Medically Speaking, the Good Ol' Days Were Not Always So Good

I just finished watching a three-disk, seven-episode series on the life of John Adams, originally aired by HBO in 2008.

It’s a marvelous series and deserved the several awards it received.

“John Adams” chronicles the life of our first vice president and second president from prior to the signing of the Declaration of Independence in 1776 to Adams’ death on July 4, 1826 – fittingly the 50th anniversary of that document. (His political rival, Thomas Jefferson, died the same day.)

The production, starring Paul Giamatti and Laura Linney (as Abigail Adams), not only was a wonderful portrayal of Adams’ life and career, but an amazing depiction of the customs and mores of the day. In this present world of instant communication and gratification, it’s hard to imagine that it took days and weeks to travel from one city to another; months to get a letter from Europe; days and maybe weeks to make basic needs like clothing and soap; and months to grow, process and store basic food staples.

The miniseries also reminded me that in the late 1700s and early 1800s, the practice of medicine was just a notch above primitive. I admit to being simultaneously fascinated and horrified watching various scenes throughout the series that depicted common medical beliefs and practices of the time.

For instance, in one segment, John Adams is in Amsterdam, hoping to raise money to support our War of Independence. He contracts something that looks like a really bad case of the flu, suffering chills, cough, fever and maybe some body aches. Treatment of choice: blood-letting.

A Dutch physician makes a horizontal slice in Adams’ upper arm, places a copper bowl under the incision and compresses the skin around the wound. There are a couple of hold-your-breath moments as the doctor nearly spills the bowl of blood while chasing an agitated Adams around the room.

In another episode, Adams is away from his farm outside Boston attending the First Continental Congress in Philadelphia, leaving Abigail and four children to run the farm. A smallpox epidemic is spreading and Abigail makes the decision to have a local doctor vaccinate her and the children – a new and highly risky treatment at the time.

There were no syringes or sterilization in the 1770s, so to make the vaccine, the doctor brings what looks like a dying person with festering smallpox (kudos to the makeup artists) on the back of a wagon to the Adams’ front door. With a small knife, he digs around in one of the weeping sores, then crudely mixes the tissue that he obtains on a plate. He slices the arms of Abigail and the children, then places this infected bloody tissue inside the incision.

It was pretty horrifying and I could hardly watch – but I was riveted – and then I realized how lucky we are today.

Abigail and her three sons come down with a mild case of smallpox, while her only daughter, Nabby, suffers a full-blown case. She does pull through, though.

Perhaps the most difficult scene to endure, though, occurs after Nabby, then 42, is diagnosed with breast cancer, a dreaded disease even in the early 1800s. A physician and two assistants perform a mastectomy in an upstairs bedroom at the Adams farm with – I’m not making this up – a scythe. The drama did not show the actual mastectomy, but it didn’t take much imagination to figure out how the scene unfolded.

According to an account that you can read at http://www.shsu.edu/~pin_www/T@S/2002/NabbyAdamsEssay.html, this is not quite how it happened; it was actually worse. (Warning: The detailed description on this site is not for the squeamish.)

There was no knowledge of bacteria, no sterile procedure, no pain medication and no anesthesia, so the only help Nabby received was a drink of strong liquor and a padded stick to place between her teeth.

I’m working at erasing the memory of this scene and being thankful for the art and science of modern medicine.