Too Many Operations?

Of the 14,000,000 patients admitted every year to U.S. hospitals, about half go in for some kind of operation. That is a fact. Many of those operations should never be performed; and some are performed by bunglers who should never be allowed to handle a scalpel. That is the shocking charge.

The charge was made to U.S. surgeons last week, by one of their number, when the American College of Surgeons convened in Manhattan. The speaker was Dr. Harold L. Foss, surgeon in chief of the Geisinger Memorial Hospital in Danville, Pa. Another surgeon publicly backed him up.

Surgery has become such a fad, some critics observed, that many an operation is now performed in hopes of finding out what ails the patient, or because the surgeon wants practice, or because a patient has a morbid desire to be cut open. According to Foss, a scandalously large number of operators have had little or no special training in surgery.

"A license to practice medicine in this country," said Dr. Foss, "entitles its holder ... irrespective of his training ... .to attempt any operation irrespective of its magnitude and technical difficulties. . . . The glamor of surgery, the superior position the young doctor believes he will attain . . . are so alluring that it is often difficult for the recent graduate to resist the temptation of plunging [unprepared] into surgery."

U.S. patients, Dr. Foss warned, now face a new hazard: many of the 40,000 young medical officers demobilized at war's end have begun to practice surgery without proper training (because surgical posts in hospitals, where they might be trained, are scarce).

Moral of all this shop talk among the surgeons: if you must have an operation, insist on getting a thoroughly trained specialist to do it.

The surgeons also heard reports of some new scientific discoveries that may make surgery safer--or less necessary:

P: A Columbia University group headed by Dr. Karl Meyer announced an exciting new clue to the cause of stomach ulcers. The culprit: an enzyme called lysozyme. Lysozyme destroys the protective mucous that lines the stomach and lays the stomach wall open to erosion by acids and other digestive juices. Discovered by Sir Alexander Fleming, penicillin's discoverer, lysozyme is also present in tears and saliva, is found in abnormal amounts in the stomachs of ulcer patients, seems to be produced in extra-large quantities during emotional upsets. The researchers hope that a cure for ulcers may be found in chemicals that inhibit the enzyme (they have already found one inhibitor: dodecyl sulfate).

P: There was a new clue to a mystery that has puzzled ulcer specialists--why do four times as many men as women have ulcers? Examining the stomach of a 21-year-old Negro girl through a surgical hole in the stomach wall (made for feeding the patient after she had accidentally swallowed some lye), Drs. Russell J. Crider and Shepard M. Walker of Washington University found that the girl's stomach was quieter and secreted less gastric juice when she was angry or upset than when she was in normally good spirits. This is just the reverse of the tightened-up way a man's stomach behaves when he is emotionally aroused.

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