Jefferson Memories

Training at Jefferson in Otolaryngology

Jefferson Memories: By Mark Belafsky

Training at Jefferson in Otolaryngology in the late 1960’s was a magical time! The large ghost of Chevalier Jackson and the smaller ghost of Louis Clerf, still haunted the department. Our Otolaryngology department had it’s own hospital within a hospital on the fourth floor of the Thompson Annex, still exactly the same set-up that had been instituted by Dr.Jackson. At one end of the floor we had our own patient beds, our own admissions department, our own nurses, our own operating room and endoscopy suite, and our residents’ on call room. The open, multi-bed surgical wards, both men’s and women’s took up the rest of the floor. We still used Dr. Jackson’s endoscopy equipment, including his laryngoscopes, bronchoscopes, esophagoscopes and his personal forceps. The bulbs at the ends of the light carriers were always going out! Years later, my son, Pete walked around with me on Saturday rounds carrying a discarded original Jackson bronchoscope.

Dr. Richard Johnson performing laryngoscopy
Dr. Richard Johnson

Broncho-esophagology was a large part of our training. The biggest responsibillity of our first year of residency was to master the proper technique of holding heads. Endoscopies were performed by the staff two days a week, just as they had been in Dr. Jackson’s days. At seven AM sharp, the patients were lined up in the pre-op holding area for anesthesia. The two residents on the endoscopy service performed the anesthesia, and only than did the attending enter the room. There was very little general anesthesia. All upper endoscopy was performed using IM Demerol and topical 10% Cocaine, or later, 4% Xylocaine. The residents held the head for the endoscopist, and were never allowed to look into the endoscope. (exceptions allowed for the second resident if his anesthesia duties were finished.) Oncologic surgery was almost always performed after full dose radiotherapy, the norm at the time. There were always patients on the floor with surgical complications. Many a night was spent on the floor clamping ruptured carotids and changing fistula dressings.

Our Broncho-esophagology attendings were William H. “Pete” Baltzell IV, and J.J. O’Keefe. Our Chairman was Fred Harbert, a double boarded Eye- Ent physician who spent his early years in the Navy. All three men were bigger than life. These were the early years of modern Otolaryngology when conservative laryngeal surgery was in its infancy, and facial plastic surgery had not yet “arrived.” Dr. O’Keefe later became interim chairman.

William H. “Pete” Baltzell IV, was a descendant of Mayflower passengers. He regaled us with tales of the “old days”. His large shock of pure white hair, his impeccable dress and bearing, his ever-present bow tie, his vintage Porsche, all added to his image. The fact that he lived in his family’s mansion in Chestnut Hill, where he hosted department dinners, only added to the aura. I also knew his brother E.Digby Baltzell. Digby was a Professor of Sociology at Penn and a Penn legend. His writings were turned into the movie The Philadelphia Story. I took his class while an undergraduate at Penn and enjoyed it immensely (Also, meeting my future wife). The cycle continued when I got to Jefferson and met Pete.

He shocked us one day by performing a total laryngectomy under local and sedation. As most always happens, time passes by. I can vividly remember scrubbing next to him one morning, on fourth annex outside the endoscopy suite, and asking him about a new flexible fiberoptic laryngo-bronchoscope that had just been announced. “Rubbish, he said. Forget about it, it will never amount to anything. It’s too small”. To Pete’s credit, he later embraced it.

When Dr. Baltzell was honored in 2003 with the Clerf lectureship at Alumni day, I taped the event and gave it to his family. In my mind, it is a treasure. After the lecture, I asked and received his permission to copy his slides from his presentation. They include, I believe, previously unpublished pictures of Dr. Jackson and his days at Jefferson.

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