Evan O'Neill Kane

American physician Evan O'Neill Kane (1861–1932) was one of the leading figures in emergency medicine and field surgery in the early 20th century. Descended from a prominent Pennsylvania family that included polar explorers and health-care pioneers, Kane secured his place in the annals of modern medicine in 1921 when he became the first surgeon to perform an appendectomy on himself.

Evan O'Neill Kane was born on April 6, 1861, exactly six days before the outbreak of the U.S. Civil War. His birthplace was Darby, Pennsylvania, just outside of Philadelphia, and the family had already emerged as an illustrious one in the first century of U.S. history. His paternal grandfather, John Kintzing Kane, was a prominent Philadelphia judge, political cohort of President Andrew Jackson, and descendant of American Revolutionary War general Robert Van Rensselaer.

Family Ties to Mormon Pioneers

Kane's father, Thomas L. Kane, was active in the abolitionist cause and during the U.S. Civil War organized a regiment of Pennsylvania riflemen known as the Bucktails. The elder Kane rose to the rank of brigadier general in the Union Army and fought in the Battle of Gettysburg; he was also a longtime friend of Brigham Young, the charismatic leader of the Church of Jesus Christ of Latter-Day Saints, or Mormon Church. As a lawyer with connections to Congress and the White House, Thomas Kane became an intermediary between the Mormons in Utah Territory and the federal government during the 1850s. In the early 1870s, when Kane was still a boy, he traveled to Utah with his parents to visit Young and other elders of the Mormon Church.

Kane's mother was Elizabeth Dennistoun Wood Kane, a graduate of the Women's Medical College in Philadelphia and the daughter of William Wood, a president of the New York Board of Education. Of the four children from the Wood-Kane marriage, three chose medicine as a profession. The exception was Kane's older brother Elisha, named in homage to Elisha Kent Kane, a paternal uncle who was a pioneering Arctic explorer but died in Cuba in 1857 at age 36. Uncle Elisha Kane's health was ruined while leading an expedition north into the Arctic Circle, there to search for the missing ships of British explorer Sir John Franklin who had disappeared in July 1845, while searching for the Northwest Passage. The Kane clan also counted sister Harriet, who would graduate from the Women's Medical College in Philadelphia.

In the early 1880s, Kane entered Jefferson Medical College in Philadelphia and graduated with his M.D. in 1884. His father had died a year earlier, after resettling the family in a corner of McKean County in northwestern Pennsylvania. It was here in Kane, Pennsylvania, that Kane would spend the majority of his career, founding at Kane Summit Hospital in 1887 with his mother and brother Thomas, Jr. The youngest brother and also a graduate of Jefferson Medical College, Thomas sometimes used another given name, William, to avoid confusion with his celebrated father, whom the Mormons had credited with averting bloodshed in Utah.

Expert in Railway Accidents




AP Images





AP Images

As a physician, newlywed, and father, however, Kane was unable to prevent one of the most common fatalities for women of the pre-modern era: complications from childbirth. In May of 1893 he wed Blanche Rupert, who gave birth to their first child, a son they named Elisha Kent Kane, in March of 1894. Blanche died 13 days later, possibly from puerperal fever, a common postpartum infection. Three years later, the widower wed his late wife's sister Lila, with whom he would have another six children.

Kane spent the entirety of his career as chief surgeon at Kane Summit Hospital. As this section of northern Pennsylvania and the larger Great Lakes region emerged as a major economic center in late 19th-century America, industrial accidents rose sharply, and he became a pioneer in treating workplace accident victims. “Kane Summit Hospital supplies the needs of a community that earns its livelihood at great cost to life and limb,” stated an 1898 volume titled Charitable Institutions of Pennsylvania Which Have Received State Aid in 1897 and 1898. “Railroad men, pioneer farmers, lumbermen, miners, oil well drillers and glass worker form the bulk of the wage earners of the counties that send patients to the hospital, and the number of desperately wounded men is out of all proportion to that of an ordinary country hospital.” The Charitable Institutions of Pennsylvania report describes the Kane family's financial largesse and its efforts to secure funds from the state that would defray maintenance costs and other expenses.

Kane gained a reputation as a pioneer in railway surgery, dashing off to sites of grim industrial accidents for five railroad companies that kept him on retainer. Active in the American Academy of Railway Surgeons, he was a frequent contributor to the professional journal The Railway Surgeon. “Conservative surgery being all the fashion, and accepted as the proper thing, it is much easier for any surgeon in any case to say, when he sees a badly mangled limb, ‘I will try to save this,’” he commented in a May 1904 issue addressing a debate about amputation over antiseptic wound care.

