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Tuesday, October 6, 2015

Because a Doctor Can Doesn't Mean a Doctor Should

Aunt Minnie's daughter, Geraldine Mary Swick, presents another example of the shortcomings of medicine at the beginning of the 20th century. Geraldine was born in 1914, something of an afterthought apparently, as her brother and sister were fourteen and thirteen years older than she. As the youngest child, she was somewhat spoiled, and she also benefitted from the family's improved living standards while she was growing up. Oh, they still used the outhouse, and pumped water from a well, but she was healthy and well-fed for her entire childhood.

At the age of fifteen she bloomed into a real beauty. Her eyes were deep-set (a McCaskey trait), her features perfect in their regularity, and she had thick, glossy ash blond hair which she wore piled high on her head.  My mother described her as fun-loving, charming, talented, and the top student in her one-room school-house.

Then tragedy struck again. She fell suddenly ill, running a high fever, and doubled over with abdominal pain.  Grandma McCaskey tried every little fever and nausea pill in her arsenal but without results. As her condition worsened, her parents loaded her into the back of a farm wagon and drove her into Ellwood City to find a doctor who could help. The town had its own hospital but no emergency room.  Three doctors took turns being on call, but for anything more serious than a case of tonsillitis, they had to send patients on to Pittsburgh, some thirty miles away. This night, there was no time for such a trip.  Diagnosing acute appendicitis, the doctor attempted to perform the needed surgery in a room unequipped to do more than set a broken bone or stitch up a cut.

Geraldine survived the operation, albeit with a scar than ran all the way across her abdomen.  Her fever and nausea went away. The wound healed. But she didn't. In the days and weeks that followed, she put on weight, her skin coarsened, she grew the beginnings of a mustache, her voice grew husky,  her hair thinned, and her menstrual periods ceased. She became despondent and lost interest in school or the activities of her friends. To give her something to do, her father turned a lean-to at the side of the house into a candy shop and put her in change of running it, which she did for years.  She never finished her education or dated or married. When her parents had both passed away, she moved into her sister Gladys's home, taking over the cooking, cleaning, and raising of two little girls so that Gladys could become an elementary school teacher. And when that wasn't enough to occupy her time, Gladys's husband also built a candy shop for Geraldine. But that's another story.

What happened in that operating room? My mother harbored a suspicion that the doctor had just butchered the operation so badly that he ended up removing her entire reproductive system. Her symptoms were certainly consistent with those of a woman who  had undergone a hysterectomy. But there was one other possibility that would explain the extent of the operation. An etopic pregnancy can sometimes mimic the symptoms of appendicitis. Perhaps a kindly doctor helped a frightened young girl conceal the true nature of her emergency.

Whatever the truth behind the story, it remains another example of how primitive our medical system was a hundred years ago, and a reminder of how far we have come.

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