Operation preservation at Royal Jubilee

By Danda Humphreys

The Pemberton Operating Room in 2007.
 

What’s the connection between the man who is remembered by a street sign in Rockland and a small building buried deep within the heart of Royal Jubilee Hospital?

It’s all in the name.

Joseph D. Pemberton, who died in 1893, made a substantial bequest to the hospital in gratitude for the treatment his wife received there. His gift divided Victoria’s medical community. Some wanted a new maternity ward; others favoured a new surgical facility.

The latter’s strongest champion was Dr John Chapman Davie, a surgeon who had become a fervent follower of Lister’s principles of antisepsis while on sabbatical in Europe in 1870. After much discussion, and despite the fact that most of Victoria’s surgeons were opposed, the hospital board earmarked Pemberton’s gift for Davie’s dream—an operating room designed to accommodate Lister’s teachings.

Dr Joseph Lister was truly a legend in his own lifetime. Born in Essex, England in 1827, he qualified as a doctor and became a Fellow of the Royal College of Surgeons in London before going to Edinburgh to build on his surgical experience. There, he perfected the techniques that would subsequently save thousands of lives.

Before Lister’s time, and particularly before anaesthetics were developed in the 1840s, surgical procedures were often a deadly affair. Operations were performed in a “theatre” and watched by an “audience” of interested onlookers. The patient, still wide awake, was firmly strapped to the operating table, and the surgeon worked as quickly as possible. Operating areas were ward side-rooms, or in separate buildings, so that the unfortunate patient’s screams were less likely to be heard by others.

Surgeons didn’t wear gowns, gloves, caps or masks, leaving the patient prey to germs carried on hands, clothes, breath or hair. Wound infections and gangrene were blamed on “bad air.” As surgeons moved from bed to bed, checking post-operative progress in the days that followed, they carried the germs from one patient to another. Few were spared the inevitable outcome. In the 1860s in Britain, almost half of all patients undergoing major surgery died from infection.

Only one man—Louis Pasteur—realized and extensively described the significance of air-borne organisms in the transmission of disease. He advocated a clean operating environment. Joseph Lister subscribed whole-heartedly to Pasteur’s theories, and took them a step further. Like Pasteur, he washed his hands frequently and insisted on laundered towels. But he also experimented with carbolic acid as an agent of antisepsis, sterilizing his instruments, soaking wound dressings in the substance, and spraying it liberally around the entire operating site.

The cleansing was not without negative effects. Carbolic was caustic. Numb skin, cracked nails and sore lungs caused some surgeons to give up using the spray entirely. Even Lister described it as “a necessary evil,” and after experimenting for some time, started using boric acid instead.

Back in London, Lister was appointed Surgeon to Queen Victoria. News of his work had spread far and wide, but many North American surgeons were slow to accept his ideas. Here in Victoria, however, Dr J. C. Davie stood firm. Keeping the operating area as clean and microbe-free as possible made perfect sense to him; while in Europe, he had seen the results with his own eyes.

The Pemberton Memorial Operating Room, designed by Davie himself, was the first OR north of San Francisco and west of Winnipeg designed specifically with Lister’s infection-fighting principles in mind. Almost free-standing, it was accessed from the hospital by a single narrow corridor. Brick walls covered with painted plaster surrounded a modest space designed to accommodate only the surgical staff and the patient—no room for observers. A sterilizing room was attached at the OR’s north end.

The hospital was proud of its newest “arrival” and anxious to show it off. Who better to appreciate its design and development than the creator of antiseptic principles himself? One year later Lord Lister visited the site, and was favourably impressed by the new operating facility. He recommended the addition of a post-anaesthetic recovery room, which was built shortly afterwards.

In 1925, when new operating rooms were completed, the original OR became home to the X-ray department, then the Cancer Clinic, then the Medical Records department. In 1995, it was granted heritage status, and last year was named a National Historic Site.

The Victoria Medical Heritage Society is raising funds from Victoria’s medical community to restore and protect the little building, so that work can begin before construction of the proposed new hospital tower threatens access to it. Money raised so far is allowing them to start the process of restoring the structure and transforming it into a public Medical History Museum and Archives.

Then the Society will have met its objective—returning this historic treasure to the community as an educational resource—and Joseph Pemberton’s legacy will continue to live on.

Danda Humphreys loves prowling around new developments, looking for hidden historic treasures. www.dandahumphreys.com.

This story was published in the November 2007 edition of Focus Magazine.