The birth of anesthesia
June 9, 2009 5:55 PM Subscribe
The day pain died. "The date of the first operation under anesthetic, Oct. 16, 1846, ranks among the most iconic in the history of medicine. It was the moment when Boston, and indeed the United States, first emerged as a world-class center of medical innovation. The room at the heart of Massachusetts General Hospital where the operation took place has been known ever since as the Ether Dome, and the word 'anesthesia' itself was coined by the Boston physician and poet Oliver Wendell Holmes to denote the strange new state of suspended consciousness that the city's physicians had witnessed. The news from Boston swept around the world, and it was recognized within weeks as a moment that had changed medicine forever." [Via]
A wise man once said "Pain don't hurt."
posted by Roman Graves at 5:58 PM on June 9, 2009 [5 favorites]
posted by Roman Graves at 5:58 PM on June 9, 2009 [5 favorites]
Brings to mind these previous MeFi posts:
Pain Management as a Human Right.posted by ericb at 6:07 PM on June 9, 2009
Cure for Pain.
A Medical Madoff.
It's arguable that no human invention other than fire has ever been of greater benefit to ourselves.
posted by Joe Beese at 6:07 PM on June 9, 2009
posted by Joe Beese at 6:07 PM on June 9, 2009
It's arguable that no human invention other than fire has ever been of greater benefit to ourselves.
ShamWow?
posted by fire&wings at 6:08 PM on June 9, 2009 [4 favorites]
ShamWow?
posted by fire&wings at 6:08 PM on June 9, 2009 [4 favorites]
It's arguable that no human invention other than fire has ever been of greater benefit to ourselves.
While I agree that anaesthesia was a monumentally beneficial invention, I'm going to argue here that the wheel, the inclined plane, and the lever are all far more useful.
posted by deadmessenger at 6:10 PM on June 9, 2009
MGH and Harvard Medical: "We have conquered pain." A Celebration of Ether.
posted by ericb at 6:12 PM on June 9, 2009
posted by ericb at 6:12 PM on June 9, 2009
I remember reading about this in a little old book from the '60s or so that I had as a kid, called The Great Doctors. It was just after a chapter on Ephraim McDowell, who performed the first successful open abdominal surgery -- before the invention of anesthesia. His patient was a Kentucky farm woman who was suffering from a large uterine tumor, the size of a pregnancy, and had to risk the operation or face a slow death. She chose the operation. He cut her abdomen clean open to remove a tumor much larger than an infant. And she got herself through it by chanting Psalms.
As the book said, "Women were made of stern stuff in Kentucky in those days."
posted by Countess Elena at 6:14 PM on June 9, 2009 [3 favorites]
As the book said, "Women were made of stern stuff in Kentucky in those days."
posted by Countess Elena at 6:14 PM on June 9, 2009 [3 favorites]
deadmessenger: "I'm going to argue here that the wheel, the inclined plane, and the lever are all far more useful."
Not after your next root canal, you're not.
posted by Joe Beese at 6:16 PM on June 9, 2009
Not after your next root canal, you're not.
posted by Joe Beese at 6:16 PM on June 9, 2009
As the book said, "Women were made of stern stuff in Kentucky in those days."
While unverified, I have it on good authority that the surgery was conducted in a freezing blizzard with the gurney rolling uphill the entire time.
posted by Krrrlson at 6:17 PM on June 9, 2009 [2 favorites]
While unverified, I have it on good authority that the surgery was conducted in a freezing blizzard with the gurney rolling uphill the entire time.
posted by Krrrlson at 6:17 PM on June 9, 2009 [2 favorites]
Preston Sturges covered this in The Great Moment. Has anyone seen it?
posted by Kinbote at 6:19 PM on June 9, 2009
posted by Kinbote at 6:19 PM on June 9, 2009
Sorry, but the first anesthetic was given on March 30, 1842, in Jefferson Georgia by Dr. Crawford W. Long. The American Society of Anesthesiologists agrees, and this event is commemorated each year on Doctor's Day.
posted by TedW at 6:20 PM on June 9, 2009 [1 favorite]
posted by TedW at 6:20 PM on June 9, 2009 [1 favorite]
I'm going to argue here that the wheel, the inclined plane, and the lever are all far more useful.
