who wrote this article?
Robert Shadle & James S. Olson
what are some specific facts about Nabby that you learned from the article?
- 44 years
... [Show More] old
- married
- 3 children
- born in Quincy, Massachusetts
- her parents were John Adams & Abigail Adams
what was the first sign of her cancer that Nabby Smith noticed?
a tiny dimple on her left breast
how old was Nabby in 1783?
17 years old
why did Nabby's family move to London in 1785?
because Congress appointed her father to serve as the first United States minister to England
who was Col. William Smith?
young man who was apart of the American diplomatic staff in London
what facts about William Smith did you gather from the article?
- dashing & handsome figure
- bold & impetuous
- veteran of the Continental Army and secretary to the American legation in London
- 28 years old
how old was Nabby when she married?
20 years old
what was Smith's major problem?
he never really slowed down
when Nabby first noticed her dimple, where was she living, and what was Smith doing for a living?
New York; working a small plot of land
by 1809, what had Nabby's dimple become?
a hard lump beneath the skin
what word did ancient Greek physicians use for cancer? why did they use this word?
"karkinos" (crab); because of its tenacious ability to hold on, to defy all attempts to cure it or cut it out
how long had well-informed people been aware of breast cancer, and why was it the first cancer that human beings identified?
2,000 years; because it was more visible than other deadly tumors
what are some reasons Nabby contacted Dr. Benjamin Rush?
the lump was visible, large, growing and moveable
what did Dr. Rush recommend?
surgery -- a mastectomy
why was surgery in the 19th century a brutal affair?
cutting instruments were crude, no anesthesia, patients were wide awake, and had to be restrained and belted down
why was massive infection a major problem for surgery patients at this point in history?
nobody understood the principle of microscopic life
what was Nabby's huband's reaction to Dr. Rush's recommendation?
denial
was breast amputation ever successful in treating cancer?
no
why was breast amputation surgery not the treatment of choice at this point in history?
because the surgery itself was narrowingly painful and the outcomes were so problematic
who performed the surgery and why was he chosen?
John Warren; he was widely considered to be the most skilled surgeon in Boston
list the surgical tools and supplies that Dr. Warren used
- large fork
- wooden handled razor
- pile of compress bandages
- small oven full of red-hot coals
- a spatula
describe Nabby's pre-surgical preparations
she was fully clothed and she only exposed the diseased breast
what was missing in these preparations, compared to what would happen in a similar procedure today?
- no gloves
- no surgical masks
- no hand washing
- no iodine wash
- no hair nets or caps
why were the elements missing from the preparations of the surgery?
they knew nothing about bacteria in the 1800s
briefly describe the surgery
he cut her, and removed things with his bare fingers while she was wide awake, feeling everything
besides the tumor, what else did Dr. Warren remove?
lymph nodes
who witnessed the surgery, besides the surgeon?
Abigail, Caroline, and William
how did Dr. Warren stop the bleeding?
he applied the red-hot spatula directly to the wound several times
describe how Nabby got home after the surgery.
by carnage
summarize what happened to Nabby during the next seven months.
she was weak and feeble, barely able to get around, she could not use her left arm at all and left it in a sling
why was Nabby going to die no matter what?
the cancer had already spread throughout her whole body
what were her next symptoms?
headaches and severe pain in her spine and abdomen
by 1813 what did Nabby's doctors in New York diagnose?
breast cancer round 2
describe Nabby's journey to Quincy.
unimaginably painful - bumpy roads where each jolt meant stabbing pain
why was her husband not with her at that point?
he had to go to Washington D.C. to obtain a military appointment
what caused the "odor of death"?
the dead tissue in her body
who was Nabby's principle caregiver?
John Adams
why couldn't her mother provide much care?
she had fallen into depression
how old was Nabby when she died? about how long did she live after the mastectomy?
46 years old; about 1 year
during the rest of the century, what new things did physicians learn?
1. anesthesia
2. bacteria
3. cells within the cancer
4. the radical mastectomy
according to 1990s statistics, what is the breast cancer rate among American women? what is the death rate?
- 1 out of 8 women will develop
- 40% death rate [Show Less]