Fanny Burney was a famous novelist in the late 18th and early 19th century. She married Alexandre d’Arblay, a French aristocrat who had escaped the French revolution. They moved to France in 1802 after Napoleon came to power. Soon after arriving, Fanny developed a terrible pain in her breast that came and went. It returned in 1806 and became unbearable by 1811. Her physician, Antoine Dubois, called in Baron Dominique-Jean Larrey, Napoleon’s surgeon, and they both decided that she needed a mastectomy. This was performed in her home on September 30, 1811. On the day of the surgery, she wrote a farewell letter to her husband. After her recovery, she wrote about her experience to her elder sister Esther Burney in March of 1812 – excerpts from this letter are quoted here.
“Frances D’Arblay” by Edward Francisco Burney
No fewer than seven doctors were present for the operation; all were dressed in black. She had been asked to write her consent, but the procedure was not what had been described to her. She was told that it could be performed while she was seated in a chair, but instead they told her to get into her bed and ordered the room cleared of nurses and maids. “Ah, then, how did I think of My Sisters!—not one, at so dreadful an instant, at hand, to protect—adjust—guard me.” Her physician Dubois had “tears in his Eyes.” She described having her faced covered by “a cambric handkerchief” and that “It was transparent, however, and I saw, through it, that the Bedstead was instantly surrounded by the 7 men and my nurse. I refused to be held; but when, Bright through the cambric, I saw the glitter of polished Steel—I closed my Eyes.”
After a moment or two, she opened her eyes, “again through the Cambric, I saw the hand of M. Dubois held up, while his forefinger first described a straight line from top to bottom of the breast, secondly a Cross, and thirdly a circle; intimating that the Whole was to be taken off.” She sat up and protested: the pain was just in one part of the breast, why did they want to remove it all. Dubois pushed her down and she said, “I closed once more my Eyes, relinquishing all watching, all resistance, all interference, and sadly resolute to be wholly resigned.” She described the removal,
When the dreadful steel was plunged into the breast—cutting through veins—arteries—flesh—nerves—I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision—and I almost marvel that it rings not in my Ears still! so excruciating was the agony. When the wound was made, and the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp and forked poniards, that were tearing the edges of the wound—but when again I felt the instrument—describing a curve—cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose and tire the hand of the operator, who was forced to change from the right to the left—then, indeed, I thought I must have expired.
She’d thought that marked the operation over, however when Dubois and Larrey tried to lift the breast, the tumour stayed attached to the chest wall. She described the shock, “Oh no! presently the terrible cutting was renewed—and worse than ever, to separate the bottom, the foundation of this dreadful gland from the parts to which it adhered.” And you can feel her desperation for it to be over, “Oh Heaven!—I then felt the Knife rackling against the breast bone—scraping it!—This performed, while I yet remained in utterly speechless torture.” And more, “Again began the scraping!—and, after this, Dr Moreau thought he discerned a peccant attom (fragments of diseased [peccant] breast tissue)—and still, and still, M. Dubois demanded attom after attom.”
Of the surgery, she concluded, “The evil was so profound, the case so delicate, and the precautions necessary for preventing a return so numerous, that the operation, including the treatment and the dressing, lasted 20 minutes! a time, for sufferings so acute, that was hardly supportable.” She described seeing her surgeon after, “I then saw my good Dr Larry, pale nearly as myself, his face streaked with blood, its expression depicting grief, apprehension, and almost horrour.”
Fanny Burney survived and died at 88 in 1840.
Burney F. Account from Paris of a terrible operation—1812 [letter to Esther Burney]. Henry W. and Albert A. Berg Collection. 22 March 1812. New York Public Library, New York. Online at the New Jacksonian Blog. Accessed 23 Nov 2014. http://newjacksonianblog.blogspot.ca/2010/12/breast-cancer-in-1811-Mme d’Arblay-burneys.html.
Burney, Edward F. Frances D’Arblay (‘Fanny Burney’). Digital image. National Portrait Gallery. National Portrait Gallery, n.d. Web. 23 Nov. 2014.