THE STORIES SURROUNDING "surgical firsts" inevitably provide interesting medical lore. Whether it is a surgeon's biography containing a suspenseful description of how he or she conceived a groundbreaking operation, or a distasteful tale of bickering professionals claiming one-upmanship, surgical firsts are part of our professional heritage. One accepted historical truth is that the first recorded surgical operation in North America occurred in 1535 when Álvar Núñez Cabeza da Vaca (1490?-1557?), a shipwrecked Spanish explorer, removed an arrowhead from an American Indian's thoracic cavity. The operative report was included in da Vaca's 1542 account of the ill-fated expedition. In 1684, Increase Mather (1639-1723), a minister based in Boston, Mass, authored his Remarkable Providences Illustrative of the Earlier Days of American Colonisation. In this work, he provides what is considered the first written account, albeit some 40 years after the event and without eyewitness verification, of a surgical operation performed in the colonies. Mather tells of a child whose skull was pierced by an iron hinge. Within a few weeks, a growth "as big as a small egg" appeared. The child's parent called on the services of a Mr Oliver, an English surgeon who resided in Boston from 1632 to 1644. According to Mather, Oliver "drove the soft matter of the bunch [growth] into the wounds, and pressed so much out as well he could . . . the skull wasted where it was pierced."