Experiences of a Deaf Man

From The Albion Magazine (1907):

When a man suddenly becomes deaf there is little or nothing he would shrink from if it afforded, or seemed to afford, the smallest chance that he would recover the enjoyment of a sense which he never properly valued until he lost it. About sixteen years ago, when well advanced in life, I suddenly lost my hearing, first in one ear and after a few days in the other; and so great was my desire for a cure, that in the course of the next twelve-month I had placed myself, consecutively, under no fewer than six medical men, most of them well-known specialists.

 

The writer then summarizes his treatments and remarks in a table:

Treatment 1: Politzer’s inflation and Eustachian Catheterism on both sides. Pilocarpine internally. Result: Deafness became absolute on both sides.

Treatment 2: Potassium Iodidum in heroic doses. Potassium Bromidum. Blisters behind Ears. Result: Depression to the verge of suicide.

Treatment 3: Phosphorus. Result: Exaltation to the verge of lunacy.

Treatment 4: Ferrum Perchloridum. Galvanic Chain. Stimulating Food, Wine. Result: none.

Treatment 5: Gaiffe’s Battery. Result: none.

Treatment 6: Nitro-Glycerine. Arsenic. Result: none.

Shock machine developed by Adolphe Gaiffe (1830-1903) for treating nervous diseases. (Gilai Collectibles)
Shock machine developed by Adolphe Gaiffe (1830-1903) for treating nervous diseases. (Gilai Collectibles)
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A Chamber of the Stillness of Death: Phyllis M.T. Kerridge’s Experiments in the Silence Room

I’m beginning a new project on the historical contributions of women to otology, many of whom have been overlooked in scholarship. My current article investigates the physiological work of Dr. Phyllis Margaret Tookey Kerridge, who died on June 22, 1940, the only daughter of Mr. William Alfred Tookey of Bromley, Kent. She was educated at the City of London School of Girls and at University College London; her graduate studies commenced at the latter institution, first in chemistry and then physiology, where she was also appointed as lecturer. She also held posts in the London School of Hygiene and Tropical Medicine, the Marine Biological Association Laboratory at Plymouth, the Carlsberg Laboratories at Copenhagen, and at London Hospital. She received her M.D. from University College Hospital, in 1933 and became member of the Royal College of Physicians in 1937.[1]

During the 1930s, Kerridge conducted experiments to measure the residual hearing capacity of children in London County Council schools, as well as experiments in teaching with electronic hearing aids. Much of her research was on patients at the Royal Ear Hospital, who were tested in the hospital’s “Silence Room:” a 3,500 cubic room in the basement of the hospital’s new building on Huntley Street, with

“walls impenetrable to extraneous noises and which will never reflect, deflect nor refract sounds—a chamber of the stillness of death, where absolute accuracy and complete consistency in results will be obtained.”

The room was built so exact tests to measure degrees of deafness can be made in ideal and constant conditions. Such stillness in this room apparently allowed people to hear heartbeats and the “flick” of their eyelids! A small table and two chairs were placed in the room. There was a bell to call the Porter’s room and an electric fan affixed there as well.

The Committee of the Royal Ear Hospital occasionally granted permission to medical practitioners to use the Silence Room for their own research purposes. For instance, in 1929, they granted the otologist Dr. Charles Skinner Hallpike (1900-1979), a research scholar from Middlesex Hospital, to use the room free of charge. Hallpike is particularly known for his ground-breaking work on the causes of Meniere’s disease (a disorder that causes episodes of vertigo) and for the Dix-Hallpike test for diagnosing benign positional vertigo (sensation when everything is spinning around you).

The Western Electric 1-A Audiometer in clinical use at the Central Institute for the Deaf in St. Louis, c.1920s. Western Electric produced only about 25 of these audiometers, which retailed at about $1,500 in 1923. (Central Institute for the Deaf Collection)
The Western Electric 1-A Audiometer in clinical use at the Central Institute for the Deaf in St. Louis, c.1920s. Western Electric produced only about 25 of these audiometers, which retailed at about $1,500 in 1923. (Central Institute for the Deaf Collection)

The hospital’s 1938 Annual Reports reveals that Kerridge was appointed to research at the Silence Room, then renamed as the “Hearing Aid Clinic,” working alongside Mr. Myles Formby to conduct hearing test on the hospital’s patients. Though the Clinic was initially started on a 6-month trial period, Kerriddge’s work was so beneficial that the hospital Committee decided to let her continue her research work and audiometer tests, extending care to private patients as well. They provided her with two more rooms in the basement, one as a waiting room and the other as an office, as well as the services of Miss W.J. Waddge as an assistant. In 1939, Kerridge viewed 170 cases, and according to the reports, her work among deaf patients was successful in helping many of them to be fitted properly for hearing aids.

