THE SELF-RELIANT DR. KANE

Dr. Evan O'Neill Kane (1861-1932) was a leading practitioner in the field of railroad surgery, which, a hundred years ago or so, was its own separate medical specialty. As the name suggests, a railroad surgeon would be utilized to treat injuries suffered by railroad workers. Even more so than today, railroad work was very hazardous, and a railroad surgeon often had to operate under very primitive and dirty conditions far away from any decent medical facility.

Kane, who was on the payroll of five different railroads, saw the need to be able to improvise with materials at hand when real medical supplies were not available. He developed the use of woven asbestos, a material which was ubiquitous at the time and available at any hardware store, to make bandages which could be sterilized by flame immediately before they were utilized. He advocated the deployment of sheets of mica, a transparent mineral, to protect head wounds which exposed the brain. The mica, which could also be sterilized by flame, would be obtained on site from any stove which had a mica window. He used an acetylene lamp on his head, coal-miner style, to illuminate the abdominal cavity to make surgical repairs.

Dr. Kane was also innovative in the traditional operating theater he had in a hospital he owned. He was probably the first surgeon to play music in the surgical parlor. Starting in 1914, he would crank up a phonograph in order to calm the patient prior to administering anesthesia.

He implemented a policy of placing a discrete tattoo on each mother during childhood as well as a matching identical one on her infant to insure that no babies were accidentally switched. In his later years, he pushed the tattoo window perhaps a little too far when he would sign all of his work by inking "-.-" on his surgical patients--the Morse code symbol for the letter "K."

What Dr. Kane is perhaps most noted for was his practice of self-surgery. He cut off his own finger after it got infected. In 1921, at the age of 60, he removed his own appendix using local anesthesia--in part, because he wanted to see how effective local anesthesia could be for use on his other patients. At the age of 70, he performed another operation on himself, attended by the press and a photographer, when he repaired his own inguinal hernia, a more hazardous procedure because of the risk of severing the femoral artery. Thirty-six hours later, he was back at work performing surgery on others.