Shotgun Surgery

She was a Maine woman, a widow of 45, and she lived alone. When she had made up her mind to commit suicide, she laid her chin on the muzzle of a 12-gauge shotgun and pulled the trigger. The charge tore through her tongue, palate and nose, went on through the front part of the brain and out through the forehead. But she did not die.

Later, in Boston's Massachusetts Eye and Ear Infirmary, Plastic Surgeon Edgar M. Holmes loosened her tongue (held fast by scar tissue), closed the hole in the roof of her mouth, replaced the bones in the nose by a graft from the hip bone. In a recent issue of the New England Journal of Medicine, Dr. Holmes reported on the outcome of the case.

Today, the patient is practically as good as new physically. Mentally, she is much better. Before she shot herself, Dr. Holmes explained, she had a "pyramiding depression" (a depression that grows steadily worse). The shotgun blast had, in effect, performed in seconds a brain operation that ordinarily takes hours. It was "practically the same," said Dr. Holmes, as an anterior lobectomy--i.e., part of the frontal areas of the brain, which control emotions, had been cut through. At the hospital the patient was "perfectly oriented and cooperative"; she is now working in a hotel and living normally with a daughter.

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