Infant surgery then and now

Infant surgery has seriously affected some of us whose lives were saved by it.

This is especially true of those like me who are now at the older end of life: we have been affected emotionally and psychologically despite having no conscious memories of the surgery we had so early in our lives.  Our bodies record potent trauma even when our mind cannot.  This does not seem to affect everybody but others’ stories and tell-tale signs are too similar to reject as fiction.

Surgery in the past was rather basic, especially when performed on infants and in the light of current practice. Often in the not-too-distant past no safe general anesthetic and trained pediatric (children’s) anesthetist were available: general anesthetic agents were hazardous for infants in their first two years unless a very careful and experienced anesthetist was available.

Local anesthesia affects the tissue at the operative site, making it hard to work on, so many surgeons would also exclude its use.  So the squirming baby was strapped down, and quite often given a shot of whisky or a sugar cube laced with rum to somewhat distract it.  Or a paralysing drug was injected and a breathing tube inserted.  No picnic for the baby, and it must have been tough on the operating room staff.

The hospital regime then was also “different”.  Two weeks or more in hospital was standard after an “uneventful” pyloric stenosis (“PS”) operation, and often the mother was allowed no contact for fear of infection, which still killed about 50% of PS babies post-op in UK public hospitals after WW2.  I understand my mother had to deliver breast milk daily over 15 km to the hospital for 2 weeks but was never allowed near me, let alone nurse me.  (My surgery was at 10 days so what an introduction to nursing her first baby I was for her…)

Starvation pre-op plus surgical shock plus maternal deprivation – none of it remembered of course, but it has really affected me and others of that generation long term.  Add to that: some years later, these baby-boomer and earlier parents were totally unaware and incapable of managing their own and their growing child’s developing ptsd.

Woodstock-1But hey!  Ever since Dr Conrad Ramstedt and others began publicising their newly discovered “pyloromyotomy procedure”, most of us PS babies no longer died of dehydration and starvation.  Even those who had the PS op in its early days have mostly lived to tell their tales and have often lived well.

But I am also very thankful that despite the many post-op issues reported on Facebook and other form sites, some of the old damage is no longer being inflicted today.  Infant surgery today, even in its most severe forms, is now far less traumatic for all concerned, and most hospital regimes are sensitive and aware.

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2 thoughts on “Infant surgery then and now

  1. Wendy

    You capture so well what we pyloric stenosis survivors went through. The situation was very complex. I must add that the medical profession also believed early on that babies didn’t feel pain – that their nervous systems weren’t developed enough to transmit it. Perhaps this belief helped them operate on the squirming, little baby that had to be tied down. You are so right – it must have been hard on the doctors and the staff. Still, it’s an important piece to integrate into the picture. I don’t know if all medical personnel believed this, but the belief was part of medical pedagogy and is documented. Thanks for reminding us what ps survivors went through back in the day. I got back in touch with compassion for myself after reading your post.

    Reply
    1. Fred Vanderbom Post author

      Thank you so much, Wendy, for your appreciative comments which as always also add something significant to what I wrote. My research tells me that over the years surgeons working with infants have understandably had a range of preferences and techniques. The “babies don’t feel or remember pain” mantra seems to have been as loud and powerful in the medical world (and thus in its consulting rooms) as the “cigarette smoking is harmless” shout was when I was younger. Professional articles conventionally do not usually include comments of a personal nature, but I have noted that the British surgeon Dr David Levi wrote many articles about PS surgery in the 1930s and 40s, and often mentioned his preference for as light as possible a use of ether for this surgery – but without reference to the “babies and pain” mantra. We know so much more today!

      Reply

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