A plea for powder-free surgical gloves

Abstract

I have always been amazed by the profound impact of the trials and tribulations during our childhood, and how they can change and influence our journeys through life. I can vividly remember how my mother’s bouts of intestinal obstruction provided a diiection to my career in medicine (Figure 1). When I was 11 years old, my mother had abdominal surgery for a large benign ovarian cyst. As we celebrated the good news about her surgery, our family had no idea that this surgery was just the beginning of a devastating illness, recurrent intestinal obstruction. During the next 4 years, she had repeated attacks of intestinal obstruction caused by adhesions. I remember distinctly her complaints of abdominal distension that were associated with intermittent episodes of abdominal pain. She was readmitted to the hospital for emergency surgery three times to relieve the recurrent intestinal obstructions. Her frequent hospitalizations left my father, a family practitioner, to nurture and support me and my two brothers. His graphic discussions of her surgical treatment were intended to provide us with hope that she would recover quickly without further surgical interventions. He described to us the surgeon’s copious lavage of her abdominal cavity with saline in hopes of removing the causes for adhesion formation. Despite my father’s assurances, I felt considerable uncertainty and despair about my mother’s illness. When I received a Ford Foundation scholarship for early admission to college at the age of 15, it gave me an opportunity to escape from our home, which was paralyzed by the fear of my mother’s next hospitalization. I entered Lafayette College with mixed emotions. While I was honored to be accepted into a pioneering educational program for gifted students, I also felt enormous guilt in abandoning my mother with the realization that I was not able to help her. My profound sadness coupled with guilt were the stimuli for my pursuit of studies of intestinal obstruction during the last 25 years. In 1962, I was 22 years old, and my heart was set on a career in academic medicine. Because the door of the Department of Surgery at the University of Minnesota was open to all aspiring residents interested in a career in teaching, I was prepared to immerse myself in the waters of that academic village. Dr. Owen Wangensteen, one of the great teachers of surgery of this century, was the chairman of the department, and his major academic objective was to create an atmosphere that was friendly to learning (1). One of Dr. Wangensteen’s most important contributions to surgery was the management of intestinal obstruction with the application of suction to an indwelling gastrointestinal tube. This conservative management of acute intestinal obstruction was essentially a team effort. Success with conservative decompression demands that the team have an enthusiastic and experienced intubator. Dr. Wangensteen encouraged each resident to take the lead in this field. I joined the team by developing a directional fmgerlike balloon at the very end of the tube that facilitated intubation of the duodenum, even in patients with great distension (2). He felt that this development extended the techniques of intestinal intubation