Surgery and Specialization

Abstract

The white heat of the Paris clinics helped in many ways to create a new ‘modern’ style of medicine: one that blended medical and surgical ideas, was research and teaching intensive, and which was, in other words, an early version of the phenomenon that we would now describe as ‘academic medicine’. An important feature of this new trend was the extent to which ‘specialist’ knowledge and practices could be rapidly developed. Take the career of Pierre-Joseph Desault, for instance, a man who began his professional life relatively inauspiciously as a barber-surgeon but who would go on to found famous centres for academic surgery, first at the Charité then at the Hôtel Dieu in late eighteenth century Paris.³ At the College of Surgery, Desault oversaw the building of a grand surgical amphitheatre that allowed students to observe and be instructed on live surgeries.⁴ A similar innovation on the wards, where Desault insisted that surgical students be placed in charge of wards—caring for patients and maintaining records—was an enormously important step, one that opened a new world of practical opportunities for would-be practitioners just as their elevation in status itself symbolized the ascendant status of academic surgery as a whole.