Facts and Fictions of Life

by Helen H. Gardener

"I'd learned how a heart should sound, so one day I tried his. He was in bed then, and it sounded all right, so when the doctor came in, I took him aside, and told him that I didn't want to interfere, but that man was scared about to death over his heart, and it seemed to me it was all right—sounded like other hearts—and his pulse was all right too. The doctor was mad as a March h*are, though he had told me to make two or three tests, and keep the record for him against the time of his next visit. Well, to make a long matter short, the final discovery was—the man don't know it yet, and he is going around in dread of dropping off any minute with heart failure—that at the first examination the man had removed only his coat and vest, and his new suspender on his starched shirt had made the squeak. That is a cold fact, and that man paid over eighty dollars for the treatment he had for his heart, or rather, for his suspender."

I was so interested in the drollery of this ex-nurse, and in his scorn for one branch of a profession, while he entertained almost a superstitious awe and admiration for surgery per se, that I decided upon my return to New York to visit a great surgeon, and ask him to allow me to see an operation that would fairly represent the advance-guard so to speak, the upward reach of the profession as it is to day.

We all know the physician who follows his profession strictly and solely as a means of support. Most of us also happily know something of one or more medical men who are a credit to humanity, in that they subordinate their ability to extort money from suffering to their desire to relieve pain, even though such relief conduces not to their own financial opulence. Very few of us who are not close students of the medical profession realize, I think, some of the magnificent developments not only of surgery, but of the character of the surgeon. We are led to think of them as rather hard and brutal men. The side of their work and nature that means tenderness and devotion to the relief of those who, but for the skilled and brave surgeon, must die or suffer for life, is seldom laid before us. The quiet, sweet, and simple devotion of such men does not reach the public ear.

The operation of which I learned, and which is the first of its kind on record, was so strange, so great, and so far-reaching in its suggestion and promise that it seemed to me it could not fail to interest and inspire the general reader, who never sees a medical or surgical journal, and who would not read it if he did.

Can you think of an operation that would create a mind? Can you conceive of the meaning to humanity of a discovery that would transform a congenital imbecile into a rational being? Such an operation was the one I was privileged to see.

The patient was a child about one year old, of good parentage and of healthy bodily growth, aside from the fact that its skull was that of a new-born child, and it had hardened and solidified into that shape and size. The "soft spot" was not there, and the sutures or seams of the skull had grown fast and solid, so that the brain within was cramped and compressed by its unyielding bony covering.

The body could grow—did grow—but the poor little compressed brain, the director of the intelligent and voluntary actions of the body, was kept at its first estate. Even worse than this, its struggle with its bony cage made a pressure which caused distortion and aimless or unmeaning movement—the arm and leg turned in, in that helpless, pathetic way that tells of imbecility. In short, the baby was a physically healthy imbecile—the most pathetic object on this sad earth. Upon examination, the surgeon, a gentle, sweet-natured man, whose enthusiasm for his profession—for the relief of suffering—makes him the object of devotion of many to whom he has given life and health, and the inspirer and final appeal for many a brother practitioner, discovered what he believed to be the trouble. Led by that most uncommon of all things, common sense, he believed that this little victim of nature's mistake might be changed from a condition far worse than death to one of comfort for itself, and to those who now looked upon it only in anguish of soul.

After explaining to the parents and the surgeons who had come to witness the wonderful experiment (for, after all, at this stage it was but an experiment based upon common-sense) that it might fail; after a modest and simple statement of his reason for undertaking so dangerous an operation, with no precedent before him; after explaining that the parents fully understood that not to try it meant hopeless idiocy, and that the trial might mean death—he began the work. I shall try to tell what it was in language that is not scientific, and may seem to those accustomed to surgical terms inadequate and unlearned; but to those who are not technical medical students I believe the less technical language will be far clearer.

The child's skull was laid bare in front. Two tracks were cut from a little above the base (or top) of the nose up and over to the back of the head. One of these tracks was cut on each side, the surgeon explained, because it would give equal expansion to the two sides of the brain, and because it would cause death to cut through the middle of the top of the head, where lies "the superior longitudinal sinus." He left, therefore, the solid track of bone through the middle, and cut two grooves or tracks through the bone, one on either side, where nature (when she does not make a mistake) leaves soft or yielding edges, by means of which the normal skull expands to fit the needs of the brain within.

The trench made displaced, or cut away, one-quarter of an inch of solid bone all the way from near the base of the nose to the back part of the head. In the middle of the top of the head on each side a cross-wise cut was made, and one inch of bone divided. Another cut was made on either side, slanting toward the ears. This was one inch and a half long. The surgeon then tenderly inserted his forefinger, pressed the internal mass loose from the bones where it adhered, and pushed the bones wider apart. This process widened the trenches to one inch.