Born body and soul into the Romantic era, Hector Berlioz found beauty in the wonder of music. As the son of a physician, however, he was encouraged by his parents to enter a career in medicine. When he began anatomical studies, he found the dissecting room was not wholly his idea of a pleasant place:
At the sight of that horrible human charnel-house, its fragments of limbs, its grimacing faces and cloven heads, the bloody cesspool in which we walked around, the revolting odor it exhaled, the swarms of sparrows fighting over scraps of lungs, and the rats in the corners gnawing bleeding vertebrae, such a feeling of horror possessed me that I leapt out of the window, and ran panting home as though Death and all his hideous crew were at my heels. I spent twenty-four hours stunned by this first impression, wanting to hear no more talk of anatomy, or dissection, or medicine, and meditating on a thousand mad schemes to extricate myself from the future that menaced me.
In spite of that initial shock, Berlioz managed to stick with his studies, at least for a time.
I consented to return to the hospital and face the funereal scene once more. How strange! Seeing again the objects that had inspired in me such profound horror, I remained perfectly calm, I felt absolutely nothing but a cold disgust; I had become as familiarized with the spectacle as a veteran soldier. It was all over. I even found some pleasure in rummaging in the gaping breast of a poor corpse for a bit of lung to feed the winged inhabitants of that charming place.
“Well done!” cried [my fellow student] Robert, laughing, “You are becoming quite human! Feeding the little birds!”
“And my bounty extends to all nature nature,” I answered, throwing a shoulder-blade to a great rat that was staring at me with famished eyes.
As a young medical student, I did not expect experiences with corpses to be easy (one might be worried if they were). What I was unprepared for was the physical impact of the hospital. The wards seemed full of the elderly, the decaying, and the demented. The smell of incontinence and diarrhea seeped into the air, clinging to me when I walked home. The institutional food merged its sickly perfume with that of the patients. They sat vacantly propped in their beds or slumped in chairs, a few clutching tattered magazines or newspapers (I came to realize that these barely altered—the same paper would do as well one day as the next). Books were scarcely to be seen, conversations hardly heard. How grateful I used to be to escape, and when it was into a sunny evening and a warm breeze, it felt like leaping into cleanness. Keats, who qualified as a family doctor and a surgeon, recalled the horrors of his own hospital wards in one stanza of his Ode to a Nightingale, wishing to
Fade far away, dissolve,
and quite forget
What thou among the leaves
hast never known,
The weariness, the fever, and the fret
Here, where men sit and hear each other groan;
Where palsy shakes a few, sad,
last gray hairs,
Where youth grows pale,
and spectre-thin, and dies;
Where but to think
is to be full of sorrow
And leaden-eye despairs,
Where Beauty cannot keep
her lustrous eyes,
Or new Love pine at them
In the Romantic era in particular, where you saw beauty—or horror—was a matter of acute and widespread concern. There was more wisdom in birdsong than in study, wrote Wordsworth. Yet while he was writing about the spiritual benefits of the countryside’s natural beauty, and Keats was worn into retreat by his experiences of suffering and death, another man was heading wholeheartedly in the opposite direction. He lived from 1768 to 1841, and his international reputation—among the populace as much as the cognoscenti—was remarkable. “We think it is indisputable that no surgeon in this, or any other country,” said one obituary, “ever realized such a fortune, or acquired such wide spread fame.” The Times of London said his career had made him the richest professional man, of any profession, ever to have lived.
Sitting around their fireside while snowstorms came down on the Yorkshire moors, the Brontë family—not medical in the least—included this surgeon in their imaginary games, placing him alongside the Duke of Wellington, conqueror of Napoleon, in their personal pantheons. He was intimately involved in the French Revolution and came close to being executed for treason for supporting revolutionary democracy in Britain. Unless you happen to be a surgeon or a medical historian, however, you are unlikely to have heard of him. His name was Astley Paston Cooper.
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What had Cooper done to achieve such success, such fame? His anatomical and surgical advances are traditionally given as reasons, but for all the orthodoxy of answering the question in that manner, it’s a mistake. His discoveries about blood vessels, joints, limbs, ears, breasts, hernias were real and they mattered. Underlying those triumphs, though, was something else. Cooper showed an ability to pursue scientific thoughts in ways that others could not, and it came not from any cold intellectual superiority but from a warm aesthetic one. What drove Cooper and made him special was his peculiar ability to fall all-consumingly in love with parts of natural history that were ostensibly revolting.
