Literature Annotations


Burney, Fanny
A Mastectomy: Letter to Esther Burney


Genre Memoir (15 pp.)
KeywordsAnesthesia, Body Self-Image, Cancer, Doctor-Patient Relationship, Empathy, History of Medicine, Illness and the Family, Illness Narrative/Pathography, Love, Medical Ethics, Pain, Patient Experience, Suffering, Surgery, Women's Health
Summary

A rare patient narrative from 1812 describes a mastectomy performed before the introduction of anesthesia. This letter from Frances d'Arblay (1752-1840) (née Frances [Fanny] Burney), addressed to her older sister, Esther, details her operation in Paris by one of Napoleon's surgeons.

In her childhood and youth, Fanny Burney moved in the best London society; she was a friend of Dr. Johnson who admired her. She served five years at the court of George III and Queen Charlotte as Second Keeper of the Royal Robes (1786-1791). Fanny Burney married Adjutant-General in the army of Louis XVI Alexandre-Jean-Baptiste Piochard d'Arblay in 1793. He had fled to England after the Revolution. They lived in England and spent ten years in France (1802-1812).

Burney's mastectomy took place 30 September 1811. The patient wrote about her experience nine months later. She chronicles the origin of her tumor and her pain. She is constantly watched by "The most sympathising of Partners" (128), her husband, who arranges for her to see a doctor. She warns her sister and nieces not to wait as long as she did. At first resisting out of fear, the patient agrees to see Baron Dominique-Jean Larrey (1766-1842), First Surgeon to the Imperial Guard.

He asks for her written consent to guide her treatment; her four doctors request her formal consent to the operation, and she makes arrangements to keep her son, Alex, and her husband, M. d'Arblay, away. Her husband arranges for linen and bandages, she makes her will, and writes farewell letters to her son and spouse. A doctor gives her a wine cordial, the only anesthetic she receives. Waiting for all the doctors to arrive causes her agony, but at three o'clock, "my room, without previous message, was entered by 7 Men in black" (136).

She sees "the glitter of polished Steel" (138). The extreme pain of the surgery makes her scream; she feels the knife scraping her breastbone. The doctors lift her up to put her to bed "& I then saw my good Dr. Larry, pale nearly as myself, his face streaked with blood, & its expression depicting grief, apprehension, & almost horrour" (140).

Her husband adds a few lines. These are followed by a medical report in French by Baron Larrey's 'Chief Pupil'. He states that the operation to remove the right breast lasted three hours and forty-five minutes, and that the patient showed "un Grand courage" (141). She lives another twenty-nine years. It is impossible to determine whether her tumor was malignant.

Commentary

Fanny Burney was already a successful novelist, diarist and journaler at the time of her marriage. Her debut novel Evelina (1778) is the first English novel about home life. Her journals and letters have earned her a high place among eighteenth century writers.

This unique report of a pre-anesthetic mastectomy is both factual and moving. Well suited to teaching the history of medicine and women's health, it also displays the narrator's aim: to show a man's courage in a woman's body. Frank in confessing her own fear and suffering, the sensitive patient is also able to empathize with the kind Dr. Larrey.

The anthology, The Body in the Library (see this database), contains an excerpt from Burney's narrative, beginning with the operation.

SourceFanny Burney. Selected Letters and Journals
PublisherClarendon Press
Edition1986
EditorsJoyce Hemlow
Place PublishedOxford
SourceA Known Scribbler: Frances Burney on Literary Life
PublisherBroadview Press Ltd.
Edition2002
EditorsJustine Crump
Place PublishedPeterborough, Ontario, Canada
MiscellaneousThe letter is in the Henry W. and Albert A. Berg Collection, New York Public Library, New York.
Annotated by Mathiasen, Helle
Date of Entry 04/13/07
Last Revised 05/18/09