Texas Surgeon: an Autobiography Page: 72
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a muscle had he moved while I incised his flesh, nor raised a
hand to push me away.
Diphtheria was a common thing. It seemed my bad luck often
to run into cases with pronounced cyanosis. Frequently I had to
make some attempt on the spot to put a tube into the larynx.
For this purpose we were provided with a set of O'Dwyer tubes
in our ambulance kit. The idea was to select a tube of the right
size and, having attached it to a curved applicator, push it
firmly into the larynx at the constriction, thus expanding the
orifice and improving the breathing.
In practice, however, intubation was not so simple as I have
made it appear. The tube had to be guided by sense of touch.
With a violently struggling child, this was a ticklish affair. As
often as not my tube would find its way into the esophagus
instead of the windpipe. For some reason, though in far more
delicate operations on the eye my sense of touch has never failed
me, I was definitely clumsy in the process of intubation. Some-
times, having vainly wasted precious minutes, as a last resort I
would slit the trachea and insert a tracheal tube. However,
though my ineptitude along this line evoked adverse comment
at City Hospital, I will say in my own defense that I never
lost a single child. In the wards this was far from the case.
The matter of intubation bothered me for years, until finally
I conquered the situation. Later on, after much close thought, I
devised a direct laryngoscope and a method of using it. The
value of this instrument, which I shall not bother to describe
here in detail, is that it so increases the visibility of the field of
operation one can insert tubes under full visual control. This
both speeded up the process and obviated damage to inflamed
tissue. In due course diphtheria antitoxin all but wiped out the
disease. My laryngoscope, however, had already found alterna-
tive application in the removal of foreign bodies from the
esophagus.
My point in dwelling on this subject is not to blow my own
72
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Atkinson, Donald Taylor. Texas Surgeon: an Autobiography, book, 1958; New York. (https://texashistory.unt.edu/ark:/67531/metapth143566/m1/84/: accessed April 23, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting University of Texas Health Science Center Libraries.