Enormous advances in science and medicine occurred during Kane's long career as a physician, and he made some small but noteworthy contributions. Foremost among them were bandages made from asbestos. “Asbestos fibre or mineral wool is the surgeon's ideal wound dressing for railway and field emergency surgery,” he enthused in an article printed in a 1916 issue of The Railway Surgical Journal. “It is soft as swan's down, absorbent as blotting paper, non-irritant, compressible and absolutely indestructible and, above all, it is fire-proof and, therefore, can be rendered absolutely germ sterile, aseptic, in a minute by flame heat.” Kane cited an earlier paper of his that appeared in the Journal of the American Medical Association and urged the wider adoption of asbestos-fiber bandages by field medics in the U.S. armed forces as American troops awaited the possibility of overseas combat in World War I.

Gained Renown for Self-Surgery

Kane performed a surgical procedure on himself for the first time in 1919, amputating an infected finger. On February 15, 1921, he performed a routine appendectomy on himself that prompted a New York Times story the next day. The 60-year-old surgeon was a sufferer of chronic appendicitis and had performed roughly 4,000 appendectomies on patients in his 37-year career to date. His brother Tom was the attending surgeon in the operating room, and Kane used pillows, mirrors, and a strong nurse to keep him in a semi-reclining position. He injected novocaine—a shortacting topical anesthetic—made the incision, and clamped off blood vessels before locating the appendix, separating it, and then leaving his brother and two other assistants to finish the surgery and suture the incision. Kane's intention, the New York Times quoted him as saying, was to show “that the operation could be done without the use of a general anaesthetic, this saving many individuals who have heart or other serious troubles.” As it was known by this time, ether and other intentionally incapacitating agents used for general anesthesia affected the respiratory system as well as the body's neurological response.

In the final decade of his career, Kane continued to promote unusual materials, including sheet mica, another mineral with remarkably fireproof properties that was more commonly known as stove isinglass. In a letter to the Journal of the American Medical Association that ran in its May 24, 1924, issue, he urged other medical professionals to consider sheet mica “as a covering for exposed and damaged brain tissue” or “as a protective covering applied in small, shingle-like layers over skin grafts.”

Kane's name appeared with much greater frequency in American newspapers in late 1931 when his 37-year-old son Elisha Kent Kane was arrested on suspicion of murder. Elisha, a professor at the University of Tennessee, was swimming with his wife, Jenny Graham Kane, at Grand View Beach near Hampton, Virginia, when she apparently drowned. He claimed that Jenny had slipped from a rock and that he attempted to resuscitate her, but Chesapeake Bay fishermen testified at an inquest that they saw the couple in the water, then heard a woman's scream before seeing a man they identified as her companion drive away with the unconscious woman. Elisha claimed that he had attempted to save his wife before driving to a nearby hospital. At the sensational jury trial in December of 1931, Kane was a witness for the defense and maintained that Jenny Kane suffered from angina pectoris, a heart condition, and her dealth was likely caused by a heart attack. There had been a formal coroner's inquest, but not an autopsy, and Kane's son was acquitted on the charge of first-degree murder.

In January of 1932, the 70-year-old Kane invited a news photographer into the operating room at Kane Summit Hospital to document another operation he planned to perform on himself, this one to repair a hernia. He completed the risky procedure without damaging the nearby femoral artery, but his overall health declined in the postoperative period. He died of pneumonia at Kane Summit Hospital on April 1, 1932, five days before his 71st birthday. Until his death, Kane resided in a home his widowed mother had built in the 1890s and named Anoatok, an Eskimo-Aleut place name that served as homage to his Arctic explorer uncle Elisha. Later known as Kane Manor, the home—at 230 Clay Street in Kane, Pennsylvania—was listed on the U.S. National Register of Historic Places in 1986 and became a bed-and-breakfast.

Kane's heroic autoappendectomy is believed to have been repeated just once, by Russian physician Dr. Leonid Rogozov, who suffered acute appendicitis while serving on an Antarctic expedition in 1961. Kane's operating-room stunt was used decades later by television writers for the Cinemax series The Knick, set at a New York City hospital in the early twentieth century. In the second-season finale in 2015, fictional pioneering surgeon Dr. John Thackery—played by British actor Clive Owen—undertakes an operation to remove necrotic tissue in his intestine, but severs the abdominal artery and presumably dies. The series’ executive producer, Jack Amiel, cited Kane's name when he explained that Owen had signed on for a two-season run on The Knick and the writers wanted to give the Thackery character a memorable exit.

Books

Charitable Institutions of Pennsylvania Which Have Received State Aid in 1897 and 1898: Embracing Their History and the Amount of State Appropriations Which They Received, Pennsylvania Office of the Auditor General, 1898.

Periodicals

Journal of the American Medical Association, May 24, 1924, p. 1714.

New York Times, February 16, 1921, p. 12; February 17, 1921, p. 6; April 2, 1932, p. 23.

Railway Surgeon, May 1904, p. 342.

Railway Surgical Journal, February 1916, p. 244.❑

(MLA 8th Edition)