The Surgeon Who Removed His Own Appendix

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On February 15, 1921, Dr. Evan O’Neill Kane decided to test a theory. At the time, people with heart conditions and other serious ailments could not undergo most basic surgeries because general anesthesia was considered too dangerous. Rather than knocking these patients out, Kane wondered if he could simply give them a local anesthetic.

There was only one way to be sure: Kane decided to give himself an appendectomy.

As the chief surgeon at Kane Summit Hospital in Pennsylvania, Kane could probably perform the procedure blindfolded. The 60-year-old physician had performed more than 4000 appendectomies over his 37-year medical career. (Besides, the timing was right: He had chronic appendicitis and the organ needed to be removed anyway.)

For his experiment, Kane decided to numb the area with novocaine. “Sitting on the operating table propped up by pillows, and with a nurse holding his head forward that he might see, he calmly cut into his abdomen, carefully dissecting the tissues and closing the blood vessels as he worked his way in,” The New York Times reported. “Locating the appendix, he pulled it up, cut [it] off, and bent the stump under.” Finished with the dirty work, he let his assistants tie up the wound.

When a reporter visited a few hours later, Kane declared he was “feeling fine” [PDF].

Overall, he was pleased with the procedure. “I now know exactly how the patient feels when being operated upon under local treatment, and that was one of the objects I had in mind when I determined to perform the operation myself,” Kane later explained to The New York Times [PDF]. “I now fully understand just how to use the anesthesia to best advantage when removing the appendix from a person who has heart or other trouble that prohibits the use of a complete anesthesia.”

This was hardly the beginning—or end—to Kane’s career as his own surgeon. Two years earlier, he had amputated his own infected finger. And 10 years after the self-appendectomy, when he was 70, Kane calmly operated on his own hernia, joking with nurses throughout the whole 50-minute operation. Thirty-six hours later, he was back in the operating room, this time patching up other people.

Kane wouldn't be the last doctor to scoop out his own appendix. In 1961, Leonid Rogozov, the sole physician at the Soviet Union's Antarctic research station, performed an emergency self-appendectomy with the station's meteorologist and mechanic as his assistants [PDF]. More recently, Beirut surgeon Dr. Ira Kahn allegedly removed the organ himself in 1986. Unlike Kane, however, Kahn didn’t put himself under the knife for the sake of a medical experiment: Stuck in a traffic jam and unable to make it to the hospital for emergency surgery, he performed the procedure from the comfort of his car.

What Is the Difference Between Heat Exhaustion and Heatstroke

YuriS/iStock via Getty Images
YuriS/iStock via Getty Images

When temperatures begin to climb, many of us can find ourselves growing physically uncomfortable. Indoors or out, warm weather can make us lethargic, sweaty, and nostalgic for winter. There are differences, though, between heat exhaustion—a precursor to more serious symptoms—and heatstroke. So what are they? And how can you treat them?

Heat exhaustion happens when the body begins to overheat as a result of exposure to excessive temperatures or high humidity. (Humidity affects the body's ability to cool off, because sweat cannot evaporate as easily in humid weather.) Sufferers may sweat profusely, feel lightheaded or dizzy, and have a weak or rapid pulse. Skin may become cool and moist. Nausea and headache are also common. With heat exhaustion, it’s necessary to move to a cooler place and drink plenty of fluids, though medical attention is not often required.

If those steps aren't taken, though, heatstroke can set in. This is much more serious and involves the body reaching a dangerous core temperature of 104°F or higher. People experiencing heatstroke may appear disoriented or confused, with flushed skin and rapid breathing. They may also lose consciousness. While heat exhaustion can be treated and monitored at home until symptoms resolve, heatstroke is a medical emergency that requires prompt attention by a health professional. Until help arrives, heatstroke should be treated with cool cloths or a bath, but sufferers should not be given anything to drink.

Although young children and those over the age of 65 are most susceptible to heat-related health issues, anyone can find themselves having a reaction to warm temperatures. If you’re outside, it’s best to drink plenty of fluids, wear light-fitting clothing, and avoid being out in the afternoons when it’s warmest. Because sunburn can compromise the body’s ability to cool itself, wearing sunscreen is also a good idea.

While it’s not always possible to avoid hot or humid weather, monitoring your body for symptoms and returning to a cool space out of the sun when necessary is the best way to stay healthy. If you have older relatives who live alone, it’s also a good idea to check on them when temperatures rise to make sure they’re doing well.

[h/t WWMT]

What You Should Know About Necrotizing Fasciitis, the 'Flesh-Eating' Infection

DragonImages/iStock via Getty Images
DragonImages/iStock via Getty Images

You’ve likely stumbled across one of several recent news stories describing cases of necrotizing fasciitis, or “flesh-eating bacteria.” The condition can follow exposure to certain bacteria in public beaches, pools, or rivers. This July, a man in Okaloosa County, Florida with a compromised immune system died after going into local waters. Just two weeks before, a 12-year-old girl was diagnosed with necrotizing fasciitis after scraping her foot in Pompano Beach, Florida. The stories and their disturbing imagery spread on social media, inviting questions over the condition and how it can be avoided.

According to the Centers for Disease Control and Prevention, necrotizing fasciitis can be caused by different strains of bacteria, with group A Streptococcus (strep) being the most common. When group A strep enters the body through a break in the skin like a cut or burn, a serious and rapidly spreading infection can develop. People will have a high fever, severe pain at the site of exposure, and eventual tissue destruction, which gives the condition its name. Necrotizing is to cause the death of tissue, while fasciitis is inflammation of the fascia, or tissue under the skin.

Because necrotizing fasciitis spreads so quickly, it’s crucial for people to seek medical attention immediately if they see early symptoms: rapid swelling and redness that spreads from a cut or burn, fever, and severe pain. Doctors can diagnose the infection using tissue biopsies, blood work, or imaging of the infected site, though they’ll almost always initiate treatment immediately. IV antibiotics, surgery to excise dead tissue, and blood transfusions are all used in an attempt to resolve the infection.

Even with care, necrotizing fasciitis can lead to complications like organ failure or sepsis. An estimated one in three people who are diagnosed with the condition die.

Fortunately, the condition is extremely rare in the United States, with an estimated 700 to 1200 cases confirmed each year. The CDC acknowledges, however, that the number is likely an low estimate.

Because group A strep can be found in water, the CDC advises people to avoid going into public waters with any kind of open wound. This applies to both public beaches and rivers as well as swimming pools or hot tubs. Chlorination is no guarantee against group A strep. Any cut or other wound should always be cleaned with soap and water. It’s especially important that people with compromised immune systems from illness, diabetes, cancer, or another conditions be exceedingly careful.

Rising ocean temperatures may make necrotizing fasciitis more common, unfortunately. A recent study in the Annals of Internal Medicine suggested that warmer water temperatures in Delaware Bay has allowed another kind of bacteria, Vibrio vulnificus, to flourish, resulting in five cases of necrotizing fasciitis in 2017 and 2018. Previously, only one case had been confirmed since 2008. Florida is also known to harbor group A strep in seawater.

But, owing to its rarity, necrotizing fasciitis should not overly concern people with healthy immune systems and unbroken skin. If you suffer a cut with a reddened area accompanied by severe pain and fever, however, seek medical evaluation right away.

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