Medicine: Operation at the Palace

King George VI’s subjects and well-wishers everywhere learned a little more this week about his operation. The drastic surgery to which he submitted was to remove an obstruction (probably cancerous, but the King’s doctors still would not say) in the left bronchus, a branch of the windpipe leading to the left lung.

In deciding to risk the operation, the King was guided by advisers of his own choosing. In all but their most private affairs, Britain’s constitutional monarchs do what they are told, but the government has no say in their choice of doctors. As Duke of York and then as King, George VI took as his family doctor a homeopath, Sir John Weir, who had attended both his mother and elder brother Edward. A genial Scot with a sporran full of jokes on himself and his countrymen, 72-year-old Sir John is flanked by two other family physicians: Welsh-born Dr. Daniel Davies, 51, a topnotch pathologist, and Sir Horace Evans, 48, specialist in diseases of the kidneys, urinary tract and arteries.

Emergency Lights. When the King’s chest was suspected as the cause of his ill health, Sir John called in Geoffrey Marshall, 64, an expert on lung diseases, and Sir Robert Arthur Young, 80, grand old man of British chest experts. X rays by Radiologist Peter James Kerley and others showed what seemed to be a growth in the left lung. Australian-born Brigadier Sir Thomas Peel Dunhill, 75, who enjoys the title of Sergeant Surgeon to the King, agreed that an operation was necessary. The doctors decided that another Welshman, Chest Surgeon Clement Price Thomas, was the man to do the surgery.

The King, Londoners heard this week, wanted the operation as soon as possible, and it was set for Sept. 22. But careful Price Thomas, who is highly regarded by fellow surgeons for his “good hands,” insisted on having emergency (standby) lighting circuits installed in the Buhl Room of Buckingham Palace. That took another day.

In his own room, the King was injected with an anesthetic (probably sodium pentothal) by Anesthetist Robert Machray. He was wheeled to the operating room and, if Surgeon Price Thomas followed his customary procedure, laid out three-quarters prone, his left side propped up slightly with pillows.

Best conjecture as to what happened then: Surgeon Price Thomas made a cut beginning about two inches left of the spine, baring the ribs, and an assistant surgeon held the wound open with retractors while the “sterile nurse” (socalled because she wears sterile gloves to handle sterile instruments) handed Price Thomas a cutter something like a pair of rose pruners. With these he snipped a rib. Then he worked around, cut the same rib near the breastbone and removed it, taking care to leave part of the rib sheath intact so that a new rib could grow in. (Adjacent ribs sometimes have to be spread, but not removed, to give the surgeon’s hands more room.) The snipped rib was laid in a waste pan for the “un-sterile nurse” to take away. Anesthetist Machray placed a rubber tube in the King’s windpipe to supply an anesthetic gas (such as cyclopropane), under positive pressure, to keep the lungs inflated.

Another assisting surgeon tied off severed blood vessels while Price Thomas worked to remove the lung. A fourth doctor pumped weak solutions of sugar and salt into a vein in the King’s ankle, to guard against shock, or gave him blood transfusions if they were necessary. The sterile nurse busily passed threaded needles, and still another nurse adjusted the lights and mopped the surgeons’ sweaty brows. Price Thomas and his assistants closed the wound and bandaged the torso.

Instead of Sixpence. The King was wheeled to his own room and infusions were resumed. For two days, he needed sedatives (British doctors favor morphine), and was given only sips of water or juices while he was kept in much the same position as during the operation. After that, Patient George was put on a soft diet, from soft-boiled eggs to such delicacies as steamed fish. Because of his old trouble with poor circulation, it was essential for the King to have a few minutes out of bed each day, as soon as his strength permitted.

British papers proudly quoted Surgeon Price Thomas: “The King is the best patient I ever had. Not only is he brave, but he is full of humor. And he is just like an ordinary individual to deal with.” Like the rest of the King’s doctors, Price Thomas does not get a sixpence for his services. His likeliest reward: the right to replace the Mr. in front of his name (surgeons in Britain are not called “Dr.”) with Sir.