Your Life is Their Toy - Emanuel Josephson

APPENDIX I: The Lempert Fenestration Operation For Deafness

MAYHEM AND HUMAN EXPERIMENTATION The fenestration (or "window") operation for the supposed "cure" of deafness is a vicious and ruthless fraud deliberately perpetrated by organized medicine upon the pathetic victims of deafness. It was promoted as a device to bolster the incomes of the boss otologic specialists that had been cut severely both by depression and by technological improvements in the treatment of chronic mastoid infections with sulfanilamide, penicillin and Iodobor (iodine and boric acid) powder. The exploitation of millions of deafened persons by this operation offered a surgical income replacing that previously derived from the oft useless and injurious radical mastoid operations, This fraud was the chief product of the multi-million fund for research on otosclerosis raised from the public by the bosses banded together in the American Otological Society, Seldom in the annals of medicine or quackery has a procedure been exploited more skillfully or more ruthlessly than the Lempert Fenestration Operation. The most costly press-agentry plus the advertising inherent in the support of the American Otological Society and of the American Medical Association were used in pushing the operation. At the same time the entire force of censorship of those organizations and their publications were used to prevent the public, the otologic specialty and the medical profession learning the ugly truth about the fenestration operation and the permanent injuries and sequellae it inflicts upon its victims, A rigid censorship by organized medicine bars the publication even in medical specialty journals of the injuries resulting from the operation. It was not until the late I930 r s that the American Otological Society awoke to the lucrative significance of some of the operative experiments on human victims of deafness that had been carried on in Europe, by Dr. Gunnar Holmgren in Sweden, and later followed by Dr. Sourdille in France, Hastily, Dr, Sourdille was invited to this country to describe his operations on the deaf before the New York Academy of Medicine. If the American public could be induced to accept this operation for deafness, the pocketbooks of the leaders of otology could be bolstered. Dr. Julius Lemper t found in these experiments on the deaf a royal road to notoriety, a means of rehabilitating his fortune and of ingratiating himself with the specialty bosses. Lempert undertook to modify Sourdille s operation in such manner as to make it more palatable to the public. Holmgren and Sourdille in their experiments had been mindful of the dangers to life, health and hearing involved in their experiments. Consequently, they had undertaken to minimize the risk involved by doing the operations in several stages. However, there would be considerable sales resistance on the part of a deafened but otherwise healthy individual to submit himself to repeated series of operations. Lempert "improved" the procedure by doing the operation in one stage that required hours on the operating table, and by using dental drills and other minor operative variations. In essence the operation consists in drilling a hole at the base of the skull, in the lateral semi-circular canal that is an integral part of the inner ear. This hole is made on the questionable theoretic premise that sound enters the inner ear by way of an opening known as the oval window; on a clearly questionable and often provably false premise that the cause of the impairment of hearing is blocking of that oval window; and on the assumption that drilling a hole in the inner ear will facilitate the entry into it of sound waves, even though it is demonstrable that the entire structure of the inner car vibrates in resonance to sound. Lempert was barred by repute and medical politics from presenting his "cunning" invention to the profession. He made a deal with Dr. Samuel J. Kopetzky, a ranking officer of the New York State Medical Society and an influential politician in the American Otological Society, to present his data on his original group of human experiments before the American Otological Society meeting at Atlantic City in 1938- As has been related, Dr. Kopetzky, who was chairman of the publicity committee of the New York County Medical Society and of the New York Academy of Medicine, also was quite successful in obtaining censor-free publicity In the lay press, especially the New York Times, for his exploitation of the operation. According to the story told by Dr. Kopetzky, however, this very publicity proved his undoing. The frequent mention of his name in the New York Times reports caused the jealousy of his colleague, the charge that he was trying to steal credit for the work, and vindictive reprisals. Dr. Lempert reported to the American Otological Society that the data which he had furnished Dr, Kopetzky had been falsified and thus forced his resignation from the Society. Shortly thereafter the selfsame data that Lempert labelled "falsified" when presented by Kopetzky, was published in an issue of the A.M.A. publication, Archives