American Medical Biographies/Cheever, David Williams
Cheever, David Williams (1831–1915)
David W. Cheever, Boston surgeon, was born in Portsmouth, N. H., November 30, 1831, the son of Charles Augustus Cheever (q. v.), a widely known physician in Portsmouth and Southern New Hampshire, and his wife, of the well-known Haven family of that city.
Cheever, educated chiefly at home, entered Harvard in 1848. where, as he wrote. "I studied Italian with Longfellow, who extemporized Dante into English verse; German with Bernard Rolker; Botany with Gray; modern literature with James Russell Lowell; natural history with Agassiz; and metaphysics with James Walker, who had a great influence on my life." After graduation, he went to Europe, and returning in several months, he began the study of medicine (1854) at the age of twenty-three, entering the Harvard Medical School, where Oliver Wendell Holmes taught anatomy, Storer obstetrics, and Henry J. Bigelow surgery.
In summer he went to the rival Boylston Medical School, taught by an ambitious group of young men without hospital or Harvard connections, where individual teaching and enthusiasm rewarded his venture. He accepted the position of student assistant at the State Penal Hospital on Rainsford Island in Boston harbor, where a profitable clinical experience in every department of medicine and, to a less extent, of surgery, gave him the real capital with which he started in practice, after graduating with honor in 1858.
General medicine, obstetrics, essays on medical topics in popular vein in the Atlantic Monthly and the North American Review, now engaged Cheever's attention. In 1859 the care of the smallpox hospital during an epidemic was eagerly accepted; in 1860 the winning of the Boylston Prize Essay brought reputation and a small stipend—such were the humble beginnings of a great career, as yet undirected into its final channel.
In 1860, Oliver Wendell Holmes, whose attention had been attracted to Cheever's industry in the dissecting room, offered him the position of demonstrator of anatomy, just vacated by Richard M. Hodges. Thus began a career of thirty-three years of teaching in the Harvard Medical School. For eight years he personally prepared the lecture demonstrations for Dr. Holmes and revolutionized the teaching in the dissecting room by the introduction of competitive student dissections and quizzes. He had the gift of teaching, perhaps inherited from his ancestor, Ezekiel Cheever, one of the earliest and most famous of the Masters of the Boston Latin School.
In 1864, the Boston City Hospital was founded and Cheever was made visiting surgeon, a rare opportunity in surgery for so young a man, who also in his teaching position had endless opportunities to practise operations on the cadaver. His colleagues, of the defunct Boylston Medical School, not connected with the conservative and established order represented by Harvard and the Massachusetts General Hospital, opened clinics, struggled for students, started novelties, and soon were rewarded by receiving appointments in Harvard. This inaugurated the present mutually advantageous relationship between hospital and school. Cheever originated or revived unusual operations, wrote and published widely, and edited the first five volumes of the Hospital reports, much of the surgical text being from his pen; he was also for a time editor of the Boston Medical and Surgical Journal. From the position of demonstrator of anatomy (1861–1866) he was advanced to assistant professor of anatomy (1866–1868), and later adjunct professor and then, in 1875, professor of clinical surgery. On the resignation of Dr. Henry J. Bigelow in 1882 he attained the zenith of surgical preferment of New England—the full professorship of surgery in the Harvard Medical School—a position which he held up to his voluntary resignation in 1893, when he was made professor emeritus and received an honorary LL. D. from Harvard. In 1895 he resigned from active hospital work, but continued to serve as president of the hospital staff. He served the University on the Board of Overseers for twelve years (1896 to 1908). He performed his last surgical operation at the age of 72, but continued to care faithfully for his old patients until shortly before his death twelve years later.
Cheever's surgical work was planned with painstaking care and thoroughness and executed with skill and despatch. He united consummate familiarity with anatomy and reasonable skill in dissection with rare surgical sagacity. He himself says: "I never thought I excelled as an operator, but rather as a painstaker." He originated or revived many bold and unusual operations: displacement of the upper jaw for nasopharyngeal tumors, removal of tumors of the tonsil by external incision, pharyngotomy, esophagotomy for foreign bodies in the esophagus, the radical cure of hernia; he performed the first two consecutive successful ovariotomies in Boston, before the introduction of antisepsis. He was one of the first, if not the first, in this region, to do Cæsarean section. He published much but judiciously—monographs, case reports, hospital reports, essays. He was the valued correspondent of Oilier, of Lyons; he attracted the attention of Reginald Harrison, in England, especially by doing Cock's operation for impermeable stricture. Holmes, of St. George's Hospital, London, was interested in his excisions of the hip for coxalgia; Billroth, of Vienna compared notes with him in the surgery of the tonsil, and John Wood, of London, in the radical operation for hernia. Cheever's work was begun in the early days of ether anesthesia, before antisepsis and asepsis, in the face of suppuration and hospital gangrene, before the introduction of the clinical thermometer, the subcutaneous syringe, or the Roentgen ray. In his prime he worked under the carbolic spray and other early forms of antisepsis; the perfection of asepsis found him still vigorous and receptive to every improvement and innovation.
