Thursday, December 2, 2010

Breast Cancer in 1811: Fanny Burney’s Account of Her Mastectomy

Introduction by Michael Kaplan

Fanny Burney at age 32. Painted by her cousin Edward Francesco Burney, 1784-85.

In this harrowing passage, novelist Fanny Burney, who had been diagnosed with breast cancer, recounted the opening incision of her mastectomy. As the year was 1811, Burney’s breast was removed without benefit of anesthesia. Surgery of any type in the days before anesthesia was a horrific experience. Author Sharon Batt, who wrote about her own ordeal with breast cancer, calls Burney’s “the most riveting account of a mastectomy on record.”

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Separated as I have now so long—long been from my dearest Father—Brothers—Sisters—Nieces, and Native Friends, I would spare, at least, their kind hearts any grief for me but what they must inevitably feel in reflecting upon the sorrow of such absence to one so tenderly attached to all her first and for-ever so dear and regretted ties—nevertheless, if they should hear that I have been dangerously ill from any hand but my own, they might have doubts of my perfect recovery which my own alone can obviate. And how can I hope they will escape hearing what has reached Seville to the South, and Constantinople to the East? from both I have had messages—yet nothing could urge me to this communication till I heard that M. Boinville had written it to his Wife, without any precaution, because in ignorance of my plan of silence. Still I must hope it may never travel to my dearest Father—But to You, my beloved Esther, who, living more in the World, will surely hear it ere long, to you I will write the whole history, certain that, from the moment you know any evil has befallen me your kind kind heart will be constantly anxious to learn its extent and its circumstances, as well as its termination.

About August, in the year 1810, I began to by annoyed by a small pain in my breast, which went on augmenting from week to week, yet, being rather heavy than acute, without causing me any uneasiness with respect to consequences: Alas, “what was ignorance?” The most sympathising of Partners, however, was more disturbed: not a start, not a wry face, not a movement that indicated pain was unobserved, and he early conceived apprehensions to which I was a stranger. He pressed me to see some Surgeon; I revolted from the idea, and hoped, by care and warmth, to make all succour unnecessary. Thus passed some months, during which Madame de Maisonneuve, my particularly intimate friend, joined with M. d’Arblay to press me to consent to an examination. I thought their fears groundless, and could not make so great a conquest over my repugnance. I relate this false confidence, now, as a warning to my dear Esther—my Sisters and Nieces, should any similar sensations excite similar alarm.

M. d’Arblay now revealed revealed his uneasiness to another of our kind friends, Mme de Tracy, who wrote to me a long and eloquent Letter upon the subject, that began to awaken very unpleasant surmizes: and a conference with her ensued, in which her urgency and representations, aided by her long experience of disease, and most miserable existence by art, subdued me, and, most painfully and reluctantly, I ceased to object, and M. d’Arblay summoned a physician—M. Bourdois? Maria will cry;—No, my dear Maria, I would not give your beau frere that trouble; not him, but Dr Jouart, the physician of Miss. Potts. Thinking but slightly of my statement, he gave me some directions that produced no fruit—on the contrary, I grew worse, and M. d’Arblay now would take no denial to my consulting M. Dubois, who had already attended and cured me in an abscess of which Maria, my dearest Esther, can give you the history.

M. Dubois, the most celebrated surgeon of France, was then appointed accoucheur (obstetrician) to the Empress, and already lodged in the Tuilleries, and in constant attendance: but nothing could slacken the ardour of M. d’Arblay to obtain the first advice. Fortunately for his kind wishes, M. Dubois had retained a partial regard for me from the time of his former attendance, and, when applied to through a third person, he took the first moment of liberty, granted by a promenade taken by the Empress, to come to me. It was now I began to perceive my real danger, M. Dubois gave me a prescription to be pursued for a month, during which time he could not undertake to see me again, an pronounced nothing—but uttered so many charges to me to be tranquil, and to suffer no uneasiness, that I could not but suspect there was room for terrible inquietude.

