The Science of Stephen King

Author Paul Sheldon is in a unique situation. Because of his severe injuries, he has to rely on a stranger. Since he is the protagonist of a Stephen King novel, this stranger naturally wants to kill him. Or, as well remembered in the brutal iconic film version, at least maim him! Much like Jessie Burlingame in King’s novel Gerald’s Game (1992), Paul is tortured by his inability to control his environment. He is trapped and must rely on his wits, rather than any physical prowess, in order to escape.

In the modern age, we are used to immediate medical attention. Yet, Annie manipulates the dire situation of a car crash in a snowstorm to her benefit. As Paul Sheldon’s “number one fan,” she is displeased by the trajectory of his career, and decides to resurrect her favorite character, Misery. She holds complete control over him, as he desperately needs pain medication to minimize his suffering.

Since Paul is far from the care of a mentally sane medical worker, we started to wonder how broken limbs were tended to in years past.

Sally Mapp was a famous bone setter in eighteenth-century UK. Known as “Crazy Sally,” she earned up to a hundred guineas a year because of her impressive skills.

Through writings, researchers have been able to discover how the rather common accident of a broken limb was tended to. In the Netherlands, an audience can watch a reenactment at the Archeon museum. Based on their understanding of the medieval times, “archeo-interpreters” as they call themselves, showcase what would happen to a man with a broken leg. By studying the thirteenth-century manual Cyrurgia, by surgeon Jan Yperman, they perfectly reconstructed the medieval bone-setting contraption, down to the same ash wood.

The Cyrurgia divided the traumatic conditions and treatments of the human body into seven chapters, ranging from the head to the feet. In the seventh and final chapter “from the neck and throat down,” Yperman addressed the fracture treatment. If necessary, the texts from Cyrurgia were supplemented with information from the book about the surgery of Yperman’s contemporary colleague, the Parisian surgeon Guy de Chauliac, who lived from 1300 till 1368.1

According to the text, two people hold the rectangular device on either end of the broken limb, while the surgeon massages the offending bone back into place. Interestingly, after twelve days of healing, a cast was applied, even as far back as 1350! This cast was made with linen scraps covered in wax, lard, and white resin heated in a pan.

In 2005, an excavation in Colorado revealed evidence of hobbling in remains from the year 800.

These acts of bone setting, where the bone would be painfully set back with force, continued for centuries. By the sixteenth century, bone setters were sent to work with soldiers. Often, if surgeons with these abilities were not available, blacksmiths were relied upon for the brutal wrenching of bones. As the nineteenth century dawned, there were more regulations about who could properly help those with broken limbs. Because of the 1858 Medical Act, surgeons had to be schooled and registered, and so blacksmiths and midwives were no longer able to set bones for a fee.

Annie Wilkes, of course, was not so concerned with any regulations, as she finds every excuse not to provide Paul Sheldon with proper care. In fact, pain relief becomes the ultimate bribery. As described, we have come a long way from the archaic methods to the opioids used in Misery:

Bone setting could be extremely painful, and pain was excruciating during amputations. Before 1853, only a few substances were available to dull pain, but these efforts were generally unsuccessful and many surgeons relied on their patients to faint from pain as a method of relief. A person in shock would feel less pain and bleed less, for their lower blood pressure would reduce the flow of blood, in the case of a jagged bone. Methods of pain control included: icing the limb, prescribing laudanum, drinking alcohol, and providing nerve compression or hypnosis. Icing the limb was problematic in that carting ice was a hugely expensive and laborious procedure, and storage through the warm months required ice houses and was available to only a few.2