July 12, 2022

We get to see nineteenth century medical techniques through Nora’s eyes. Which treatments surprised you the most? What carried over into modern medicine?

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Jessica S

Whenever I read historical fiction, especially anything that showcases medicine, I’m always confounded by how commonly people used to die from medical issues that are so readily treatable now, they are considered mundane (appendicitis, child birth, a hernia).


The lack of abdominal surgeries. The use of ether. We still need to learn from autopsies and now from genetics also. So glad to live today with anesthesia, antibiotics, and women in the medical field.


I thought they would have used something other than ether for putting people to sleep. I’m glad we do have medicines that can put you to sleep during operations now.


The book definitely reiterated how grateful we should be for modern medicine, especially the use of anesthesia. It was quite sobering to realize that I myself and some of my family members would likely be dead had we lived in this time period given that the abdomen was off limits for surgeries. On another note, thank God we know to wash our hands now. 😳 Those scenes with the pig swill were… rough.


Probably the treatment of the woman whose hand was run over by a wagon wheel – the debate about cauterizing to “burn away” infection, pouring absinthe in the wound…


I did not realize that the use of leeches for bloodletting extended so late in the 1800s in England. The use of cadavers for medical training has continued.


The importance of decorum and the roles of men and woman taking priority over saving lives is a sad surprise. “The Girl in His Shadow” is an amazing work of historical fiction describing these disturbing choices that I’m sure were repeated over and over. Hopefully the world has grown past these archaic beliefs.


What surprised me the most was how Nora was able to recognize certain signs to make it okay for her move forward with the surgery. Also, I am glad to see that there has been progress in the medical field because amputation does not sound like fun.


Anaesthesia, dissection, women medical personnel allowed to practice and to be in “delicate “ situations


The medical process that surprised me most was the way Nora recognised life in the twisted colon. As this was ground breaking surgery and they only had minutes for the patient to remain under the ether, it was incredibly tense, waiting for the colour of the blood to change – and that they could see the difference in such poor lighting. I think the authors did a great job of capturing that sense of risk and revolution.


I was shocked that they didn’t understand that literal pig poop was bad for wounds! They even compared it to urine.


I was surprised how often they amputated limbs. What carried over was that women all over the world die in childbirth even today.


The body snatching bought my attention. It reminded me of the doctors on the TV show House who broke into people’s homes to collect more information about the patient. I know they’re just stories but I wonder if anything similar actually happens.


The evolution of the use of anesthesia and advances related to its use in childbirth. As OB nurse, I have heard about use of “gas” and alcohol drips during labor.


I was surprised that abdominal surgeries were forbidden by the medical college, and that it was accepted that people with abdominal infections would die.


Most surprised the common practice of experimenting on the dead bodies, even without permission. Altho understandable that so much knowledge was gained that way.


This was a huge issue in Cincinnati – look up the death of President Harrison and the bodies being taken. People used to think the iron grates over graves were to keep in vampires(ha!) they were actually to keep out the body thieves.


Ether brought back memories from the 1960s. So glad anesthesia has evolved.


Medical ethics are complex. I was so nervous for Daniel, Nora and Dr. Croft to publicly justify the rationale and outcome of what they had done. It was exciting and the most compassionate, morally appropriate thing they could do in the presentation of such a case. They had a survivor who could testify that use of a woman and ether were expedient and necessary and beneficial.


I thought the hearing was a great addition to the story. I feel like it was very appropriate to the justice of the book. I believe that good stories have justice, and Audrey Blake’s did not disappoint.


Thank goodness for ether
Now some antibiotics would be nice
Sterilize ing would be great top
Love studying specimens


I was surprised when they touched on appendix surgery, and how “we never go in the abdomen”. I think the authors shared this because they wanted us to realize how far we’ve come. It’s shocking that not even 200 years ago doctors wouldn’t touch the appendix and now it’s such a common surgery to remove it entirely.


I don’t think they were aware of germs. From looking around the web, it seems that a surgeon named Lister, influenced by Louis Pasteur, introduced the practice of antiseptic surgery in the 1860’s.

Last edited 1 year ago by Nancy

I am amazed at how far medicine and technology have changed in a relatively small amount of time. Thousands of years passed without breakthroughs discussed in this book. Humans have intellect and we can do so much good, and bad. I was glad none of the doctors were jailed for trying something new! Fun to learn how human rights are different amongst countries and still are.

The thought of amputations on conscience people? I’m extremely grateful for this to be a thing of the past!

Marcia Sculley

I applaud Daniel’s willingness to let Nora go. He has the foresight to allow her the education so she will equal him in skills and have a matching education.


There were so many things that surprised me. The surgeons did EVERYTHING. They were dentists, anesthesiologists, emergency surgeons , pathologists you name it. Today we have so many sub specialists. The research was also surprising. She wanted to figure out why Daniel’s patient died. At first she was going to use puppies to simulate what they thought happened to the woman, but they were too cute so she used chicks. Also , the fact that they had to dig up bodies secretly in order to conduct research to figure out why people died. I also surprised by the accidental discovery… Read more »


Ether is nothing like what we use today, thank goodness. It’s hard to control, causes vomiting, and is highly flammable. However, it did introduce the science of anesthesiology.


