La medicina en el siglo XIX era un campo todavía muy inexplorado. Aunque muchos de los avances desarrollados en la época marcaban un antes y un después, todavía quedaba mucho camino por delante. Los principales obstáculos que tanto médicos como pacientes enfrentaban entonces eran el dolor, la pérdida de sangre y la infección. Por ello descubrimientos posteriores como la anestesia y la penicilina fueron de los progresos más importantes en la materia. Otra gran dificultad de la época era la falta de tiempo a la hora de aplicar tratamientos, operar o incluso diagnosticar. Uno de los mayores y más complejos retos era realizar cirugías a los pacientes conscientes, donde la velocidad de ejecución era clave para garantizar la supervivencia. En este contexto, el mejor cirujano no era el más efectivo, sino el más rápido. Y ahí es donde destacaba Robert Liston.
Las habilidades de Robert Liston
Si leyéramos hoy las descripciones de las cirugías de entonces, como mínimo nos temblarían las piernas. La falta de recursos, de conocimiento, de ciencia y por supuesto de método e higiene, eran pavorosas. Pero comprensibles para la época. Salvando las distancias, lo cierto es que los médicos hacían lo mejor posible su trabajo, aunque de forma poco ortodoxa a nuestros ojos sesgados por el presente.
A Robert Liston se le apodaba «el cuchillo más rápido de Londres» y no era en vano. Donde un cirujano exitoso podía realizar una amputación en unos tres minutos, él lo lograba prácticamente en segundos. Sus formas, su velocidad y su destreza despertaban la envidia entre sus iguales en el gremio y el pasmo entre sus estudiantes.
Los pacientes hacían largas esperas para ser tratados por él en vez de por otros médicos. Estaba muy bien considerado en su especialidad y gozaba de una gran reputación. Para comprender bien su estatus, en 1835 los cirujanos perdían en promedio a 1 de cada 4 pacientes. Incluso morían de dolor o huían de pánico antes de comenzar la cirugía. En contraposición a estas estadísticas, Liston salvaba a 9 de cada 10 enfermos y se convirtió en el primer profesor de cirugía de la Universidad de Londres.
Aún así, uno de sus récords, probablemente el más recordado, no es tan insigne como otros.
La cirugía con tasa de mortalidad del 300%
En un momento en que la velocidad lo era todo (es importante concentrarnos en las características de la medicina de entonces), Robert Liston logró realizar una amputación en tan solo 25 segundos.
Era 1847. La intervención exigía la mayor velocidad posible. Urgencia que llevó a Liston a cortar los dedos de su asistente y el abrigo de un espectador al mismo tiempo que amputaba al paciente, evidentemente sin querer. Recordemos que estas prácticas eran públicas entonces y contaban con médicos y estudiantes observadores.
La sepsis inevitable terminó con el paciente amputado y con la asistente sin dedos, y el shock mató al espectador. Aquel día murieron tres personas en la cirugía menos exitosa de la historia, que quedó registrada con una tasa de mortalidad del 300%.
Los primeros usos de la anestesia que opacaron a Robert Liston
A mediados del siglo XIX comenzaron a utilizarse en Estados Unidos el óxido nitroso y el éter como método de anestesia. Calificándolo como «artimaña yanqui», Liston empleó por primera vez estos químicos en una cirugía exitosa, donde su velocidad y su destreza ya no eran tan necesarias.
Los indispensables avances de la medicina en aquella época sobrepasaron al «cuchillo más rápido de Londres», aunque por mucho tiempo sus habilidades subsanaron las terroríficas carencias.
Pese a que hubiera sido interesante conocer su punto de vista al respecto, Robert Liston nunca llegó a ver la expansión del uso de la anestesia ni su desarrollo como fármaco. Murió algunos meses después en un accidente a los 53 años.
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