I must confess I have a hard time following your logic. Is it correct to say that you object to this kind of procedure simply because it looks rather grisly (I dare say! - Aztec cardiology and all that)? Your earlier comment, "It is not the outcome that I am drawing a comparison on, it is the activity." leads me to that conclusion.

I wouldn't have the option of open heart surgery without anesthetic, and several other technologies - remember my heart was not beating and in a certain sense I was dead with a fairly sophisticated heart lung machine continuing to maintain my organs, as well as a whole bunch of items of which I remain oblivious. I am fairly certain I was not a pretty sight on the table in the OR. But the outcome was extremely positive - I have remained fairly vigorous, continuing active fieldwork and doing a lot of bike riding. I ran into a chap the other day who had undergone the very same procedure and he was also rather vigorous, positive, and pleased with the final result.

I understand that surgical procedures were unspeakably primitive during the Civil War era, but fortunately that era is behind us and therefore irrelevant.

Let me offer an analogy - running a marathon. One endures a lot of physical punishment and pain, with the risk of traumatic injury. My first marathon (I completed five), especially, was really rough, particularly the last five miles, and I could barely walk the next day. Was it worth it? Absolutely! I was hurting, but I was extremely happy, satisfied, and content. One gets the same result on any challenging undertaking - finishing and writing up research, for instance. Go through the fire, achieve the objective, and enjoy the result. Pain inflicted becomes rather minor.