of Otolaryngology entirely devoted to the subject of the Lempert Fenestration Operation by its editor, Dr. Shambaugh. It may be a mere matter of coincidence that Dr. Shambaugh's son was boosted by Lempert as one of the few otologic surgeons who could be trusted to do the Lempert Fenestration Operation, thus insuring young Shambaugh a share in the spoils inuring from the publicity. Publicity that would do credit to the highest-priced perverters of public opinion in the land has been fed to the public in a constant stream to lure the deaf to victimization and doom. The pathetically hopeful victims of deafness have been fleeced of millions of dollars with the help of articles in Sunday newspaper supplements, Saturday Evening Post, Reader's Digest (which presented two articles promoting the operation in one year) , Hygeia and the columns of Damon Runyon, Ed Sullivan and Waiter Winchell, among numerous others. The editors of these publications refused to publish the truth about the operation or the pathetic plaints of its victims. They submitted the latter to the censorship of organized medicine, that wished only to boost and promote the operation and the fees it implied. The Lcmpert Fenestration Operation has been truthfully acknowledged to be an experimental procedure fraught with danger for its victims, by Dr. Julius Lcmpert himself. He was forced to acknowledge this under oath in the course of an examination before trial for malpractice brought by one of a series of victims fortunate enough to be able to sue for the total deafness and injuries resulting from the operation at Lempert's hands. They were able to bring suit because I dared to testify as expert on their behalf. In the case of Charles Tucek vs. Dr. Julius Lempert, which Dr. Lempert paid twelve thousand dollars ($ 12,000) to settle rather than go to trial, during the crossexamination on January 31, 1944, Lempert was forced to acknowledge that in every fenestration operation there is inflicted upon the victim an acute labyrinthitis that may destroy hearing permanently; that there is no way of determining in advance if the labyrinthitis will or will not destroy hearing. His statements read as follows: " . . . all {victims of the fenestration operation) have , following this operation,, a certain degree of labyrinthitis. Now, it either subsides or it does not . . . If the hearing does not return and gets worse, that is evidence that a labyrinthitis? . . has taken the course for the worse instead of better " {page 170) "Q. And there was inflammation accompanying—acute inflammation accompanying this in the first stages, was there not? A. There is always a sterile serious labyrinthitis , an acute inflammation of the membranous labyrinth." "Q. And the acute stages disappear, and it becomes chronic, is that right? A. The acute stage disappears and either resolves and the hearing comes back to the original state, or it does not resolve and becomes chronic and the hearing does not come back." "Q. Well is there any scientific bases upon which to prognosticate after say, four or five months, that it will subside or that it will not subside? A, Nothing else (except to wait and sec)." "Q. And you can not tell which will and which won't? A. You can not tell which will and which won't, that is right." (page 171) "Q. Well let me put the question to you this way, then: is it not a fact that chronic serous labyrinthitis occurring post-operatively usually results in a destruction of both the vestibular and cochlear function? A. That is correct." "Q. And is it not true that as a result of such a complication the improvement in air conduction hearing obtained by fenestration rapidly recedes until the hearing reaches a level much lower than the preoperative level? A.That is right." U Q. And is it not a fact that in such cases bone conduction completely disappears? A. As a rule." (page 179) It is interesting to note that his hearing initially improved to such an extent that Tucck encouraged other victims to submit to the operation. But two years later he was completely deaf. Though the Tucek case is reported in the medical literature as "successfully operated," he recovered damages for malpractice and total deafening from Lemper t by a settlement out of court The settlement was made on the erudition that the matter would be hushed and not publicized at the time. Thus it is a fact acknowledged even by Lempert that a fenestration operation is a reckless gamble with deafness and with a deliberately inflicted labyrinthitis that can and very frequently does destroy the very sense of hearing that the operation is represented as designed to preserve. The medical profession when it represents the fenestration operation, with its gamble and its many dangerous and disabling sequcllae, as "accepted practice," is a deliberate accomplice in maiming and disabling the victims of deafness. It is in common decency as well as duty bound to honestly inform the public that the Lempert Fenestration Operation is an experiment that is dangerously destructive to the hearing in a large proportion of the subjects; that the improvement obtained in a fraction of the cases can not