Cheever was an enthusiastic teacher of surgery, and thirty-three classes of students at the Harvard Medical School were his devoted disciples. At a period when the didactic lecture had not yet been relegated to an apologetic existence. Cheever's lectures in surgery were such models of brilliant condensation, lucidity, and system that they could not but be inspiring. He lectured extemporaneously in clean-cut simple words, in an easy conversational manner lacking any spectacular elements. His clinical teaching was seasoned with shrewd intuition and a dry wit which never stung. His sympathy with the patient and interest in the student created a helpful atmosphere of mutual understanding. He insisted that the opportunities of a hospital surgeon imposed the obligations, first, to succor the patient, and, second, to share his advantages with students and fellow physicians. He was a leader in medical progress and played a foremost part in the reforms of medical edu cation at Harvard under the administration of President Charles W. Eliot.
As a clinical teacher of surgery he instituted the class conference, a weekly clinical essay by a student with criticisms and comments by his fellows and instructors. At the hospital, he established a "Concours," or competitive examination for house-officers, until then unknown in New England. He supported the high and increasing premedical requirements for admission to the Medical School, the graded four-year course, and the development of laboratory and clinical teaching.
His was a slim, slightly stooping figure: his frame was frail, but in action vigorous. His manner was reserved, preoccupied, absorbed, partly by nature and partly by a curious inaptness in recognizing faces. His mien, his words, his clothes were without pretense—the outward expression of native simplicity and dignity. Weighing about one hundred and thirty pounds, his delicate physique seemed scarcely able to bear the weight of work, responsibility, and anxiety which he carried. He loved three things completely and unreservedly—his home, his profession and Nature. For years each major case operated on (usually for charity) at the hospital was visited again in the evening. An impecunious early case of esophagotomy, slow to recover, was visited at his home daily for a year. Many years later this patient tendered him a fee of one hundred dollars. A case of ovariotomy, before the days of antisepsis, was visited every six hours—at six o'clock in the morning, at noon, in the evening and at midnight, until her recovery.
Cheever was active in medical societies; he organized a conference of the hospital staff. He initiated and aided wise public health legislation. For years he was one of the bulwarks at legislative hearings against the measures of the anti-vivisectionists and antivaccinationists. He helped to overthrow the pernicious coroner system in 1877, substituting the trained medical examiner. He fought for the sanctity of privileged communications from patient to physician, under due legal safeguards. He was often sought as an expert, since judge and jury recognized his sincerity and freedom from prejudice; he gave this up because, to quote his own words: "I can almost say that I never left the court after testifying with a feeling of honorable satisfaction, or that I had been allowed to tell the exact truth after complicated questions and having my mouth shut by technicalities."
He was president of the American Surgical Association (1889); president of the Massachusetts Medical Society (1888–1890), and of many local professional organizations. He was honorary member of various state and foreign societies. He was president of the Boston Medical Library from 1896 to 1906, during the time that the funds were raised and the Library was established in its new building at the Fenway. Urged in his old age to become charter member of the American College of Surgeons, he hesitated, but in 1915 at the meeting in Boston, he accepted honorary membership.
He married Anna C. Nichols of Boston in 1860, and the advent of six children constituted their chief happiness. His greatest sorrows were the deaths' in childhood of his first-born, a son, and in adult life of a daughter by accidental drowning. He made to the Medical School and Hospital generous gifts, and gave in private to the needy; it was his especial delight to aid poor students and worthy colleagues. At leisure during the last ten years of his life, he resumed the study of Latin and Greek with a Harvard teacher, who, when cataract dimmed the vision, became his faithful secretary. Though doubtless aware that he could not live to greet his return, he gladly urged his only son to accept an opportunity to bring surgical aid to the wounded in France. On December 27, 1915, shortly after his eighty-fourth birthday, he died after a short illness and in full possession of his faculties.