Attracted partly by the conjunction of his once-sweeping fame and his present obscurity, partly by his wild and colorful life, I spent some time writing a biography of Cooper. More than anything, though, what fascinated me about him was his influence on Keats, who was his student and who, I should admit immediately, has always seemed to me one of the finest men to have ever lived. Keats, as tough as they came, was the opposite of an effete and dreamily disconnected Romantic. A small man who handled himself well in a fight, he would enter into one on principle when he saw bullying or cruelty. While still a student he was awarded a prestigious assistantship in one of the world’s leading hospitals, and his daily work there was grim, bloody, and brutal. Keats wrote poetry as a way of grappling with the reality of the world, its ugliness as well as its beauty, and of doing some great and lasting good. He was a surgeon for the same reasons. Why did he admire Cooper? In his surviving letters Keats never says, but it was for something more than the older man’s financial success and operative skill.
A charismatic but shiftless adolescent, Cooper seemed set on fraud and criminality. What pushed him onto a more adult path was anatomy. A mentor, despairing of Cooper’s failure to attend to his studies, decided to no longer tolerate the young man’s lack of attendance in the dissecting room. In the blunt manner of the time, he brought a human arm home and slammed it down on a table, demanding Cooper immediately set to work dissecting it. Cooper did so. Something about the arm gripped him, and it never let go. As an old man, Cooper remarked that he felt the day wasted if he laid his head on his pillow without having dissected something. His days were rarely, in that sense, ever wasted.
The literal truth of the anecdote has to be dubious, at best. Romantic biographies had a tradition, even in their own day, of describing childhoods of ruinous wildness that were transformed by moments of epiphany into greatness. While the incident almost certainly happened, I am not at all sure that Cooper’s transformation was quite as sudden as it is portrayed. But in later life, that’s what he believed had happened: he believed that the beauty revealed by human dissection had blasted his youth into a love affair with the hard study of reality, and away from the slick easiness of delinquency.
The laws he continued to break were those on the desecration of graves, since in those days to study anatomy required stealing corpses. Cooper went from digging them up himself in the dead of night to running an international network of men who did it for him. As king of the body snatchers he acquired human dead in every state of liquefaction and decay. He risked himself daily in order to examine bodies—the slightest slip and the smallest wound, and infections commonly turned anatomists into cadavers.
“Become a doctor!” exclaimed Berlioz.
Study anatomy! dissect! witness horrible operations! instead of delivering myself heart and soul to music, that sublime art of which I had already glimpsed the grandeur! Forsake the empyrean for the saddest place on Earth! The immortal angels of poetry and love and their inspired songs for filthy hospitals, dreadful medical students, hideous cadavers, the shrieks of patients, the groans and death-rattles of the dying. Oh! no, it seemed to me the utter reversal of the natural conditions of my life—monstrous and impossible.
If I had come across Berlioz’s writings in the years I first walked the wards of hospitals, I’d have agreed wholeheartedly. Even today I think he has a point.
Literature professors—who preach about the importance of reading, but often have a disdainful and shaky grasp of the literature of science—give us Keats on how the delight of the rainbow is destroyed by unweaving it, Wordsworth announcing that “we murder to dissect.” What gets more often overlooked is Keats as a bloody and successful surgeon, Coleridge as a devotee of science (“I shall attack [study] Chemistry, like a Shark”), and Wordsworth as someone capable of recognizing not merely the utility of science but also its natural beauty. “Wherever we sympathize with pain,” Wordsworth wrote, “it will be found that the sympathy is produced and carried on by subtle combinations with pleasure.”
The Man of Science, the Chemist and the Mathematician, whatever difficulties and disgusts they may have had to struggle with, know and feel this. However painful may be the objects with which the Anatomist’s knowledge is connected, he feels that his knowledge is pleasure; and where he has no pleasure he has no knowledge.
