William Stewart Halsted

Money was not a problem in the Halsted house: a place on Fifth Avenue, an estate in Westchester County, a father in the dry goods trade. William was tutored at home until he was ten, sent to boarding school in Monson, Massachusetts, where he ran away, then to Phillips Academy, and then to Yale, where he captained the football team, rowed, played baseball, and finished academically below average. Medicine did not interest him until his last undergraduate year. He entered Columbia's College of Physicians and Surgeons in 1874 and the indifferent student vanished. He talked his way into a competitive Bellevue internship exam meant for men who already held degrees, won it, and graduated near the top of his class in 1877.

He came back from two years in the clinics of Vienna and Germany in 1880 and worked at half a dozen New York hospitals at once. He got Bellevue to put up a tent, at a cost of 10,000 dollars, so he could operate antiseptically. In 1881 he found his sister bleeding to death after childbirth, drew his own blood, transfused it into her, and then operated. He took seven gallstones out of his mother on a kitchen table at two in the morning. In 1882 he performed the first radical mastectomy in the United States. At Johns Hopkins from 1889 he built the thing that outlasted the rest: a ladder of internship, six years as assistant resident and two as house surgeon, which became the American surgical residency. Harvey Cushing and Walter Dandy came up it.

In 1884 he read that cocaine numbed the eye, and he and his students began injecting each other and themselves. The nerve block came out of that work. So did an addiction that lasted the rest of his life. His one paper on the subject, published in 1885, is incoherent. Friends got him aboard a steamer for Europe and let the two-week voyage detoxify him. It did not hold. He committed himself to the Butler Sanatorium in Providence, where the cure for cocaine was morphine, stayed seven months, went back for nine more, and was still taking morphine when he died. Osler kept a private record of the dose: never below three grains a day, roughly 200 milligrams. In New York he had been a charismatic teacher. At Hopkins he attended to a few students and ignored the rest.

He and Caroline Hampton, the scrub nurse whose eczema had made him order rubber gloves from Goodyear in 1889, married in 1890 and had no children. Summers went to High Hampton in the North Carolina mountains, where he grew dahlias and studied the sky. He died in Baltimore on September 7, 1922, 16 days short of 70, of bronchopneumonia after surgery for gallstones and cholangitis. The addiction stayed private until Osler's account surfaced. What survives him is not a discovery but a structure, and every American surgeon still trains inside a version of it. The radical mastectomy outlived him too, until the evidence showed that how far a cancer had spread mattered more than how much tissue came out.

William Stewart Halsted's life against the full span of the corpus.

• Halsted radical mastectomy invention
  First performed in the United States at Roosevelt Hospital, and the standard for decades 1882
• Surgical rubber gloves invention
  Ordered from the Goodyear Rubber Company to protect Caroline Hampton's hands 1889
• Halsted inguinal hernia repair invention
  Published the same year as Bassini's, and still a reference operation 1889
• The Johns Hopkins surgical residency company
  The first formal surgical training program in North America 1890
• Johns Hopkins School of Medicine company
  Founded with Welch, Osler and Kelly. Halsted was its first Professor of Surgery. 1892

• 1874 aged ~22 Graduates from Yale as football captain and a below-average student
• 1877 aged ~25 Takes his MD at Columbia near the top of his class
• 1881 aged ~29 Transfuses his own blood into his hemorrhaging sister, then operates One of the first emergency transfusions performed in the United States.
• 1884 aged ~32 Begins injecting cocaine to test it as a local anesthetic He and his students experimented on each other. Several became addicted.
• 1886 aged ~34 Commits himself to the Butler Sanatorium, where the cure for cocaine is morphine Seven months, then a further nine after a relapse.
• May 1889 aged 36 Johns Hopkins Hospital opens and he joins as associate professor of surgery The modest title reflected the trustees' worry about his history with cocaine.
• 1890 aged ~38 Marries Caroline Hampton and is made surgeon-in-chief
• 1898 aged ~46 Presents his radical mastectomy results in New Orleans He reported a sharp fall in local recurrence, and presented again in 1907.
• September 7, 1922 aged 69 Dies in Baltimore, 16 days short of his 70th birthday

• Harvey Cushing 1869–1939
  Surgeon who established modern neurosurgery as a specialized medical discipline. trained
• William Osler 1849–1919
  Built bedside clinical teaching into American medical education as a founding Johns Hopkins professor. colleague who kept the record of his addiction
• H.L. Mencken 1880–1956
  Satirist and cultural critic whose biting prose defined American journalism in the early 20th century. wrote his best tribute
• Elizabeth Blackwell 1821–1910
  First woman to receive a medical degree in the United States and a pioneer of women’s medical education. opened American medical training to women