Dr. William Halstead: The Cokehead Who Fathered Modern Medicine

By now, you have probably heard many stories of how cocaine was used in the late 1800s and early 1900s. It was used in quack medicines, cocktails, stimulants, and even in soft drinks such as Coca-Cola. Of course, we now know that cocaine is a highly addictive  substance that can lead to destructive behavior and regrettable fashion choices, but at that time, it was viewed as harmless at worst. One turn-of-the-century doctor was basically a medical Pablo Escobar. His whole practice was fueled by cocaine, leading to some of the most groundbreaking medical advances of his day. Let’s look at the extraordinary career of Dr. William Stewart Halstead: doctor, innovator, and cocaine addict. 

A Maverick Doctor

Bold and confident even without the aid of the cocaine, William Stewart Halstead was more than just a medical doctor; he was an innovator. Born in 1852, he practiced medicine at an exciting time. The earlier discoveries of harmful microorganism and subsequent adoption of good physician hygiene practices meant that surgeries were becoming safer and more commonplace. Halstead prescribed to this antiseptic approach and was diligent about cleanliness. He also promoted new surgical techniques that were less invasive and more effective than previous practices. 

The Father of Modern Surgery

Between 1880 and 1900 alone, at least 100 new surgeries and surgical techniques were created. Halstead led the way. He believed, for example, that cancer cells spread through blood and tissue, so he advocated for radical mastectomies to treat breast cancer in his patients. He even invented new surgical procedures to keep the surrounding tissue as undamaged as possible to aid in healing. He contributed to advances in surgeries for hernias, aneurysms, and thyroid disorders. He even pioneered the first blood transfusion. In all of his surgeries, he emphasized cleanliness to aid with wound healing. In fact, he was the first doctor to wear rubber gloves in the operating room. 

A New Teaching Method

Halstead recognized early on that the United States lacked advanced medical training schools. He himself had traveled to Europe to learn about sophisticated surgical methods. Back in the U.S., Halstead and three other prominent American physicians founded Johns Hopkins University, which is now one of the country's most prestigious medical schools. Halstead taught for years at Johns Hopkins and radically changed how medical students are taught. He turned his classroom lectures into hands-on demonstrations and demanded a high degree of dedication from his students. 

A High Functioning Addict

He was also a raging cocaine addict throughout most of his professional life. Cocaine had yet to be labeled an addictive and dangerous drug, so it was legal and easily available in Halstead's day. Like many other physicians of his time, he was intrigued by the promises of cocaine as medicine and anesthesia, so he used his own body to experiment with the effects of cocaine. He injected himself with the drug, ingested it, and even rubbed it in his eyes. The stimulating effects that the drug had on him gave Halstead almost endless energy, allowing him to work long hours, perform many surgeries, and train students. There was no need for food and sleep. There was only progress and cocaine.

Halstead, the Pusher?

Halstead was not only a prodigious user but also cocaine's best promoter, encouraging his students to try it so that they, too, could keep up with the high standards and demands that Halstead set. He expected his residents to be on-call 362 days a year and handle a workload that was difficult to maintain without artificial stimulants.

Cocaine, a Gateway Drug?

Halstead's cocaine use was well-known and well-documented. In his own journals, he noted that he was developing a high tolerance for cocaine. He switched to morphine in an attempt to recreate the desired effect, but he never managed to completely kick his coke habit. He tried a few times, but he could never get below 200 mg of cocaine per day.

Regulating Narcotics

William Halstead was not alone in his cocaine addiction. In the late 1890s and early 1900s, when Halstead was practicing medicine, the addictive and harmful qualities of the drug were coming to light. It was soon abandoned as a medicine, but it found a new application as a recreational drug or stimulant to help laborers be more productive. The Harrison Narcotics Tax Act of 1914 was enacted to staunch the flow of cocaine by making it and other narcotics illegal unless prescribed by a doctor. Fortunately for William Halstead, he was one of those, so this legislation did nothing to restrict his access to the drugs that he needed to fuel his addiction. On September 7, 1922, just a few weeks shy of his 70th birthday, Halstead died of complications from pneumonia. He left a legacy of medical breakthroughs and innovations attached to his name, albeit with a warning to other doctors about the dangers of addiction.