Wordsworth may have been the leading poet of his day, but the leading critic was William Hazlitt. He reached similar conclusions:
The anatomist is delighted with a coloured plate, conveying the exact appearance of the progress of certain diseases, or of the internal parts and dissections of the human body. We have known a Jennerian Professor as much enraptured with a delineation of the different stages of vaccination, as a f lorist with a bed of tulips. . . . Not only the imitation pleases,—the objects imitation pleases,—the objects themselves give as much pleasure to the professional inquirer, as they would pain to the uninitiated. The learned amateur is struck with the beauty of the coats of the stomach laid bare, or contemplates with eager curiosity the transverse section of the brain. . . .It is here, then, the number of the parts, their distinctions, connections, structure, uses; in short, an entire new set of ideas, which occupies the mind of the student, and overcomes the sense of pain and repugnance, which is the only feeling that the sight of a dead and mangled body presents to ordinary men.
A contemporary used the same analogy for Cooper, describing him on a ward round as like a florist tending his flowerbeds. Cooper sought out the diseased, the traumatized, and the mutilated. He vivisected animals unstintingly, buying them or stealing his neighbors’ pets and subjecting all to every imaginable atrocity. He operated on his fellow human beings without anesthetic or painkillers, without even the morphine and alcohol that were freely available but which he believed (with good reason) reduced their chances of survival. He operated on people without warning and without their consent—sometimes, indeed, when they were actively against it.
“Sir,” protested one of his patients afterwards, “you had no right to do that without consulting me; God bless my soul! Sir, the pain is intolerable;—if you had asked me, I don’t think I should have submitted.”
“The very reason,” retorted the surgeon, “that I considered it right to think for you.”
To perform an operation only when necessary was a commonly held professional ideal. Cooper pursued the notion that when an operation was necessary, it ought to be done. No matter if the patient was too frightened to agree, no matter if the chances of success were tiny. Given the appalling pain and complication rates of operations, surgeons were often terrified of performing them. Cooper watched his surgeon uncle sigh with relief when a patient with a tumor on his leg fled, after limping into the operating theater and seeing the bone saws at the ready. It was a failure of manliness, Cooper believed. It was understandable that the patient should quail, inexcusable for the surgeon to have done so.
When a young Chinese man traveled all the way to London to have a vast growth removed from one testicle, a group of surgeons gathered for the operation. Cooper was not due to take part, but his opinion was sought, and he advised his colleagues that he thought their plans mistaken. Their aim was to try to delicately dissect the tumor away and preserve, at his urgent request, the young man’s genitals. Cooper accused them of cowardice—of cowardice masquerading as compassion. Only a swift and brutal operation had a chance of success. The patient might be too frightened to make the right decision; his surgeons needed the moral courage to do better. The slower operation went ahead as planned and, over its drawn-out course, the patient bled agonizingly to death.
A colleague once confided to Cooper that he felt surgery a worthy but also an awful and a chilling profession. But in the anatomical structure of the world Cooper found beauty, in the animal experiments on which he built his skill and knowledge he found pleasure, and in the useful practice of surgery he took joy.
Did Cooper behave the way he did because he had a suspiciously high tolerance for other people’s pain? It doesn’t seem so. A bit of sadism crept in, but for the most part he was free of it—remarkably free, given how he spent his life.
[media:node/2240 caption left horizontal medium]Two objects that I found in my research struck me, as physical objects are wont to do, with unexpected force. One was a loose leaf of paper on which Cooper had hastily written some anatomical observations. They were colored by their social context, but also in more literal ways. The day after the death of King George IV, Cooper was called on to examine the body. “An account of the appearances which were observed in inspecting the body of his late Majesty,” runs the title—except Cooper felt it wasn’t respectful enough, so went back, crossed out “body,” and replaced it with “mortal remains.” Respect, characteristically, wasn’t allowed to efface insight. “The body,” begins the account, “exhibited very slight appearances of putrefaction. . . . Notwithstanding the apparent emaciation of His Majesty’s person [there is] a very large quantity of fat” (George IV was famously obese). Spattering the page are stains, and they aren’t ink. The postmortem report grew suddenly more striking as I realized my fingers were brushing the remnants of a monarch.
The other object that moved me unexpectedly was odd from the beginning. In a box of anatomical illustrations was a scene of a forest. It was unmistakably painted with Romantic sensibility. Against a pitch-dark background a mysterious tangle of trunks and leaves were silver under an unseen moon. What was it? No forest, it turned out, but an illustration made for Cooper’s final book, which was about the human breast. The trunks were not of trees but were the ducts along which flowed a mother’s milk; the leaves were the glands producing it.
