In the second half of the 19th century, New York City's population swelled from several hundred thousand to just over 2 million people. Conditions were not pleasant: Sewers were virtually nonexistent; piles of manure sat several inches high on sidewalks; and the city was overrun by disease.
Medical practices of the time were crude, at best: If surgical procedures were performed, they were done without sterilizing the equipment or the operating room, and typically ended with the patient losing an entire limb, if not his life.
It was in this environment that Dr. William Halsted began his surgical career. Halsted, who began the nation's first residency program, pioneered techniques ranging from blood transfusions to sterilizing operating rooms. He also developed the radical mastectomy — also known as the Halsted mastectomy — reducing the local recurrence of breast cancer in patients nearly 50 percent. When Johns Hopkins Hospital opened its Department of Surgery in 1889, Halsted was named its first supervisor.
Though his legacy suggests a medical pioneer who made surgery safer and more precise, Halsted's life was frequently messy.
That dual life is examined in Gerald Imber's new biography of the doctor, Genius on the Edge: The Bizarre Double Life of Dr. William Stewart Halsted.
Imber traces Halsted's journey from a young Columbia-trained medical student to a successful surgeon who secretly suffered from several narcotic addictions. Imber, himself a plastic surgeon, says that while Halsted was a "rigid perfectionist in some portions of his life, [he was] totally negligent and forgetful in others. He could leave a patient in a hospital bed for weeks on end and forget to operate on them."
Imber talks to Fresh Air about Halsted's dual lives and about 19th century American medicine. Imber is an internationally known plastic surgeon who specializes in facial rejuvenation and noninvasive surgical techniques.