Wartime of course, changed the course of things. The clinic was abandoned during World War II, but the hospital still provided hearing tests with the audiometer to test the hearing of patients suffering from “bomb blast.”

NOTES

[1] Nature 146 (august 3, 1940).

Refitting a Hospital during the Great War

During the Great War, several institutions in London were refitted as auxiliary hospitals to treat the wounded servicemen returning from the battlefields. With large numbers of hospital staff heading to the front lines or volunteering for the war effort, some smaller hospitals even refitted their premises to contribute to the war effort.

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One such volunteer hospital was the Royal Ear Hospital, formerly the Royal Dispensary for Diseases of the Ear. Located on 42-43 Dean Street, Soho, the hospital provided specialized treatments for aural diseases since its founding in 1816. As practically the entire staff of the institution was depleted by military duties or volunteer service during the Great War, the hospital closed down. In August 1914, the Governing Committee unanimously resolved that the building should be offered to the Red Cross Society and beds temporarily placed at the disposal of the War Office, for the benefit of soldiers suffering from deafness or ear injuries inflicted during the war. The offer was promptly accepted and 20 beds were reserved for the use of the Navy, though a smaller outpatient clinic overseen by the aural surgeon MacLeod Yearsley still operated in London.

An October 1914 report revealed that the committee debated whether the hospital should provide only specialist care:

It occurred to us that we must decide whether we should still require that only ear cases be sent or should admit other than ear cases. We are agreed I think that the administration should be entirely in the hands of the Committee and that if we reopen, all the medical arrangements [should] be left to the Medical Board.

It was decided that the hospital would deal with ear cases that were too complex for the physicians or surgeons to deal with at the Naval Hospitals, but also welcome general injuries if needed so by the Admiralty.

Yet, apparently there was still plenty of space being unused at the Royal Ear Hospital during the Great War. As I was examining the archives of the hospital, I came across interesting correspondence between the Committee and a Mr. Peter Gallina, proprietor of the Rendezvous Restaurant that occupied space next to the hospital.  The Franco-Italian restaurant was praised for its clean kitchen, economic cookery, and tasteful interior, and became one of the “landmarks” of Dean Street, catering up to 200 people.[1]

A letter dated 15 March 1915 from Gallina reveals that there some vacant rooms under the children’s ward of the hospital, and that Gallina inquired whether the Committee was willing to accept an offer or £50/annum plus rates and taxes for the use of these rooms for the purposes of storage and cellarage, possibly for a lease up to 21 years. A letter by Allan Collard, one of the Committee members and presumably their lawyer, indicates that the Committee was uncomfortable with the offer but found it difficult to ignore the financial benefits that could serve the institution. Collard’s letter reveals that he did

not regard the offer of £50 per annum for the two vacant floors of the rear of the hospital as particularly good. It would be much more tempting of he paid a premium of say £100. Even in that case it would be prudent for the hospital to insist upon payment of the rent in advance annually.

If Mr. Galilna were to use the premises solely for the purposes of storage and cellarage and not as lavatories for his staff, a former objection to his proposed tenancy would be eliminated…I think it would be quite easy for Mr. Gallina to have an opening cut in the party wall which separates the back of his restaurant from the room under your Children’s ward.

The Committee decided to decline the offer on the recommendation of Collard and Mr. G.H. Paine, another of the Committee members.

However, meeting records of the Royal Ear Hospital Committee of Management dated to March 1921 reveals that the Committee reconsidered the offer. They unanimously agreed to recommend that the proprietors of the Rendezvous Restaurant be offered two rooms at the rear of the hospital for a tenancy of one year, and such tenancy thereafter subject to termination by either party at 6 months’ notice, for a yearly rental of £150. The proprietors renegotiated the offer for storage purposes on a 7 year lease terminable at the end of three or five years at the option of the hospital.

Minutes from the January 1922 meeting outline that

The Clerk reported that no reply had been received from the Rendezvous Restaurant regarding the letting of the rooms at the rear of the Hospital. It was suggested by Mr. Lake that if the one room were turned into a ward, which had been the original scheme, it would be of the greatest service. Mr. Pain produced the original plans that had been draw up relating to that proposal…

Discussions continued on with the Committee, largely due with heavy costs associated with renovating the rear rooms into wards. They kept tabling the discussions to analyzing the cost-benefit ration of renovations, the amount of financial support, as well as for an analysis of waiting lists of patients. Changes recommended including another ward for isolation cases, a lavatory and bathroom strictly for the House Surgeon, and the addition of extra baths. Minor renovations were made, including the addition of four extra beds, and a makeshift waiting room with a curtain for the Sister-in-Charge. No major renovations were made: in 1920, it was announced that Mr. Geoffrey Duveen, supporter of the hospital and once on the Governing committee, donated £50,000 to build a new building for hospital on a piece of land purchased on Huntley Street.