be expected as a rule to be more than temporary, and following some measure of improvement in these cases, the hearing is gradually lost. The profession should also inform the public that the consensus among the informed members of the profession is that the improvement obtained on the operating table, in a moderate per cent of cases, is due to decompression of the inner car and reduction of its fluid pressure. This decompression of the inner ear and associated improvement in hearing has been obtained by spinal tap and introduction of air, as for encephalography. This has been reported in the literature by me (Science, v8o: 2075 1337), and subsequently by Max Meyer (Acta Otolaryngologica, V27; 1-15 139; Monatschr. f. Ohrenheilkunde, V73: 140: Feb. 1939; Annales d'Oto-Laryngologie, 57588a: June 1939; Praktika Oto-Rhino-Laryngologia, v3: 1-16:40). Spinal tap and encephalography is a relatively innocuous procedure and can be done usually with no injury, in sharp contrast with the dangers of the fenestration operation. Incidentally, the enccphalographic studies of chronic progressive deafness cases reveal in a high percentage of cases, evidences of brain lesions such as cerebral atrophy with enlargement of the ventricles, meningitic adhesions, mcningiornata and others, as the causes of the deafness. Wisdom dictates that in a large proportion of cases of progressive deafness encephalography should be done for diagnostic purposes before any more drastic measures are even considered. This procedure alone suffices in many cases to give a startling improvement in hearing. As an experimental operation, fenestration naturally involves the risk: of suit against the opejator for malpractice, even in those theoretic cases in which no damage is done to the victim. But it is not possible to do the operation without inflicting injury and damage. To injure a person by an experimental procedure aggravates the negligence and malpractice. Fortunately for the operators, few of the victims of the Lempert Fenestra* lion Operation have been able to obtain the expert medical testimony that is required by the court, or competent counsel sufficiently informed about medicine, to go on trial. The victims of the earlier operations who have been able to get the legal and medical aid have brought suit and recovered from ten to twenty-five thousand dollars each from the originator of the operation and others. More recently the surgeons have sought to protect themselves from the consequences of the injuries inflicted by their operation by increasing the number of victims, through publicity of a favorable variety, to the point where the operation can be classed as "practice accepted by the profession," This would be an almost complete defense legally, unless special negligence can be proved, no matter what injury is inflicted on the victim of the operation, even total deafness and death. The more serious consequences and sequellae of the Lempert Fenestration Operation, which I will illustrate below by cases operated by Lempert that I have had occasion to observe at first hand, and that are corroborated by court records and by malpractice verdicts, or by settlement made out of court, are the following: 1. Permanently Impaired Sense of Equilibrium. The victim loses more or less permanently his sense of balance and coordination. This injury is the invariable consequence of a "successful" operation. It is the natural result of injury done to the semi-circular canal by the operation, including the heat of the drill and the mechanical trauma, by drilling a hole in the wall of the canal, by interference with the flow of lymph and blood, and the other fac tors involved in cutting away a section of the base of the skull, which is done in every Lempert Fenestration Operation; and by depriving the delicate vestibular structures of the protection given by an intact middle car and ossicular mechanism against mechanical injury from sound vibrations. Theoretically this injury should be remedied when the fenestrum, or hole, cut in the canal wall closes, as it usually does. But despite healing of the bony wall, the loss of equilibrium generally persists. 2. Vertigo. The dizziness is intense in every case following the operation due to the trauma and irritation and the labyrinthitis that Lempert acknowledged occurs in every case. Generally the acute vertigo subsides in varying measures; but in some cases it persists unabated and permanently, 3. Progressive Deafening advances steadily despite the operation even in the small per cent of cases that show initial improvement. The fenestration operation does not affect the underlying cause of progressive deafness or of otosclerosis. It merely is pretended that it corrects only one of the many manifestations of otosclerosis, i. e. fixation of the stapes. Fenestration could not conceivably, and does not, prevent progressive loss of hearing by otosclerotic changes in the round window, by impairment of vascularity of the inner ear, by damage to nerves and nerve endings, and others. 