THE ANESTHETIZATION OF FANNY LONGFELLOW

Yahweh asked the woman, “What is this you have done?

The woman replied, “The serpent tempted me and I ate.”

Yahweh said to the woman, “I will multiply your sorrows

in childbearing.  You shall give birth to your children in suffering. . .

Genesis 3:13, 16

The first recorded use in the western hemisphere of anesthesia in the birth of a child occurred in Cambridge, Massachusetts, on April 7, 1847.  The lady was Fanny Appleton Longfellow, the wife of the poet Henry Wadsworth Longfellow.  The doctor attending Mrs. Longfellow was Dr. Nathan Cooley Keep b 1800, d 1875.

Since the beginning, it was felt that women should experience pain during childbirth.  According to scripture, women suffered because of Eve’s disobedience in the Garden of Eden, and it was not right to avoid the punishment of God.  Also, some clergy felt that if God meant it to be painless, he would have made it that way.  When Queen Victoria chose to elect the new wonder of anesthesia for her eighth delivery, the religious reasons fell quickly by the wayside.

Fanny had learned that four months earlier a Scottish physician had successfully administered anesthesia to a woman in labor. It had never been done in the western hemisphere, probably because of the surrounding controversy.  The Longfellows were unable to find what might have been called an obstetrician at that time willing to do this, so they called upon Dr. Keep, who had administered anesthesia hundreds of times to his dental patients.   As it happened, just that day Dr. Keep had published a paper on the use of dental anesthesia in the Boston Medical and Surgical Journal, later known as the New England Journal of Medicine.* 

According to Dr. Richard B. Clark,**  the anesthesia was administered by an apparatus made by Dr. Keep, and Fanny’s husband wrote that “the suffering of the last moments were greatly mitigated. . .and no unpleasant symptoms occurred, all the results were highly satisfactory.”  Henry also wrote, “While under the influence of the vapor there was no loss of consciousness, but no pain. All ended happily.”  The mother and little girl did well.

Henry must have been so impressed that the day after the delivery, he wrote, “Stepped into Dr. Keep’s and had a double tooth extracted under the ethereal vapor.  On inhaling it, I burst into fits of laughter.  Then my brain whirled round and I seemed to soar like a lark spirally into the air.  I was conscious when he took the tooth out and cried out, as if from infinitely deep caverns, ‘Stop,’ but I could not control my muscles or make any resistance and out came the tooth without pain.”

William Morton gave a public demonstration of the use of ether anesthesia in Boston on October 16, 1846.  Prior to this, Dr. Keep had admitted Morton to his practice and became Morton’s mentor in dentistry.   Dr. Keep therefore was by no means a newcomer to the process when he attended Fanny Longfellow in April of 1847.  Dr. Clark tells us that prior to that time, Dr. Keep had written that he had administered ether in no fewer than 200 cases, but never to a woman in childbirth.

Fanny Longfellow died a tragic death in 1861 while “sealing up” the hair of her daughter, which involved hot wax.  Somehow, Fanny’s dress caught fire, and despite the frantic efforts of Henry to put out the flames, she died shortly after.

*Dr. Darshak Sanghavi, Boston Globe, July 23, 2006.

 **Richard Clark, MD  (Professor Emeritus, Department of Anesthesiology at the University of Arkansas for Medical Sciences):  Fanny Longfellow and Nathan Keep, American Society of Anesthesiologists Newsletter, Sept., 1997, v. 61 No. 9.   

NORMAN NIGEL KEEP 

Diagnostic Radiology

Norman Nigel Keep was born September 4, 1924 in Berkeley, California. He attended San Francisco schools, the University of Notre Dame, and graduated from Northwestern University in March of 1948 with his M.D. degree.  He completed his internship at Herrick Memorial Hospital in Berkeley and residencies at Cuyahoga Tuberculosis Hospital, Deaconess Hospital in Milwaukee, Children’s Hospital in San Francisco, United States Veterans Administration Hospital in San Francisco, and finally in October of 1953 completed a residency program in x-ray therapy at Stanford University Hospital.  Dr. Norman Keep received staff privileges at Fresno Community Hospital on November 19, 1953 in the radiology department.

As Director of Diagnostic Radiology Services, Dr. Keep was responsible for the tremendous growth of the department. Because of his efforts and leadership, Diagnostic Radiology at the hospital grew to be one of the most sophisticated and comprehensive hospital diagnostic radiology services of its time. In 1953, Dr. Keep started Nuclear Medicine, the first such unit in the San Joaquin Valley.  The hospital had been approved by the Atomic Energy Commission for the use of atomic medicine in diagnosis and treatment of such ailments as thyroid disorders.  The approval was granted only after Dr. Keep’s three month training period under the direction of the AEC at Stanford University and after the appropriate equipment and safeguards had been installed.

In 1959 Dr. Keep developed and operated the valley’s first approved x-ray technician school, which was later moved to Fresno City College.  The same year saw the installation of the first cobalt unit in the valley at Fresno Community Hospital for the treatment of cancer.  1974 saw the installation of the valley’s first ultra-sound unit and in 1976 the first full-body scanner in the area.  By that time the department had grown from residing in a small basement to having 12,000 square feet, with more than 80,000 radiological procedures performed yearly.

Dr. Keep was certified by the American Board of Radiology and was an Associate Member of the American College of Radiology.  He also chaired and served on numerous hospital committees. Outside the duties of the hospital Dr. Keep was an active Rotarian, amateur painter and sculptor, organist, antique collector, and an avid traveler.

