he took a train down to Baltimore, where friends secured him a job at the new Johns Hopkins hospital.
Unfortunately, his cocaine addiction had been “treated” with morphine and, unknown to all, he arrived in his new life in the grips of a double-barreled addiction.
Dr. Imber, a plastic surgeon and clinical assistant professor of surgery at Weill Medical College of Cornell University, makes the intense strangeness of Halsted’s subsequent career a gripping story.
As a surgeon, Halsted was extraordinary; he soon advanced to chief at Hopkins and pioneered treatments for breast cancer, hernias and gallstones. His knowledge of anatomy and his meticulous technique meant lengthy operations but negligible complication rates, even though antibiotics were still decades away.
Halsted the addict, however, was a mess. He would disappear for long stretches (his summer vacations routinely lasted five months); no one knew quite where he went. His behavior was erratic; friendly to colleagues and patients one moment and hostile the next, he would bow out of operations at the last minute, and his residents pretty much ran his service without him. “The Professor” was often missing in action.
His friend, Dr. Welch, wrote about Halsted’s lifelong addiction. “As long as he lived, he would occasionally have a relapse and go back to the drug.”
Sicker and sicker, Dr Halsted finally crashed due to gallstone complications and died at the age of 69.
His cleanliness of the OT, hospital charts, his mastering the work in Onco surgery and his double drug addiction is a legacy he left behind.