4. Total Permanent Deafness is the eventual result of the operations. It ensues immediately after many of them. Fixation of the stapes, which Lempert Fenestration Operation is designed to correct, seldom if ever causes total deafness (in sharp contrast with blocking of the round window which almost invariably causes total deafness, and can not possibly be relieved by fenestration)* Lempert Fenestration Operation can and does cause permanent total deafness in the operated ears. Only bull-headedness, stupidity and utter disregard of human values of the operation can be regarded as explaining the complete deafening of both ears by operating on the second ear after the first has been completely deafened by fenestration. But many such cases have come to my attention. These cases make it quite clear that the operator who performs the Lempert Fenestration Operation deliberately risks destruction of the victims hearing while pretending to seek to correct an otosclerotic stapes fixation which can not be diagnosed with certainty, clinically. The deliberate risk and hazard imposed on the victim by the operator is inexcusably brutal malpractice. 5. A steadily progressive contraction of the field of vision has been found in every case of the Lempert Fenestration Operation that has been observed thus far. In many cases of progressive deafness there is to be found some contraction of the field of vision, which should be taken in every case of deafness. Determination of the cause of this contraction of the field may lead to the diagnosis of the cause of the deafness—especially in those cases involving cerebral lesions. What the cause of the progressive contraction of the field of vision following the Lempert operation may be, remains to be determined and studied. 6. Roaring tinnitus is caused in many cases by the Lempert Fenestration Operation. It is paradoxic and ironic that it frequently persists in so aggravated a form as to drive the victim frantic even after the hearing has been lost completely. 7. Pain in the jaws when attempt is made to chew solid foods. This pain has been noted ns a persistent sign in a majority of the victims observed. Other sequellae of the operation that arc less regularly observed, and complications, are the following: 8. Excessive sensitivity to vibrations occur in some victims of the Lempert Fenestration Operation even after hearing has been severely damaged or destroyed. Loud or rumbling sounds nauseate them and cause them to fall in the direction of the operated ear. These victims dare not go out on the street alone for fear that the tooting of an automobile horn will cause them to fait in front of the auto, or that the vibration of an oncoming train will cause them to fall before the train. 9. Facial paralysis occurs as both a sequela and a complication of the fenestration operation. Lempert has testified that facial paralysis should not occur as a result of his operation and denies its occurrence in any of his cases. But the case cited In the court records above quoted, presented a facial paralysis as a sequella. I quote from the record, once again (page 168): Q. Now the only observation that appears on the card is under the date of May 24, 1940: 'Facial paralysis, right,' "A. That is right," 10. Agonizing headaches from which no relief can be obtained, 11. Subdural abscess is denied by Lempert as a possible complication of the operation. But one of his victims, H—L n, received from Lempert last year a settlement of eleven thousand dollars out of court in a malpractice suit arising out of deafening and epilepsy caused by a fenestration operation at his hands. The subdural abscess was complicated by 12. Epilepsy that occurred as a sequela of the operation. 13. Sleeplessness is not an infrequent sequela. 14. Rapid fatigue of the eyes has been noted in a number of cases. These cases prefer to keep their eyes shut, especially after exertion. Light and bright colors may nauseate them. Impairment of ocular muscle balance with attacks of diplopia occur in most cases. The medicolegal consequences of the Lempert fenestration operation are best illustrated by case histories. The following three have been selected because they were performed by Lempert himself, and can therefore not be explained away as consequences of the operator's ignorance of the authentic technique: Case No. 1. Mrs, Racie B. Sherry, Age 48. CC. Total deafness following fenestration operations by Dr. Julius Lempert. PH, Ear infections in childhood. Chorea at nine years. Aggravation of hearing impairment at onset of menses that subsequently improved with restoration of fair hearing that remained stable. Tonsillectomy and adenectomy, 1907. Acute exacerbation of right ear infection October io, 1939, onset with pain and sero sanguineous or sanguino purulent discharge from the ear coming on during the night, complicated by nausea, vomiting, rigidity of the neck and extreme vertigo. Was hospitalized for five days and confined to bed for ten days longer. Ear drained profusely untit February, 1940, when the car cleared up and some hearing was restored. Edge water Hospital diagnosis— labyrinthitis complicating chronic otitis media. X-ray diagnosis by Dr. Zeitlin then revealed "sclerotic right mastoid with no development of squamous cells 4 . . , indicating old chronic pathology dating back to infancy." Hearing was impaired but was adequate enough in left ear to permit her to hear loud conversation, radio, telephone, music and the theatre. In an April 1940 issue of Time patient she read about the marvels of the Lempert Fenestration Operation in improving the hearing of the deafened. A letter to Dr. Lempert brought a reply referring her to Dr. Pcrelman, an agent of his. Dr. Perelman examined her and told her (the conversations here reported arc abstracted from the court records of the case); "Your right ear or any running ear is out of Lempert's line. But your left ear is perfect," and made an appointment for her with Lempert on April 19, 1940. "I'll make your left ear 100 per cent," Lempert told Mrs. Sherry at the consultation. "You will hear without a hearing aid . . . The fee will be $1000.00." After bargaining, he settled for a fee of $75000 plus the charges of his hospital, the York Hospital, and argued: "You uevei cuu tell what will happen to your left ear.'* This was a clinching argument for Mrs. Sherry who depended on the hearing in her left car for the conduct of her business. On May 25 , 1940, Mrs. Sherry came to New York to be admitted to the York Hospital for an operation on her left ear. "Have you got my money?" was the first question asked her by Dr. Lempert. When she offered a payment of $500.00, she was told, "I said $750.00." But when Mrs. Sherry threatened to return to Chicago, Lempert agreed to let her pay the balance later. On the following Friday, Mrs. Sherry was prepared for an operation on her right ear instead of the left. She protested that it was the wrong ear, but was carried off to the operating room. Later that day she awoke in great pain, intense nausea and vertigo, and found that her right ear had been operated upon despite Lem pert's repeated assurance that nothing could be done for that ear because of the earlier infection and he had no authorization for the operation. For two weeks she suffered agony in the hospital. During the first ten days her face was paralyzed and her right lip drawn back, After discharge from the hospital, she submitted to numerous painful treatments consisting of brutal cutting, pulling and probing in the painful wound for six more weeks. At the end of two months of torture—what hearing she had had in her right ear was completely destroyed. When the patient and her husband protested against the erroneous and needless opration on an infected ear, Lempert attempted to shift the responsibility to them by alleging that they had not given a history of an infection in the right ear to the interne. When it was pointed out to him that he had taken X-rays of the ears and mastoids, had examined them, and that he should have known first hand that there was an infection present, he merely offered to operate on the left ear without any charge. This incident is an eloquent commentary on the reliability of the doctor's records and reports. During the time that Mrs, Sherry was receiving post-operative care, Lempert urged her persistently to have her left car operated. In payment he asked no fee and assured her she would have normal hearing if she permitted him to operate again. July 25, 1940, she returned to the York Hospital to have her left ear operated upon. The $250.00 balance of the first operative fee was demanded of her, plus hospital expenses. When she refused to pay and left to return to Chicago, she found a note in her box at the hotel offering to waive the fee. Following the second operation she was even worse off than after the first. She had intense pains in her head, arms and shoulders, had terrific head noises and was dizzy and vomited continuously. Immediately after the operation she discovered that she had completely lost her hearing in both ears as a result of the operations. The after treatments were as brutal as after the first operation. Dr. Lempert represented that after due time there would be recovery of hearing. After seven weeks of after-treatment, Mrs Sherry returned to Chicago. In the coriespondence that followed Dr. Lempert was evasive. After the lapse of several months, Mrs. Sherry gave up all hope of recovering nor mal hearing. But she pleaded with Dr. Lempert to give her relief from the horrible consequences of the operation. She was so completely deaf that even a fraction of her defective hearing would be a Godsend. Her sense of balance was so badly impaired that not infrequently she fell on the street and had to be helped by passers-by or the police officers, who sometimes suspected her of being drunk. And when she stood on the curb and an approaching car tooted its horn, she pitched forward in front of the auto and narrowly escaped death For the same reason she could not travel in the subway. Roaring noises, blasts and sirens filled her ear continually despite deafness. In September 1941, Dr. Lempert prevailed upon Mrs. Sherry to submit to a "revision" of the operation, by a "new technique and improvement" which lie had "invented," on the left ear which he assured her would give her the relief she sought. But following the "revision," Mrs. Sherry was