244 – An evening with an Ear, Nose, and Throat surgeon

A few months ago, I met Dr Michael Schultz when he was recommended to us by a doctor friend in Melbourne, to help deal with chronic blood noses my eldest daughter was suffering. Sitting with him in his rooms as he studiously investigated my daughter’s nose, I started wondering about what it takes to not only commit your life to getting intimately involved in people’s ears, noses, and throats, but also what it might take not to be dry reaching the whole time. So, he’s here tonight. Welcome, Michael.

For the record, I have opted to use ENT as the shorthand for your speciality, what is its full title? Otorhinolaryngology

Let’s get some other terms out the way. Your website for ENT Surgeons, has these specialities across the homepage:

• Otology
• Neuro-otology
• Rhinology
• Laryngology
• Head and Neck Surgery

To pick up, so to speak, on my introduction, I’d like to share a quote from Greenday drumer, Tre Cool: It’s not how you pick your nose, it’s where you put that booger that counts. Are you totally at ease with all things snot?

You’ve been in this field for 23 years. What intrigued you about our ears, noses, and throats?

What are some of the trends in conditions people have, as well as trends in medical advances in treating them?

According to the Royal College of Surgeons in the UK, there are 10 surgical specialities. So, being a former journo, I was trying to work out where ENT would sit compared to Brain Surgery, and the others. For example, if I compared needing a hip replacement to having no ability to breathe easily while sleeping, what surgery would be more important first? What possible way could we ever rank the specialities?

I saw a German article (by the way, Germans produce the most research papers in the ENT field) suggesting there are ongoing discussions about who is IN and who is OUT of the ENT church. Are you much concerned by this?

So, let’s take a closer look at each of the three main areas.

EARS

Epictetus said: We have two ears and one mouth so that we can listen twice as much as we speak. Apart from that being a cliche, how has evolution done, when it comes to our ears and hearing?

Are ears made well to protect, or do they gather gunk?

I grew up with the first wave of walkman devices. That stuff was crack cocaine for playing loud music. It was so intoxicatingly clear and good. For my generation and below, and for people who worked in radio most of their lives who get frustrated by the way people mumble around them, what advances are their for boosting our hearing? Is there enough technology to help whole generations dodge the deafness bullet?

Do you get involved in the size of ears? My dad doesn’t like how big his ears are BUT don’t bigger ears help you hear? I was at Cummins House the other day and saw an old fashioned sound amplifier.

NOSES

Last week’s guest, Philip White, the renowned wine writer, lamented the way our society has neglected the sense of smell. Do you concur?

He said we actually have smell sensors around out body and limbs and even in our intestines. Is this so?

Randy Pausch, a computer science professor from the states, has this quote: Smelling a crayon takes you right back to childhood. When I need to go back in time, I put it under my nose and take another hit. How fragile is this nose-to-memory connection, or is it robust?

I found this intriguing quote online by Ivan Turgenev and would like your reaction: Most people can’t understand how others can blow their noses differently than they do.  Is there a right way to blow?

THROATS

Alfred Hitchcock said: I have a perfect cure for a sore throat: cut it.  As someone who has often wanted to rip my throat out when suffering sore throats, will we ever get a silver bullet for dealing with them?

Is it possible that a throat can be your fuse? I run in the cold – get a cold. Walk, okay. Is this normal?

Chuck Berry once said: My singing days have passed. My voice is gone. My throat is worn. And my lungs are going fast.  When we interviewed Deanna Kangas, the singing teacher, she talked about singing lessons being about training the muscles in the throat. Are they really muscly sectors? Should we be warming them up each day?

I choked up during a French Film recently. How connected are throats to our emotions?

What is your advice for keeping our ENT areas in top shape?

Nigel Dobson-Keeffe challenges the panel to pick the fake story from three stories from South Australia’s past. And Adrian, one of Ralf’s popular drivers, also steps in for the challenge.

The Advertiser January 1901
A Remarkable Discovery
A remarkable discovery has just been made by Dr. Fischer, of Adelaide, whilst operating upon the nose of a little boy, aged 8 years, a son of Mr. M. J. Moseley, of Port Augusta. The boy had been suffering for five years, and Mr. Moseley determined to bring him to the city for treatment. There
was no apparent cause for the trouble, but the boy’s breathing was affected and he suffered pain. When the doctor applied the instruments he immediately discovered that there was what appeared to be a large growth high up in the nostrils, which necessitated surgical attention. An operation was performed and a screw an inch in length was found embedded in the cavity. The metal, which was covered with flesh, had become rusty, but the head of it was perfect. The boy is now recovering from the effects of the operation and there is no obstruction to his breathing. Mr. Moseley is satisfied that the screw must have been in the boy’s nose since he was about 3 years of age.

The Advertiser May 1936
Dangers Blowing Nose the Wrong Way
Successful blowing of the nose is not as easy an operation as would seem. A nose specialist, Dr. J. W.H. Hathaway, a foremost nose surgeon writing in a medical magazine, points out that the forcing of a passage of air through a single narrow nasal opening could easily force harmful secretions up a connecting tube to the ear. He further states that there is conclusive evidence to show that middle ear disease has definitely followed forcible blowing of just one nostril by patients suffering from the fever of childhood. It is stated that the safest way for adults to blow the nose is to blow both sides together. When children blow their nose it is best for an adult to lightly places their finger in the child’s open ear whilst the child blows through both nostrils. This is claimed to prevent damage to their sensitive ear drums which do not complete developing in children until they are of roughly 10 years of age.

Chronicle 1947
Hearing Aid for Deaf Children
Four-valve electric hearing aids, which magnify sound up to 1,000 times, gave normal hearing for the first time to South Australian rubella children last week. It is expected that the aids will enable most of the 60 rubella children in South Australia to learn to speak in about two months and eventually attend school. When they were fitted with the new aids, these children heard sounds for the first time in their lives at an acoustics laboratory established by the Commonwealth Government in Adelaide to provide hearing aid service for deaf children and deaf ex-members of the fighting forces.