A hardly-known fact is that many of the people who had surgery in infancy before the 1990s were not given a general anesthetic, and of these not everyone was given pain killers. This awful fact has understandably been kept out of the public domain as much as possible, which was not very difficult before the advent of the internet and social media, but it is now reported and conceded by many.
Giving a general anesthetic to infants in the first two years was too complex and risky for many doctors until the later 20th century, and because locally administered painkillers affect the tissue around the incision, many surgeons chose to have their infant patients simply intubated (given an artificial breathing tube down their throat) and then paralysed. It seems parents were rarely told the details of what infant surgery involved, and probably chose not to ask. After all, the life of their new treasure was at stake. Can we blame them?
Most medical students accepted the mantra that “babies do not feel or remember pain” and so surgical procedures ranging from circumcision to abdominal and chest surgery were often done without pain management – and without much further concern.
Several of my posts have been about the huge change forced on the medical establishment by the research, writing and advocacy of Drs K J S Anand and P R Hickey since 1987. (You can find these posts using the “Categories” Search-box at the top right.) Together with their work, it also became clear that many who had had early surgery without pain control had struggled (usually lifelong) with post-traumatic stress. The late Dr David Chamberlain, the late Dr Louis Tinnin, Dr Robert Scaer and others have studied, published material on pre-verbal memory and trauma, and developed therapies to treat PTSD arising from infant trauma caused by abuse, surgery, and tragedy.
One of the links most relevant to these matters is to the blogsite Restory your Life, published by my friend and blogging colleague Wendy P Williams. Her blogging has concentrated on what has been written about PTSD after infant surgery, and on therapies that have been developed and found helpful.
But there is always more to be said and explored on this subject area.
This past month I received an email from Sarah, which I pass on with minimal editing –
Firstly, just wanted to say thanks for your great blog. I have found a lot of reassurance and inspiration. My infant trauma was different, but as you know there’s not a lot of info out there, especially written by people who have experienced it, so it’s been so helpful. Also I’m sorry for what you went through and how it was (not) handled. It’s great that you’re helping to make things better for babies now, I hope that also gives your young self some comfort.
I found some more stuff and you may already have it, but thought I’d send it just in case you haven’t.
The first is the book The Trauma Spectrum by Robert Scaer. It has a really great chapter on pre-verbal trauma. He also points out similar things to you about infant pain management. It’s ridiculous to think babies wouldn’t feel pain.
The second is an article by Dr Bruce Perry, How we remember. It’s about infant sexual abuse, but I think the principles are the same.
The third is a PDF written for caregivers of traumatised children and infants. It’s by Dr Perry too.
Fourth, a book called Transformative Nursing in the NICU: Trauma-Informed Age-Appropriate Care by Mary Coughlin. Can’t afford it and haven’t read it, but it looks like something all medical professionals helping infants could really use.
People think I’m kind of weird when they find out how much I think and read about trauma, so it’s sort of nice to ‘meet’ another person who has handled theirs in one similar way.
Well, keep up the excellent work, I wish you all the very best.
In response to my emailed thanks and response, Sarah replied –
Of course you can pass my email on, and put on your website. It’s the least I can do to thank you for your very much appreciated blog. Thanks for introducing g me to Wendy’s blog, I really liked the artwork. It was interesting hearing a little more about how you found healing, I somehow imagine a lot of us are big readers. The networking is such a good idea, I’m glad you eventually managed to find more people.
I found another book, it’s called Pre-Parenting: Nurturing Your Child from Conception. The relevant bit is about how even foetuses have consciousness, memory, feelings and other important things. It has some amazing stories of very young kids accurately telling their birth stories when they learn to talk. Interesting to think about what he’s written in the context of infant trauma.
Thanks and best wishes to you too.
I had infant surgery to relieve a fairly common and fatal stomach blockage (pyloric stenosis) in the dim, distant and tongue-tied past; in 1945 most people didn’t talk about unpleasant matters. So I know almost nothing about the operation and associated matters and had no help in coming to terms with their consequences. It has taken me much of my lifetime to piece together the puzzle parts that tell me that whatever happened to me (and my parents) resulted in the clear symptoms of PTSD (albeit mild) with which I have struggled until recent years.
PTSD which results from something that happened in our infancy is lodged in our pre-verbal memory. This makes it more complex and much harder to recognise, understand and treat than traumatic events which we can consciously remember.
Sarah’s emails and the references she has shared here underline that people struggle with PTSD caused by all kinds of events which they have remembered pre-verbally (in their “somatic” or body memory).
Sarah has also reminded me that all those affected by infant trauma share similar feelings and frustrations, and can draw on the same interpretations and treatment of our symptoms.
And finally, Sarah’s reference links make me feel encouraged that there are always more people than I had known about or imagined working to bring healing to those of us affected by trauma of infancy.