Amazing Medical Stories (6 page)

The world's largest married couple spent an extended honeymoon visiting the crowned heads of Europe. Their joy was marred by the birth of a stillborn female child in 1872. The infant weighed eighteen pounds at birth, and was reported to measure twenty-seven inches in length. The
body was donated to the London Hospital for educational purposes, but apparently it was lost. (My own attempts to track it down by contacting the hospital were fruitless.)

Martin and Anna subsequently settled in the small town of Seville, Ohio, attracted by its lovely rural setting. Their custom-built home had fourteen-foot ceilings, and normal-sized dinner guests had to mount the rungs of the dining-room chairs to obtain a seat. The couple were avid churchgoers. Anna began teaching Sunday school at the First Baptist Church, and a special oversized pew was constructed to accommodate the new parishioners. Amiable and kind, the giants soon became popular and well-liked members of the community, though some altercations did arise from Martin's habit of continuing to wear his Confederate captain's uniform in a northern state, long after the Civil War was over. Children were always welcome in the couple's home, and they especially adored Anna's pet monkey, Buttons. Houseguests included circus friends, among them the Dog Faced Boy, the Skeleton Man and Mrs. Tom Thumb. Perhaps the most unusual of the many visitors was the “Two-Headed Nightingale,” actually a pair of Siamese or conjoined twins noted for their beautiful vocal duets, who had also attended the couple's wedding. The cost of the Bates's new home was somewhat more than anticipated and this resulted in another tour, this time with the W.W. Cole Circus, as “The Tallest Couple on the Globe.”

On January 19, 1879, tragedy struck once more with the birth of a second child, a twenty-three-pound boy. He lived only eleven hours and is listed in the
Guinness Book of World Records
as the largest baby ever born.
The Medical Record
, a journal of the time, adds that the infant was thirty inches long, had a chest diameter of twenty-four inches and a head circumference of nineteen inches. His feet were five and a half inches long and his breech twenty-seven inches in diameter. Attended initially by Dr. A. P. Beach, Anna had a thirty-six-hour labour with failure to progress. Apparently she passed an estimated six gallons of fluid when her membranes ruptured, a volume attributed by her doctor partly to her large size and partly to generalized “dropsy,” or edema. Subsequently the head emerged, but no further progress occurred. This was probably due to shoulder dystocia, when the shoulders become trapped in the birth canal. Dr. Beach attempted to apply forceps, but was unable to find a pair big
enough for the infant's head, which lay in a vagina “measuring twelve inches in its posterior aspect and seven to nine inches in its anterior” (or about double the normal dimensions). He summoned Dr. J. D. Robinson from a nearby town to assist, and the two managed to accomplish delivery by using a bandage wrapped around the neck of the baby for traction.

Anna never recovered completely and became quite fatigued in her later years, eventually giving up teaching her beloved Sunday school class. Unfortunately, her medical records have been lost, but it is said that she suffered from “consumption” or tuberculosis, a condition which killed many in her family. The giantess died on August 5, 1888, only a day before her forty-second birthday, apparently peacefully and in her sleep. Her last attending physician, Dr. Beach, listed the cause of death as “heart failure.”

Martin had a fifteen-foot memorial erected for Anna in Mound Hill Cemetery, not far from the family homestead. The funeral unfortunately was delayed due to failure to obtain an appropriate sized casket. The undertaker who received the initial order thought someone was a playing a joke on him and sent a standard-sized coffin instead. To avoid a repeat of this incident, Martin ordered his own casket shortly afterwards, apparently not expecting to much outlive his beloved Anna. He survived, however, to the ripe age of seventy-four, and the coffin sat propped against a wall in his barn for many years.

The giant widower did remarry at about the turn of the century, this time to a woman who was just over five feet tall. Anna's great-great-nephew, Dale Swan, told me that the ladies of the church tried to delicately dissuade the prospective bride from the union, because of certain “potential anatomical complications.” These did not seem to materialize, or at least if they did it is not recorded, and the couple lived for many years as husband and wife.

Medically, it seems evident that Anna Swan suffered early in life from the effects of excess growth hormone, probably secondary to a pituitary adenoma, a type of brain tumour which affects glandular function. The normal size of her parents and siblings would make a genetic cause for her stature unlikely. The giantess was also well documented to have a goitre, which appears in about one-fourth of such patients. Diabetes, or at least abnormal glucose tolerance is common in this condition and could have contributed to the large size of Anna's babies, as well as to the hydramnios,
or large quantity of amniotic fluid found in her pregnancy. This in turn could have been responsible for the failure of her second labour to progress, due to overdistension of the uterine muscles. Growth hormone does cross the placenta and would be the main cause for the huge size of Anna's babies.

High blood pressure is often found with growth hormone excess, and this, combined with diabetes, may have predisposed Anna to pregnancy-induced hypertension, or toxemia. This is often associated with maternal edema (or “dropsy” as described by Dr. Beach); together with the higher infant mortality found with diabetes, it may well have been the reason for Anna's inability to produce healthy infants. Of course, neonatal asphyxia (lack of oxygen) and birth trauma may have played a role in the death of her second offspring, judging from the description of the labour.

Anna's exceptionally difficult labour and the weakness and fatigue she experienced after her second pregnancy lead me to speculate that she may have developed Sheehan's Syndrome, or postpartum necrosis of the pituitary gland. Her abnormal pituitary would have been especially prone to damage from the tumultuous birth. The cause of her death was listed as heart failure, and this is indeed increased in incidence with gigantism. But if Sheehan's Syndrome were present, then the loss of glandular function, especially thyroid and adrenal, would neatly explain Anna's postpartum deterioration and eventual demise. Further light might be shed on her health if records could be found, though that seems unlikely as this late date.

