But first, Let me remove my Appendix!

Being a surgeon, I would be the right person to vouch for the fact that it is one of the toughest branches in medicine. After all, cutting open another living being, manipulating their bodies and hoping that they come out of surgery as good as new should send shivers down anyone’s spine. We, the surgeons are known to be serious, some are known to be outgoing and of course a lot of us are supposed to be eccentric. After all, only someone eccentric would dare to operate on himself, don’t you think?

Dr Evan O’Neill Kane might just be one among them. He worked as a surgeon in the hospital started by himself along with a number of family members who also happened to be doctors. The hospital was the Kane Summit Hospital in Pennsylvania. Having done numerous appendectomies (apparently over 4000) over the course of his illustrious career, at the age of 60, Dr Evan was diagnosed to have appendicitis for which he was promptly posted for surgery on 15^th February 1921. He was supposed to be operated by his brother, Dr Thomas L Kane jr.

The day of the surgery arrived, and he lay in the operating room with music playing in the background, for he believed that it helped patients to be calm before a surgery. His brother was standing beside him scrubbed in, ready to start the procedure. Both the surgeon and the patient waited for the anesthetist, Dr Theresa McGregor to finish setting up her equipment so that she could administer the local anesthesia. Just then the patient and our main protagonist for the day, Dr Evan O’ Neill Kane came up with what most would call a mad idea.

Dr Evan propped himself up on his elbows and informed the anesthetist that he had a change of heart and that he would be performing the surgery himself. The declaration obviously caused pandemonium in the operating theatre leaving the nurses, the technicians, the anesthetist and most of all the surgeon shocked. While they stared at him in disbelief, Dr Evan asked a nurse to provide himself some pillows for his back so that he could bend over and get a good view of the operating field i.e. his own abdomen. His brother, the surgeon as per Alex Boese’s his book, Electrified Sheep was supposed to have stepped forward and said “Evan, what are you talking about? Lie down and behave.”

Paying no attention to his brother, Dr Evan instructed the nurse to hand him a scalpel. Then reminding his brother that he was the chief surgeon of the hospital which meant that he outranked him, and so could do as he pleased, put a large incision on his own abdomen after the local anesthesia was administered by the anesthetist. Not being able to digest what was happening, Dr Thomas went and stood in the corner of the Operating room in disgust but didn’t leave as he was of the feeling that Dr Evan would not be able to go through this madness and would need him eventually.

Ignoring everyone, Dr Evan deepened the incision through the layers of the abdomen i.e. the fascia, the muscles and the peritoneum. He then incised the peritoneum (the inner most covering of the abdominal wall) and since he was bending over and operating, his bowel loops jumped out into the open which left him embarrassed. But regaining his composure he then pulled out his caecum where the appendix was attached, observed then appendix and declared that it was so inflamed that it would burst anytime. He then called the assistant surgeon to hold the appendix while he continued the surgery.

Finally, after ligating the all-important appendicular artery, Dr Evan cut off the appendix and handed over the specimen to the nurse. He then closed the layers of the abdomen himself and in the end having no more energy left asked his brother to suture his skin.

He survived to fight another day. In fact, he was fit enough to continue his work as surgeon and went about his business as usual for the next 10 years. If you think that he would have been happy with this experience and would not want to try it out again, then you would be grossly mistaken. For 10 years later, at the age of 70, when Dr Evan was diagnosed to have a hernia, he decided to operate on himself again. The surgery lasted for 1 hour and 55 minutes. He was back in the operating theatre 3 days later to operate on one of his patients.

Many would ask as to what was the whole purpose of this exercise? Why would you subject yourself to such punishment when you have qualified people to do it for you. Honestly, I don’t have an answer except for the fact that it’s because they have the ability to do it. It’s not easy, which is why only a handful of surgeons have tried it. Besides, if he wouldn’t have done it, today probably we wouldn’t know who Dr Evan O’Neill Kane was.

Dr Evan O’Neill Kane might sound like an eccentric after you read about these anecdotes, but he has made numerous contributions to the medical field.  He was a railway surgeon and often had to work in difficult areas with minimum facilities and he devised his own surgical instruments for the same. He also made his own bandages from woven asbestos.

He had numerous theories. One of them being that music helps to soothe a patient before a surgery. That is why, before every surgery (including his own), when the patient is lying on the OT table preparing to be anesthetized, music would be played in the background to calm the patient. Medicos now know about the various studies being made about music therapy on patients with cancer or depression.

But there is another reason why he is remembered and that was because it was sensational as his self-surgery. Dr Evan’s son Elisha Kent Kane was charged with the murder of his wife by drowning her in Chesapeake Bay. Dr Evan Kane managed to get his son acquitted by presenting medical evidence at the trial that his son’s wife Jane had a heart condition which contributed to her drowning.

 

  Appendicitis

 

 

Facts about appendicitis:

1. Appendix is a vestigial organ.
2. It is found at the junction of the ileum with the caecum (i.e. at the junction of the small bowel with the large bowel)
3. Inflammation of the appendix is called appendicitis.
4. If left untreated, the appendix can rupture which can even be fatal.
5. Surgery is not always required. It can be controlled with antibiotics. However, there is a chance of recurrent episodes of pain if the appendix is left alone.
6. Surgery can be done as an open procedure with an incision at the junction of lateral 1/3^rd and medial 2/3^rd between the belly button and the prominent part of the hip bone laterally on the right side.
7. The surgery can also be done laparoscopically.

This Post is a part of the #AToZChallenge for the month of April with the theme #DoctorsAndScientistsWhoSelfExperimented

Also tagging this post to #MondayMusings hosted by Everyday Gyaan