It’s difficult to imagine life without modern medicine. Mercy Street, a civil war drama inspired by real events set at an army-run orthopedic hospital on PBS, confronts viewers with its graphic depictions of nineteenth-century medicine – but do all of the facts add up?
Mercy Street and Hospital for Special Surgery (HSS) share a common history: HSS was founded in 1863 to care for pediatric orthopedic patients in the New York area. Although HSS introduced its first anesthesiologist-in-chief at the turn of the century, HSS doctors were using advanced anesthesia approaches as early as the 1870s.
As both a history buff and an anesthesiologist, Mercy Street provided me the opportunity to watch the show through a unique lens. I was curious to research the accuracy of the show’s medical and historical information. Here’s what I uncovered…
MYTH: Syringes were introduced during the Civil War
FACT: Hypodermic syringes were introduced by Alexander Wood in 1853, eight years before the start of the Civil War, according to the Wood Library Museum. Wood also researched the use of syringes to administer morphine to reduce pain. While syringes are a modern-day medical necessity, anesthesiologists at HSS use several different methods to manage patients’ pain. While some orthopedic patients require a patient-controlled analgesia pump, others may require oral medications following surgery.
MYTH: Bandages were used on different patients without being cleaned
FACT: Sadly, this is accurate. While Mercy Street implies a lack of funds, historians from The Civil War Trust point to a lack of knowledge among providers. Many rural doctors and nurses dispatched to work in emergency hospitals, like the one featured in Mercy Street, were unaware of the need for cleanliness and sterility in the operating room. Only after Joseph Lister published findings in 1867 that connected sterility to improved surgery outcomes did English practitioners begin using clean bandages, noted Jason T. Miller and colleagues in Medscape. It would be years before doctors in the United States would adopt this practice, which was associated with a 30% decrease in the amputation mortality rate.
HSS prioritizes sanitation and cleanliness and boasts one of the lowest hospital infection rates in the United States. Anesthesiologists at HSS use regional anesthesia techniques when possible because regional anesthetics associated with a lower infection rate compared with general anesthesia.
MYTH: Most surgeries resulted in amputation during the Civil War
FACT: Nearly three-quarters of all surgeries done in the Civil War were amputations, according to the North Carolina Museum of History. If you have a limb at risk, HSS experts will determine if you are a candidate for limb salvage surgery or amputation reconstruction surgery. Our mission is to provide optimal care and achieve the highest level of function and mobility for our patients.
MYTH: Chloroform and ether were used to a form of anesthesia
FACT: The first successful use of ether anesthesia was reported in 1846. By 1861, both ether and chloroform were commonly used by orthopedic surgeons to anesthetize thousands of soldiers, wrote historians from History.com. Once doctors discovered prolonged exposure to chloroform caused cardiac and hepatic issues, ether became the anesthetic of choice for doctors until the turn of the century. Today, HSS anesthesiologists customize modern anesthetic drugs that fit your specific procedure and manage post-operative pain and nausea. Over 30 thousand regional anesthetics were performed in 2015 alone.
MYTH: Surgery hospitals were common during the Civil War
FACT: While the oldest existing orthopedic surgery hospital is Hospital for Special Surgery, hospitals that could provide amputation care to the thousands of injured soldiers called for several orthopedic hospitals across the United States, in the North and the South, reported The Civil War Trust. Physicians affiliated with HSS are highly specialized and practice both surgical and non-surgical approaches to musculoskeletal care. Patients travel from 105 countries and all 50 states because our team can help them determine whether their condition requires surgery or can be managed by other types of treatment.
While the medical facts presented in Mercy Street fit the time period, we can’t be sure of the exact times of some of the newer medical innovations being introduced into common practice in the U.S. At HSS, we are proud of our history and the role we have played to evolve the practice of surgery and anesthesia to where it is today.
Dr. Michael A. Gordon is a board-certified anesthesiologist who specializes in cardiac anesthesiology.