Sure, everybody gives credit to the wheel, but nobody seems to acknowledge that the wheel would be nothing without the lowly axle to keep it steady.
If anything, the wheel is a specific type of axle.
posted by abc123xyzinfinity at 6:20 PM on June 9, 2009 [2 favorites]
Sure, everybody gives credit to the wheel, but nobody seems to acknowledge that the wheel would be nothing without the lowly axle to keep it steady.
If anything, the wheel is a specific type of axle.
posted by abc123xyzinfinity at 6:20 PM on June 9, 2009 [2 favorites]
Funny you should mention, Krrlson -- I just Googled the name of the patient, Jane Todd Crawford, and found this biographical article (embedded pdf), which states that she did in fact climb a hill, on horseback, after fording several rivers, to get to the doctor for her operation.
posted by Countess Elena at 6:33 PM on June 9, 2009 [1 favorite]
posted by Countess Elena at 6:33 PM on June 9, 2009 [1 favorite]
Ether Dome: Two man enter, two man pass out.
posted by spikeleemajortomdickandharryconnickjrmints at 6:40 PM on June 9, 2009 [5 favorites]
posted by spikeleemajortomdickandharryconnickjrmints at 6:40 PM on June 9, 2009 [5 favorites]
Oliver Wendell Holmes Sr. was an interesting character. He originally trained as a lawyer and wound up switching to medicine halfway though. During his transition, he wrote the alternatingly hilarious and prattling The Autocrat of the Breakfast Table. As a doc, his other achievements include the advancement of germ theory & the stethoscope, holding the contentious position that surgeons who washed their hands ended up losing fewer patients to infection. Oh, and he's also the father of one of the greatest Supreme Court Justices ever to take the bench.
posted by The White Hat at 6:40 PM on June 9, 2009
posted by The White Hat at 6:40 PM on June 9, 2009
As the book said, "Women were made of stern stuff in Kentucky in those days."
While unverified, I have it on good authority that the surgery was conducted in a freezing blizzard with the gurney rolling uphill the entire time.
Funny you should mention, Krrlson -- I just Googled the name of the patient, Jane Todd Crawford, and found this biographical article (embedded pdf), which states that she did in fact climb a hill, on horseback, after fording several rivers, to get to the doctor for her operation.
Yes, I do believe Krrlson got well and thoroughly pwned here. Indubitably, this is mighty mighty pwnage.
posted by effugas at 6:50 PM on June 9, 2009 [3 favorites]
While unverified, I have it on good authority that the surgery was conducted in a freezing blizzard with the gurney rolling uphill the entire time.
Funny you should mention, Krrlson -- I just Googled the name of the patient, Jane Todd Crawford, and found this biographical article (embedded pdf), which states that she did in fact climb a hill, on horseback, after fording several rivers, to get to the doctor for her operation.
Yes, I do believe Krrlson got well and thoroughly pwned here. Indubitably, this is mighty mighty pwnage.
posted by effugas at 6:50 PM on June 9, 2009 [3 favorites]
Sorry, but the first anesthetic was given on March 30, 1842, in Jefferson Georgia by Dr. Crawford W. Long. The American Society of Anesthesiologists agrees, and this event is commemorated each year on Doctor's Day.
posted by TedW at 8:20 PM on June 9 [+] [!]
that's gotta hurt, homunculus.
posted by lester at 6:56 PM on June 9, 2009
posted by TedW at 8:20 PM on June 9 [+] [!]
that's gotta hurt, homunculus.
posted by lester at 6:56 PM on June 9, 2009
While I agree that anaesthesia was a monumentally beneficial invention, I'm going to argue here that the wheel, the inclined plane, and the lever are all far more useful.
