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From the Bookshelf of Science and Inquiry…

Open Wound: The Tragic Obsession of Dr. William Beaumont

Jason Karlawish

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Dec 10, 2011 Mag rated it really liked it · review of another edition

Shelves: medical-ethics, biography, history, moral-issues, review-copy

This novel is written by a physician about another physician alive almost two centuries ago and deals with an interesting ethical and moral dilemma. It’s based a on a real life story of doctor Beaumont and, by today’s standards, his ethically questionable experimentation on a young man whose life he saved.
In 1822 Dr. William Beaumont, an assistant surgeon in the American army stationed on Mackinac Island on Lake Huron, Michigan, found himself called to an accident in which a young French Canadi This novel is written by a physician about another physician alive almost two centuries ago and deals with an interesting ethical and moral dilemma. It’s based a on a real life story of doctor Beaumont and, by today’s standards, his ethically questionable experimentation on a young man whose life he saved.
In 1822 Dr. William Beaumont, an assistant surgeon in the American army stationed on Mackinac Island on Lake Huron, Michigan, found himself called to an accident in which a young French Canadian voyageur, Alexis St. Martin, took a full blast from an accidental discharge from a gun at a very close proximity. The wound involved both lungs and stomach, was big and complicated and there was little hope that the young man would survive.
Beaumont saved the young trapper’s life but as the wound was healing it became a big fistula into his stomach. Beaumont then, instead of surgically closing it, saw it as a research opportunity and in time became obsessed with probing it and studying digestion through it. The procedure went on for years and had reluctant acquiesce from Alexis who was first dependent on the surgical care of the wound, and then on financial support from Beaumont. As to the pain inflicted by the procedure, we are told that it wasn’t so much the pain as the discomfort and the feeling of nausea and faintness that the young man was experiencing.

By modern ethical and moral standards what Beaumont did is very questionable, even if what propelled him forward was the need for serving humanity as much as the thirst for his own fame. To judge him by our own standards alone would be anachronistic, though. We know from the book that his contemporaries were divided in the appraisal of his efforts- some condemned it, some praised it and found it highly commendable. What real value it has had in furthering our knowledge of digestion the book doesn’t say. My impression is that it remained obscure and not many scientists got acquainted with it. Beaumont, being no scientist, did not conduct his research according to any strict research standards either. As to fistulas, Pavlov, to whom we owe Pavlov’s ‘conditioned reflex’, surgically made fistulas in dogs’ cheeks and stomachs to collect their saliva and gastric acid and study digestion. At least Alexis’ fistula was accidental.

Both of them and countless others used live subjects for experimentation to further medical knowledge. As Better Angels of Our Nature by Pinker informs us the ethical and moral standards have changed over the ages and are still changing in the direction of progress and minimization of pain, humility and towards providing informed consent. And, that’s a great development and one that we hopefully won’t veer from.

The book is quite engrossing and well written to boot. Reminiscent a bit of The Immortal Life of Henrietta Lacks in its subject matter.
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Aug 12, 2016 Sara marked it as to-read

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