Married to a Frenchman and living in Paris in 1811, the novelist and playwright Fanny Burney discovered that she had a tumour of the breast. After considerable hesitation (to the very last, as we shall read) she agreed to have an operation. In this hair-raising journal letter sent to her sister Esther (it would have been beyond the bounds of good taste for her to have written this “up” into a memoir), she describes in exact detail what was a routine experience, for those whose wits were not fuddled with alcohol, until considerably later in the century. Fanny Burney lived on for another forty years after being rid of the “peccant attom.”
The sight of an immense quantity of bandages, compresses, spunges, Lint—Made me a little sick:—I walked backwards and forwards till I quieted all emotion, and became by degrees, nearly stupid—torpid, without sentiment or consciousness;—and thus I remained till the Clock struck three. A sudden spirit of exertion then returned,—I defied my poor arm no longer worth sparing, and took my long banished pen to write a few words to M. d’Arblay—and a few more for Alex, in case of a fatal result. These short billets I could only deposit safely, when the Cabriolets—one—two—three—four—succeeded rapidly to each other in stopping at the door. Dr. Moreau instantly entered my room, to see if I were alive. He gave me a wine cordial, and went to the Sallon. I rang for my Maid and Nurses,—but before I could speak to them, my room, without previous message, was entered by 7 Men in black, Dr. Larry, M. Dubois, Dr. Moreau, Dr. Aumont, Dr. Ribe, and a pupil of Dr. Larry, and another of M. Dubois. I was now awakened from my stupor—and by a sort of indignation—Why so many? and without leave?—But I could not utter a syllable. M. Dubois acted as Commander in Chief. Dr. Larry kept out of sight: M. Dubois ordered a Bed stead into middle of the room. Astonished, I turned to Dr. Larry, who had promised that an Arm Chair would suffice; but he hung his head, and would not look at me. Two old mattrasses M. Dubois then demanded, and an old Sheet. I now began to tremble violently, more with distaste and horror of preparations even than of the pain. These arranged to his liking, he desired me to mount the Bed stead. I stood suspended, for a moment, whether I should not abruptly escape—I looked at the door, the windows—I felt desperate—but it was only for a moment, my reason then took command, and my fears and feeling struggled vainly against it. I called to my maid—she was crying, and the two Nurses stood, transfixed, at the door. “Let those women all go!” cried M. Dubois. This order recovered me my Voice—”No,” I cried, “let them stay! qu’elles restent!” This occasioned a little dispute, that re-animated me—The Maid, however, and one of the nurses ran off—I charged the other to approach, and she obeyed. M. Dubois now tried to issue his commands en militaire, but I resisted all that were resistable—l was compelled, however, to submit to taking off my long robe de Chambre, which I had meant to retain—Ah, then, how did I think of My Sisters!—not one, at so dreadful an instant, at hand, to protect—adjust—guard me—I regretted that I had refused Mme De Maisonneuve—Mme Chastel—no one upon whom I could rely—my departed Angel!—how did I think of her!—how did I long—long for my Esther—my Charlotte!—My distress was, I suppose, apparent, though not my Wishes, for M. Dubois himself now softened, and spoke soothingly. “Can You,” I cried, “feel for an operation that, to You, must seem to trivial?”—”Trivial?” he repeated—taking up a bit of paper, which he tore, unconsciously, into a million pieces, “oui—c’est pell de chose—mais—” he stammered, and could not go on. No one else attempted to speak, but I was softened myself, when I saw even M. Dubois grow agitated, while Dr. Larry kept always aloof, yet a glance shewed me he was pale as ashes. I knew not, positively, then, the immediate danger, but every thing convinced me danger was hovering about me, and that this experiment could alone save me from its jaws. I mounted, therefore, unbidden, the Bed stead—and M. Dubois placed me upon the Mattrass, and spread a cambric handkerchief upon my face. It was transparent, however, and I saw, through it, that the Bed stead was instantly surrounded by the 7 men and my nurse. I refused to be held; but when, Bright through the cambric, I saw the glitter of polished Steel—I closed my Eyes. I would not trust to convulsive fear the sight of the terrible incision. A silence the most profound ensued, which lasted for some minutes, during which, I imagine, they took their orders by signs, and made their examination—Oh what a horrible suspension!—I did not breathe—and M. Dubois tried vainly to find any pulse. This pause, at length was broken by Dr. Larry, who in a voice of solemn melancholy, said “Qui me tendra ce sein?—”
No one answered; at least not verbally; but this aroused me from my passively submissive state, for I feared they imagined the whole breast infected—feared it too justly,—for, again through the Cambric, I saw the hand of M. Dubois held up, while his fore finger first described a straight line from top to bottom of the breast, secondly a Cross, and thirdly a circle; intimating that the Whole was to be taken off. Excited by this idea, I started up, threw off my veil, and, in answer to his demand “Qui me tendra ce sein” cried “C’est moi, Monsieur!” and I held My hand under it, and explained the nature of my sufferings, which all sprang from one point, though they darted into every part. I was heard attentively, but in utter silence, and M. Dubois then, re-placed me as before, and, as before, spread my veil over my face. How vain, alas, my representation! immediately again I saw the fatal finger describe the Cross—and the circle—Hopeless, then, desperate, and self-given up, I closed once more my Eyes, relinquishing all watching, all resistance, all interference, and sadly resolute to be wholly resigned.
