Read a Q&A with Christine Ball | The Chloroformist

Christine Ball is an anaesthetist at the Alfred Hospital in Melbourne. She has been an honorary curator at the Geoffrey Kaye Museum of Anaesthetic History at the Australian and New Zealand College of Anaesthetists for 30 years and has written many articles about the history of anaesthesia.

Today, Christine Ball is on the blog to answer a few questions about her new book, The Chloroformist — the historical biography of Joseph Clover and the invention of anaesthesia. Read on …

Christine Ball

Please tell us about your book, The Chloroformist!

CB: It is the story of the first 35 years of anaesthesia in Britain, told through the eyes of a surgeon called Joseph Clover. Clover eventually gave up surgery to become one of the first full time anaesthetists in the world. Anaesthesia was discovered in 1846 so those 35 years span a fascinating time in Victorian England, encompassing wars, revolutions, international exhibitions, the first medical congresses and of course, major developments in surgery and medicine.

You’re an anaesthetist yourself at the Alfred Hospital in Melbourne. What made you want to take your interest in the invention and history of anaesthesia further than regular practice?

CB: When I was training to be an anaesthetist, a friend took me up to the attic of the College of Surgeons where there was a collection of old anaesthetic equipment stored in boxes. It was the beginning of what would become the Geoffrey Kaye Museum. It was irresistible, so many curious objects stored in one place, pieces of equipment waiting to be reunited – like a huge mystery jigsaw puzzle. I started trying to help sort it all out and then I started reading about the history of anaesthesia. There were so many wonderful stories which captured my imagination and I have been driven ever since to discover more.

Apart from the obvious benefit of being able to render patients unconscious and unable to feel the pain of surgery, what else was groundbreaking about the discovery?

CB: Prior to the discovery of anaesthesia, surgery was restricted to a very limited number of essential quick operations and a few others that desperate people were prepared to undergo. Anaesthesia allowed surgery to proceed slowly and carefully so new operations were developed – like, for example, the removal of diseased knee joint without the need for an amputation. It also allowed the delivery of pain relief in labour, with chloroform in particular being used by women during childbirth, most famously Queen Victoria and others, like the wives of both Charles Dickens and Charles Darwin. Women were quick to see the advantages of anaesthesia!

What was early anesthesia like?

CB: Primitive. Essentially ether or chloroform dripped onto a piece of cloth and placed over the patient’s face. Ether smells terrible and patients often struggled against its administration and vomited during or after the procedure. It was also flammable, which was not helpful when the only light was from candles and gas lighting, and the only heat from open fires. Chloroform smelt much better but it was occasionally inexplicably fatal – which was quite a disadvantage. And then, even if you survived the anaesthetic, surgery was still very risky as infection remained a major complication until Lister developed antiseptic surgery in the late 1860s.

You focus in part on the development of the relationship between surgeon and anaesthetist. Can you briefly tell us why this is so important?

CB: Keeping the patient anaesthetised is only a small part of our job. We need to know exactly what the surgeon is planning to do and when the problematic times will be. The simplest example is blood loss; we can plan if it is anticipated but sometimes it is not and we all need to work through the process together. The surgeon may need to stop for a while to allow us resuscitate the patient or there may be things we can do to allow the surgeon better access to the bleeding area. If the anaesthetist and surgeon know each other well, a lot of this communication becomes second nature and they can anticipate each other’s needs.

What was your favourite part of the writing process for this book?

CB: The research, especially the travel. I love hanging about in old libraries and archives with original documents in my hands or scrambling around in churchyards and cemeteries. I went to all the places Clover had lived and worked. I walked around unfamiliar parts of England with 1840s maps and imagined I had travelled back in time. I met so many people along the way too, people who were so helpful and have become great friends.

Who did you write this book for? Who do you wish would read it?

CB: I hope that anyone who likes medical history, or just the history of Victorian times, will enjoy this book. Although there are technical elements to the story, it has been written with a non-medical audience in mind.

What is the last book you read and loved?

CB: I never read just one book at a time! I have just finished Unwell Women by Elinor Cleghorn but am also deep in The Magic Mountain by Thomas Mann. Each is wonderful in its own way. I am also reading a series of essays by Andrew O’Hagan called The Secret Life.

What do you hope readers will discover in The Chloroformist?

CB: I hope readers will discover, not just the story of Joseph Clover himself, but the evolution of surgery and anaesthesia. Victorian England was such an exciting place with arts, theatre, entertainment and travel, and I have tried to convey some of that excitement.

I also hope people will discover something about anaesthesia. Anaesthetists are now involved in every part of the patient’s perioperative journey – from the preoperative clinic to the postoperative pain round. I hope this book will explain how that has occurred.

And finally, what’s up next for you?

CB: I have lots of ideas for another book but I’m just letting them percolate for a while. Meanwhile, I’d love a holiday but it’s difficult to plan anything at present!

Thanks Christine!

—The Chloroformist by Christine Ball (Melbourne University Publishing) is out now.

The Chloroformist

by Christine Ball

Until 1846, surgery was performed without anaesthesia; extraordinary operations, carried out on conscious, terrified patients. Surgeons of that era were bold and courageous and saved many lives. But anaesthesia changed everything.

With an unconscious patient, the surgeon could take his time. Surgery became slower, more careful and more delicate. And as anaesthesia removed the pain of surgery, the medical world gave more attention to surgical infection, heralding in the use of antiseptics and eventually aseptic surgery. By 1881, the operating theatre was unrecognisable- everything had changed...

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