Historical Essay: In Search of Jackson

Circa 1989, the AMA News published a front page article with a photograph of the interior of the College of Physicians and Surgeons of Philadelphia’s Mutter Museum. The accompanying article described some featured contents that included “The Chevalier Jackson Collection” of approximately 3500 foreign bodies that had been removed mostly from the food and air passages of children.

Seeing this brought to mind a story my Grandmother (Anda Fette Hellman 1884-1967) told Thanksgiving Day, 1945, about the three day train trip in 1916 that she and a very ill son Rudy (my father, Rudolph Joseph Hellman 1907-1962), took from Texas, to see “a Dr. Chevalier Jackson”, because of a “Brass Cap” from a bedstead that had lodged in his lung.

Even after 64 years, I recall Thanksgiving in Grandmothers house in Muenster Texas 1945 was different. Present was Grandmother’s sister Agnes, who was anticipating the homecoming of her five servicemen sons and her brother, Henry who had lost a son to the war. ‘ There was much to reflect upon’. “Home Front” was history and “World Peace” was the new reality. After a day focused on “fun” and “war stories” and after her homemade peppermint ice cream, it was Grandmother’s turn telling us the story of how my father Rudolph Hellman’s life was saved by Chevalier Jackson.

In 1907, Grandmother, age 22, had her first of 5 children within six years; Rudy was the first born. At the age of 7, while whistling by inhaling over a metal decorative cap from a bedstead, the new “toy” slipped into his air passage. This resulted in a paroxysm of coughing, followed shortly thereafter by no further immediate symptoms. The assumption was that the metal had been swallowed. A chronic, persistent fever signaled the end of the “symptom-less interval” and the beginning of consecutive disappointments in the quest for relief. The illness was unyielding, a combination of “walking pneumonia” with frequent intermittent acute episodes.

My grandparents were without a clue of what to do. When dealing with ailing farm animals, passivity was not a “standard of care”. A diagnosis of “pneumonia” was of little value, since waiting for the crisis to pass was all that could be done. Rudy pulled through many crises and the best they could do was to hope that he would pull through again.

Brother Hugo became a classmate when Rudolph failed second grade. According to another classmate, “the students at Sacred Heart School, a 2 mile walk from the farm, would include a special “get-well” intention for their absent classmate with the class’ morning-prayer”.

In 1915, a new physician, Leroy W. Kuser M.D settled in Gainesville Texas, a nearby town. He was a 1913 graduate of the Baylor College of Medicine, who limited his practice “to X-ray and electric treatment”. Dr. Kuser aspired to more income by also administering anesthetics. The X-ray machine that made the diagnosis of the airway foreign body was fifteen miles away over dirt and gravel roads by horse and buggy. Dr Kuser recommended extraction under oil ether colonic anesthesia, which was the latest anesthetic technique of the time for airway intervention.

Dr. Kuser made “numerous attempts” to remove the brass cap, which apparently was very near the carina. Grandmother quoted the doctor “it was not difficult to see or to feel the metal with forceps during bronchoscopy but there was no point of seizure.”

She said, “Each time, I thought the anesthetic was going to kill him. When he woke up, he would cry and cry about his raw, sore behind, which hurt so bad from the oil ether colonic irrigation”. She had no criticism of Dr Kuser; her attitude was very clear: “You do what you can do”.

For the moment, she had run out of options but with her son’s diminishing state something needed to be done. A now widowed daughter-in-law (97 years of age at the time of this writing), recalls grandmother saying that ” a local priest suggested that ‘some fellow’ in Pittsburgh, Pennsylvania, was performing miracles for little children with a bronchoscope”. This “fellow” was Dr. Chevalier Jackson.

Grandmother sent a personal note to Dr. Jackson detailing her son’s story, explaining the situation, including “we don’t have ‘. much money”. Dr. Jackson replied that if she could bring her son to Pittsburgh, she “wouldn’t need ‘.. much money. By return post, her calculated response was that “after the harvest, we will have enough money, for two tickets to Pittsburgh.”

Dr Jackson’s fame beyond Pittsburgh was based not only on his authority, innovative operative and teaching skill sets, but also by acclaim in the popular press. However, the reach of his fame to North Central Texas is uncertain. There were German papers in Pennsylvania as there were German papers in the immigrant communities of central Texas. Perhaps this was the path.

With a desperately ill child and new hope, Grandmother and son departed from the Muenster Texas Depot, September 22, 1916, on the Missouri Kansas and Texas Railroad Eastbound at 9:15 a.m. (according to the Southern Methodist University archives of U.S Train Timetables for 1916). They arrived at the Allegheny General Hospital, September 25, 1916.

Dr. Jackson failed on the first attempt to remove the brass cap. He told Grandmom that there was “no point of seizure”.

Reassuringly Dr. Jackson confided that he was confident, that with a newly designed “special” forceps, which he would create that evening in his workshop, he would succeed tomorrow. Delivered in her mixed-choir solo-alto, with an occasional involuntary pause, Grandmother described the trip to the operating room, followed by a random stroll, from the operating suite on the seventh floor, down the stairwell, while she contemplatively struggled to control her ebbing expectations and scuppered hope, as if yet this attempt should fail.

The second attempt was a success, performed in 17 minutes 53 seconds, without anesthesia. Grandmother’s arrival on the “ground floor” coincided with the exit of Rudy from the elevator, sitting up on a Gurney, when he announced, “Mom’.. they got it!”

At the time of release from the hospital, Dr. Jackson’s farewell included a “show and tell” with the “Brass Cap.” Before departing, Grandmother had to ask her hero to take the offending metal piece for her very own, back to Texas, to show to the solicitous observers of this two year saga for the now to be triumphant homecoming.

His reply, “No, Mrs. Hellman, this is my fee.” Her response reflexly reverting to the vernacular of her adopted home town, “Much obliged….much oblige”

So ended a two year lap on a track of terminal illness, and while Rudolph’s discharge document read, “cured,” he was only cured of the brass cap. However, bronchiectasis with a muco-purulent productive cough was something to attend daily and for the rest of his life he had self-limiting episodes of low grade fever, aches and chills which indicated to him and as explained to those who worried about it, “I just didn’t cough right.”

Her grandson noted that “The only time I saw Grandma Anda shed tears was at the funeral of her son Rudy”.