My dearest Esther,—all my dears to whom she communicates this doleful ditty, will rejoice to hear that this resolution once taken, was firmly adhered to, in defiance of a terror that surpasses all description, and the most torturing pain. Yet—when the dreadful steel was plunged into the breast—cutting through veins—arteries—flesh—nerves—I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision—and I almost marvel that it rings not in my Ears still! so excruciating was the agony! When the wound was made, and the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp and forked poniards, that were tearing the edges of the wound—but when again I felt the instrument describing a curve—cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose and tire the hand of the operator, who was forced to change from the right to the left—then, indeed, I thought I must have expired. I attempted no more to open my Eyes,—they felt as if hermetically shut, and so firmly closed, that the Eyelids seemed indented into the Cheeks. The Instrument this second time withdrawn, I concluded the operation over,—Oh no! presently the terrible cutting was renewed—and worse than ever, to separate the bottom, the foundation of this terrible gland from the parts to which it adhered. Again all description would be baffled—yet again all was not over, Dr. Larry rested but his own hand, and—Oh Heaven!—I then felt the Knife rackling against the breast bone—scraping it!—This performed, while I yet remained in utterly speechless torture, I heard the Voice of M. Larry,—(all others guarded a dead silence) in a tone nearly tragic, desire everyone present to pronounce if anything more remained to be done; or if he thought the operation complete. The general voice was Yes,—but the finger of M. Dubois—which I literally felt elevated over the wound, though I saw nothing, and though he touched nothing, so indescribably sensitive was the spot—l pointed to some further requisition and again began the scraping!—and, after this, Dr. Moreau thought he discerned a peccant attom—and still, and still, M. Dubois demanded attom after attom—My dearest Esther, not for days, not for Weeks, but for Months I could not speak of this terrible business without nearly going through it! I could not think of it with impunity! I was sick, I was disordered by a single question—even now, 9 months after it is over, I have a head ache from going on with the account! and this miserable account, which I began 3 Months ago, at least, I dare not revise, nor read, the recollection is still so painful.
To conclude, the evil was so profound, the case so delicate, and the precautions necessary for preventing a return so numerous, that the operation, including the treatment and the dressing, lasted 20 minutes! a time, for sufferings so acute, that was hardly supportable—However, I bore it with all the courage I could exert, and never moved, nor stopt them, nor resisted, nor remonstrated, nor spoke—except once or twice, during the dressings, to say “All Messieurs! Que je vous plains”—for indeed I was sensible to the feeling concern with which they all saw what I endured, though my speech was principally—very principally meant for Dr. Larry. Except this, I uttered not a syllable, save, when they re-commenced, calling out “Avertissez moi, Messieurs! avertissez moi!—” Twice, I believe, I fainted; at least I have two total chasms in my memory of this transaction, that impede my tying together what passed. When all was done, and they lifted me up that I might be put to bed, my strength was so totally annihilated, that I was obliged to be carried, and could not even sustain my hands and arms, which hung as if I had been lifeless; while my face, as the Nurse has told me, was utterly colourless. This removal made me open my Eyes—and then I saw my good Dr. Larry, pale nearly as myself, his face streaked with blood, and its expression depicting grief, apprehension, and almost horrour.
Excerpt from a letter to Esther Burney, March—June, 1812.
- Fanney Burney writes, “To conclude, the evil was so profound, the case so delicate, and the precautions necessary for preventing a return so numerous, that the operation… lasted 20 minutes! a time, for sufferings so acute, that was hardly supportable.” If Burney was administered proper anesthetics, would she have still suffered?
- What do you think surgeons can learn from reading about the experience of surgery from the perspective of a patient?