Historian, Writer, Commentator, Consultant.

For Fear of Pain

Posted by on Jan 18, 2012 in Books | 0 comments

For Fear of Pain coverFor Fear of Pain: British Surgery 1790-1850 (Editions Rodopi/Wellcome Institute, Amsterdam, 2003)

As I describe in the book’s epilogueFor Fear of Pain goes back to my childhood:

I decided in about 1994 that I needed to investigate and exorcise this preoccupation with surgery. I remember that the first real research I did was in the Library of Congress in Washington in October 1995, when I took a break from research for Tarakan to look at surgical manuals from the 1820s and 1830s. Then in the Brownless Medical Library at the University of Melbourne I read the manual John Bell’s The Principles of Surgery, which gave me the title, ‘For Fear of Pain’ (which thanks to David Lodge’s novel Thinks… I learned was taken from John Milton: ‘who would for fear of pain lose this intellectual being’). This, and preliminary reading in medical history (which seemed to either avoid or misrepresent painful surgery) persuaded me that there was a book in this.

Back in Canberra I discovered that the admirable Hancock Life Sciences Library at ANU holds the Lancet from its inception, and I began reading my way into the clinical literature from the mid-1820s. Reading reports of operations written by surgeons and students in the early months of the project was about the hardest research I’ve ever done. I would return home with my armpits soaked, relived to be out of the Hancock’s silent basement. But after a few months I realised that even the most graphic account of operations were no longer upsetting. When I learned more about medical students I realised that they too became habituated to surgery’s power to shock, disgust and distress. (Obviously students in the operating room had much more powerful experiences than I had, who merely read about it rather than seeing or hearing surgery.) After some time I also realised something else: I stopped having nightmares about surgery: I had faced my fear and had conquered it.

I continued to research, mostly in published primary sources, but including a hugely valuable week in the library of the Royal Australasian College of Surgeons and the Wellcome Institute in London. In 1999, while on a visiting fellowship in Edinburgh, besides reading my way into what became the opening chapters of Alamein, I made the most of the wonderful collections of the Royal College of Surgeons of Edinburgh, the National Library of Scotland and the Edinburgh University Archives. The first held the papers of John Simpson (who discovered chloroform’s anaesthetic properties), the journal of Tina Malcolm (who died of breast cancer in 1830) and the records of the Edinburgh Royal Infirmary (the most complete hospital records of the period).

By this time I knew that I had a book that could say something worth reading about a period of medical history that was still being represented (misrepresented, I thought) as bloody, brutal butchery. Painful, of course, but I argued that the fifty years following John Hunter’s death (to take a useful starting point) was a period marked by rapid anatomical and surgical advances, bold and largely successful operations despite the absence of anaesthesia. In 2000 research in the Royal College of Surgeons of England, the National Archives and especially the King’s College Archives (which holds the papers of John Lister) gave me the wherewithal to write the manuscript, which was accepted by Christopher Lawrence and the Welcome Institute’s Cliomedica series, published by Editions Rodopi in Amsterdam. That it became the first of 70 books in the series to be reprinted (with a colour cover no less) confirmed that it seemed to be regarded as making a worthwhile contribution.

For Fear of Pain was published in 2004 and launched by Barry Smith at the British High Commission, Canberra, in September 2004. (At that launch Gabrielle Hyslop, later to be a valued colleague at the National Museum, recited several of Thomas Hood’s poems, including ‘Mary’s Ghost’.) Of course five years later the television celebrity doctor Michael Moseley could still perpetuate all the old stereotypes in Blood and Guts, no doubt reaching an audience a thousand times greater. (I wrote to him to point out that his portrayal was just wrong, and didn’t get a reply.) But after For Fear of Pain no one has any excuse for portraying surgery and surgeons of this period as merely bloody butchers. I must say that I have been delighted at the way For Fear of Pain has been received, especially by reviewers who know what they’re talking about.


“…an excellent and useful book.”
Wellcome History, Vol.29, 2005

“…innovative historical focus […] eloquent descriptions […] More clearly than in any other historical account, Stanley delineates and substantiates the “inescapable tension” that surgeons faced…”
The Bulletin of the History of Medicine, Vol.78, 2004

“an excellent and useful book … a moving and provocative account of a world difficult to imagine and painful to contemplate”
Stephen Casper, Wellcome History, 29

“more clearly than in any other historical account, Stanley delineates and substantiates the “inescapable tension” that surgeons faced between inflicting pain and answering their calling.”
Philip Wilson, Society of the History of Medicine, 2004, 78

“Stanley has made an important contribution to our understanding of early nineteenth century surgical practice … a very valuable and interesting book.”
Sally Wilde, Health and History, Vol.5, No.2, 2003, pp.156-158

“…this book is a well-organized graphic account told with humility and intense feeling for all those facing ‘The Fear of Pain'”
Canadian Bulletin of Medical History, Vol.21, Number 1, 2004, pp.195-19


To buy For Fear of Pain visit the Editions Rodopi website.

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