Journal of the History of Medicine and Allied Sciences Advance Access originally published online on July 31, 2008
Journal of the History of Medicine and Allied Sciences 2009 64(1):38-77; doi:10.1093/jhmas/jrn055
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Learning from Mistakes: Early Twentieth-Century Surgical Practice
Correspondence: * Sally Wilde, School of History, Philosophy, Religion & Classics, University of Queensland, Brisbane QLD 4072, Australia. Email: s.wilde{at}uq.edu.au.
Correspondence: ** Geoffrey Hirst, Director of Surgical Services, Mater Health Services, South Brisbane QLD 4101, Australia. Email: geof{at}hirst.com.
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Abstract |
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Archibald Watson was an Australian anatomist and surgeon who kept operating theater diaries. He made detailed notes on the work of surgeons that he observed in Britain and North America, as well as in Australia. Watson's diaries provide significant evidence that early twentieth-century surgeons did not just apply scientific knowledge produced somewhere else. They generated new surgical knowledge themselves and worked within a culture that valued innovation. Some of the surgeons observed by Watson practiced in academic centers and regularly engaged in laboratory research, but most did not. Nevertheless, it is clear that whether in Australia, Britain, or North America, the active search for improved techniques was a routine feature of the practice of full-time surgeons. In the process, they often made mistakes—or rather, they often did things with which at least some of their colleagues did not agree. Much of surgical practice was contestable. Doing things the "right" way and finding better ways to do things were overlapping categories; but it is often difficult or impossible to draw any distinction at all between doing things the "wrong" way and failed attempts at finding a better way to perform an operation. This article examines some aspects of the relationship between scientific ideas, clinical experience, contestable errors, and the generation of new knowledge through surgical practice.
Key Words: history of surgery • surgical knowledge • surgical practice • art and science of surgery • clinical experience • technology • innovation
The research by the first author was supported by an Australian Research Council Post-Doctoral Research Fellowship. The authors are grateful to the Royal Australasian College of Surgeons for permission to publish extracts from the diaries of Archibald Watson.