Saturday, October 27, 2007

Monday Oct 27

At home.

Ruchale was operated
on tonsils last week and
is still so weak and
Yosale is still ill. Oh
Allmighty speed their recovery.

Those constant pre election
speeches almost get my
goat, and all the
candidates seem to flock
to my block every night
and disturb my rest.


Matt's Notes

I don't think Papa has ever mentioned Ruchale, his sister Nettie's daughter, without referring to some kind of illness. Sadly, her newborn brother Yosele (who was born right after Papa's father died and was named for him) took after her and started coughing incessantly when he barely a month old. This wouldn't have been too unusual; childhood illnesses like whooping cough, measles and diptheria were on the wane in the 1920's, but they still haunted the halls of New York's tenements. I wonder, too, if something was particularly wrong with the ventilation, gas jets or other environmental conditions in Nettie's home.

Then again, with Nettie's husband Phil also recovering from a recent, debilitating injury to his hands, I'm tempted to say, as Halloween approaches, that Nettie's life was just cursed. As we've discussed before, Ruchale would not survive a later bout of meningitis and Nettie would one day die by her own hand. (This made her only the second of four wives Phil would eventually see die under tragic circumstances, earning him the nickname "The Serial Killer" among certain members of my family.) I don't really believe in curses, but I certainly do detect an absence of blessings here.

The thought of Ruchale's surgery immediately conjures images of unsanitary Victorian operating theaters, but the 1920's were pointedly post-Victorian and, in fact, the period was witness to a bit of a tonsillectomy/adenoidectomy renaissance. According to an abstract for an article called "The rise and decline of tonsillectomy in twentieth-century America" in The Journal of the History of Medicine and Allied Sciences, tonsillectomy/adenoidectomy was the most frequently-performed operation in the United States between 1915 and the 1960's. If you don't believe that, the Web site for the American Academy of Otolaryngology−Head and Neck Surgery says this type of procedure accounted for 33% of all U.S. surgeries performed between 1920 and 1960. Quoth:

Tonsillectomies were typically performed in response to hypertrophy, recurrent tonsillitis, and enlarged cervical lymphatic glands. Ether vapor was often used as anesthesia. If local anesthesia was preferred, cocaine, novocaine, or bisulphate of quinine was usually used. A mouth gag held open the mouth and retracted and elevated the tongue. A gauze pack was placed in the nasopharynx to block the entry of blood, saliva, and/or vomit into the tonsil area. The tonsils themselves were normally removed by sharp dissection – no snares or tonsillotomes. Black silk was used to suture the area.

This still strikes me as worrisome, and I'm sure Papa would have lost sleep over it even if he wasn't kept awake by politicians hawking their candidacies until all hours. It looks like the campaign onslaught was particularly intense in New York City, with Democratic Presidential nominee John W. Davis, Republican Vice Presidential nominee Charles Dawes, incumbent New York State Governor Al Smith and his challenger, Colonel Theodore Roosevelt (the eldest son of the former President of the same name) all in town for a final push before the November 4th elections.

Radio was just emerging as a campaign tool for the first time in 1924, but old-fashioned, street-clogging hawkers, brass bands and loudspeaker-equipped autos were still the preferred broadcast media of the day. By the last week in October, the city was so full of campaign-related traffic that a marching band hired by a Republican group accidentally found itself leading a Democratic torchlight parade. I can only imagine what the Lower East Side, which had more than its fair share share of flyer-waving union reps, Socialists, Democrats and Zionists running about and shouting, must have been like.

Yet note how Papa says such activity "almost," but not completely, gets his goat. He was an inherently tolerant soul, but he was also no stranger to expressing his own political passions. With that in mind, he probably thought it best to remember his own days of street campaigning, contemplate the joys of democracy, and fold a pillow over his ears.



My cousin Ken, the dentist (who I only just met after he read about Papa's Diary Project in the New York Times and found his grandfather's name in it) says:

Tonsillectomies were very common up until probably the late 1960's. I had mine removed, so did my sister and probably most people my age. I didn't realize they were so common in the early 20th century. When kids got numerous colds and sore throats, doctors thought a tonsillectomy would help because the tonsils would enlarge and become very swollen and they thought their removal would decrease the number and severity of their infections. We now know that tonsils play an important role in fighting infections in the throat and their removal doesn't affect the number of colds a person gets. When they swell up they are just doing their job of fighting the infection.

Today they would be removed only if they became chronically so enlarged they caused problems with breathing or sleep apnea. I had my tonsils removed as outpatient surgery. The person you are writing about probably was given ether or another anesthetic gas and the tonsils(and usually the adenoids at the same time) would be cut out(the tonsils are on each side of the throat at the base of the tongue). I don't know if they cauterized the area to stop the bleeding back then, as they do now.

I guess it was a more serious procedure when she had them because they did not have many antibiotics(maybe sulfa?) and one could die from an infection. The tonsillectomy probably made her breathe better when she had a cough or cold but did not lessen the number or severity of illnesses she developed. Doctors today realize that tonsillectomies are one of those common procedures that were overdone and didn't really help most patients.


References from the New York Times archive:

1 comment:

  1. Knowing what we do about hospitals, you have to wonder whether kids weren't safer when the doctor came to the house and took out the tonsils on the kitchen table.

    I had mine out around 1950 and was out of school for a month (usually it was just two weeks). No one seems to do it now for the reason they did mine -- to improve hearing. And yes it did improve my hearing, as well as reduce the number of colds I had afterwards. Every case is different.