My alarm was encreased by the non-appearance of M. d’Arblay after his departure. They had remained together some time in the Book room, and M. d’Arblay did not return—till, unable to bear the suspence, I begged him to come back. He, also, sought then to tranquilize me—but in words only; his looks were shocking! his features, his whole face displayed the bitterest woe. I had not, therefore, much difficulty in telling myself what he endeavoured not to tell me—that a small operation would be necessary to avert evil consequences!—Ah, my dearest Esther, for this I felt no courage—my dread and repugnance, from a thousand reasons besides the pain, almost shook my faculties, and, for some time, I was rather confounded and stupefied than affrighted.—Direful, however was the effect of this interview; the pains became quicker and more violent, and the hardness of the spot affected encreased. I took, but vainly, my proscription, and every symtom grew more serious.

At that time, M. de Narbonne spoke to M. d’Arblay of a Surgeon of great eminence, M. Larrey, who had cured a polonoise lady of his acquaintance of a similar malady; and, as my horror of an operation was insuperable, M. de Narbonne strongly recommended that I should have recourse to M. Larrey. I thankfully caught at any hope; and another friend of M. d’Arblay gave the same counsel instant, which other, M. Barbier Neuville, has an influence irresistible over this M. Larrey, to whom he wrote the most earnest injunction that he would use every exertion to rescue me from what I so much dreaded. M. Larrey came, though very unwillingly, and full of scruples concerning M. Dubois; nor would he give me his services till I wrote myself to state my affright at the delay of attendance occasioned by the present high office and royal confinement of M. Dubois, and requesting that I might be made over to M. Larrey. An answer such as might be expected arrived, and I was now put upon a new regime, and animated by fairest hopes.—

M. Larrey has proved one of the worthiest, most disinterested, and singularly excellent of men, endowed with real Genius in his profession, though with an ignorance of the World and its usages that induces a naiveté that leads those who do not see him thoroughly to think him not alone simple, but weak. They are mistaken; but his attention and thoughts having exclusively turned one way, he is hardly awake any other. His directions seemed all to succeed, for though I had still cruel seizures of terrible pain, the fits were shorter and more rare, and my spirits revived, and I went out almost daily, and quite daily received to my Apartment some friend or intimate acquaintance, contrarily to my usual mode of sauvagerie (unsociability)—and what friends I have found! what kind, consoling, zealous friends during all this painful period! In fine, I was much better, and every symptom of alarm abated. My good M. Larrey was enchanted, yet so anxious, that he forced me to see le Docteur Ribe, the first anatomist, he said, in France, from his own fear lest he was under any delusion, from the excess of his desire to save me. I was as rebellious to the first visit of this famous anatomist as Maria will tell you I had been to that of M. Dubois, so odious to me was this sort of process: however, I was obliged to submit: and M. Ribe confirmed our best hopes—

Here, my dearest Esther, I must grow brief, for my theme becomes less pleasant—Sundry circumstances, too long to detail, combined to counter-act all my flattering expectations, and all the skill, and all the cares of my assiduous and excellent Surgeon. The principal of these evils were—the death, broke to me by a newspaper! of the lovely and loved Princess Amelia (at age 27) —the illness of her venerated father (King George III) —and the sudden loss of my nearly adored—my Susan’s nearly worshipped Mr Lock—which terrible calamity reached me in a few lines from Fanny Waddington, when I knew not of any illness or fear!—Oh my Esther, I must indeed be brief, for I am not yet strong enough for sorrow.—The good M. Larrey, when he came to me next after the last of these trials, was quite thrown into a consternation, so changed he found all for the worse—“Et qu’est il donc arrive?” (“And so, what is going on?”) he cried, and presently, sadly, announced his hope of dissolving the hardness were nearly extinguished. M. Ribe was now again called in—but he only corroborated the terrible judgement; yet they allowed me to my pleadings some further essays, and the more easily as the weather was not propitious to any operation. My Exercise, at this time, though always useful and chearing, occasioned me great suffering in its conclusion, from mounting up three pair of stairs: my tenderest Partner, therefore, removed me to La Rue Mirmenil, where I began my Paris residence nearly 10 Years ago!—quite 10 next Month! Here we are au premier (on the first floor) —but alas—to no effect! once only have I yet descended the short flight of steps from which I had entertained new hopes.