worse off than ever. She consulted Dr. Perelman and other physicians, who advised her that relief could be had from the head noises only by operating and destroying the auditory nerve. Several months later Mrs. Sherry took the matter up with Dr. Lempert, who advised for relief the destruction of the inner car instead of destroying the auditory nerve, because it would equally effectively destroy all possibility of hearing. When Mrs. Sherry railed at Dr. Lempert, he tried to play on her emotions by asking sympathy for the death of his son. Mrs. Sherry replied, "I am more to be pitied than he. I must live so." Mrs. Sherry sued Dr. Lempert for recovery of damages for the malpractice he had perpetrated. On January 25, 1944, after a dramatic trial during which Dr. Lempert undertook to spellbind the jury with the same spiel as he used on his professional colleagues, the jury awarded Mrs. Sherry and her husband $24,000, which was promptly paid by Dr. Lempert and his insurance company. So influential were Dr. Lempert's public relations advisers that news of this dramatic case was suppressed in most of the newspapers and publications in the country. And even the report that was published in the February 7, 1944, issue of Newsweek, they were able to have written in such way as to praise Dr. Lempert to the skies as a public benefactor who had been abused and imposed upon. Case No. 2. Charles Tucek, male. Age 58. CC* Severe deafness in both cars that precludes gainful employment as a consequence of a fenestration operation by Dr. Julius Lempert. FH. Negative. RH. Had suffered from a slowly ptogressive deafness for a period of twenty years. Prior to time of operation his hearing in the right ear was fair and permitted continuing in gainful employment as a railroad man, especially with the use of a hearing aid. Heard well over the telephone. As a consequence of glowing publicity of the Lempert Fenestration Operation in Time magazine, and of assurances that he would improve his hearing, patient submitted to a fenestration operation. His right car, on which he depended for hearing, was operated by Dr. Julius Lempert on April 2, 194 > at his York Hospital. During his post- operative stay in the hospital he noted that his hearing had been severely impaired though he could still hear loud noises. On the sixteenth day after the operation, two days after he had been discharged from tile hospital, the patient became completely deaf in his operated right ear. On the following day he was assured by the operator that this was "nothing to worry about," and repeatedly was assured during the following year and a half that he would recover his hearing. On October 22, 1941, patient submitted to another operation on his right ear at the hands of Dr. Julius Lempert, a so-called revision. Though his hearing was unimproved after the operation and his right ear was completely deaf, he commuted to New York for treatment to "restore hearing" until more than two years after his initial operation. In the meantime he lost all useful hearing in both ears and could not continue in his vocation and was compelled to resort to lip-reading. In addition to loss of hearing, he has frequent attacks of vertigo, often can not walk straight but staggers as if drunk, has suffered impairment of coordination, loses his balance on change of posture as when arising from a chair or turning around, and falls over unless he is supported. Fears going out in the street alone. Examination revealed a chronic inflammation with massive crust formation at the site of the operation. The fistula test was positive and elicited nystagmoid movements of the eyes. Past-pointed widely. Field of vision was sharply contracted. HEARING COMPLETELY LOST IN RIGHT EAR; LEFT EAR SHOWED RESIDUAL HEARING RANGING FROM 80 TO 110 DECIBELS BELOW NORMAL. Following extensive examinations of the defendant physician before trial, he settled the malpractice case brought for injury to hearing and loss of equilibrium for twelve thousand dollars ($12,000) with the proviso that no publicity should be given the case at the time of settlement. Case No, 3. H. L, . Male. Age 34. CC. Total deafness in left ear following the fenestration operation by Dr. Julius Lempert for the relief of progressive deafness, complicated by epileptiform convulsions, impaired coordination and equilibrium, double vision and other disabilities FH. Father slightly deaf for ten years before death. Uncle on father's side deaf. Two sisters deaf. No members of the family hear perfectly. PH. Chickenpox at eight years. Measles at ten years. Frequent colds. Hearing impaired since age of fifteen years. Repeated fractures: 1. Right thigh, caused by being knocked off wagon by a box which struck and injured his head at nine years. 