Reward vs Reputation

Something occurred to me in class while we were discussing anesthesia and how it initially met with resistance from the medical community. We had gone over basic reasons why certain surgeons didn’t want to use anesthesia: anesthesia isn’t completely safe, we can’t risk people’s lives just to lessen their pain in surgery, it puts our women in too submissive a state to be deemed appropriate, god wanted eve to suffer in childbirth, etc. But I suspect that a big reason the prospect of using drugs such as nitrous oxide, ether, and chloroform to alleviate pain in surgery wasn’t immediately adopted or accepted by the conservative medical community (and this explanation came up later in our class, and many people made the same comparison that I am soon to make) was because those drugs had been used recreationally before their potential as anesthetics was ever proposed.

We hadn’t discussed, in depth, the extent to which nitrous oxide, ether, and chloroform were used recreationally in the Victorian era. We read that Humphrey Davey, once he stumbled upon the mind-altering properties of nitrous oxide, used to inhale it and sit in the dark to “ponder existence” and “become one with the universe.” We heard briefly about ether frolics, and that James Young Simpson, the early pioneer of chloroform as an anesthetic, used to offer chloroform on handkerchiefs to his guests at dinner parties. Taking a closer look (which in this case means browsing the internet to learn a little more about the histories of these drugs), we see that the drugs extended a little further into the Victorian culture, into places other than just Davey’s laboratory and Simpson’s dinner parties. Nitrous oxide was used recreationally by the British upper class for four decades after Davey made a case for it as an anesthetic before it was finally used in surgery. It was served in the place of wine at social gatherings of the British upper class, its state-heightening properties were showcased at street fairs and festivals, and it was soon given the nickname, “laughing gas.” Before ether’s entry into the surgical world, it was used, especially in the United States, in “frolics” in which groups would gather, inhale various amounts of ether, become exhilarated, and dance around like madmen. Ether was also sometimes drunk, especially in Ireland. Chloroform, although not used recreationally for a long period of time, was certainly known for its intoxicating effects before it was observed that it eliminated pain for the user. Again, chloroform was mostly experimented with by members of the upper class.

Though these drugs were overshadowed by the recreational use of drugs such as opium and laudanum, opium mixed with alcohol, they were still known to society as state-altering substances. From the medical community’s point of view, these drugs did not seem like a breakthrough to be used to eliminate pain from the operating room. These were drugs that they already known, drugs that had no history of medical application, but a rich history in frivolity. And now for the comparison. The Victorian surgeons and physicians were faced with the same sort of situation that we, today, are faced with in considering letting a drug like marijuana into the medical realm. I think marijuana has a stronger reputation than was “enjoyed” by the anesthetic gasses of the nineteenth century, but the principle is the same. People use marijuana to get high. Is that enough of a reason to ban it for medical use?

One difference in the way that we, today, consider something like marijuana for medical use, versus how surgeons in the nineteenth century would have considered ether or chloroform, is that we know a lot more about substances today than did the Victorians. For example, the Victorians didn’t know that chloroform could deal serious damage to the liver, but they used it anyway. Today, we need to know everything about a substance before it’s cleared for medical use, though there is still a debate over exactly how much marijuana can help or harm the body. Studies show that marijuana can help patients that need to increase their appetites, such as patients with eating disorders or patients that are undergoing various cancer treatments. Marijuana is also a mild pain reliever, a reducer of nausea, and a muscle relaxant. However, other studies report that marijuana, when smoked, can cause lung cancer and bronchial damage. However the medical community weighs the risks versus the potential rewards of using marijuana in medical treatments, we as a society, who ultimately end up deciding if marijuana will or will not be used by doctors when we vote for or against it, judge it primarily on its reputation as a recreational drug. I’m not quite sure where I stand on today’s medical marijuana debate, but I know that many painful years passed for patients that could have had anesthesia in surgery if not for conservative surgeons basing their condemnation of pain-alleviating drugs on their recreational reputations. So I think we should try our best today to separate marijuana’s reputation from the debate over whether or not doctors should be able to prescribe it to their patients. We should consider marijuana on the basis of risk vs reward, not reward vs reputation.