“If It Isn’t Fun.” – An Unusual Tonsillectomy
On summer vacation of 1947, before my senior year in medical school, I arrived at my parents’ comfortable parsonage on East 55th Terrace in Miami and found them preoccupied with the medical problems of “Scooter,” the family cocker spaniel. He had had a chronic cough for many weeks and they had been told by their veterinarian that it was due to chronic tonsillitis. The tonsils should be removed — for the substantial sum in those days of $75.
Surely, the brashness of junior-year medical students is nowhere exceeded, and mine was no exception. As a young hospital extern, I had already located, dissected, snared, and clipped off the tonsils of half-a-dozen kids, making me an “expert” of the more dangerous variety. Confirming the presence of infected tonsils in our pet, I assured my parents that the veterinary fee was an unnecessary expense and that I would be happy to take care of the matter for them.
With the confidence and chutzpa of youth, I looked up and phoned a leading otolaryngologist in Miami, indicating what I wanted to do, asking him if I might borrow a tonsillar snare, forceps, scalpel, and blunt dissecting instrument. Presumably out of amused “professional courtesy” to this budding doctor, he said I might pick up the instruments at his office later that very day.
My first gross incompetence in this whole situation was lack of knowledge of the anesthesia necessary for surgery in dogs. But in those innocent times I was able to persuade our local pharmacist to sell me a bottle of morphine and proceeded to give the dog the dose appropriate to an adult human, which I assumed would be sufficient to put him down for a tonsillectomy. It didn’t faze the dog. The next afternoon I tried a double dose. Scooter drunkenly slipped off the card table and lurched away across the porch. I then sought help by phone to the veterinarian and learned that the dosage for small animals, with their rapid metabolism, varies between four and 10 times that required for humans.
The next day I administered enough morphine, and, with my father retracting the cocker’s jaws, and with illumination reflected from a venerable gooseneck lamp via the silvered otoscopic headpiece I wore, I identified the ropelike, reddened tonsils, each about the size of a small chili pepper. I was then able to grasp each tonsil with forceps, dissect it bluntly to the base with little blood loss, then to place the snare around the base, pull the snare taut, and successfully remove the tonsil from each fossa.
Remarkably, Scooter recovered, and within a few days his chronic cough disappeared. I washed the surgeon’s equipment well and returned it to his office, suggesting to his surgical nurse that she double autoclave the materials, considering their unusual application.
My surgical reputation was thus established with my proud parents. It was soon to be sullied, however. On my next visit, I attempted to put down our lovely orange tabby, infirm and aged 16 years. That effort, with chloroform on cotton in a grocery box, was botched so badly that we had to rush the dear animal to the veterinarian to be put down. My hubris was replaced thereafter by a more rational humility — at least in matters veterinary.