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Good Morning Doctor! - Chapter 15

The Tracheotomy Tube

Diphtheria, which had been the subject of Dr. Middleton's prophetic lecture and which had brought me my first consultation call, also gave me one of the most tragic experiences in my early career.

It was in 1892 that I was called out into the night, a few miles in the country, to see a "little boy who was choking to death." Arriving I found a seven-year-old lad with membranous diphtheritic croup (in which the membrane forms in the windpipe instead of in the throat). The child was near death unless some immediate relief was given. But since the family doctor had prescribed whiskey I suggested perhaps that better be tried.

I left the home. Three hours later I was called back. The child was worse. Antitoxin, in this advanced case, would be of no avail. I told the family that the infection of the disease had progressed to such a stage that I feared nothing could be done to save his life; but that I could give him temporary relief by the insertion of a tracheotomy tube.

The little fellow was turning blue as I spoke. He was fighting, gasping for breath. His parents begged that I hurry, that I perform the operation without delay.

I had only a pocket instrument case and a tracheotomy tube that I had brought from the office. But there was no time to waste; so I proceeded. By the time I had scrubbed and had boiled the instruments the boy was practically unconscious.

His father held the kerosene lamp over the bed; it was the only light. His mother helped as I directed. Without any local anaesthetic or anaesthesia I opened the trachea and succeeded in inserting the tube. Then, with my own mouth, I sucked out that choking membrane through the tube.

As if by miracle, the child began breathing normally through the tube; his natural color returned; he became conscious and smiled wanly, albeit a bit puzzled.

The mother, sobbing with joy at this relief, clutched my arm. "Oh, doctor, even if he doesn't get well, you must know that I will always be thankful for what you have done."

The poor boy went out from his infection about a week later. He died with the tube still in his throat. His case is typical of what faced the country doctor in those days; twice pitiful in retrospect because with today's knowledge and equipment that life could have been saved.

  Version: World Wide Web Edition Copyright 1995 by Richard Rathe
  Created: October 1, 1995   Modified: July 5, 1999

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