Knowlton Biography, Chapter 11

Eleven: Twitchell the Surgeon

I went into the office of Dr. Amos Twitchell, of Keene, with whom I remained until the commencement of the medical lectures at Hanover, in the fall of 1823. While with Twitchell, I saw him perform several important operations, one of which was to amputate a thigh, which I then said, and still think, ought not to have been amputated, at least not until a trial had been made to save the leg.

After the body-snatching scandal in Royalston, the Bachellers sent all their medical students away.  For the final preceptorship of his career as a student, Charles went back to Keene to work with the region’s most famous surgeon, Dr. Amos Twitchell.  Like Charles, Twitchell was the son of a farmer—and like Charles, he’d learned his trade by practicing on stolen bodies.

Amos Twitchell was born in 1781 in southern New Hampshire.  His father was a pioneer farmer and grist miller in Dublin, and Amos was the eighth of ten children.  Like Charles, Amos attended his village school for four months a year until he was fourteen years old.  After studying on his own for another three years, Amos rode one of his father’s farm ponies eighty miles to Cambridge, Massachusetts.  Twitchell expected to be welcomed into Harvard, but he was turned away at the gates.  So he got back on his pony and rode to Hanover. 

Although it was unusual for the sons of farmers to attend New England’s colleges, Amos found a place for himself at Dartmouth College, where he earned a bachelor’s degree in four years and gave a commencement speech in Greek.  But the turning point in his life came when Twitchell met Dr. Nathan Smith, who had just begun the medical lectures in Hanover and was the program’s only instructor.  Smith was a New England-born, Scottish-trained doctor, who in spite of being distrusted for his lack of religion by orthodox academic leaders such as Reverend Timothy Dwight, president of Yale College, went on to establish medical schools at Dartmouth, Bowdoin College, the University of Vermont, and at Yale itself.

When Twitchell arrived, Smith had just begun the program at Hanover.  Dr. Smith gave all the lectures, covering anatomy, chemistry, surgery, and the Materia Medica.  He recruited Twitchell to be his assistant, and Amos was impressed by the doctor’s skill and originality in surgery.  Smith also taught Twitchell “the underground channels by which the ‘Resurrection Man’ brought cadavers to the dissecting tables of the Scottish medical schools,” and gave his young student the assignment of keeping Hanover well-stocked with bodies. 

Amos quickly became both an expert body-snatcher and an expert surgeon.  He would scan the obituaries in county newspapers, and ride out to nearby graveyards late at night.  Amos was arrested once for body-snatching, but he was acquitted on a technicality.  Twitchell stole corpses in the vicinity of Hanover for several years—it’s interesting to speculate how many local graves don’t really contain the bodies of the people named on their headstones. 

When Charles stayed with Amos Twitchell in Keene, the thirty-two year old doctor was already the most famous surgeon in the northeast.  Unlike most of his fellow physicians, Twitchell specialized in surgery and was regularly called in by other doctors who would then assist him in operating on their patients.  Amos had been offered professorships at Dartmouth, Vermont, and Bowdoin, but he was making three to four thousand dollars a year in his practice, and preferred to be his own boss.  Twitchell was considered an autocrat, even by his closest friends.  But he was also happily married to a local woman, and actively involved in Keene’s social and political life.  He is remembered in the town’s history as “a gregarious individual who enjoyed playing whist and swapping jokes at the local tavern and came to be regarded with affection and pride as Keene’s first citizen.” 

Charles was not as awed by the famous surgeon as some of the other students who flocked to his clinic and the twenty-four bed hospital he built in Keene.  Knowlton argued with Twitchell over how quickly the doctor resorted to surgery.  In this, ironically, Charles was more like Twitchell’s teacher Nathan Smith, who preferred to let the body try to heal itself and in his later years even argued against the excessive use of bleeding and purging.  But Twitchell was the region’s leading surgeon. 

Charles saw Twitchell perform several operations in the late-summer weeks before he returned to Hanover for a second round of medical lectures.  Generally these surgeries were done on the patient’s kitchen table—and they were done as quickly as possible.  Anesthetics and antiseptics were unknown at the time, so surgery was horrifically painful and infection was a constant danger.  In the amputation case Charles claimed was unwarranted, Twitchell operated on a patient who had fallen out of a tree, causing a compound fracture of the tibia and fibula.  The break was near the middle of the leg.  Although the bones had broken through the skin, they had not severed any major veins or arteries and the laceration didn’t seem that bad to Charles.  Twitchell made no effort to set the bones before he amputated the leg.  Charles objected, giving his own opinion in what must have been a surprising and unwelcome challenge to the famous doctor’s authority.  But Knowlton was done following.  He had his own ideas about medicine, and the confidence to rely on his judgment and to speak his mind.  The time had come for Charles to stop being an apprentice.