Easing children through surgery

To the Editor:

This letter is written is response to your article about the work of Zeev Kain. [“Easing children’s minds about surgery,” Fall 1999|Winter 2000.] I trained at Yale in the late 1950s, when there were no pediatric surgeons on the staff. After completing my training, including a year at Pittsburgh Children’s Hospital, I returned to practice with Dick Selzer.

I was the first surgeon trained as a pediatric surgeon and had quite a time convincing the hospital and Blue Cross that outpatient surgery was a good thing for children and deserved coverage. Drs. Pickett, Toloukian and Seashore followed and established an excellent pediatric surgery section.

Besides the use of sedation, as the article mentioned, there are many other ways of reducing stress. Playing children’s music in the operating room makes a big difference, too. It relaxes the children and the staff. However, I was deemed an explosion hazard the first time I showed up with my tape recorder, in the 1970s, when cyclopropane and ether were still in vogue.

I also have found that children are excellent subjects for hypnosis and that simple stories and suggestions will often change their attitudes toward surgery. A statement such as “You’ll be going out” can be scary if it is understood to mean “out of control.” On the other hand, “You will go to sleep in the OR” induced sleep in several of my young patients almost instantly as they were wheeled to surgery. I often spoke to children and adults while under anesthesia because they hear and respond to the suggestions and information given them. I was considered crazy until the beneficial effects were seen. Then I got to present anesthesia grand rounds. As a matter of fact, my greatest compliment came from Dr. Jake Goldstein, who declared I was equal to 10 cc’s of Pentothal.

Hopefully the surgeons are less of a problem today than in the past. If not, there are drugs available that could be helpful. Perhaps preoperative sedation for surgeons should be the next study undertaken.

Bernie Siegel, M.D., HS ’61
Woodbridge, Conn.

P.S. I am always available for another grand rounds.