By the time 1893 rolled around, W.W. Keen (1837–1932) was arguably the most prominent doctor in the country. That year, more than any other, would require his best work, because the stakes could not have been higher: The fate of America’s leader and, possibly, the country’s entire economy rested on his shoulders.
Keen graduated from Philadelphia’s Central High School and then attended Brown University. He graduated from Brown in 1859 as valedictorian. He remained at the university an additional year in preparation for his medical studies, to be conducted at Jefferson Medical College in 1860. The following year, however, would be the start of America’s great turmoil: the Civil War.
While studying at Jefferson Medical College, he was recommended by John H. Brinton, who had recently been commissioned by President Abraham Lincoln as brigadier surgeon of volunteers, to become the surgeon for the Fifth Massachusetts Militia Regiment. From July to September, he cared for wounded soldiers, particularly those from the First Battle of Bull Run. In 1862, he then returned to Jefferson Medical College to earn his M.D. After receiving his credentials, he returned to the war as the Union Army’s acting assistant surgeon until 1864.
Before the war ended, Keen wrote two important works with fellow Civil War physicians Silas Weir Mitchell and George R. Morehouse, entitled “Reflexive Paralysis: The Result of Gunshot Wounds” and “Gunshot Wounds and Other Injuries to Nerves.”
After the war, Keen spent his time lecturing, writing, and practicing medicine. In 1875, he became president of the Philadelphia School of Anatomy, wrote and edited works in Gray’s Anatomy, and, in 1892, co-authored the groundbreaking text “Surgery: Its Principles and Practices.”
Keen utilized the brilliant work of other surgeons, like that of Joseph Lister, who introduced the idea of antiseptic surgery. This made surgeries safer by taking precautions against infections. Keen’s adherence to the warnings set out in germ theory assisted him as the first to successfully remove a brain tumor, which took place in 1888. This was the same year Grover Cleveland lost his re-election bid for the presidency. Four years later, though, Cleveland would win re-election. Although Keen had nothing to do with Cleveland getting back into office, he would have much to do with his remaining there.
The country was in economic straits with the ongoing silver crisis and the Panic of 1893. Cleveland had been re-elected on the campaign promise to remain on the gold standard and to fight against the free silver cause, which was creating mass inflation.
Only a few months after his inauguration, Cleveland discovered a mass on the roof of his mouth. It was malignant and Dr. Joseph Bryant recommended an immediate removal. Keen was just the surgeon for the operation. The operation, however, had to be conducted clandestinely. With a fragile economy and a vice president who was pro-free silver, news of an imperiled president could cause economic shockwaves throughout Wall Street and Main Street.
The operation was conducted July 1 aboard the Oneida, a yacht belonging to banker and Cleveland’s personal friend, E.C. Benedict. With no table to operate on, Cleveland was confined to a large chair that was strapped to the mast in the middle of the vessel’s saloon. Under anesthesia, Cleveland went under the knife.
According to Keen’s report, “The entire left upper jaw was removed from the first bicuspid tooth to just beyond the last molar, and nearly up to the middle line. ... A small portion of the soft palate was removed.” The president also had several teeth removed. The operation took all of 90 minutes and was a complete success. The president would address Congress early the following month and none would be the wiser.
For Keen, it was the height of his career achievements. “The operation itself was as nothing compared with scores that both of us [he and Bryant] had performed; but on it hung the life not only of a human being and an illustrious ruler but the destiny of a nation. It was by far the most responsible operation in which I ever took part.”
