Robert Liston and the Surgery with a 300% Death Rate

Robert Liston was born in Ecclesmachan, Linlithgowshire, Scotland on October 28th, 1794. He attended Edinburgh University in 1808 and in 1810 he began working and studying under the prominent anatomical expert John Barclay. From 1814-1818 Liston received expert medical training from a variety of distinguished professionals. In 1818, Liston’s thesis gained him membership into the Royal College of Surgeons in London and Edinburgh. However, a disagreement between Liston and Barclay led to Liston breaking away and establishing his own anatomy class.

During this time, his reputation grew. He was known for taking ‘lost causes’ as patients and establishing new treatment methods for them. His surgical skills were remarked upon and he often made improvements to old medical practices or treatments he felt were outdated. He made multiple advancements to medical science including his own inventions, such as Liston’s long leg splint.

He was, however, particularly skilled at amputations. In a time when the death rate of a typical amputation was 1 in 4, Lister was averaging a death rate of 1 in 10. He was unusually quick and was able to perform a full amputation in times ranging from 3 minutes to 28 seconds. Prior to anaesthetic, speed was the key to success. The faster the surgery was completed, the greater the chance of survival. He became known as the ‘fastest knife on the west end’. He typically needed only one assistant, and on occasions where he needed full use of both his hands, Liston was known to have held the knife in his mouth.

All this qualifies Liston as a reputable surgeon; however, he is now mostly remembered for two main surgeries which ended in disaster. On this occasion Liston was performing a lower leg amputation. In his haste, he cut off his assistant’s fingers as well as the patient’s leg. The result was that both the patient and the assistant died of infection. Medical students now tended to hide nearer the back and were more reluctant to assist Liston during his surgeries. During the same surgery, Liston lost his grip on his knife, sending it flying into his audience. It cut through the coattails of one audience member who promptly died of shock. To this day, it remains the only surgery on record to have a 300% death rate.

During another leg amputation, Liston’s speed proved detrimental when he accidentally cut off the patient’s testicles with his leg.

However, alongside his fatal errors, Liston did help inspire and influence his students, some of whom went on to make important medical advancements. Liston was the first surgeon to have formally used anaesthetic during surgery in England, (when his patient woke up he initially didn't believe the surgery was complete due to the help of the anaesthetic). During this surgery, James Simpson wondered if the anaesthetic could be used in childbirth, but worried about the impact on the baby. This prompted him to create chloroform in 1831 (although it was created in France and America around the same time).

Another student of his, Joseph Lister was integral to the development of antiseptic, which lessened death rates due to infection.

Robert Liston was far from a perfect surgeon. He seems to have made multiple errors, many of which were fatal. However the speed with which he performed his surgeries meant that he had a much lower death rate than others of the same time. His contributions to medicine are extensive and well known. He died in London on December 7th, 1847 aged 53 of an aneurysm. He is now buried in Highgate Cemetery.