SlapChop? Gratey?
posted by fire&wings at 7:01 PM on June 9, 2009
SlapChop? Gratey?
posted by fire&wings at 7:01 PM on June 9, 2009
I'd just like tp give a big shout out to valium (and nitrous oxide) because it made the removal of my wisdom teeth a pleasurable experience.
posted by Sargas at 7:11 PM on June 9, 2009
posted by Sargas at 7:11 PM on June 9, 2009
The day pain died
Some surgery is downright traumatic no matter how many morphine drips your mainlining.
posted by stbalbach at 7:28 PM on June 9, 2009
Some surgery is downright traumatic no matter how many morphine drips your mainlining.
posted by stbalbach at 7:28 PM on June 9, 2009
I attended a conference in the Ether Dome once - cool place, but the seats are really uncomfortable. I don't have a joke here, I just wanted it noted.
posted by blahblahblah at 7:43 PM on June 9, 2009
posted by blahblahblah at 7:43 PM on June 9, 2009
Holmes took note of the controversy over who was really the first to use anesthesia. He called the statue in the Public Garden (which only depicts ether allegories, not Morton) "a monument to ether - or either."
posted by adamg at 7:49 PM on June 9, 2009
posted by adamg at 7:49 PM on June 9, 2009
Yes, I do believe Krrlson got well and thoroughly pwned here. Indubitably, this is mighty mighty pwnage.
You use that word a lot. I do not think it means what you think it means.
posted by Krrrlson at 7:51 PM on June 9, 2009
You use that word a lot. I do not think it means what you think it means.
posted by Krrrlson at 7:51 PM on June 9, 2009
Sorry, but the first anesthetic was given on March 30, 1842, in Jefferson Georgia by Dr. Crawford W. Long. The American Society of Anesthesiologists agrees, and this event is commemorated each year on Doctor's Day.
Ouch.
posted by homunculus at 7:52 PM on June 9, 2009
Ouch.
posted by homunculus at 7:52 PM on June 9, 2009
I can recommend Ether Day if you're interested in this story. The descriptions of operating theatres pre-anaesthetic with the holding chains, restraints etc. that were necessary to hold a patient still, are harrowing to read.
posted by tellurian at 8:25 PM on June 9, 2009
posted by tellurian at 8:25 PM on June 9, 2009
The descriptions of operating theatres pre-anaesthetic with the holding chains, restraints etc. that were necessary to hold a patient still, are harrowing to read.
No thanks, I'd like to sleep again sometime this year. *shudder* Every time I have to have some minor procedure done, I'm always a bit grateful for the various chemicals they stuff me with. Even if, as I've discovered, some of them don't actually knock you out, they just make you forget about it as it happens. I was a little surprised when the surgeon said he intended to perform my last hernia repair directly under local anesthetic. Eep! But in retrospect, while I might have been awake for it, I don't remember much more of the surgery than I do when I went under general anesthetic. Yay for modern science!
posted by Kyol at 8:30 PM on June 9, 2009
No thanks, I'd like to sleep again sometime this year. *shudder* Every time I have to have some minor procedure done, I'm always a bit grateful for the various chemicals they stuff me with. Even if, as I've discovered, some of them don't actually knock you out, they just make you forget about it as it happens. I was a little surprised when the surgeon said he intended to perform my last hernia repair directly under local anesthetic. Eep! But in retrospect, while I might have been awake for it, I don't remember much more of the surgery than I do when I went under general anesthetic. Yay for modern science!
posted by Kyol at 8:30 PM on June 9, 2009
Hee! The ASA have Who was first? T-shirts.
posted by tellurian at 8:36 PM on June 9, 2009 [1 favorite]
posted by tellurian at 8:36 PM on June 9, 2009 [1 favorite]
Ouch.
