In the days before anesthesia, the prospect of having to go under the knife was far more horrific than the affliction the procedure was supposed to cure. Without the means to render the patient unconscious, surgeons administered opium or liquor in a vain attempt to numb the pain, but many patients mercifully passed out halfway through the process. Anybody who didn’t had to endure the physical pain as well as the mental trauma of watching their own operation. Even if the patient did survive the surgery, there was still the risk of infection as knowledge about microorganisms and hygiene were nonexistent in those times.

Frances Burney, also known as Fanny Burney, an 18th-century English novelist, leaves us a harrowing account of her own surgery that she underwent without the benefit of anesthesia to remove a tumor from her breast. The wealth of detail in her riveting narrative and the calmness with she relays the horrors makes it one of the most powerful and courageous work of literature that’s almost too painful to read.

Fanny Burney was almost sixty and living in Paris in 1806, when she began to suffer pain in her right breast, which gradually became so severe that she could not lift her arm. The doctors diagnosed her condition as breast cancer and a mastectomy was recommended. Burney deliberated for months, hoping the problem would go away, but when her discomfort became progressively worse she reluctantly submitted herself to the decision of her doctors. The date of her operation was fixed on 30 September 1811, and as she waited for the fateful day to arrive the anxiety and apprehension became almost crushing. This was made worse when she learned on the morning of the appointed day that the surgeons would be delayed by two hours. “I walked backwards and forwards till I quieted all emotion, and became, by degrees, nearly stupid - torpid, without sentiment or consciousness,” she wrote.

At three in the afternoon, four carriages arrived at her door and seven grave men alighted, dressed in solemn black. Burney was given a drink, probably mixed with laudanum, to calm her nerves. A bed was moved into the middle of the room, and old sheets were placed on it so as not to spoil the good mattress or linens.

“I now began to tremble violently, more with distaste and horror of the preparations even than of the pain.”

The lead surgeon, M. Dubois, ordered Burney upon the bed and a flimsy handkerchief was placed upon her face.

“It was transparent, however, and I saw, through it, that the bedstead was instantly surrounded by the 7 men and my nurse. I refused to be held; but when, bright through the cambric, I saw the glitter of polished steel—I closed my eyes.”

Moments later, the blade plunged into her breast.

“I began a scream that lasted unintermittingly during the whole time of the incision—and I almost marvel that it rings not in my ears still! so excruciating was the agony. When the wound was made, and the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp and forked poniards, that were tearing the edges of the wound—but when again I felt the instrument—describing a curve—cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose and tire the hand of the operator, who was forced to change from the right to the left—then, indeed, I thought I must have expired.”

Over and over again the surgeons dug into her breast cutting away the infected tissue, and she could feel and hear the scrape of the blade against her breastbone. Her sufferings lasted twenty minutes.

“When all was done, and they lifted me up that I might be put to bed, my strength was so totally annihilated, that I was obliged to be carried, and could not even sustain my hands and 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—and I then saw my good Dr. Larry, pale nearly as myself, his face streaked with blood, its expression depicting grief, apprehension, and almost horror.”

It took Burney several months to recover, and although it is impossible to know today whether the removed tumor was indeed cancerous, it did, in fact, save her life. She went to live another twenty-nine years and neither the original pain nor the tumor ever came back

Nine months after the incident, she wrote in a letter to her sister Esther, a detailed account of her mastectomy and posted it without rereading or revision because “the recollection is still so painful.” However, years later, she did revisit her miserable memories when she once again wrote an account of this experience and of her Paris years in her Waterloo Journal.