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Frances Burney, later Madame D’Arblay, wrote the well-known books, Evelina, Cecilia and Camilla. As well as writing her views on Boswell in letters and her diaries, Fanny also left behind one of the earliest accounts of a mastectomy in a letter to her sister, Esther, written on March 22 1812.
Frances Burney Feared Breast Cancer
In 1810, Frances, while living in Paris, “began to be annoyed by a small pain in [her]breast. It did not cause her any uneasiness, but her worried husband encouraged her to see a surgeon. She ignored his entreaties and those of her friend, Madame de Maisonneuve. Months passed, but when another friend who had experienced breast cancer, stressed the urgency of the situation, Frances succumbed and saw a physician. Fanny grew worse, and non-surgical attempts to cure her met no success.
At the Tuilleries lived one of France’s most celebrated surgeons, M. Dubois. Physician to the Empress Marie-Josephine, he inspected Franny, after which he retired to the Book Room with Fanny’s husband. Her husband’s non-appearance increased her alarm. She “could not but suspect there was room for terror in quietude.” When her husband entered the room, “his looks were shocking! his features, his whole face displayed the bitterest woe.” She knew she would need a “small operation,” but was keen to avoid that. Having cared for relatives in their illnesses, seen surgeons in action when she was lady in waiting to Queen Charlotte and heard of her brother-in-law’s practice as a trained surgeon, Fanny knew well the dangers and pain of an operation.
Frances Put off the Inevitable
To avoid an operation, Frances Burney consulted another leading doctor, M. Larrey. Initially he put her on a different regime. While this helped ease the pain, on a subsequent visit, the change in her demeanour was such that M. Larry urged an operation. By now exercise was causing her great suffering and even though she moved to a house with less flights of stairs, she was struggling. Eventually a formal conference of three doctors advised there was no alternative to an operation. Fanny was “as much astonished as disappointed – for the poor breast was no where discoloured, & not much larger than its healthy neighbour.” When she agreed to an operation, Larrey had tears in his eyes. Still they consulted M. Dubois once more. Her “heart beat fast; I saw all hope was over. M. Dubois … pronounced my doom.”
19th Century Healthcare
Surgeons operating in the nineteenth century, even by Frances’ leading surgeons, would have to work without giving anaesthetic to their patients. In period films, sailors tip bottles of whisky down the throats of injured crewmen. A battlefield surgeon offers a leather strap to bite on. A gang of men hold the writhing patient Rarely do we see the same horror experienced by a woman on film.
Frances Burney waited in ignorance for her operation. Her husband filled “a closet with Charpie, compresses & bandages.” Her merely told her she would need an armchair and some towels. Fanny wrote her will, but did not tell her husband that she had done so. She then waited for three weeks in “hourly expectation of a summons to execution.” What she did not know, until months after the operation, was that M. Dubois was not confident. He thought the evil was too far advanced for any remedy. “The cancer was already internally declared; that [she] was inevitably destined to die that most frightful of deaths & that an operation would but accelerate [her] dissolution.” Fanny reassured M. Larrey that she would rather suffer a quick end than “a lingering life with this dreadfullest of maladies.”
Frances’ Preparation for the Operation
On September 30, 1811, while she was in bed arranging some letters, Fanny received a letter from M. Larrey saying that he with others would arrive to carry out the operation that morning. The doctors had judged it best to give her as little notice as possible. To ensure her husband would be absent and not have to bear witness to her operation, she devised a ruse to have him detained on urgent business. She tried to finish her breakfast, without much appetite. Forcing down a crust of bread, she begged for the operation to be delayed until one o’clock. Servants prepared rooms and folded linen.
Frances kept herself busy with orders and sundry works until one o’clock, when there was a delay. With everything ready, all Franny had to do for two hours was to think. The sight of the immense quantity of bandages, compresses and sponges made her a little sick. She paced backwards and forwards until she quieted her emotions, becoming “nearly stupid – torpid, without sentiment or consciousness”. At three o’clock she stirred her pen to write a few words to her husband and son in case she died.
Who was present?
Three cabriolets arrived at the door, one, two, three. Frances drank a wine cordial and then 7 Men in black entered her room. She was indignant, “why so many & without leave?” she thought, but she could not utter a syllable. In the middle of the room stood a bed stead not the expected arm chair, with two old mattresses and an old sheet . By now Fanny’s maid was crying, two nurses stood transfixed by the door and Fanny felt desperate, but her reason then took command.
Only one woman remained in the room. Fanny had to submit to taking off her long robe de chambre. In her distress, M Dubois spoke soothingly to her. “”Can you” she cried “feel for an operation that to you must seem so trivial?” “Trivial,” he repeated – taking up a bit of paper, which he tore into a million of pieces, “oui – c’est peu de chose – mais” he stammered & could not go on. No one else attempted to speak, but I was softened myself, when I saw even Dubois grow agitated, while Dr Larry kept always aloof, yet a glance showed me he was pale as ashes. I knew not, positively then, the immediate danger, but everything convinced me danger was hovering about me, & and that this experiment could alone save me from its jaws”.
Fanny mounted the bed. Someone placed a thin cambric handkerchief on her face. But, it was too transparent to blind her to what was happening. “When I saw the glitter of polished steel – I closed my eyes.”
In the ensuing description of the operation, Fanny does not flinch from describing the details. She describes the rush of air after the incision is made, the feel of the knife rackling on her breast bone, the excruciating pain and her screams which she marvels do not still ring in her ears months later. Frances recounts the words of the doctors and believes she fainted twice.
She “never moved, nor stopped them, nor resisted nor remonstrated nor spoke – except once or twice during the dressings … When all was done, & they lifted me up that I might be put to bed, my strength was so totally annihilated, that I was obliged to be carried, & could not even sustain my hands & 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 – & I then saw my good Dr Larry, pale nearly as myself, his face streaked with blood, & its expression depicting grief, apprehension, & almost horrour.”
Frances Burney’s Recovery
In all the operation lasted twenty minutes, but for months she could not talk a word about it.
Her account is hard to read, but her letter is also a tale of hope. By the time she wrote the letter she was well. No matter how terrible the experience, she survived, and lived for almost thirty-nine more years. It is also a cautionary tale, she warns her sister not to ignore any signs of trouble, and consult a doctor at the first signs. It is a warning, all of us today should heed.
The Henry W. and Albert A. Berg Collection of English and American Literature, The New York Public Library houses the original letter.
A copy and a transcript is available online at the British Library. https://www.bl.uk/collection-items/letter-from-frances-burney-to-her-sister-esther-about-her-mastectomy
Fanny Burney, Charles Turner, published by Paul and Dominic Colnaghi & Co, after Edward Francisco Burney
mezzotint, published 16 May 1840 NPG D930 © National Portrait Gallery, London
Thomas Girtin, 1775–1802, British, View of the Pantheon, Paris, 1802, Soft ground etching with gray, blue, and yellow wash on medium, slightly textured, cream, wove paper mounted on thick, slightly textured, cream, wove paper, Yale Center for British Art, Paul Mellon Collection, B1977.14.4140
Julia is a corporate lawyer by day, and a historical detective in her spare time. She researches the 18th century and the women history has overlooked. She competed in the 1992 Barcelona Olympics, for fencing and was granted an OBE in 1999. Today, she lives outside Edinburgh. Follow the instagram link below for daily posts on inspirational and controversial women.