Described as an “immersive live theatre performance”, I was immediately attracted to an event at the Science Museum called Time Travelling Operating Theatre, which purported to offer insight into what operating theatres were like in 1884, 1984 and 2014. I do love immersive theatre, and despite my inherent squeamishness I have an interest in the history of science and medicine, so I really wanted to attend this free event.
The event was organised by Imperial College Centre for Engagement and Simulation Science. When I got there I began to wonder if it was in fact aimed at medical professionals and students – attendees had to fill in a questionnaire and from the conversation around me I gathered that many other people there had a vested interest in the subject matter. Having said that, I later discovered that there were plenty “ordinary” members of the public present, though the “immersive theatre” aspect was not what I expected. Nevertheless, I did find it incredibly interesting and worthwhile.
We watched three surgical re-enactments, each using genuine medical professionals along with authentic sets and costumes. The Victorian-era operation, set in 1884, was perhaps the most interesting to me, as it’s a time I am especially interested in. During this period, internal operations were in their infancy, owing to the relatively recent introduction of anaesthetics; administering pain relief was still a far from exact science and the anaesthetist, usually an assistant rather than a specialist, would have to keep careful watch on the patient to establish how much to give. Anaesthetics were given via a cloth placed over the patient’s mouth. Operations would usually take place in the patient’s house; the set was an ornate room lined with bookcases, and to modern eyes looked both oddly homely and appallingly unhygienic. After visiting the Old Operating Theatre Museum near London Bridge a few weeks ago, this fitted in nicely, exploring the post-anaesthetic stage of surgical history.
By 1984 things had moved on considerably, and operations took place in hospital, with surgeons gowned and equipment sterilised. The kind of operation we were watching – the removal of a gall bladder – was still performed via open surgery, which involved one large incision. However, conditions were much more hygienic and this sort of operation was relatively straightforward with a high success rate.
Interestingly, the professionals performing this re-enactment were those responsible for advances in keyhole surgery, the technique demonstrated in the 2014 scenario. Keyhole surgery is much less invasive and means a much faster recovery time. Here, computer screens helped the surgeon complete the operation via much smaller incisions, using long instruments which did not require first-hand viewing of the area to be operated on. Masks were no longer worn, most instruments were single-use, and robes were blue instead of green (they don’t look so bad when covered in blood, apparently). The patient’s vital signs were monitored via a computer, and the job of the anaesthetist was much more specialised, measuring the correct dose of drug for each patient. I was surprised by how noisy this particular room was, with chatter from the professionals present, music, and mobile phones all in evidence.
One of the interesting aspects which came out of watching all three re-enactments was the roles of the various medical personnel involved. In the Victorian era, the roles were distinctly hierarchical with the nurse and assistant following the orders of the head surgeon. There were still elements of this by 1984, but by 2014 the structure was much more democratic, and the atmosphere of the operating room much more relaxed. Music was allowed, talking was more common, and staff kept in touch with the outer world via modern technology such as mobile phones.
Surprisingly, although, as I have mentioned, I am incredibly squeamish, I didn’t have any problems observing any of the surgeries, even though they were very realistic. Perhaps I was just interested, or perhaps the scenarios were so clean and “ordered” that I found it hard to relate them to the things that normally make me feel queasy.
After observing all three scenarios, there was a discussion with clinicians, historians, medical ethicists and policy-makers that included attendees at the event. It examined surgical ethics – such as the element of patient choice – and I found it really enlightening. To date, I’ve been lucky enough not to need surgery in my life (unless having several teeth taken out of my tiny mouth via general anaesthetic as a pre-teen counts…) but after attending this event I feel much better-informed, and if I were to need surgery in the future I think I would be much less apprehensive about it.
This event wasn’t really what I was expecting, but I still felt that I got a great deal from it. I would recommend it to anyone with any interest in the history and future of surgery, whether you have professional medical knowledge or are a lay person with no relevant experience at all.