NOTES

[1] Judith Walkowitz, Nights Out: Life in Cosmopolitan London (University Press, 2012), 101-2.

Inside an Operating Theatre of the 1900s: A Review of Cinemax’s “The Knick”

This post includes a review of Cinemax’s The Knick and contains minor spoilers.

On arriving to Bellevue Hospital in New York in the 1880s, American surgeon Robert Morris (1857-1945) commented on the new surgical operating rooms at the institution:

[T]he operating room was similar to that of other large general hospitals. The set-up consisted of a plain wooden table to carry instruments, lint or oakum dressing, unbleached muslin bandages (we had no absorbent gauze or cotton), and a large tin basin of tap water. Sometimes plaster of paris and other splint outfit was added.[1]

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Dr. William Williams Keen conducts a surgical clinic in the Jefferson Medical College Hospital amphitheater, c.1890s.
Archives & Special Collections, Thomas Jefferson University, Philadelphia.

I’m utterly fascinated with the surgical operating theater and how it evolved from a simple room with minor equipment to a packed theatre stage, and eventually to the sterile and spacious environment of modern operating rooms. The transformation of the operating theatre mirrors many tremendous advancements in the surgery during the twentieth century, as surgeons became more skilled and innovative as they mastered complicated and dangerous procedures. It’s no surprise then that I was completely riveted by Cinemax’s new television series, The Knick, directed by Steven Soderbergh, written  by Jack Amiel and Michael Begler, and starting Clive Owen.

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The show takes place in turn-of-the-century New York City, with Owen playing the anti-hero Dr. John Thackray, surgeon at the Knickerbocker Hospital. The pilot episode, “Method and Madness” brilliantly captures the dual nature of medicine: we see Thackray begging his nurse (Eve Hewson) to inject him with 22cc of cocaine, and a short time later, watch him order her to prepare a 2% solution as an innovative spinal anaesthetic to inject a patient on the operating table.

The show’s opening scene in the operating room is, in a word, gory, illustrating the difficulty of procedures that are considered as routine today. Bareknuckle surgery. 100 seconds to perform a caesarean section on a patient with haemorrhage in the womb. Brass hand cranks for suction. White aprons and rolled-up sleeves of street clothes. The rubber apron of Dr. Jules Christiansen (Matt Frewer), which could barely camouflage the surgeon’s hopelessness and despair over 12 unsuccessful caesarean operations. When the patient and baby die on the operating table, Christiansen turns to his audience and reminds them that surgery is about advancement: “It seems…it seems we are still lacking. I hope, if nothing else…this has been instructive for you all.”

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During the early 19th century, operative surgery was limited to breakages, fractures, and amputations. Experimental operations to save the life of a patient were incredibly painful, gruesome, and, in many instances, unsuccessful. Two major advances during the mid-19th century would establish a foundation for surgeons to innovate new life-saving operations with greater confidence: the discovery of anaesthetics and the introduction of antiseptics. Analgesics were always made use of in medicine, as medical practitioners were aware of certain natural substances contained properties for relieving pain, such as opium or alcohol. During the 1790s, experiments of the effects of inhaling various gases and vapours first initiated the possibility pain relief could be achieved by inhalation of some suitable vapour or gas. Humphrey Davy (1778-1829) experimented with nitrous oxide (laughing gas), but other medical practitioners did not pay attention to his developments. The 1840s introduced ether as a more satisfactory anaesthetic, though chloroform anaesthesia became widespread as well after 1847 when James Young Simpson (1811-1870) first used it to relieve a patient’s difficult childbirth pains.

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Dr. William Halstead is the inspiration for Clive Owen's character.

However, post-operative sepsis infection accounted for the majority patient deaths after major surgery. Antiseptics and antiseptic surgical methods became widespread with Joseph Lister’s (1828-1912) introduction of carbolic acid (phenol) as a method for eliminating bacteria on skin and on surface objects. The development of anaesthetics and antiseptics spearheaded the notion of a painless surgical operation. In the 1870s, towns with 10,000 residents had only 100 hospitals within their limits or nearby; by 1910, the number of hospitals increased to over 4,000, as new, innovative surgical procedures were became more successful.[2]

Even with anaesthetics and antiseptics, surgery was an incredible gruesome practice. Operations were performed either in patient wards, a small operating room, or in front of hundreds of students in the ordinary lecture theatre. We see this in The Knick, which surely benefited from the medical, historical and technical advice of Dr. Stanley Burns and the Burns Archive.