Cooper’s work on the breast depended on obtaining specimens. He jotted down a request to the body snatchers to provide “breasts of any age (old women or young).” The specimens they supplied were diseased, rotten, hacked apart. Is there anything more calculated to destroy one’s sense that the human form is beautiful than to steal from the grave the breasts of dead women, and then to dissect them?
“This sketch was made in great haste, and by candle-light,” records one Cooper illustration.
There was very little difference in colour between the areola and the surrounding integuments. There were no hairs. Four or five prominences were apparent beyond the areola and superiorly. Two rows of tubercles were slightly visible. . . . The parts, generally, much resembled those of the Venus de Medici according to my recollection of that Statue.
The book saved lives, massively improving diagnostic skills—breasts were often removed because surgeons mistook abscesses for cancers—and establishing an understanding of anatomy, and in particular the lymphatic drainage of the breast, so advanced it gets cited as a relevant authority in modern research papers.
Cooper’s stubborn hold on the idea of human beauty was based on two things. The first was the conviction that to see the world truthfully, to observe natural history with all the power and clarity one could bring to bear, was fundamentally honorable.
The breasts are slung upon the chest, supported by the fibrous tissue, and they are projected at the nipple forwards and outwards. I have, in my work on the Testis, pointed out the errors of those who paint or chisel from imagination, and not from observation of nature, in placing those bodies of equal height, although the left is usually much lower than the other; and the same remark may apply to the breasts, modellers, sculptors, and painters sometimes represent the nipples as being pointed forwards, and place them as their imagination leads them to conceive them to be, and not as they really are.
By forcing himself and his colleagues to attend more closely to things as they really were, Cooper made his breakthroughs. He recognized anatomy in new ways, saw the strengths and weaknesses of approaches to it, explored experimentally whether his ideas had clinical power. Close attention to natural history fortified his obstinate sense of its beauty, for his other great conviction was that deepening one’s understanding of the natural world deepened one’s appreciation of it. The beauty of the breast was not in its anatomy alone, but in the way its anatomy reflected its role in human life:
[media:node/2239 caption vertical left]This natural obliquity of the mamilla, or nipple, forwards and outwards, with a slight turn of the nipple upwards, is one of the most beautiful provisions of nature, both for the mother and the child. To the mother, because the child rests upon her arm and lap in the most convenient position for sucking.. . . But it is wisely provided by nature, that when the child reposes upon its mother’s arm, it has its mouth directly applied to the nipple, which is turned outwards to receive it; whilst the lower part of the breast forms a cushion upon which the cheek of the infant tranquilly reposes. Thus it is we have always to admire the beauty, and the utility, of those deviations of form in the construction of the body which the imagination of man would lead him, à priori, to believe most symmetrical, natural, and convenient.
Astley Cooper’s discoveries in anatomy and surgery won him worldwide renown, but it was aesthetic achievement that made him. When Mary Shelley wrote of Victor Frankenstein, she told a story of a man whose inability to perceive beauty was fatal. “The dissecting-room and the slaughter-house furnished many of my materials; and often did my human nature turn with loathing from my occupation.” Not only did Frankenstein regard his creature as physically repulsive, he also assumed that physical unattractiveness was a marker of spiritual repulsiveness. In making that assumption he doomed his hopeful monster and himself. Cooper’s life showed what could be achieved by seeking beauty where others saw only horror, and by apprehending beauty through being sensitive to its meaning.
Study the patterns and connections in natural history, Cooper found, and even the most off-putting parts of it yield up wonder. For medical students getting used to the smell of hospital wards and the decay that age and illness bring, for scientists seeking to understand the human body in richer detail, for statisticians daunted by the apparent coldness of numbers, for poets sitting in their gardens and listening to songbirds—for all of them, Cooper’s success makes for a fine lesson. To see heaven in the pursuit of science is necessary for enjoying it, and just as vital in order to do it well.
Druin Burch has written a biography of Astley Cooper, Digging Up the Dead: Uncovering the Life and Times of an Extraordinary Surgeon (Random House UK, 2007)