A Physician was now called in, Dr Moreau, to hear if he could suggest any new means: but Dr Larrey had left him no resources untried. A formal consultation now was held, of Larrey, Ribe, and Moreau—and, in fine, I was formally condemned to an operation by all Three. I was as much astonished as disappointed—for the poor breast was no where discoloured, and not much larger than its healthy neighbour. Yet I felt the evil to be deep, so deep, that I often thought if it could not be dissolved, it could only with life be extirpated. I called up, however, all the reason I possessed, or could assume, and told them that—if they saw no other alternative, I would not resist their opinion and experience—the good Dr Larrey, who, during his long attendance had conceived for me the warmest friendship, had now tears in his Eyes; from my dread he had expected resistance. He proposed again calling in M. Dubois. No, I told him, if I could not by himself be saved, I had no sort of hope elsewhere, and, if it must be, what I wanted in courage should be supplied by Confidence. The good man was now dissatisfied with himself, and declared that I ought to have the First and most eminent advice his Country could afford; “Vous êtes si considerée,” Madame, said he, “ici, que le public même sera mecontent si vous n’avez pas tout le secour que nous avons à vous offrir.—” (“You are so esteemed here, Madam, that the public itself would be unhappy if you did not receive all the help that we have to offer.—”) Yet this modest man is premier chirugien de la Garde Imperiale, and had been lately created a Baron for his eminent services!—M. Dubois, he added, from his super-skill and experience, might yet, perhaps, suggest some cure. This conquered me quickly, ah—Send for him! Send for him! I cried—and Dr Moreau received the commission to consult with him.—

What an interval was this! Yet my poor M. d’Arblay was more to be pitied than myself, though he knew not the terrible idea I had internally annexed to the trial—but Oh what he suffered!—and with what exquisite tenderness he solaced all that I had to bear! My poor Alex I kept as much as possible, and as long, ignorant of my situation.—M. Dubois behaved extremely well, no pique intervened with the interest he had professed in my well-doing, and his conduct was manly and generous. It was difficult still to see him, but he appointed the earliest day in his power for a general and final consultation. I was informed of it only on the Same day, to avoid any useless agitation. He met here Drs Larrey, Ribe, and Moreau. The case, I saw, offered uncommon difficulties, or presented eminent danger, but the examination over, they desired to consult together. I left them—what an half hour I passed alone!—M. d’Arblay was at his office. Dr Larrey then came to summon me. He did not speak, but looked very like my dear Brother James, to whom he has a personal resemblance that has struck M. d’Arblay as well as myself. I came back, and took my seat, with what calmness I was able. All were silent, and Dr Larrey, I saw, hid himself nearly behind my Sofa. My heart beat fast: I saw all hope was over. I called upon them to speak. M. Dubois then, after a long and unintelligible harangue, from his own disturbance, pronounced my doom. I now saw it was inevitable, and abstained from any further effort. They received my formal consent, and retired to fix a day.

All hope of escaping this evil now at an end, I could only console or employ my Mind in considering how to render it less dreadful to M. d’Arblay. M. Dubois had pronounced “il faut s’attendre à souffrir, Je ne veux pas vous tromper—Vous Souffrirez—vous souffrirez beaucoup!—” (“You must expect to suffer, I do not want to deceive you—you will suffer—you will suffer very much!—”) M. Ribe had charged me to cry! to withhold or restrain myself might have seriously bad consequences, he said. M. Moreau, in echoing this injunction, enquired whether I had cried or screamed at the birth of Alexander—Alas, I told him, it had not been possible to do otherwise; Oh then, he answered, there is no fear!—What terrible inferences were here to be drawn! I desired, therefore, that M. d’Arblay might be kept in ignorance of the day might be kept in ignorance of the day till the operation should be over. To this they agreed, except M. Larrey, with high approbation: M. Larrey looked dissentient, but was silent. M. Dubois protested he would not undertake to act, after what he had seen of the agitated spirits of M. d’Arblay if he were present: nor would he suffer me to know the time myself over night; I obtained with difficulty a promise of 4 hours warning, which were essential to me for sundry regulations.

