Intended for healthcare professionals

Fillers A memorable patient

Treves's young patient

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7258.437 (Published 12 August 2000) Cite this as: BMJ 2000;321:437
  1. Michael Lavelle, consultant surgeon
  1. Haywards Heath

    EMG will be 100 years old this month. She is both a friend and a former patient. I first met her as a friend in 1984, and in 1993 I found myself operating on her for gallstones. Laparoscopic surgery had arrived, and so I performed a laparoscopic cholecystectomy. Preoperatively, she mentioned that she had had her appendix removed as a child, and as a routine I asked her the name of the surgeon. “Treves—Frederick Treves,” she said.

    It turned out that she had had her appendix removed at home in Ealing at the age of 6 (in 1906). Her father was well off and was able to command the services of a surgeon in his home, rather than allowing his child to be taken to the local hospital. At that time, the operation of appendicectomy was still not commonly performed, but it had gained in popularity when Sir Frederick Treves had operated on the Prince of Wales in 1901, the night before his coronation, and drained an appendix abscess that had been brewing for several days. The coronation had to be postponed, but the Prince of Wales survived to be crowned King Edward VII. Treves is also remembered today for his role in studying and looking after “the Elephant Man.”

    EMG remembers waiting for Treves to arrive, and she remembers a table being taken upstairs to one of the bedrooms for the operation. She then remembers that after the operation she was in bed for three weeks. During that time, she had a day nurse and a night nurse, and her mother was not allowed to see her at all. In fact, her mother peeped through the keyhole one day and when the nurse found out about this she stopped up the hole. EMG remembers having regular dressing changes, and this was a very painful business. The local doctor supervised the dressings, and if EMG behaved herself—that is, she didn't scream the place down—he left a penny on the mantlepiece. After three weeks, she was allowed out in a push chair and had to suffer the taunts of the local children. At about the same time, EMG remembers that another child of her age developed appendicitis and went to the local hospital, but died in hospital.

    When I performed EMG's laparoscopic cholecystectomy in 1993, I was able to visualise the caecum and thus see the results of Sir Frederick Treves's handiwork. She has a large incision in the right iliac fossa, which would have been necessary in prerelaxant days to gain access to the appendix.

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