Dr. Norman Nigel Keep retired from Fresno Community Hospital July 1, 1977.  When asked about the future of diagnostic radiology he indicated that “The next five years will see a radical change in x-ray film.  It will not be the same as we know it today.  The film will be miniaturized and an electronic device will probably be developed to read the new film quite easily.  Many strides can be made but costs will be the limiting factor.”  He felt that computerization of the Department was definitely in the future.  He also felt that the full-body scanner was “here to stay and has its place in the diagnosis of disease.”  However, he felt that because of the costs of acquiring and operating the scanning equipment, its use would continue to be limited.

At his retirement dinner, the hospital’s President of the Board of Trustees and Executive Administrator presented Dr. Keep with a Resolution of Commendation for his years of dedicated service and leadership in the area of diagnostic radiology.

Dr. Anne Wight Phillips, b March 7, 1917, d February 12, 2009, was a pioneer woman surgeon.  She was the great-granddaughter of Dr. Nathan Cooley Keep, the pioneer dentist who was the founder and first dean of the Harvard School of Dentistry.  She was also named after Nathan’s mother, Anne Bliss Keep.  She had a distinguished career as a doctor and was a world-renowned burn surgeon for many years. 

She received her AB from Bryn Mawr College, her M. D. from the Univ. of Pennsylvania Medical School, and was a member of the Harvard Medical School faculty and staff of Massachusetts General Hospital (and was the first woman surgeon to perform a surgical operation there.)   She studied at the Oak Ridge Institute of Nuclear Studies in Tennessee and while there she served on the federal Atomic Energy Commission.  In 1970 she was appointed by the President of the United States to serve on the Presidential Commission on Fire Prevention and Control.  She also took part in creating fire safety films and stronger standards for flammable fabrics.  It was Dr. Phillips who isolated lung damage as the cause of deaths of so many fire victims after the Army asked her to evaluate the treatment of burns during the Korean War.

She received many awards, including the highest honor conferred by the American Burn Association.  The accomplishments that pleased her the most:  In 1930 at age 13 she set up the first fire drill at the Oceanic Hotel on Star Island off Portsmouth, New Hampshire. They emptied the hotel, identifying everyone outside in four minutes. 

The American Coalition of Patriotic Societies gave her their Patriotic Service Award.  For her work on the Presidential Commission on Fire Prevention and Control, the Society of Fire Protection Engineers chose her for their national “Fire Protection Man of the Year,” the first woman to receive it.  She wrote over fifty articles on fire safety, published in seven languages.  In 1963, to please her adventurous husband, the family, including three children ages four, three, and two, made a pioneer circumnavigation of Nova Scotia, despite 40 foot tides, 12 knot currents, and Hurricane Alma.

Here in her own words is a brief summary of her long life.

“I was born in 1917, in the days when cars had running boards and rumble seats, but no heaters; and the ice man shouldered a hundred pound block of ice into the venerable ice chest every Friday.  I was a little thing, the smallest in my school, but that small package was jammed full of determination.  Questioned at age five about what I wanted to be when I grew up, I answered, “I want to be a doctor, and I got my M. D. when I was 25.

“At 22 I became a collector, collecting rejection letters from medical schools. The letter from Harvard Medical School read: “Dear Miss Wight, if, due to the exigencies of war, we are unable to obtain male medical students, we shall reconsider your application.  Sincerely yours, Eliot Cutler, Dean.”

“Finally, after waiting a year, I was accepted at the University of Pennsylvania, one of the top schools.  In my first year as a student, someone let the air out of my bicycle tires every night from September until Christmas. I never complained.  My Junior Year, as­signed to care for Joseph Flynn, a seem­ingly moribund boy who had been hit on the head by a truck, I cut all my classes and worked on him around the clock for three weeks, never leaving his bedside.  I packed him in ice when his temperature sky­rocketed, transfusing him during a black-out, bringing down his soaring blood pressure with intravenous medication, and reducing the fracture in his left leg when I thought he could survive the procedure.  I snatched a few minutes nap on the other bed in his room whenever I could. At the end of 25 days, I was terrified.  He breathed, swallowed, and could digest, but nothing more.  Had I resuscitated a vegetable?  Then, gloriously, conscious­ness returns.  Joe lived to walk out of the hospital and became a radar operator in the U.S. Navy.

“It was probably because of that effort that I gained the coveted internship at the Hospital of the University of Pennsylvania.  Liking surgery best, I decided to become a surgeon.  Getting a surgical residency was as difficult as getting into medical school, but I found one in New Jersey, where I did hysterectomies, appendectomies, amputations, and hernia repairs. When I discovered that the senior residency was not open to women, I transferred to West Virginia only to learn that the senior residency there was not open to women either.   Women had to have a year more training than men (for whom a year of military service counted as a year of residency), and I could not find a hospital that would give me that last year.  By the grace of God, by this time [a doctor who attended her when she was small] was Chief of Surgery at the Massachusetts General Hospital.  A month later I started what proved to be a quarter of a century in the surgery department at Massachusetts General.

“Because of the Korean War, I did research on burns and smoke inhalation for the Army and Navy, revealing a little known but major cause of death in burn victims [damage to the lungs].  The damage is done before the patient is carried through the hospital door.  Kicking over the traces, I abandoned burn care for burn prevention. In 1943, at my future husband’s suggestion (and with the help of other concerned doctors and fire safety people), we established the non-profit National Smoke, Fire and Burn Institute, Inc.  It operates nation-wide, has over 4,000 members and has a lot of lives saved to its credit.  My husband was its first president.  I succeeded him after his death, working 25 hours a day, eight days a week (or at least it seemed that way), writing all our educational materials and raising funds, at which I was not an unqualified success”

Dr. Anne Wight Phillips’ accomplishments resulted in the recognition she richly deserved.

Adapted from Phillips Greetings and Dr. Phillip's submission to the Keepsake.