1. Fracture of left maxillary process in the course of a boxing match at twenty-three years. Submucous resection, 1928. Tonsillectomy, 1930, Attacks of deafness in 1925 and 1927, which cleared up spontaneously. Deafness recurred and became progressive in the early thirties but up to the time of his operation he was able to engage in his occupation with comfort, with the aid of a Sonotone bone -conductor hearing aid. In July 1940, as a result of the reported success in restoration of hearing of Case No. i, Charles A. Tucek, who is the brother of a fellow-worker, this patient was admitted to the York Hospital for a Lempert Fenestration Operation for the restoration of hearing. He was about to marry, but decided in stead to spend the money, several thousand dollars, to improve his hearing. At the time of his admission to the hospital he was suffering from an acute abscess of three upper teeth on the right side. Due to the illness of his dentist he had not had them pulled out on the day before his admission to the hospital. He hoped that the teeth would be taken care of in Dr. Lempcrt's York Hospital before the operation; but both his abscesses and the pain were completely disregarded. On the morning following his admission to the hospital, his right ear was subjected to a fenestration operation. No relief of his abscesses and toothache was obtained by him during his stay in the hospital. Promptly after his discharge from the hospital, his teeth were extracted by his dentist and infected jaw treated. For a few days after the operation the patient's hopeful thinking led him to believe that his hearing was improved. But shortly after the operation on his right ear, it became completely deaf. The ear discharged profusely. He continued under daily treatment for months because he was led to believe that his hearing would be restored. In March 1941, he was informed that the hope for restoring his hearing rested in an operation of his left ear, to which he submitted because it was represented to him that the ear was better suited to an operation, and that the operation on the left ear would improve the condition of the right ear and relieve the terrible head noises that had been caused by the operation. The operation on the left ear caused immediate subtotal and permanent destruction of his hearing in the left ear also. 1. As a consequence of these operations, this patient has completely lost his hearing in the right ear and has lost it almost completely in the left Before the operation the patient could hear fairly well by cupping his hand to his ear, and quite well with a Sonotone hearing aid. After the operation he could not use the hearing aid because of the profuse discharge and because the pressure of the instrument on the operated ear caused extreme nausea and vertigo. 2. Despite the extreme deafness, the operation caused extreme sensitivity to loud noises, which gave rise to nausea, dizziness, lurching and falling— most frequently to the left side of the completely deafened ear. Dares not go out in street alone or stand at curb for fear that the tooting of an automobile horn will cause him to lurch and fall in front of car. Does not dare to stand on the subway or train platform because of fear of falling in front of oncoming train. 3. Also, despite deafness, the operation has caused terrific tinnitus—roaring noises, ringing bells, peanut whistles, twang of a bow, that are constant, persistent and so loud as to be frightening. Also the pitch of the loud sounds which he hears with his right ear, shift suddenly, distorting the hearing that remains in the left ear. 4. Since the operation on the right ear the patient suffers from constant pain over the right mastoid. 5. Since the operations, patient's equilibrium and sense of balance has been so completely destroyed that walking is an effort that is marked by constant lurching and falling. He bumps into people when he tries to walk along 253)?> the street. Swallowing and sneezing throw him off balance. Can not walk in darkness because of his loss of sense of balance. 6. Coordination and timing are so severely impaired that he can not play ball or engage in any vocational activities involving these functions. 7* Can no longer drive his car safely because of faulty coordination, impaired sense of balance and sudden lurches which cause him to lose control of steering and causes the car to weave from side to side. As a consequence he had numerous collisions and has been forced to give up driving. 8. Loss of field of vision caused by the operation makes it impossible for him to see to either side. This caused inability to see cars coming at the side and contributed to his inability to drive. 9. Since the operation, he has suffered from double vision that blurs his sight. Eyes fatigue rapidlj' and he is forced to keep them closed after exertion. 10. Since the operation intense light and bright colors nauseate him, 11 . Has suffered from constant and terrific headaches, 12. Has frequent attacks of intense nausea and vomiting* Also has attacks of vertigo and nausea during the night that are so intense they wake him up. 13. Since the operation has had violent convulsions preceded by an aura of loss of balance, that usually comes on during the night and throws him out of bed so violently that he has suffered severe injuries repeatedly. 14. Difficulty in chewing solids and locking of his jaws has been caused by the operation. Pain over the mastoids and zygomatic processes is intense when chewing. 