Like a scene in the mad scientist’s laboratory right out of an old horror movie, a doctor at Good Samaritan Hospital in 1874 ran several electrified needles into a patient’s brain. Although his work opened up new avenues for neurological research, the doctor was pressured to make a public apology, which led to new developments in medical ethics.
The doctor in question was Roberts Bartholow, born in Maryland in 1831. He enjoyed a solid liberal arts education before entering medical school. Throughout his life, his intelligence, erudition, and literary skills were widely praised, but he had few friends. Otto Juettner, historian of Cincinnati medicine, described him in 1909:
“Roberts Bartholow, that strange child of genius, who was thought by his contemporaries to be the very embodiment of cold cynicism, while he was, strangely enough, the fervent apostle of faith and warm optimism in the very department of medical knowledge where nowadays cynicism, pessimism and hopeless agnosticism are the rule.”
From the U.S. National Library of Medicine
Bartholow’s reputation for “cold cynicism” emerged from his often sarcastic critiques of his colleagues’ shortcomings. Few Cincinnati doctors could marshal the intellectual firepower or the wealth of experience he brought to any debate. On a couple of occasions, Bartholow engaged in the 19th-Century version of a “flame war,” publishing pamphlets and counter-pamphlets with attacks on other doctors.
Much of the friction between him and his colleagues hinged on his educational philosophy. Where most medical professors explained concepts, processes, and treatments, Bartholow believed that education is best conducted by demonstration. Where human subjects could not be found, he employed animals in his classroom demonstrations of surgical techniques and pharmaceutical substances.
This practical approach to medicine derived from Bartholow’s long service in the U.S. Army out on the western frontier, back when it really was the “Wild West.” He was sent to Utah in 1857 as surgeon to troops engaged in what was variously known as the “Utah War” or “Mormon Rebellion” and remained with the Army throughout most of the Civil War. He resigned his commission in 1864 and settled in Cincinnati, where an established doctor helped him build a practice and earn a professorship at the Medical College of Ohio. Although respected, Bartholow antagonized almost everyone. Per Juettner:
“His splendid academic training, backed up by a vast amount of observation and experience, gave him the advantage in contests with most men. He was fearless and merciless. This is what raised hosts of enemies for him. He fought with weapons of analogy, logic and sarcasm up to the point of extermination. His intense nature could not tolerate concessions. It is not surprising that he was not popular in the vulgar sense of the word.”
Academic feuds drove Bartholow out of the city’s Commercial Hospital and into the somewhat friendlier staff of Good Samaritan Hospital, then located in the East End beneath Mt. Adams. There, he built his dream laboratory. In a medical journal he founded, Bartholow described his “electrical room”:
“By the intelligent liberality of a gentleman of this city, Good Samaritan Hospital now contains an electrical room furnished with all the appliances needed for the practical uses and scientific study of electricity.”
Claiming that electricity could cure anything from hemorrhoids to nasal polyps to cysts caused by tapeworms, Bartholow used the apparatus housed in the electrical room to instruct students convened in the operating theater next door.
From The Clinic (February 1872), image extracted from PDF by Greg Hand
Into this laboratory, in 1874, walked Mary Rafferty, a 30-year-old Irish immigrant with a most unusual condition. As a young girl, she had fallen into a fire and severely burned her scalp. To cover the scarred bald patch, she wore a variety of wigs. A sore, which she believed was caused by her wigs, got worse and worse, eventually becoming cancerous. The cancer ate away Rafferty’s skull to the extent that a hole exposed a portion of her brain.
Rafferty worked as a housemaid. Some sources claim she worked for Bartholow, while others deny that connection. By whatever route, she found herself in his electrical room at Good Samaritan Hospital, where Bartholow inserted electrically charged needles into her exposed brain over the course of about a week. While some of this probing elicited little more than tingling and giggles, some precipitated seizures, convulsions, and weeping. Eventually Rafferty’s condition worsened, the experiments were terminated, and she died.
In his first report on the research, published three months later, Bartholow candidly described each attempt to stimulate Rafferty’s brain and the disturbing results. So many doctors objected to the report that Bartholow felt compelled to publish a detailed apology in the British Medical Journal. In this mea culpa, he concluded:
“Notwithstanding my sanguine expectations, based on the facts above stated, that small insulated needle-electrodes could be introduced without injury into the cerebral substance, I now know that I was mistaken. To repeat such experiments with the knowledge we now have, that injury will be done by them, would be in the highest degree criminal. I can only now express my regret that facts which I hoped would further, in some slight degree, the progress of knowledge were obtained at the expense of some injury to the patient.”
Bartholow’s reputation did not suffer. Five years after the experiment and three years after his apology, he accepted a distinguished chair at the Jefferson Medical College in Philadelphia, where he remained until he retired in 1893. Poor health and a mental breakdown tormented his retirement, and he died in 1904.
Modern perceptions of Bartholow’s macabre experiments might best be summed up in a paper published in 2019 by Devi P. Patra, et al, in Neurosurgical Focus:
“Despite the audacious nature of the experiment with possible ethical breaches of human research, Bartholow’s findings formed the foundation of the electrophysiology of the human brain. Although his methods seem crude in retrospect, they demonstrated the basic principles of human cortical mapping that are still followed in the modern era, although in a more sophisticated way. While his methods cannot be condoned, we recognize his scientific curiosity and his passion for integrating clinical medicine and experimental medicine. Just as importantly, we pay sincere tribute to the ill-fated soul, Rafferty, whose sacrifice should not be forgotten in medical history.”
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