From this time, I assumed the best spirits in my power, to meet the coming blow;—and support my too sympathising Partner. They would let me make no preparations, refusing to inform me what would be necessary; I have known, since, that Mme de Tessé, an admirable old friend of M. d’Arblay, now mine, equally, and one of the first of her sex, in any country, for uncommon abilities, and nearly universal knowledge, had insisted upon sending me all that might be necessary, and of keeping me in ignorance. M. d’Arblay filled a Closet with Charpie, compresses, and bandages—All that to me was owned, as wanting, was an arm Chair and some Towels.—Many things, however, joined to the depth of my pains, assured me the business was not without danger. I therefore made my Will—unknown, to this moment, to M. d’Arblay, and entrusted it privately to M. La Tour Maubourg, without even letting my friend his Sister, Mme de Maisonneuve, share the secret. M. de Maubourg conveyed it for me to Maria’s excellent M. Gillet, from whom M. de Maubourg brought me directions. As soon as I am able to go out I shall reveal this clandestine affair to M. d’Arblay—till then, if might still affect him. Mme de Maisonneuve desired to be present at the operation;—but I would not inflict such pain. Mme de Chastel belle soeur de Mme de Boinville, would also have sustained the shock; but I secured two Guards, one of whom is known to my two dear Charlottes, Mme Soubiren, portiere de l’Hotel Marengo: a very good Creature, who often amuses me by repeating “ver. vell, Mawm;” which she tells me she learnt of Charlotte the younger, whom she never names but with rapture, The other is a workman whom I have often employed. The kindnesses I received at this period would have made me for-ever love France, had I hitherto been hard enough of heart to hate it—but Mme d’Henin—the tenderness she shewed me surpasses all description. Twice she came to Paris from the Country, to see, watch and sit with me; there is nothing that can be suggested of use or comfort that she omitted. She loves me not only from her kind heart, but also from her love of Mrs. Lock, often, often, exclaiming “Ah! si votre Angelique amie étoit ici!—” (“Ah! if your angelic friend were here!—”) But I must force myself from these episodes, though my dearest Esther will not think them de trop.

After sentence thus passed, I was in hourly expectation of a summons to execution; judge, then to my surprise to be suffered to on full 3 Weeks in the same state! M. Larrey from time to time visited me, but pronounced nothing, and was always melancholy. At length, M d’Arblay was told that he waited himself for a Summons! and that, a formal one, and in writing! I could not give one. A consent was my utmost effort. But poor M. d’Arblay wrote a desire that the operation, if necessary, might take place without further delay. In my own mind, I had all this time been persuaded there were hopes of a cure: why else, I thought, let me know my doom thus long? But here I must account for this apparently useless, and therefore cruel measure, though I only learnt it myself 2 months afterwards. M. Dubois had given his opinion that the evil was too far advanced for any remedy; that the cancer was already internally declared; that I was inevitably destined to that most frightful of deaths, and that an operation would but accellerate my dissolution. Poor M. Larrey was so deeply affected by this sentence, that—as he has lately told me, he regretted to his Soul ever having known me, and was upon the point of demanding a commission to the furthest end of France in order to force me into other hands. I had said, however, he remembered, once, that I would far rather suffer a quick end without, than a lingering life with this dreadfullest of maladies: he finally, therefore, considered it might be possible to save me by the trial, but that without it my case was desperate, and resolved to make the attempt. Nevertheless, the responsibility was too great to rest upon his own head entirely; and therefore he waited the formal summons.—

In fine, One morning—the last of September, 1811, while I was in Bed, and M. d’Arblay was arranging some papers for his office, I received a Letter written by M. de Lally to a Journalist, in vindication of the honoured memory of his Father against the assertions of Mme du Deffand. I read it aloud to My Alexanders, with tears of admiration and sympathy, and then sent it by Alex. to its excellent Author, as I had promised the preceding evening.

I then then dressed, aided, as usual for many months, by my maid, my right arm being condemned to total inaction; but not yet was the grand business over, when another Letter was delivered to me—another, indeed!—’twas from M. Larrey, to acquaint me that at 10 o’clock he should be with me, properly accompanied, and to exhort me to rely as much upon his sensibility & his prudence, as upon his dexterity and his experience; he charged to secure the absence of M. d’Arblay—and told me that the young Physician who would deliver me this announce would prepare for the operation, in which he must lend his aid: and also that it had been the decision of the consultation to allow me but two hours’ notice.—judge, my Esther, if I read this unmoved!—yet I had to disguise my sensations and intentions from M. d’Arblay!

