Admittedly, I picked up Dr. Mütter’s Marvels: A True Tale of Intrigue and Innovation at the Dawn of Modern Medicine by Cristin O’Keefe Aptowicz a few years ago because of the cover. I thought this book was going to be about a doctor in the 1800s and the crazy cases he saw and the surgeries he performed on people with serious deformities. But what I got instead was a book that was dedicated to showcasing Dr. Thomas Dent Mütter’s revolutionary thinking and beliefs when it came to patient care and medical student teaching. In the mid-1800s, Philadelphia may have been a rapidly-growing, modern city, but it was also an incredibly dangerous place. During this time, asthma, a broken bone, or a rotten tooth could just as easily kill you as yellow fever, cholera, or smallpox. Amidst all of this, Philadelphia was also the city with one of the oldest and most renowned medical schools in the country – the University of Pennsylvania. However, compared to what we expect of medical school graduates these days, very little was required of students in those days. Students often graduated with as little as a year or two of schooling, and essentially no practical, hands-on experience with patients. It should come as no surprise that patients were treated simply as cases, with little attachment or care shown to them by doctors. It was not a good time to fall ill.
Based on what is known about Thomas Dent Mütter’s early school days, one would be surprised that he became a doctor, let alone one so sought-after for both his skill and compassion. Young Mütter was an erratic individual, who often skipped out on classes and spent far too much money on clothes. However, an encounter with a small-town doctor who was transparent about Mütter’s lifelong lung condition changed his course of direction. From then on, he dedicated himself to medical school and learning as much as he could from experts. Even still, Mütter wasn’t immediately successful as a doctor in such a busy city where ‘coming from the right family’ held a lot of weight. It wasn’t until he was asked to step in and teach an ailing professor’s classes that Mütter began to make a name for himself. Students of his often commented on how “dynamic and effortless” his teaching style was; he was able to seamlessly transition between the foundations of the material and the more complex topics. Not only that, but Mütter did what almost no other teacher did back then – his lectures were a place of discussion and critical thinking, not just a place where students were talked at. His charisma and energy, combined with the numerous and varied medical specimens he collected through his career further helped capture the attention and respect of his students. Perhaps most importantly, Mütter was a strong advocate for providing medical students with hands-on experience with patients and always had his students help him in his clinic; an idea that was not that common among his colleagues.
Mütter wasn’t just revolutionary with how he taught, but also in his medical practice. In a time where doctors completely scoffed at the idea of contagion and a bloody apron was a sign of high-demand and respect, Mütter was one of the few who understood the role doctors had in spreading diseases and infections. He was fastidiously clean whenever he treated or performed surgery on patients. As a result, he could perform innovative and life-changing plastic surgeries that had unheard of success and survival rates. His uncanny surgical skills and willingness to think outside of the box helped him create procedures that are still used over 150 years later. Despite how much he contributed to the actual practice and advancement of surgery, arguably his biggest contribution was in overall patient care. Prior to Mütter championing treating patients as humans and spending extensive time with them before, during, and after surgeries, surgical patients were only seen by doctors during the procedure and very little was explained to them. When most of his colleagues held disdain and suspicion for ether when it became available in the 1840s, he strongly advocated for its use in surgeries so that patients no longer had to suffer incredible pain. Even with all of his surgical skill, he was still rational about what would and would not increase a patient’s chances of survival or quality of life; just because he could perform a surgery didn’t mean he would if it didn’t benefit the patient. Overall, he was a compassionate man who just wanted to ease the suffering of those he treated.
Thomas Dent Mütter’s name eventual became very well-known and his skills as a surgeon were highly sought after across the country, as well as internationally. Unfortunately, because he died young, he never got to write a textbook to permanently record all he knew. However, his legacy lives on in the ideologies he instilled in the thousands of medical students he taught. When people spoke of him after his death, they spoke more often of his compassion and the attention he brought to his patients, making sure they understood what they were going through and what every step of the surgery would be. One of his students would go on to refine ether manufacturing and administration, form a pharmaceutical company (now called Bristol-Myers-Squibb), and advocate for precise labeling of ingredients. The latter would lead to the Pure Food and Drug Act of 1906, which then became the basis for the Food and Drug Administration. Another student of Mütter’s started the Children’s Hospital of Philadelphia after seeing how poorly and improperly children were treated in adult hospitals. Mütter was vocal about his belief that a doctor should be a good human who treated their patients with respect and care, and this belief has trickled down through time and generations of doctors to today’s modern medicine.
