Read Genius on the Edge: The Bizarre Double Life of Dr. William Stewart Halsted for Free Online

six-story, neo-Gothic brick building, it occupied the entire block between 15th and 16thstreets and Fifth and Sixth avenues. It was said to be at the cutting edge of hospital design. A decade earlier, the tragic conditions of the Civil War underlined the need for a sanitary environment, good ventilation, and adequate heating in hospitals. A report in Harper’s Weekly said of the new building:
Various appliances said to be available in no other public hospital in the world have been introduced, which add to the comfort of the patients and reduce at the same time the labor of attendants. Bell wires and speaking tubes are placed throughout the building, and two elevators run from the basement to the top story …. Bars will be placed over beds offering patients able to take advantage of them the means of shifting their positions without assistance.
    Many of the faculty members of the College of Physicians and Surgeons used New York Hospital for their patients, and Halsted was happy to find himself among familiar faces. Though he was house “physician,” he utilized the opportunity to attend conferences, observe surgeries that interested him, and continue his relationship with the professors he admired from his student days. Fascinated by the clinical and surgical challenges around him, he studied every aspect of hospital life and questioned everything he saw.
    Clinical progress notes were made in longhand in the physician’s recording book. All entries were made by the same man, and since hospitalizations were usually long, the notes read like an epic novel. There were no laboratory tests to scan daily, so the only recognizable signs of change were the patient’s appearance and the chart of vital signs: pulse, temperature, and number of breaths per minute. Blood pressure monitoring would not be invented until the turn of the 20th century. This graphic record of vital signs was then made available on the bedside chart. While still a junior staff member, Halstedredesigned the patient’s bedside chart to include color-coded graphs of temperature and pulse, marked by joined dots. This made changes in the pattern of vital signs quickly apparent. Halsted had these charts lithographed and provided them for use at the hospital. 1
    While he spent as much time as possible observing surgery, it became clear that little more could be learned under a stagnant system with no organized postgraduate training. He made it his business to read the flood of new surgical papers coming from the European capitals where the leading professors and practitioners held forth. Great strides were being taken in Germany, Austria, Switzerland, and Great Britain; barely the smallest steps were being made at home. Observing these great men at work was the most desirable training available. With the indulgence of his proud father, Halsted set off to spend two years traveling through Europe, availing himself of the best that surgery had to offer.

    GIVEN THE RIGOROUS track of modern surgical training, it is difficult to imagine the haphazard state of higher education in Halsted’s time. Formal surgical training simply did not exist in America. Young surgeons, at least those with the means, would seek out this or that great European surgeon, brush up on the language, study the written works of the master surgeon, present himself, and proceed to shadow the master through clinics and surgeries. Experiences varied. Sometimes the visitor could ask questions, sometimes he was permitted to assist at surgery, and sometimes he was lost in the gallery, unable to see much more than the surgeon’s back and an occasional glimpse of the procedure.
    Halsted had performed well and was fairly well connected in the New York medical establishment, and he was easily able to secure the proper letters of introduction for access to European surgical circles. Financed by his father, he sailed for France. Arriving in Paris in the fall of 1778, Halsted was met by several New York