posted by homunculus at 10:52 PM on June 9
Actually, I enjoyed the post (I appreciate any positive PR for anesthesiology), so thanks for posting it. As is often the case with scientific/medical discoveries the story isn't that simple. The quest for effective surgical pain relief/anesthesia (which is usually defined as not just pain relief, but loss of all sensation, loss of autonomic response to surgery, lack of movement in response to surgery, and loss of ability to recall the procedure-or some similar definition) has obviously gone on ever since the first surgeries were done. Wikipedia gives a pretty good overview; to sum up a little, drugs such as ethanol and opium were used for centuries to make operations such as amputations and lithotomies somewhat bearable. As medicine began to modernize around the turn of the 18th-19th centuries, people began to look for better anesthetics. Humphrey Davy speculated that nitrous oxide might be useful but never followed up on it; Henry Hickman experimented with carbon dioxide but got poor results. The potential usefulness of ether in this role had been noted by many people, including Crawford Long when he attended ether frolics at the nearby University of Georgia (plus ça change...). Eventually he tried on a patient with good results but didn't publish it for some time. The reason why is unclear; some have speculated that it was because he was in a somewhat rural area and didn't have access to urban journals; others have said he waited until he had a series of several patients in order to make sure his results weren't a fluke. While he was waiting to write up his experience (which he did in 1849) a dentist named Horace Wells began experimenting with nitrous oxide (although others may have used it for minor dental procedures earlier) and decided to give a public demonstration of its use in surgery. We now know that nitrous oxide is not effective as a general anesthetic unless given at greater than one atmosphere of pressure (as in a hyperbaric chamber), and so Wells demonstrations failed and he was viewed as a charlatan. His partner, one W. T. G. Morton, kept on looking for a suitable drug, and somehow happened upon ether, with the help of C. T. Jackson. That is when the events described in the original post happen. From there, the acceptance of anesthesia by the medical community is pretty straightforward, with some setbacks and resistance, but generally moving ahead (I will save the Queen Victoria and obstetric anesthesia story for later). What makes for more drama, however, is the epilogue. Wells, Jackson, and Morton, all claimed to be the sole discoverer/inventor of anesthesia, and sought to profit from it by such things as patenting it under the name "Letheon" and petitioning congress for a reward for their discovery. They became bitter enemies and Wells and Jackson met unseemly ends. Wells committed suicide by slicing open his femoral artery after throwing acid in the face of a prostitute (and also while under the influence of chloroform, the English contribution tot he early anesthetic armamentarium); Jackson died in an insane asylum. Long, in contrast, concentrated his efforts on his medical practice (although maintaing that he was the discoverer of anesthesia) and enjoyed a successful career. He died of a stroke delivering a baby; his last words were reportedly "care for the mother and child first".
A good summary of the story of anesthesia's beginnings can be found here. More detailed accounts can be found in American Heritage and at the Wood Library-Museum.
My brother got married in Boston a few years ago, and of course my wife, daughter, and me went to see the Ether Monument. We took our picture in front of it wearing Crawford Long t-shirts, purchased at the Crawford Long Museum.
I know this is long, but this is a subject I have a personal interest in on a variety of levels. So if you stuck with me this long, thanks for reading, and I am glad to see the discussion this post has generated.
On preview, I agree with tellurian that Ether Day is worth a read; it gives short shrift to Long, but goes into a lot of detail about the Boston contingent. Also, I normally wouldn't include so many wikipedia links in a post this long, but it is late and I am getting tired and lazy.
posted by TedW at 9:43 PM on June 9, 2009 [8 favorites]
posted by homunculus at 10:52 PM on June 9
Actually, I enjoyed the post (I appreciate any positive PR for anesthesiology), so thanks for posting it. As is often the case with scientific/medical discoveries the story isn't that simple. The quest for effective surgical pain relief/anesthesia (which is usually defined as not just pain relief, but loss of all sensation, loss of autonomic response to surgery, lack of movement in response to surgery, and loss of ability to recall the procedure-or some similar definition) has obviously gone on ever since the first surgeries were done. Wikipedia gives a pretty good overview; to sum up a little, drugs such as ethanol and opium were used for centuries to make operations such as amputations and lithotomies somewhat bearable. As medicine began to modernize around the turn of the 18th-19th centuries, people began to look for better anesthetics. Humphrey Davy speculated that nitrous oxide might be useful but never followed up on it; Henry Hickman experimented with carbon dioxide but got poor results. The potential usefulness of ether in this role had been noted by many people, including Crawford Long when he attended ether frolics at the nearby University of Georgia (plus ça change...). Eventually he tried on a patient with good results but didn't publish it for some time. The reason why is unclear; some have speculated that it was because he was in a somewhat rural area and didn't have access to urban journals; others have said he waited until he had a series of several patients in order to make sure his results weren't a fluke. While he was waiting to write up his experience (which he did in 1849) a dentist named Horace Wells began experimenting with nitrous oxide (although others may have used it for minor dental procedures earlier) and decided to give a public demonstration of its use in surgery. We now know that nitrous oxide is not effective as a general anesthetic unless given at greater than one atmosphere of pressure (as in a hyperbaric chamber), and so Wells demonstrations failed and he was viewed as a charlatan. His partner, one W. T. G. Morton, kept on looking for a suitable drug, and somehow happened upon ether, with the help of C. T. Jackson. That is when the events described in the original post happen. From there, the acceptance of anesthesia by the medical community is pretty straightforward, with some setbacks and resistance, but generally moving ahead (I will save the Queen Victoria and obstetric anesthesia story for later). What makes for more drama, however, is the epilogue. Wells, Jackson, and Morton, all claimed to be the sole discoverer/inventor of anesthesia, and sought to profit from it by such things as patenting it under the name "Letheon" and petitioning congress for a reward for their discovery. They became bitter enemies and Wells and Jackson met unseemly ends. Wells committed suicide by slicing open his femoral artery after throwing acid in the face of a prostitute (and also while under the influence of chloroform, the English contribution tot he early anesthetic armamentarium); Jackson died in an insane asylum. Long, in contrast, concentrated his efforts on his medical practice (although maintaing that he was the discoverer of anesthesia) and enjoyed a successful career. He died of a stroke delivering a baby; his last words were reportedly "care for the mother and child first".
