One of the most commonly-noted events in the novelist Frances Burney's life was her 1811 mastectomy. She endured this procedure without anesthesia, and in an explicit letter to his sister Esther, produced one of the few patient narratives of this remarkable and painful experience. It is a fascinating document both for medical and historical reasons, and is summarized below.
Burney had been experiencing pain in her right breast since 1810, and her husband suggested it might indicate breast cancer. The couple was living in Paris at the time, and so she began to visit several French physicians, who ultimately recommended an operation. The surgery took place on September 30th, 1811. She was attended by seven men: Dr. Larrey; M. Dubois; Dr. Moreau; Dr. Aumont; Dr. Ribe; a pupil of Dr. Larrey; and another pupil of M. Dubois. M. Dubois was the accoucheur to the Empress Marie Louise, Duchess of Parma, and was widely viewed as the most accomplished doctor in France.
Burney wrote that she was only given two hours' notice before the operation so that she would not be made insensible with fright. When she arrived in the room prepared for her, she felt sick at the sight of the bed and instruments. As anesthesia was not yet available, she was only administered a cordial of wine to stave off as much consciousness of the pain as possible. Her bedside was surrounded by the men and nurses, and she wrote: "I refused to be held; but when, Bright through the cambric, I saw the glitter of polished Steel - I closed my Eyes. I would not trust to convulsive fear the sight of the terrible incision. A silence the most profound ensued, which lasted for some minutes, during which, I imagine, they took their orders by signs, & made their examination - Oh what a horrible suspension!" To her great anguish she interpreted their signs to mean that her entire breast was to be amputated.
As they began to cut, she let out a continuous, torturing scream that did not abate even after the surgery endured. The procedure was terrible, as her account makes very clear: "When the wound was made, & the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp & forked poniards, that were tearing the edges of the wound - but when again I felt the instrument - describing a curve - cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose & tire the hand of the operator..."
After the operation, she could not think or speak of the incident for nearly nine months; she felt so utterly sick at what had happened to her that she battled incessant headaches. She had, however, remained still and never tried to resist the doctors or to stop the procedure. She prided herself on her courage and endurance, and this is precisely why the account has remained widely-read outside of its medical significance: she demonstrates her bravery and fortitude in a truly horrifying, embarrassing, and painful situation.
Burney survived the operation and lived another twenty-nine years. It is impossible to know whether or not she actually had a malignant form of cancer. Her letter has remained a riveting medical and literary document, and is unquestionably one of the earliest accounts of a mastectomy.