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The scenes in the operating theatre appear to jump out of the incredible photographic collections housed at the Burns Archives. I found it difficult to get emotionally connected to characters, though the pilot episode did set up a solid foundation to explore their developments as well as the broader cultural strokes of America in the 1900s. Midwifery and “Stretcher Men;” divisions of the rich and poor; hospital administration; and of course, new technological developments like electricity being fitted in the Knick as it undergoes renovation. Dr. Algernon Edwards (Andre Holland) the “Negro” surgeon, gives us an interesting insight into America racial tensions, but I was more captivated with the scenes of the squalor and poverty of immigrants. The New York Public Health Board’s inspections of tuberculosis cases and their forced removal of sick persons, for instance, shows us how medicine was enforced in the legislative level, as laws outlined demands to enforce structural changes in housing to eradicate breeding grounds for disease. These scenes are a reminder of the terrifying cloud of disease and death.

You can watch the first episode here: http://youtu.be/ItBAXOEE8Vk

 

NOTES

[1] Quoted in Roy Porter, Greatest Benefit to Mankind: A Medical History of Humanity (New York: W.W. Norton & Company, 1997), 374.

[2] Morris J. Vogel, “Managing Medicine: Creating a Profession of Hospital Administration in the United States, 1895-1915,” in Lindsay Granshaw and Roy Porter (Eds.), The Hospital in History (New York: Routledge, 1989).

Switching On Hearing

Harold

It’s an iconic and powerful photo.

The face of a young child, born deaf, hearing sounds for the first time. Jack Bradley, photojournalist from the Peoria Journal Star, captured the exact moment a doctor fitted five year old Harold Whittles with an earpiece and turned on the hearing aid. First printed in the February 1974 issue of ReadersDigest, the photo has propped up in numerous “best-of” lists on the Internet. It is “shocking,” “miraculous,” “unbelievable,” “influential,” “heartbreaking,” “heart-warming,” “amazing,” and “evocative.” It has been circulated thousands of times on Facebook, where commentators have expressed their thoughts: the photo brings tears, it serves as a reminder of our humanity, it tells people to “count their blessings,” it resonates to personal experiences with deafness and hearing, and it triggers debates about language, culture, and technological achievements. For many individuals, the photo immortalizes more than Harold’s astonishment. It serves as a testament of the wonders of medicine and science, the abundance of hope, and provides us with a glimpse into the future.

Bradley’s photo is only one in a long list of sensationalized stories on deaf people hearing sounds. A search through YouTube lists about 72,800 results for videos on “hearing sound for the first time.” At least once a month, someone sends me a link to a new video, or to a post discussing the novelty of sharing stories like this.

I may not remember exactly what it was like when I first heard sounds again after losing my hearing, but I have a problem with the way these videos are promoted: they sensationalized the notion that hearing could be “switched on.” This is a misleading claim. Implants, whether they are cochlear, auditory, or the newer brainstem versions do not restore “normal” hearing but makes it easier for deaf individuals to distinguish sounds. It’s not like wearing these technologies miraculously provide the wearer an understanding of all the sounds in the world. I’ve had friends who’ve been fitted with cochlear implants describe how overwhelming the sound were, and how certain everyday noises, like wind hitting the trees or leaky faucets, created so much confusion.* Cochlear implants in particular, create a representation of sounds that serves to assist in understanding speech; because of this, speech can sound robotic, or filtered as if everyone was speaking underwater. I wear digital hearing aids and even I have trouble distinguishing certain noises or even pinpointing the source of sounds.

Once, while out dining with friends, I watched a restaurant worker remove the external part of her cochlear implant nearly every time she went behind the counter. But when she went towards the dining room to seat customers or bus tables, she had the device on. I imagine the cacophonic atmosphere of the dining room might have overwhelmed her–I know for me, it was so loud I ended up leaving the restaurant with a throbbing headache (I’m very sensitive to loud sounds, which often trigger migraines).

But for me, the larger problem with these videos is that they depict deafness as a defect, a problem that must be corrected, medically, surgically, technologically, and even culturally. This is a perspective that has long been criticized  by members of the Deaf community, who argue these devices are another instance of the historical oppression of Deaf culture and a tremendous threat against sign-language. I’m not going to go too much into this. There’s plenty of literature on the subject. I don’t identify myself as a member of the Deaf community and I do write about the medicalization of deafness, but I try to be sensitive to balancing the perspectives of both hearing and Deaf culture–even if at times, it’s so challenging to do so.

*This point reminds me of one of my favourite philosophical thought experiments: If Mary was born and raised in a black-and-white room and never seen color, but one day, is allowed to go outside, does Mary understand, or have any concept of, the color red?