A good summary of the story of anesthesia's beginnings can be found here. More detailed accounts can be found in American Heritage and at the Wood Library-Museum.
My brother got married in Boston a few years ago, and of course my wife, daughter, and me went to see the Ether Monument. We took our picture in front of it wearing Crawford Long t-shirts, purchased at the Crawford Long Museum.
I know this is long, but this is a subject I have a personal interest in on a variety of levels. So if you stuck with me this long, thanks for reading, and I am glad to see the discussion this post has generated.
On preview, I agree with tellurian that Ether Day is worth a read; it gives short shrift to Long, but goes into a lot of detail about the Boston contingent. Also, I normally wouldn't include so many wikipedia links in a post this long, but it is late and I am getting tired and lazy.
posted by TedW at 9:43 PM on June 9, 2009 [8 favorites]
The BBC Radio-4 program In Our Time did a great show about Anesthesia. It blows my mind that Anesthesia was frowned on because God made us hurt since we learned about good and evil in the garden.
posted by Uncle at 9:47 PM on June 9, 2009
posted by Uncle at 9:47 PM on June 9, 2009
It blows my mind that Anesthesia was frowned on because God made us hurt since we learned about good and evil in the garden.
You say that like it's in the past tense; have you heard the crap women get for wanting pain relief in childbirth?
posted by rodgerd at 10:00 PM on June 9, 2009
You say that like it's in the past tense; have you heard the crap women get for wanting pain relief in childbirth?
posted by rodgerd at 10:00 PM on June 9, 2009
For a description of pre-anesthesia surgery, see Fanny Burney's extraordinary account the mastectomy she endured in 1811.
posted by jokeefe at 10:20 PM on June 9, 2009 [1 favorite]
posted by jokeefe at 10:20 PM on June 9, 2009 [1 favorite]
I didn't want to read that jokeefe. But I did.
posted by tellurian at 11:06 PM on June 9, 2009 [1 favorite]
"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 & 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."And now I can't un-read it.
posted by tellurian at 11:06 PM on June 9, 2009 [1 favorite]
The Monument to Ether is the single weirdest statue I have ever seen. I walk by it on a daily basis and it never ceases to look like the doctor just killed the dude and is now ripping rags out of his lifeless ribcage.
posted by grapefruitmoon at 4:01 AM on June 10, 2009
posted by grapefruitmoon at 4:01 AM on June 10, 2009
At the risk of repeating myself
Update: I'm getting my wisdom teeth taken out TOMORROW. Can't afford the gas, so getting the needle. Thankfully they're all fully-out so no digging around in the jaw ahhhhh! I'm getting the creeps just thinking about it wonder if it's too late to get the gas..
posted by The Whelk at 7:24 AM on June 10, 2009
Update: I'm getting my wisdom teeth taken out TOMORROW. Can't afford the gas, so getting the needle. Thankfully they're all fully-out so no digging around in the jaw ahhhhh! I'm getting the creeps just thinking about it wonder if it's too late to get the gas..
posted by The Whelk at 7:24 AM on June 10, 2009
I just wanted to pop in to give a shout out for the fine Boris Karloff movie Corridors of Blood. It's about a doctor experimenting with opium as an anesthetic, gets addicted, and of course falls in with a gang of murderers and grave-robbers.
posted by marxchivist at 7:42 AM on June 10, 2009
posted by marxchivist at 7:42 AM on June 10, 2009
A story I heard, repeated in the link above about "anethesia's beginnings" was that ether was first used as a fun alternative to alcohol at parties. When one doctor noticed bruises the next day from some unremembered collision, the idea first occurred to him that ether would make a good anesthetic.
