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The psychological significance of surgical procedures in childhood is now generally recognized (Coleman, 1950); (Deutsch, 1942); (Fries, 1946); (Jessner and Kaplan, 1949); (Levy, 1945); (Lindemann, 1941); (Menninger, 1934); (Michaels, 1943); (Miller, 1951); (Pearson, 1941); (Pillsbury, 1951). Helene Deutsch (1942) found evidence in the analysis of adult patients that "operations performed in childhood leave indelible traces on the psychic life of the individual." David Levy (1945) and Pearson (1941) found in psychotherapy with children that operations experienced earlier in childhood had a traumatic effect on some patients. In our work with children we were impressed that in some cases the onset of emotional difficulties was attributed to an earlier operation.
Our knowledge of the meaning of operations in childhood comes mainly from retrospective studies. We felt that direct observations of children undergoing surgery would contribute to the understanding of this problem. While we plan to study a number of operations, we began with a most common operation in childhood, tonsillectomy and adenoidectomy (T&A). We were not only interested in the effects of operation, but also wanted to find out how children experienced short-time hospitalization and minor operation.
From November, 1947, to February, 1952, 143 children were observed while they were undergoing T&A at the Massachusetts Eye and Ear Infirmary. These children were unselected except for their accessibility for follow-up. This depended upon their living sufficiently close to the hospital and upon their mothers' willingness to co-operate with the study.