In 1963 I had my tonsils removed with either as the anesthetic! Apparently, it was the worst tonsilectomy (sp?) my surgeon had ever done. I assume that meant they used more ether as getting them out took more time! I threw up for days!!! I was 7.

I share this as some might think ether disappeared from anesthesiology much sooner!

I thank God for modern anesthesia!!!

Meredith E

I was actually surprised at how much they were learning and how quickly things changed in medicine in the nineteenth century. I was not really aware of the history of medicine and when they learnt about the beginnings of medical practices such as discovering ether.
I was really surprised that there was so much amputation for things and that people were usually awake. I guess I have never really thought about what they did before anesthetic.


I don’t think it’s the treatments so much that surprise me but rather the language. I know it’s different, it only makes sense that was.


I was surprised by most of them, only because I guess I’d never given much thought to the evolution of medical procedures and medications. The whole cadaver thefts was disturbing but unfortunately necessary for the advancement of science.


I was surprised by the the use of ether as an anaesthetic. The use of anaesthesia carried over into modern medicine. The treatment for a hernia by detecting if the bowel was necrotic or just had an obstruction was very adept.


What most surprised me was that ether and nitrous oxide were both used for so long as parlor tricks before being used in medicine! When they first discovered what ether did, I was expecting them to go straight to the idea of using it for surgery, but they took so long to think of it! I was also shocked that she had to perform experiments to prove that pig dung was infectious. That just seems like common sense today!

C Beagle

Daniel’s interest in arthritis at the end. There is medicine today to help ( much like his poultices) but no cure really still.

Kimm R.

The criminality of abortion struck hard for me following the recent distressing events in the US.


I was thinking the exact same thing about abortion. It was truly a backstreet procedure throughout history.


And we will see a rise of backstreet abortions again in the US, unfortunately as well as just an increase of pregnancies for the poor and/or the uneducated.

Kimberly Araki

I was annoyed that the girl that got the abortion was considered diminished afterwards too.


I thought it seemed more that her spirit had been diminished by the experience.


The use of ether must have been such a relief for surgeons and patients. Ether use continued for quite awhile. The clandestine use of cadavers to study anatomy.


Ether was still used in 1963 for my tonsillectomy!


Very happy that ether isn’t used now. The lack of cleanliness of the instruments and hygiene. The need to bleed patients with the belief that was a cure still makes my skin crawl.


Chapter 11-13 is interesting with the debate between cauterization and leeches. Dr Croft vs Dr Vickery. It is also interesting to see the long route we have traveled from alcohol/ drugging to modern anesthesia. I couldn’t imagine having to undergo an amputation wide awake and yelling “don’t cut off my hand”.

Laura Macdonald

I was surprised by the idea that cauterizing a wound was not the best way – I thought it was always a good choice.


I was surprised at the use of bleeding and leaches. I didn’t realize that was still normal practice at that time.


medical leeches are still used today

raymond polone

It was interesting that you provided so much attention to appendix/intestinal issues in the 19th Century when so much contemporary 21st Century medical assistance and inattention to abdominal intestinal scar adhesion surgery is not possible in the USA. However, I am aware there are some advances and attention to the adhesions being addressed in Germany.


I shared some of the medical techniques with my husband, who is a paramedic. He was surprised that the use of ether started that early!
This time period was the beginning of the end of the “4 humours” beliefs (thank goodness).
The use of leeches still happens on occasion for blood poisoning and necrosis!

Rhena Wahlen

The Cesearan section done by the female doctor in The hospital that she was studying in. It used to be for emergency only now done for convenience!


I can’t wait to dive into the sequel (The Surgeon’s Daughter) and see how that patient of hers fares. Had to buy it after I finished this one because the online libraries have such a long waiting list for both it and it’s audiobook. Very interesting stuff in these stories that are like a good medical drama.


I really expected more understanding of human anatomy by the middle 1800’s & germ theory. Look how far we have advanced in a short period of time.


Deb, we have come a long way, but I feel we are throwing the knowledge away, such as making COVID a political issue, rather then leaving it with medical professionals to manage the situation.




I couldn’t get over how they were practicing on each other with ether. Obviously it’s how you learn about it, but with what we know now…


Jess—I know right? So risky but necessary—“trial & error”.


Scientists still sometimes experiment on themselves and other scientists because they feel if they are going to try it on someone it should be themselves first. Morally speaking I get that even if it does mean they risk milking themselves of course. I got a painful procedure done (EMG), which required me to get shocked on my hand and arm repeatedly and needles stuck in to my hand arm and neck. The doc who gave it to me told me he and all students who studied it had to get it done as well so they know what it is… Read more »


I didn’t know that they discovered ether that early. The use of ether to relieve pain.


You could die from having a. Stone or a hernia.

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