Dr Aumont, the Messenger and terrible Herald, was in waiting; M. d’Arblay stood by my bedside; I affected to be long reading the Note, to gain time for forming some plan, and such was my terror of involving M. d’Arblay in the unavailing wretchedness of witnessing what I must go through, that it conquered every other, and gave me the force to act as if I were directing some third person. The detail would be too Wordy, as James says, but the wholesale is—I called Alex to my Bedside, and sent him to inform M. Barbier Neuville, chef du division du Bureau de M. d’Arblay that the moment was come, and I entreated him to write a summons upon urgent business for M. d’Arblay and to detain him till all should be over. Speechless and appalled, off went Alex, and, as I have since heard, was forced to sit down and sob in executing his commission.

I then, by the maid, sent word to the young Dr Aumont that I could not be ready till one o’clock: and I finished my breakfast, and—not with much appetite, you will believe! forced down a crust of bread, and hurried off, under various pretences, M. d’Arblay. He was scarcely gone, when M Du Bois arrived: I renewed my request for one o’clock: the rest came; all were fain to consent to the delay, for I had an apartment to prepare for my banished Mate. This arrangement, and those for myself, occupied me completely. Two engaged nurses were out of the way—I had a bed, Curtains, and heaven knows what to prepare—but business was good for my nerves. I was obliged to quit my room to have it put in order—Dr Aumont would not leave the house; he remained in the Salon, folding linen!—He had demanded 4 or 5 old and fine left off under Garments—I glided to our Book Cabinet: sundry necessary works and orders filled up my time entirely till One O’clock, When all was ready—but Dr Moreau then arrived, with news that M. Dubois could not attend till three. Dr Aumont went away—and the Coast was clear. This, indeed, was a dreadful interval. I had no longer anything to do—I had only to think—Two Hours thus spent seemed never-ending.

I would fain have written to my dearest Father—to You, my Esther—to Charlotte James—Charles—Amelia Lock—but my arm prohibited me: I strolled to the Sallon—I saw it fitted with preparations, and I recoiled—But I soon returned; to what effect disguise from myself what I must so soon know?—yet the sight of the immense quantity of bandages, compresses, sponges, Lint—made me a little sick:—I walked backwards and forwards till I quieted all emotion, and became, by degrees, nearly stupid - torpid, without sentiment or consciousness;—and thus I remained till the Clock struck three.

A sudden spirit of exertion then returned,—I defied my poor arm, no longer worth sparing, and took my long banished pen to write a few words to M. d’Arblay— and a few more for Alex, in case of a fatal result. These short billets I could only deposit safely, when the Cabriolets—one—two—three—four—succeeded rapidly to each other in stopping at the door. Dr Moreau instantly entered my room, to see if I were alive. He gave me a wine cordial, and went to the Sallon. I rang for my Maid and Nurses,—but before I could speak to them, my room, without previous message, was entered by 7 Men in black, Dr Larry, M. Dubois, Dr Moreau, Dr Aumont, Dr Ribe, and a pupil of Dr Larry, and another of M. Dubois. I was now awakened from my stupor—and by a sort of indignation—Why so many? and without leave?—But I could not utter a syllable.

M. Dubois acted as Commander in Chief. Dr Larry kept out of sight; M. Dubois ordered a Bed stead into the middle of the room. Astonished, I turned to Dr Larry, who had promised that an Arm Chair would suffice; but he hung his head, & would not look at me. Two old mattrasses M. Dubois then demanded, and an old Sheet. I now began to tremble violently, more with distaste and horror of the preparations even than of the pain. These arranged to his liking, he desired me to mount the Bed stead. I stood suspended, for a moment, whether I should not abruptly escape—I looked at the door, the windows—I felt desperate—but it was only for a moment, my reason then took the command, and my fears and feelings struggled vainly against it. I called to my maid—she was crying, and the two Nurses stood, transfixed, at the door. “Let those women all go!” cried M. Dubois. This order recovered me my Voice—“No,” I cried, “let them stay! qu’elles restent!” (“Let them stay!”)

