if you were to look at a surgical procedure in an american hospital in the 1830's, there was no anesthesia and the operation had to be done in second. or else the patient would die of shock. you can imagine the pain. surgeons would ask the patient that one of the arm to come off. if the patient said no, that was it. patientsaid yes, the was brought to the operating reader -- theater. and tonted sunlight muffle the screens. they would take up the arm, and the pain was excruciating. you move forward dirty years and anesthesia is in full bloom. half the patients being operated on at bellevue are dying of postoperative infection. more at have now bellevue hospital is the beginning of antiseptic medicine and the acceptance of germ theory. you have an operation that will help patient and not kill them. that is one of the reasons why , even the middle class in new york city began to understand that it was better to go to a hospital for certain procedures than to have it done in your home. there was no reason not to have it done in your home. now they have x-rays and laboratories in germ theory at