Promise Me by Nancy G. Brinker Read Free Book Online

inception, however, the mastectomy set at odds two guiding principles of the practice of medicine:
    Primum succurrere
, “First, hasten to help.”
    And
Primum non nocere
, “First, do no harm.”
    Before the time of anesthesia, before any concept of antiseptics or any reliable method for determining the difference between benign and malignant tumors, most women who underwent mastectomies died, either from the surgery itself or from rapidly raging infection. But some survived, lending credibility to the idea that mastectomy offered a potential “perfect cure.”
    Surgical procedures became more and more aggressive. Even when only a small portion of the breast was diseased, surgeons zealously went after the axillary lymph nodes by opening up the armpit. Soon surgeons in Paris were performing “en bloc” mastectomies, removing the entire breast, chest wall, and lymph nodes. The director of the cancer instituteat England’s Middlesex Hospital urged removal of the surrounding skin as well, rather than risk a return of the cancer owing to any “mistaken kindness to the patient.”
    “Madame, it’s a small thing,” Dr. Larrey assured Fanny Burney. “You sit in a chair. I excise the tumor. All over in a few minutes. I must caution you, Madame: The consequences of procrastination are dire.”
    Fanny later wrote to her sister Esther that she rose at eight on the appointed day and dressed with the help of her maid; the advancing cancer had left her right arm almost useless. Young Dr. Aumont arrived with a letter from Larrey, advising her that he and his colleagues would come at ten. Larrey reassured her of his dexterity and expertise, and admonished that, for sensibility and prudence, she should “secure the absence” of her husband and son.
    Fanny made a pretense of lingering over the note, struggling to hide her growing apprehension. She had to protect her son from “the unavailing wretchedness of witnessing” what was about to happen. She dashed off a note to the
chef du division du Bureau
where her husband was at work, informing him of her situation and entreating him to trump up some urgent business to detain d’Arblay until it was over. She sent her maid down to Dr. Aumont—“the terrible Herald”—to inform him in no uncertain terms, she would not receive Larrey until one.
    “I have an apartment to prepare for my banished Mate,” she fussed. “Two engaged nurses are on the way. I have a bed, curtains, and Heaven knows what to prepare.”
    Dr. Aumont remained in the salon, stolidly folding stacks of linen. Word came that the surgeons couldn’t come until three. Dr. Aumont left, promising to return at that time, leaving Fanny for two lonely hours with nothing to do but contemplate her fate. She tried to write letters to her family, but the debilitating ache in her arm prevented her. She wandered the apartment, finally forcing herself to open the door to the salon, where she discovered Dr. Aumont’s immense supply of bandages, compresses, sponges. Clearly, significant blood loss was anticipated.
    Fanny recoiled. In a state of torpid shock, she paced until the clock struck three. Gritting her teeth at the agony in her arm, she forced a few words onto paper, short notes for d’Arblay and Alex “in case of a fatal result.” She rang for her maid and hired nurses, but before she could speakto them, seven men in black—Dr. Larrey, Monsieur Dubois, Dr. Moreau, Dr. Aumont, Dr. Ribe, a pupil of Dr. Larrey, and another of Monsieur Dubois—entered without announcement. Fanny was indignant, but she found herself unable to assemble a single syllable to object.
    Why so many?
she wondered.
And how dare they enter without leave?
    “Dubois acted as Commander in Chief,” she wrote to Esther. “He ordered a bedstead into the middle of the room. Astonished, I turned to Larrey, who had promised that an arm chair would suffice, but he hung his head, and would not look at me.”
    “Two old mattresses and an old sheet,”