This occasioned a little dispute, that re-animated me—The Maid, however, and one of the nurses ran off—I charged the other to approach, and she obeyed. M. Dubois now tried to issue his commands en militaire, but I resisted all that were resistable—I was compelled, however, to submit to taking off my long robe de Chambre, which I had meant to retain—Ah, then, how did I think of My Sisters!—not one, at so dreadful an instant, at hand, to protect—adjust—guard me—I regretted that I had refused Mme de Maisonneuve—Mme Chastel—no one upon whom I could rely—my departed Angel!—how did I think of her!—how did I long—long for my Esther—my Charlotte!—

My distress distress was, I suppose, apparent, though not my Wishes, for M. Dubois himself now softened, and spoke soothingly. “Can You,” I cried, “feel for an operation that, to You, must seem so trivial?”—“Trivial?” he repeated—taking up a bit of paper, which he tore, unconsciously, into a million of pieces, “oui—c’est peu de chose—mais”—(“Yes—it’s a small thing—but”—) he stammered, and could not go on. No one else attempted to speak, but I was softened myself, when I saw even M. Dubois grow agitated, while Dr Larry kept always aloof, yet a glance shewed me he was pale as ashes. I knew not, positively, then, the immediate danger, but every thing convinced me danger was hovering about me, and that this experiment could alone save me from its laws. I mounted, therefore, unbidden, the Bed stead—and M. Dubois placed me upon the mattrass, and spread a cambric handkerchief upon my face.

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. I would not trust to convulsive fear the sight of the terrible incision. A silence the most profound ensued, which lasted for some minutes, during which, I imagine, they took their orders by signs, and made their examination—Oh what a horrible suspension!—I did not breathe—and M. Dubois tried vainly to find any pulse. This pause, at length, was broken by Dr Larry, who, in a voice of solemn melancholy, said “Qui me tiendra ce sein?—” (“Who will hold this breast for me?—”)

No one answered; at least not verbally; but this aroused me from my passively submissive state, for I feared they imagined the whole breast infected—feared it too justly,—for, 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. Excited by this idea, I started up, threw off my veil, and, in answer to the demand “Qui me tiendra ce sein?” cried “C’est moi, Monsieur!” (“I will, Sir!”) and I held My hand under it, and explained the nature of my sufferings, which all sprang from one point, though they darted into every part. I was heard attentively, but in utter silence, and M. Dubois then re-placed me as before, and, as before, spread my veil over my face. How vain, alas, my representation! immediately again I saw the fatal finger describe the Cross—and the circle—Hopeless, then, desperate, and self-given up, I closed once more my Eyes, relinquishing all watching, all resistance, all interference, and sadly resolute to be wholly resigned.

My dearest Esther,—and all my dears to whom she communicates this doleful ditty, will rejoice to hear that this resolution once taken, was firmly adhered to, in defiance of a terror that surpasses all description, and the most torturing pain. Yet—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.

I attempted no more to open my Eyes,—they felt as if hermetically shut, and so firmly closed, that the Eyelids seemed indented into the Cheeks. The instrument this second time withdrawn, I concluded the operation over—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—Again all description would be baffled—yet again all was not over,—Dr Larry rested but his own hand, and—Oh Heaven!—I then felt the Knife rackling against the breast bone—scraping it!—This performed, while I yet remained in utterly speechless torture, I heard the Voice of Mr Larry,—(all others guarded a dead silence) in a tone nearly tragic, desire everyone present to pronounce if anything more remained to be done; The general voice was Yes,—but the finger of Mr Dubois—which I literally felt elevated over the wound, though I saw nothing, and though he touched nothing, so indescribably sensitive was the spot—pointed to some further requisition—and 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.—

My dearest Esther, not for days, not for Weeks, but for Months I could not speak of this terrible business without nearly again going through it! I could not think of it with impunity! I was sick, I was disordered by a single question—even now, 9 months after it is over, I have a headache from going on with the account! and this miserable account, which I began 3 Months ago, at least, I dare not revise, nor read, the recollection is still so painful.

To conclude, 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—However, I bore it with all the courage I could exert, and never moved, nor stopt them, nor resisted, nor remonstrated, nor spoke - except once or twice, during the dressings, to say “Ah Messieurs! que je vous plains!—” (“Ah Sirs! how I pity you!—”)  for indeed I was sensible to the feeling concern with which they all saw what I endured, though my speech was principally—very principally meant for Dr Larry. Except this, I uttered not a syllable, save, when so often they re-commenced, calling out “Avertissez moi, Messieurs! Avertissez moi!—” (“Warn me, Sirs! warn me!”) Twice, I believe, I fainted; at least, I have two total chasms in my memory of this transaction, that impede my tying together what passed.

