In on Monday 3rd April 1843 Isambard Kingdom Brunel was less than a week away from celebrating his 37th birthday. He was one of the most famous men alive and close to the peak of a spectacular career. He was Chief Engineer of the Great Western Railway which had cut the journey time from Bristol to London from a couple of days to a few hours; he had built the ‘Great Western’, the first steamship to provide a regular transatlantic service and an even bigger ship the ‘Great Britain’ was nearing completion. Brunel was also engineer for a number of smaller railways (including some in Italy) and various other civil engineering projects. Engineering was the high-technology profession of the day and the combination of Brunel’s achievements and personality meant that his name was a familiar to the public as those of people like Bill Gates, Steve Jobs and Mark Zuckerberg in the current era.
Brunel was also a family man. He had married in 1836, had two sons and his house in Duke Street, London was also often visited by his young nephew ‘Little Ben’. He would sometimes put on a conjuring show for the children and on this particular afternoon he included the trick of putting a coin into his ear and then retrieving it from his mouth. Unfortunately, the coin he had hidden in his mouth slipped down his throat (apologies if this has forever spoiled this trick for anyone). Initially, he seemed to think nothing of it, presumably expecting the coin to work its way through his digestive system and reappear a day or two later!
A Troublesome Cough
After a few days he began to suffer from a ‘troublesome cough’, and when the coin had still not worked its way through his system by 18th April a leading doctor, (Sir Benjamin Brodie, who was also Queen Victoria’s physician) was called. As a letter written by Brunel’s brother-in-law to the Times newspaper explained:
“his opinion was that the half-sovereign had passed into the windpipe. The following day Mr Brunel strengthened this opinion by a simple experiment. He bent his head and shoulders over a chair, and distinctly felt the coin drop towards the glottis; whilst raising himself a violent fit of coughing came on, which ceased after a few minutes. He repeated this a second time, with the same results.”
The doctor returned a few days later:
“A consultation was held on the 22nd, at which it was decided that conclusive evidence existed of the half-sovereign having passed into the windpipe, that it was probably lodged at the bottom of the right bronchus, and that it was movable.”
So Brunel had a gold coin about 2cm in diameter and 1mm thick stuck in his windpipe – and it had already been there for nearly three weeks!
Hanging Upside Down
Dr Brodie and Brunel came up with a plan. If Brunel was suspended upside down, gravity might help the coin work its way back into Brunel’s mouth. Brunel organised making a suitable board he could be strapped to.
“The first experiment was made on the 25th. The body of the patient being inverted, and the back gently struck with the hand between the shoulders, violent cough came on, but of so convulsive and alarming a nature that danger was apprehended, and the experiment was discontinued. On this occasion the coin was again moved from its situation, and slipped towards the glottis”
So they tried something different:
“On the 27th tracheotomy was performed by Sir B Brodie, assisted by Mr Aston Key, with the intention of extracting the coin by the forceps, if possible, ….. On this occasion, and subsequently on May 2, the introduction of the forceps was attended with so much irritation, that it could not be persevered in without danger to life.”
‘Irritation’ is a wonderful bit of Victorian understatement. In his home, Brunel had his windpipe cut open and a pair of metal forceps pushed down towards his lungs to try and locate the coin! 1843 was three years before the first public demonstration of ether as an anaesthetic, so if Brunel had any pain relief it was minimal. Then, after one failure, he let the surgeon try again five days later.
The next day two more doctors were called in and the four physicians decided to try turning Brunel upside down again. But they had to wait until he had recovered from the two attempts with forceps. So:
“On Saturday, the 13th, Mr. Brunel was again placed on the apparatus, the body inverted, and the back gently struck. After two or three coughs, he felt the coin quit its place on the right side of the chest, and in a few seconds it dropped from his mouth without exciting in its passage through the glottis any distress or inconvenience, the opening in the windpipe preventing any spasmodic action of the glottis.”
After six weeks the coin was finally removed and the wound from the tracheotomy which had been open for 16 days was closed. Throughout this period, Brunel was actively involved in deciding the course of his treatment and, as he was a renowned workaholic, would also have been carrying on with his day to day workload as much as possible.
Whilst the coin was refusing to budge, Brunel’s fame ensured he was a hot topic of conversation. When the news was spread that ‘it is out’ the message needed no extra explanation.
Superficially this seems like a fairly minor aside in the life of a great engineer who created much of infrastructure that allowed Victorian Britain to thrive (many of his bridges, railway lines and stations are still in use today). However, knowledge of medical hygiene and infection control was still in its infancy in the 1840s and there was a very real possibility that a conjuring trick gone wrong could have proved fatal. In 1855 Brunel designed the first ever portable Army Hospital, which was shipped flat-pack and assembled in the Crimea, helping to provide the cleaner conditions for wounded soldiers for which Florence Nightingale had been campaigning. So if Brunel had died in 1843 of an infection, it may well have had a knock on effect on hundreds of soldiers twelve years later.