So let's drink (or inhale) to recreational drug use!
posted by kozad at 9:05 AM on June 10, 2009
So let's drink (or inhale) to recreational drug use!
posted by kozad at 9:05 AM on June 10, 2009
And all this time I thought a large rabbit delivered it to mankind in a basket on a springtime Sunday morning.
All my childhood beliefs are now shattered.
First the Sanity Clause, now the Ether Bunny.
posted by Floydd at 9:20 AM on June 10, 2009
All my childhood beliefs are now shattered.
First the Sanity Clause, now the Ether Bunny.
posted by Floydd at 9:20 AM on June 10, 2009
jokeefe, I was just looking for my hardback copy of Eyewitness to history to type out some excerpts from Burney's account. I read it years ago and just the memory still makes me shiver. Not only that she endured it, but that she had the fortitude to write a blow-by-blow account of it.
Glad to see it's on the web.
posted by goofyfoot at 1:10 PM on June 10, 2009
Glad to see it's on the web.
posted by goofyfoot at 1:10 PM on June 10, 2009
"It was just after a chapter on Ephraim McDowell, who performed the first successful open abdominal surgery -- before the invention of anesthesia. His patient was a Kentucky farm woman who was suffering from a large uterine tumor, the size of a pregnancy, and had to risk the operation or face a slow death. She chose the operation. He cut her abdomen clean open to remove a tumor much larger than an infant. And she got herself through it by chanting Psalms."
This gentleman was part of a family I married into, and the story they tell is just like this one, passed down through the ages. I actually saw a very old movie on TV about this. (I've married into several families; this is the only one that comes with an interesting story.)
posted by unrepentanthippie at 7:37 PM on June 10, 2009
This gentleman was part of a family I married into, and the story they tell is just like this one, passed down through the ages. I actually saw a very old movie on TV about this. (I've married into several families; this is the only one that comes with an interesting story.)
posted by unrepentanthippie at 7:37 PM on June 10, 2009
You say that like it's in the past tense; have you heard the crap women get for wanting pain relief in childbirth?
That actually depends on the culture in which she's giving birth. Here in France, midwives and obstetricians tend to be wary of women who refuse epidurals.
Incidentally, James Young Simpson first used chloroform to ease the pain of childbirth. Queen Victoria popularized its use when she had some in 1853.
posted by Lezzles at 8:47 AM on June 12, 2009
That actually depends on the culture in which she's giving birth. Here in France, midwives and obstetricians tend to be wary of women who refuse epidurals.
Incidentally, James Young Simpson first used chloroform to ease the pain of childbirth. Queen Victoria popularized its use when she had some in 1853.
posted by Lezzles at 8:47 AM on June 12, 2009
That actually depends on the culture in which she's giving birth. Here in France, midwives and obstetricians tend to be wary of women who refuse epidurals..
Unfortunately I'm in the culture where there is the opposite extreme; it is nicely summed up with:
posted by rodgerd at 11:31 PM on June 13, 2009
Unfortunately I'm in the culture where there is the opposite extreme; it is nicely summed up with:
“Childbirth instructors describe epidurals as unnecessary, or even harmful, interventions and make women feel that requesting one is a sign of weakness that may harm their baby. Labour is seen as an extreme sport - ‘no pain, no gain' - and yet this quasi-religious fervour is based on myth and misconception. The founders of natural childbirth movements NCT and Lamaze, both men, incidentally, claimed that women in primitive cultures experienced no pain in labour. Pain in childbirth, they claimed, is a product of Western civilised society - a learned phenomenon. The implication was that if women breathed ‘properly' or assumed the ‘correct' positions, the labour would be pain-free. Women were made to feel they had failed if they asked for pain relief. There is evidence that in all cultures giving birth has been a painful experience,” says Grant.I'm sure the French approach has pitfalls of its own, but I wouldn't expect to try passing a gall stone without some sort of pain relief.
posted by rodgerd at 11:31 PM on June 13, 2009
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posted by Nelson at 5:57 PM on June 9, 2009