When all was done, and they lifted me up that I might be put to bed, my strength was so totally annihilated, that I was obliged to be carried, and could not even sustain my hands and arms, which hung as if I had been lifeless; while my face, as the Nurse has told me, was utterly colourless. This removal made me open my Eyes—and I then saw my good Dr Larry, pale nearly as myself, his face streaked with blood, its expression depicting grief, apprehension, and almost horrour.

When I was in bed,—my poor M. d’Arblay—who ought to write you himself his own history of this Morning—was called to me—and afterwards our Alex.—

Source: Frances Burney, Journals and Letters, selected with an introduction by Peter Sabor and Lars E. Troide (New York: Penguin Classics, 2001), pp. 431-443. Manuscript letter is in the Henry W. and Albert A. Berg Collection, New York Public Library.


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  3. Thanks very much for this great article;this is the stuff that keeps me going through out these day.
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  4. Just listened to In Our Time on Radio 4,briefly covering life of Francis Burney.
    Cancer is a subject my epidemiological family have been studying for half a century,with some fascinating connections/experiences/conclusions.
    Apart from the severe stress Fanny Burney was under during periods in her life, which would have undermined her immune system,leading up to her diagnosis,can anyone point me to any references to her diet fact,consumption or exposure to anything toxic?Is there any record of a favourite tipple?
    Arsenic has been found in some wallpaper from that period(see about Napoleon at,and of course lead was commonplace,but doubt whether she had elevated levels of the latter.Did she have any other health issues,for instance,skin complaints?
    Thank you

  5. Thanks for the great information. It is very useful and informative.
    Dr. Michael A. Fiorillo

  6. what an amazing story.Thank you for sharing such wonderful information!In my opinion, Keep a healthy life by consuming healthy food and doing exercise regularly is the best healthy formula.
    Medical Careers

  7. Thank-you for putting this up online in full. It's an amazing account from a brilliant patient in a pre-anaesthetic and pre-antisepsis era. What I cannot see mentioned is that Fanny Burney wrote this in 1812, and lived until the age of 87 (she died in 1840) so this was a very successful operation, if what she had really was breast cancer. It might have been a benign tumour, but no-one could have known that then, and we cannot check the the pathology now. It seems to have been affecting her arm, so may have reached her arm-pit. But no metastases, no resurgence in 28 years. Those kind surgeons did a good job.
    Ruth Richardson

    I'm here again to appreciate. DR WILLIAMS God will always continue to bless you more abundantly, for the good works you don in my life, I will always keep on writing good and posting my testimonies about you on the Internet, I’m Jessica from Orlando, Florida. I was tested breast cancer positive, I saw a blog on how DR WILLIAMS cured people with his herbal portion, i did not believe in natural medicine but i just decided to give him a try, I contacted him,and explain my situation to him,few day later he sent me the herb, after taking doc Williams herbal medicine for few week i also got my healing with his herbal portion, i am so happy. If you have any type of cancer problem or you are also infected with any kind of disease, contact him for advice and for his product,i hope this testimony also help some one out there

    I'm here again to appreciate. DR WILLIAMS God will always continue to bless you more abundantly, for the good works you don in my life, I will always keep on writing good and posting my testimonies about you on the Internet, I’m Jessica from Orlando, Florida. I was tested breast cancer positive, I saw a blog on how DR WILLIAMS cured people with his herbal portion, i did not believe in natural medicine but i just decided to give him a try, I contacted him,and explain my situation to him,few day later he sent me the herb, after taking doc Williams herbal medicine for few week i also got my healing with his herbal portion, i am so happy. If you have any type of cancer problem or you are also infected with any kind of disease, contact him for advice and for his product,i hope this testimony also help some one out there

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  11. ד"ר שגית משולם דרסון ניתוחים פלסטיים, כירורגיה פלסטית, מומחה לכירורגיה פלסטית, רופא בכיר ומנהל ניתוח שחזור שד במרכז הרפואי רבין בפתח תקוה. היא מנהלת מרפאה לניתוחים אסתטיים ושיקומיים וכן ניתוחים קוסמטיים, פלסטיים, ניתוחים פלסטיים, ניתוחים פלסטיים הקטנת חזה