Elias Cooper, Danville Surgeon
In 1843 Elias completed his apprenticeship with Esaias in Greenfield, Indiana, and moved to Carrol County in northwest Indiana. There he intended to enter the practice of medicine but was soon dissatisfied with the prospects and, within a few months, moved west to the town of Danville, Illinois, on the Illinois-Indiana state line. 
Elias met with remarkable success in Danville as a medical practitioner. He at once acquired a large practice, from the proceeds of which he realized near $800 per month, an amount which was enormous for a western country practice. It was the surgical cases that interested him most, and among them was a young man with a lesion that required the removal of a large portion of the lower jaw. Elias performed the operation with such poise and skill as to reveal to himself and others his talent, indeed his true vocation, as a surgeon. 
We have no details of this operation, but such a procedure, involving the complex and highly vascular terrain of the face and neck, would demand skill in dissection and experience in the control of bleeding. Strong assistants would be required to restrain the limbs and head of the patient, for anesthesia was still undiscovered. We need not dwell on the starkness of the room in the patient's house where the operation probably took place on an ordinary table with elementary, unsterilized instruments. Infection, its cause yet unknown, was inevitable. In such circumstances, a crowd often gathered outside to await the outcome of the operation, and the surgeon could never predict their mood in case of failure. We shall later further illustrate the status of surgery in the early 1800's by referring to an historic operation performed by Dr. Ephraim McDowell in a neighboring state, an operation that must certainly have kindled yearnings in Elias to become a surgeon.
At the time of the Danville procedure, Elias was 23 years of age and, as far as we can determine, almost entirely self-educated in anatomy and self-trained in surgery. He had never attended a medical school and was thus without formal medical education and credentials. He may have had some surgical experience during his apprenticeship but, if he did, there is not the slightest hint of it in the available records. His decision to undertake and his success in carrying out this difficult operation showed him to be unusually capable and self-assured, qualities he displayed throughout the remainder of his life. Encouraged by his accomplishments in Danville, and seeking a more promising field for the pursuit of his ambitions in surgery, Elias moved to Peoria, Illinois, in 1844 - a phase of his career to which we shall return after a consideration of medical education and practice in the region.
Medical Education West of the Alleghenies
We have now followed Esaias, Elias and Levi through their premedical and medical education and seen them all enter medical practice in their native Northwest. Preceding them in the region were pioneer physicians who recognized that there were only three medical schools in the entire United States when the Territory was opened to settlement in 1787, and all were east of the Alleghenies:
- University of Pennsylvania Philadelphia 1765
- College of Physicians and Surgeons New York 1767
- Harvard Medical School Boston 1782
To found the first medical schools west of the mountains became an irresistible challenge and those who responded to it made medical history. We will now look to the origins of these new schools as a further means of tracing the evolution of medical education in America, and of defining the setting in which Elias's aspirations were awakened. But first an introduction to the outstanding medical figure in the Northwest during its pioneer era - Daniel Drake.