What Happens Next: A Gallimaufry

melancholic romantic comic cynic. bi & genderqueer. fantasy writer. sysrae on ao3.

[T]he existence of anesthesia and its availability were two very different issues. The technology collided with cultural assumptions about women and pain. Sentimentalists had long celebrated the pain of childbirth as a prerequisite to the development of maternal instincts. One mid-century New York obstetrician concluded, “The very suffering which a woman undergoes in labor is one of the strongest elements in the love she bears for her offspring.” Others believed that pain developed a better character. Samuel Gregory of the Boston Female Medical College rejected anesthetics because “this suffering one’s self to avoid a trifling pain is a mark of prudence or courage.” Augustus Gardner, a New York City gynecologist, argued in 1872 that the blessings of pain “are not limited to the mere physical strengthening of other facilities… this baptism of pain and privation has regenerated the individual’s whole nature… by the chastening made but a little lower than the angels.” Some prescriptions for female pain bordered on sadism. In 1850 Benjamin Hill, a Boston surgeon, tried to get breast cancer patients to accept cauterizations of their tumors without anesthetics: “I have not unfrequently had patients, after submitting, perhaps for an hour, to this ‘burning alive,’ without flinching or groaning, open their mouths for the first time, after I had got through, to express their fears that the operation had been not carried far enough, because they had felt it so much less than I had given them reason to expect.” Hill went on to extol the virtues of “pain as moral medication”.

But even surgeons prepared to use anesthesia could be burdened by a host of prejudices. Most Americans believed that older women were not as subject to pain as younger women because time had diminished their sensitivities. Poor women were considered oblivious to pain. “Country women,” argued Dr. William Dewees in 1806, “are more obnoxious to it [pain], than those of the cities.” J. Marion Sims, the father of American gynecology, regularly performed experimental operations on slave women because “white women are too sensitive to pain.” The London Medical and Chirugical Review claimed in 1817 that “negresses will bear cutting with nearly, if not quite, as much impugnty as dogs and rabbits.” Surgeons often limited anesthesia to well-to-do white women who “needed” to be protected from pain. It was not until the 1890s that most surgeons became willing to use anesthesia on every patient.

Bathsheba’s Breast: Women, Cancer and History, by James S. Olson, Chapter Three: William Stewart Halsted and the Radical Mastectomy, pg. 54-55

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