An operation for fistula and its creative aftermath

My book Creators was finished some weeks ago and whizzed off to the publishers without my having fixed on any theory of the creative process. But the problem continues to nag at me. Take this example. In October 1841, Dickens was operated on for fistula. This piece of surgery was then horrific and extremely painful, performed without anaesthetic, of course, and often unsuccessful. Macvey Napier, editor of the Edinburgh Review, told Dickens that he had twice been ‘done’ for fistula but twice ‘bungled’, and only on the third shot had it worked: ‘My flesh still creeps at the recollection.’ Dickens was lucky for his surgeon was the remarkable Frederick Salmon (1796–1868) who, despite opposition in his own profession, opened in 1835 his ‘Infirmary for the Relief of the Poor Afflicted with Fistula and the Diseases of the Rectum’ (it is now St Mark’s Hospital). Working over 20 years almost single-handed, he carried out more than 3,500 such operations without a single fatal result.