Though it was reported that Anna had tuberculosis, this probably did not cause her death. Dr. Beach would have been very familiar with this condition, which was rampant in the nineteenth century, and would surely have listed it as the cause of death, rather than heart failure. Sheehan's Syndrome, however, would have been difficult to diagnose without modern lab tests which were unavailable at the time.

Anna Swan's medical condition brought her fame and a degree of financial reward, but she must at times have longed to be normal in size. We should remember her, not just for her extraordinary height, but for her dignity and her devotion to her husband and to her community.

George Burden

Sewed up his heart!” shouted the headline. Readers of a Chicago newspaper gasped at the exciting news, and why not? In 1893, this was a medical miracle made even more newsworthy because it had been performed by one of North America's few black surgeons.

Dr. Daniel Hale Williams was the remarkable surgeon who was clearly committed to defying the status quo of late-nineteenth and early-twentieth-century medicine.

What is significant for Canadians to know is that this man had an ancestral link to the Maritimes. Helen Buckler, in her excellent biography,
Daniel Hale Williams: Negro Surgeon,
traced his heritage, on his mother's side of the family, back to a freed slave who lived in Yarmouth, Nova Scotia, in the late 1700s.

Born in 1856 to Pennsylvania parents of mixed Shawnee Indian, Welsh, Irish, Scottish and African-American blood, Dan was fair-skinned with red hair. Like his parents and grandparents, he took great pride in the knowledge that he could claim African roots. During his lifetime, despite his fair skin, he refused to pass himself off as a white man. This strength of character is not surprising, since, in order to reach his goal of excelling in the medical profession, he was forced to deal with enormous obstacles.

He was only eleven when his father died, and his mother arranged for him to become a shoemaker's apprentice. He hated the tedious work and courageously ran away, making his way back home only to discover that his widowed mother had moved, leaving him to fend for himself.

Dan, however, was not your average youngster. By the age of seventeen, he owned a small barbershop in a town in Wisconsin. Not content with this role, he joined an established business in a nearby community.
Barbering part time, playing the bass fiddle in the evening, Dan was able to earn enough money to pay for private tutoring. After completing high school, he began to read law books, but concluded the legal profession was not for him, especially as he abhorred confrontation.

Several articles in the community's small weekly newspaper caught Dan's attention. They chronicled the interesting adventures of the town's doctor and former mayor, Dr. Henry Palmer. The stories intrigued Dan, and in 1878 he convinced Dr. Palmer to accept him as an apprentice. The next two years proved to be anything but adventurous for the young apprentice. He had to balance mundane duties such as sweeping the doctor's waiting room and cleaning his horse barn with the responsibility of helping to dress wounds, set fractures and test urine samples.

Dan was ecstatic when in 1880 his mentor informed him that he would be prepared to give him the credentials needed for medical school. Elated by this prospect, Dan chose the Chicago Medical College, which was later affiliated with Northwestern University. The young man's first year at medical school proved to be another difficult time in his life. He was barely able to exist on borrowed money, and although he studied constantly, his grades were mediocre. Fortunately, his second year was more rewarding. He found anatomy classes fascinating and was able to visit Mercy Hospital, where he witnessed the impact that Joseph Lister's evolutionary theories on antisepsis were having on surgery.

In March 1883, Daniel Hale Williams was qualified to write MD after his name. Now twenty-seven and equipped with an Illinois medical licence, he opened his office in an area of Chicago that would offer him access to both white and black patients. Dr. Williams soon found himself performing surgery on a regular basis; he was asked to demonstrate his surgical ability to medical students, and his name often appeared in
The Conservator
, a Negro newspaper.

The outstanding surgeon's reputation quickly spread, and he was invited to join the prestigious Hamilton Club, a Republican organization with few black members. He was also appointed to the Illinois State Board of Health, though he was never fully recognized there.

In 1890, a plea for help from a pastor at a local black church served as a cruel reminder of the rampant racism of the day. The Reverend Louis Reynolds was angry that his well-educated sister Emma could not find a

Daniel Hale Williams, chief surgeon at the Freedmen's Hospital, Washington, DC, 1894-1898.
DANIEL HALE WILLIAMS: NEGRO SURGEON

nursing school that would accept her as a student. Dr. Williams — greatly disturbed by this situation — decided it was time to found a hospital where black doctors could serve as interns and where black women could train as nurses. He insisted on only one thing: it must be an interracial institution that would be open to all, regardless of race, gender or creed. In May
1891, Provident Hospital opened its doors with black and white doctors on staff, and seven young women, including Emma Reynolds, enrolled in the first interracial nursing class in the United States. (A Canadian woman, Jessie Sleet, was a member of that class. She became the first black woman to work as a district nurse for a charitable organization in New York City.)

It was at the new hospital, two years later, that Dr. Williams performed his miraculous surgery. James Cornish was in critical condition when he was rushed to Provident Hospital. He had been stabbed in the chest, was in severe pain and obviously dying. Most colleagues, when faced with such a terrible injury, would not have considered operating. Dr. Williams did not share this kind of reticence. Boldly and skillfully, he repaired the tear in his patient's heart. Today, the significance of this surgery continues to be challenged, but there is little doubt that Dan Williams deserves full credit for performing the first operation of its kind in medical history.

James Cornish made a rapid recovery. The positive outcome encouraged Dr. Williams to perform at least two other successful heart operations. Later, while working at the Freedmen's Hospital in Washington, D.C., he operated on a number of other complex cases. During his time there, fewer than ten postoperative deaths were reported, yet he was never invited to join the District Medical Society, which was a predominantly white professional association. Dr. Williams felt it was imperative that he respond to this racial prejudice. In 1895, with the support of three white and five black physicians, the Medico-Surgical Society of the District of Columbia was formed. The same year, he helped found the National Medical Foundation.