15. Insomnia has been constant since the operation. In part it is caused by the intense pain in the right ear and mastoid, when he lies on it, and by attacks of vertigo and nausea caused by lying on the left ear. Physical Examination: Right ear. Profuse, fetid, purulent discharge fills ear, flowing from region of base of pkull. Extreme tenderness over mastoid and zygomas. Posterior wall of canal and mastoid region destroyed exposing horizontal semicircular canal and wall of inner ear. Totally deaf . Left ear. Posterior external auditory canal wall and mastoid destroyed. Cavity covered by crusts and moderate amount of pus. Hearing loss averages 80 decibels. Intensities of sound above threshold cause nystagmus, vertigo and nausea. The victim suffered not only from the consequences of the experiments performed on his cars, but also from a brain abscess (subdural) caused by the operation in the presence of the neglected acute dental infection, which should have contraindicated operation. Dr. Lempert settled this case for the sum of eleven thousand dollars ($n,ooo.) with the proviso that it would not be given publicity at the time. The steady flow of false and misleading publicity matter on Lempert and his fenestration operation that has been pouring into lay channels during early 1945, coupled with acquaintance with an extensive series of cases that have been hopelessly deafened and maimed for life by him and his operation impelled me to act for the protection of the public. In particular the stream of articles in the Reader's Digest and in the New York Journal American aroused my interest. For 1 knew directly from the editorial staff that Reader's Digest relied upon the advice of Dr. lago Galdston of the Medical Information Bureau of the New York Academy of Medicine for editorial advice and censorship in medical matters Dr Galdston acted also in concert with the Censorship Committee of the New York Journal American and no advertising or publicity matter that he did not approve was accepted or published by that newspaper and its affiliates. Articles by Damon Runyon in the New York Journal American of May 15 and 16 were so obviously inspired by its subject and so false, that I determined to beard the lion in his den and thrash out the issue. The Journal American refused any correction of the misleading data that had not been requested by the Medical Information Bureau or which Dr. Galdston would not approve. I therefore decided that the best way to protect the public would be to organize the victims of the fenestration operation who have been deafened and maimed for life and let them tell their story and truthfully warn prospective victims of the very real dangers involved. They would emphasize dramatically for the victims the danger of completely losing the hearing that they hope to improve by the operation. With this obejetive in mind I tried to insert advertisements in the New York Times, The World Telegram and The Journal American inviting those victims to meet for organization. The advertisements were rejected on the basis of Galdston's censorship. On May 16 1 called at the office of the Medical Information Bureau at the New York Academy of Medicine. I was announced by his receptionist. In his office I found Dr. Galdston seated at his desk in the corner of the room, sipping coffee. 1 told Galdston I had come to sec him about giving the public the truth about the Lempert Fenestration Operation but was being blocked by his censorship. I told him that 1 regarded the publicity as false, misleading and injurious to the public. Dr. Galdston signified that he sanctioned and approved of the Lempert publicity matter in his official capacity, thus indicating that he virtually was acting as publicity agent and making the Academy sponsor the publicity* He expressed his annoyance at my disapproval of it in no uncertain terms, that reflect no credit on the Academy and contrast sharply with its genteel, scientific pose. Dr. Gladstones conduct befittea more an irate pugilist than the official representative of the Academy. He refused to discuss civilly the Lempert publicity. Instead he berated me abusively, loudly accused me of exposing him and his activities in this book; said he was going to revenge himself for my expose; and ordered me out of his office. As I sat in my seat, he arose and struck at me, and threatened to call the police to oust me. When I arose to leave, he opened the door and ordered a }'Qung lady in his anteroom to call the police to remove me. I left and returned the same afternoon with a secretary to witness and record further conversations with Galdston—as censor of the Medical Information Bureau. He categorically refused to see us despite the fact that I emphasized in my message given his receptionist that the issue was of vital public interest, that I had no desire to see him as an individual, hut merely in his quasi-public official capacity as censor for the Academy, Thus the most sanctimonious of medical organizations, the New York: Academy of Medicine presents the revolting spectacle of fostering and "protecting" in true gangster spirit, one of the most vicious of the modern day medical rackets that sacrifices human health and life.