HISTORY OF MEDICINE

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Eva Peron

 

María Eva Duarte de Peron (May 7, 1919 – July 26, 1952) was an Argentine political leader, the second wife of President Juan Peron (1895 – 1974) and served as the First Lady of Argentina from 1946 until her death in 1952. She is usually referred to as Eva Peron, or by the affectionate Spanish language diminutive Evita. The nature of Peron’s illness was initially shrouded in silence. Her doctors diagnosed advanced cervical cancer in August 1951, but as was common at the time, the patient was told only that she had a uterine problem. According to the biographers Nicholas Fraser and Marysa Navarro, secrecy was so paramount that an American specialist, Dr. George Pack, performed Peron’s cancer operation without her or the public ever knowing. He entered the operating suite after she was under anesthesia.

 

Despite surgery, radiation and chemotherapy, Peron gradually worsened, dying in late July 1952 at age 33. Only then was it revealed that she had died of cervical cancer, although details of her treatment, including Dr. Pack’s involvement, remained concealed.

 

Peron’s first wife also died of cervical cancer, a venereal disease almost always caused by the Human Papilloma Wart Virus (HPV). Probably not a coincidence that both wives died of cervical cancer. Most likely, they both received the virus (HPV) that causes almost all cases of cervical cancer, from Juan Peron. In a 1972 biography, Erminda Duarte, Peron’s sister, claimed she had suffered intense pain and distress.

 

Eva Peron addresses the Peronists on 17 October 1951. By this point she was too weak to stand without Juan Peron’s aid.

 

By 1951, it became evident that Evita’s health was rapidly deteriorating. On January 9, 1950, she fainted in public and underwent surgery three days later. Although it was reported that she had undergone an appendectomy, she had actually developed advanced cervical cancer. Fainting continued through 1951, with extreme weakness and severe vaginal bleeding. Although her diagnosis was withheld from her by Juan Peron, she knew she was not well, and a bid for the vice-presidency was not practical in light of her condition. Only a few months after “the Renouncement,” Evita underwent a secret radical hysterectomy in an attempt to eradicate her advanced cervical cancer. In 2011 a Yale neurosurgeon studied Evita’s skull x-rays and photographic evidence and stated that Peron was possibly given a prefrontal lobotomy in the last months of her life in order “to relieve the pain, agitation and anxiety she suffered in the final months of her illness”. When used for psychiatric illness, lobotomy was once seen as a huge advance. Dr. Egas Moniz, a Portuguese neurologist who developed the procedure in the 1930s, was awarded the Nobel Prize in Physiology or Medicine in 1949.

 

Lobotomies for mental illness fell out of favor in the 1960s because of the development of effective antipsychotic medications, misuse of the procedure and a growing unease among doctors with the confusion and stupor that resulted from the operation. But the earliest practitioners of lobotomy saw another potential benefit: relief from severe and resistant pain. Lobotomy, the New York neurosurgeon Dr. Sidney W. Gross wrote in 1953, was a “valuable and humane” procedure that reduced pain by blunting patients’ emotional reactions to it. Even advocates acknowledged it could make patients “childish, dull, apathetic, with little capacity for any emotional experiences.” They simply believed such a state was preferable to constant pain.

 

In 2005, the Hungarian-born neurosurgeon Dr. George Udvarhelyi, who claimed to have assisted in Peron’s care in the 1950s and later moved to the Johns Hopkins School of Medicine, publicly discussed for the first time a lobotomy he said Peron received for intractable cancer pain a few months before her death. But it wasn’t until a Yale neurosurgeon, Dr. Daniel E. Nijensohn, himself an Argentine, began to research Dr. Udvarhelyi’s assertion that evidence began to accumulate. Dr. Nijensohn’s research, published in the journal World Neurosurgery and posted online, turned up several pieces of suggestive evidence. He confirmed details of Dr. Udvarhelyi’s story and found other contemporaries of Peron who had said she had had surgery for her pain. Dr. Nijensohn also unearthed information indicating that Dr. James L. Poppen, a neurosurgeon at the Lahey Clinic in Boston and an international expert on the use of lobotomy for intractable pain, had been summoned to operate on Peron in the summer of 1952. X-rays of Peron’s skull, Dr. Nijensohn found, showed indentations in the areas where lobotomies were usually performed. Dr. Nijensohn believes that a lobotomy was performed in May or June of 1952, meaning that Peron may have already had the procedure at the time of her last public appearance, riding in a limousine at her husband’s second inaugural.

 

If Peron indeed had a lobotomy, was she aware of what the doctors – with the permission of her husband, President Juan Domingo Peron – planned to do? Perhaps not, given the efforts to conceal her fatal diagnosis in general. And could a lobotomy actually have helped ease Peron’s suffering? Dr. Nijensohn is not sure. But many patients who were lobotomized in those days reported relief. “After the operations,” Dr. Frank J. Otenasek, a neurosurgeon at Johns Hopkins, told The Baltimore Sun in 1947, “patients either said they were not suffering or that the pain did not bother them.”

One of the ironies of Dr. Nijensohn’s story, if true, is that another method already existed for treating Peron’s pain: aggressive use of opiates like morphine. Doctors of the era, however, so feared that their cancer patients would become addicted to these drugs that they saw lobotomy as a suitable alternative. Today, our understanding of cancer pain has certainly changed. The liberal use of narcotics, accompanied by other medications to treat side effects, is seen as appropriate, not indicative of untoward behavior by patients. One of the most successful innovations in pain treatment, the morphine pump, allows patients to give themselves enough medication to dull the pain but to remain alert.

 

On 4 June 1952, Evita rode with Juan Peron in a parade through Buenos Aires in celebration of his re-election as President of Argentina. Evita was by this point so ill that she was unable to stand without support. Underneath her oversized fur coat was a frame made of plaster and wire that allowed her to stand. She took a triple dose of pain medication before the parade, and took another two doses when she returned home. In a ceremony a few days after Juan Peron’s second inauguration, Evita was given the official title of “Spiritual Leader of the Nation.” She died one month later. In 1971, Evita’s body was exhumed and flown to Spain, where Juan Peron maintained the corpse in his home. Juan and his third wife, Isabel, decided to keep the corpse in their dining room on a platform near the table. In 1973, Juan Peron came out of exile and returned to Argentina, where he became president for the third time. Peron died in office in 1974. His third wife, Isabel Peron, whom he had married on 15 November 1961, and who had been elected vice-president, succeeded him, thus becoming the first female president in the Western Hemisphere. It was Isabel who had Evita’s body returned to Argentina and (briefly) displayed beside Juan Peron’s. The body was later buried in the Duarte family tomb in La Recoleta Cemetery, Buenos Aires.

 

 

On July 26, 2012, to commemorate the sixtieth anniversary of Evita’s death, there began to be issued publicly tickets with a value of 100 pesos, in which the controversial effigy of Julio Argentino Roca is replaced by that of Eva Duarte, making the first real woman that appears on the coins of Argentina. The image in the notes is based on the design of 1952, whose sketch was found in the Mint, made by the engraver Sergio Pilosio with artist Roger Pfund settings. The emission totals 20 million tickets and is not yet clear whether it will fully replace the notes with the images of Roca and the Desert Campaign. Sources: The New York Times, by Barron H. Lerner MD; Dr. Barron H. Lerner, professor of medicine and public health at Columbia University Medical Center, is the author, most recently, of “One for the Road: Drunk Driving Since 1900;” Wikipedia

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