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	<title>Bookworm Room &#187; Surgery</title>
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	<description>Conservatives deal with facts and reach conclusions; liberals have conclusions and sell them as facts.</description>
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		<title>Brave?  Yes.  Unique?  No.</title>
		<link>http://www.bookwormroom.com/2008/06/02/brave-yes-unique-no/</link>
		<comments>http://www.bookwormroom.com/2008/06/02/brave-yes-unique-no/#comments</comments>
		<pubDate>Tue, 03 Jun 2008 03:50:16 +0000</pubDate>
		<dc:creator>Bookworm</dc:creator>
				<category><![CDATA[Media matters]]></category>
		<category><![CDATA[Medicine]]></category>
		<category><![CDATA[Cancer]]></category>
		<category><![CDATA[Edward Kennedy]]></category>
		<category><![CDATA[Fanny Burney]]></category>
		<category><![CDATA[media]]></category>
		<category><![CDATA[Surgery]]></category>

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		<description><![CDATA[If you stop at the first paragraph of this AP article, you might think that Teddy Kennedy is the only person on earth who has ever faced a cancer surgery as daunting as the one he underwent (emphasis mine): Bravery in the face of cancer? Sen. Edward M. Kennedy has given it new meaning. Few [...]]]></description>
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<p>If you stop at the first paragraph of <a href="http://news.yahoo.com/s/ap/20080602/ap_on_he_me/med_kennedy_targeted_surgery;_ylt=Agu_yZen34CZXyoR8FL0uMoDW7oF" target="_blank">this AP article</a>, you might think that Teddy Kennedy is the only person on earth who has ever faced a cancer surgery as daunting as the one he underwent (emphasis mine):</p>
<blockquote><p>Bravery in the face of cancer? <strong>Sen. Edward M. Kennedy has given it new meaning.</strong> Few things require as much courage as being wide awake and aware, lying perfectly still for hours, while surgeons methodically slice out bits of your brain.</p></blockquote>
<p>In fact, although this approach to surgery is not common, Teddy is by no means the only one who has done it:</p>
<blockquote><p>To avoid cutting through vital areas controlling speech, doctors often return the patient to consciousness and stimulate tissue in the planned surgical path with a probe.</p>
<p>&#8220;We&#8217;ll have them do language tests like hold up pictures, name objects, repeat words, hold a conversation,&#8221; Ewend explained.</p>
<p>After that, the patient is usually put back under while the tumor is cut out, which takes about three to four hours.</p>
<p>However, Kennedy was awake for the removal of the tumor, his doctor&#8217;s statement says. That usually means local rather than general anesthesia.</p>
<p>His head would have been in a vise-like device and he&#8217;d have to remain very still for hours while the doctors poked, probed and sliced away the cancer, using his responses to guide them.</p>
<p>&#8220;That&#8217;s the best way you can determine if you&#8217;re incurring neurological impairment&#8221; as the operation proceeds, said Dr. Kevin McGrail, neurosurgery chief at Georgetown University Medical Center.</p>
<p>&#8220;It&#8217;s a safe way to do the operation, but it can sometimes be very stressful on the patient,&#8221; who is aware of what&#8217;s going on even though it is not painful, he said.</p></blockquote>
<p>As it happens, I am extremely impressed by the fact that Teddy was willing to do this, although I can understand the motive too:  the best surgical outcome.  Frankly, I don&#8217;t know if I could have done that, even sharing his motive. Let me say again, therefore, that I am not writing this to denigrate Teddy&#8217;s courage in the face of what seems to be an incredibly uncomfortable and frightening procedure.</p>
<p>My beef &#8212; as it almost always is &#8212; is with the way in which the media spins things like this (and I&#8217;m confident that the spin would have been . . . um, different if Cheney had been the one undergoing surgery).  That first paragraph makes it sound as if Kennedy is unique in the history of cancer patients and that <em>no one</em>, absolutely <em>no one</em>, has ever demonstrated this type of courage before.  Courageous?  Definitely.  Unique?  Only in AP&#8217;s eyes, and that&#8217;s true despite the fact that their own article gives the game away.</p>
<p>On the subject of bravery in surgery, I&#8217;d like to recommend to you Fanny Burney&#8217;s experience.  She was a late 18th/early 19th century courtier and writer in England who, <a href="http://wesclark.com/jw/mastectomy.html" target="_blank">in 1811, underwent a radical mastectomy &#8212; without anesthetic</a>.  Here is her description of that surgery (which is not for the faint of heart):</p>
<blockquote><p>Yet &#8211; when the dreadful steel was plunged into the breast &#8211; cutting through veins &#8211; arteries &#8211; flesh &#8211; nerves &#8211; I needed no injunctions not to restrain my cries. I began a scream that lasted unintermittingly during the whole time of the incision &#8211; &amp; I almost marvel that it rings not in my Ears still! so excruciating was the agony. When the wound was made, &amp; the instrument was withdrawn, the pain seemed undiminished, for the air that suddenly rushed into those delicate parts felt like a mass of minute but sharp &amp; forked poniards, that were tearing the edges of the wound &#8211; but when again I felt the instrument &#8211; describing a curve &#8211; cutting against the grain, if I may so say, while the flesh resisted in a manner so forcible as to oppose &amp; tire the hand of the operator, who was forced to change from the right to the left &#8211; then, indeed, I thought I must have expired.</p>
<p>I attempted no more to open my Eyes, &#8211; they felt as if hermetically shut, &amp; so firmly closed, that the Eyelids seemed indented into the Cheeks. The instrument this second time withdrawn, I concluded the operation over &#8211; Oh no! presently the terrible cutting was renewed &#8211; &amp; worse than ever, to separate the bottom, the foundation of this dreadful gland from the parts to which it adhered &#8211; Again all description would be baffled &#8211; yet again all was not over, &#8211; Dr Larry rested but his own hand, &amp; &#8211; Oh Heaven! &#8211; I then felt the Knife tackling against the breast bone &#8211; scraping it! &#8211; This performed, while I yet remained in utterly speechless torture, I heard the Voice of Mr Larry, &#8211; (all others guarded a dead silence) in a tone nearly tragic, desire everyone present to pronounce if anything more remained to be done; The general voice was Yes, &#8211; but the finger of Mr Dubois &#8211; which I literally felt elevated over the wound, though I saw nothing, &amp; though he touched nothing, so indescribably sensitive was the spot &#8211; pointed to some further requisition &#8211; &amp; again began the scraping! &#8211; and, after this, Dr Moreau thought he discerned a peccant attom &#8211; and still, &amp; still, M. Dubois demanded attom after atom.</p></blockquote>
<p>Burney lived another twenty-nine years after that ordeal.</p>
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