Jack, a devoted Air Force veteran, served his country with immense personal sacrifice. His struggles began with sinus issues that worsened during flight training. In search of relief, Jack underwent several sinus surgeries over the years. Under pressure from superiors, he also had a turbinectomy performed, a procedure that left him disabled and ultimately ended his military career. Read Jacks PDF file here.
Initially, Jack held onto hope that these surgeries would ease his sinus issues and allow him to continue flying, but the outcome was far from what he had envisioned. Each surgery brought complications and did not ease his pain. Instead, they led to a condition known as Empty Nose Syndrome (ENS). This syndrome occurs when excessive tissue is removed from the nasal passages, leaving the patient with a feeling of nasal obstruction, despite the physical space being open. Jack felt suffocated by the very air that was supposed to relieve him, leading to profound emotional and psychological distress.
The impact of ENS on Jack’s mental health was devastating. He experienced a significant change in personality, becoming withdrawn and depressed. The physical pain he endured was intensified by the emotional toll of feeling trapped in a body that had been butchered. Jack struggled to articulate his suffering to those around him, which only added to his sense of isolation. His family noticed the changes in him—he became irritable and distant, unable to engage with his loved ones. They could only watch as he battled a silent torment, feeling helpless to alleviate his pain.
In the spring of 1961, overwhelmed by his suffering Jack could no longer endure the pain. He left the house with a .22 caliber handgun and never returned. His suicide was not an impulsive act but rather a culmination of years of physical and emotional struggle, as he felt that his condition had robbed him of his dignity and quality of life.Initially, the Department of Veterans Affairs (VA) ruled that Jack’s suicide was not connected to his military service or his chronic disability. However, his wife, determined to secure recognition of Jack’s struggles and the impact of his service, appealed the decision. In her appeal, she emphasized her inability to support their children on her meager salary of $4,040 a year (equivalent to about $34,000 today) and argued that she was not seeking to defraud the government but simply wanted to ensure her children could pursue their education.
After nearly a year of appeals, the VA reversed its initial ruling and acknowledged the severe impact of Jack's chronic pain and subsequent mental health issues. They ultimately granted his widow a monthly Dependency and Indemnity Compensation payment of $122 (approximately $1,000 today). This decision marked a small victory in recognizing the Empty Nose Syndrome that took Jack's life, though it came too late for him.
Read the full article about jack Ackland here. The article can also be found in this PDF file
Excerpts from the Article:
"In this hospital, I was placed under the care of Major RW Wright, MD, head of the ENT department. I was determined not to undergo surgery on my sinuses, but after considerable pressure, I ultimately consented to a 'submucosal' operation... referring to a submucosal resection that removes the cartilage and bone from the nose.""Wright hypothesized that a set of tiny nasal bones called 'turbinates' are often infected and could contribute to ear problems. During Jack's first surgery in March 1943, Wright cut nasal cartilage and bone. He then operated on Jack's turbinates, performing a turbinectomy. Not only was too much of the nasal structure removed, leading to a collapse of the nose, but the ends of the turbinates were resected, resulting in excessive airflow due to an enlarged nasal cavity and atrophic rhinitis. Other doctors criticized the surgery... examining him and deeming the operation 'unnecessary.'"
"Majors Wilucki and Neff in Tucson made very complacent remarks about the well-done work on my nose and expressed doubts about my ability to continue flying but said I deserved a chance to try, Jack recalled in his letter from March 1952. Jack did indeed try, and he failed."
"The symptoms were the same as before hospitalization in Santa Ana, and the pain was exacerbated by flying... The symptoms were so severe that he was unable to fly. Jack was grounded, demoted to private with 'no prejudice,' and sent to Amarillo Air Force Base for assignment," he wrote in his 1952 letter.
Len writes: "I now knew the details of his surgery, but I still had a significant unanswered question: why did Wright, an experienced surgeon, perform such a radical operation that left my father too disabled to continue his service? Did he, in the eyes of other doctors, botch the surgery? Were his resections intentional or the mistakes of an overworked military surgeon?"
"While I could not determine Wright's surgical rationale for my father, the results of the operation are indisputable. I asked Dr. Robert M. Meyers, an ENT professor at the University of Illinois in Chicago, to review the details of Jack's surgery and its consequences. Meyers stated that surgical procedures in the 1940s were 'performed coarsely compared to today.' Today, he said, Jack's condition would be referred to as 'Empty Nose Syndrome.'"
"In November 1946, he was hospitalized for sinusitis and streptococcal sore throat... resulting in 'specific arthritic infection and acute rheumatic fever with almost septic temperatures and significant swelling in each joint, to the point that his wife did not recognize him.' Jack wrote, 'It is thanks to the care of Dr. Brenann and his colleagues... that I finally pulled through, and on Christmas Day, my wife was informed that I was expected to live.'"
"After 1946... Jack filed a claim with the VA for an increase in his disability rating, seeking more benefits. He and his civilian doctors argued that the chronic bronchitis caused by the aftereffects of his sinus issues should be considered alongside the disability for sinusitis. The following September, the VA rejected his claim... His unsuccessful appeal to the VA included a supporting letter from Dr. E.R. Fenton of Washington: 'Mr. Ackland came to see me on December 31, 1943, and I have seen him regularly since. He has constant drainage from his posterior sinuses and an acute bronchial cough from bronchial pneumonia and pleurisy. He has been thoroughly examined... and there is nothing we could do to clarify this situation. Following these infections, the patient has suffered from infectious arthritis. In my opinion, the disability is permanent and total. I have recommended his retirement from official duties and that he seek a warm, dry climate in which to live.'"
Jack writes: "It is often necessary for me to lie down immediately after work so that I can show up the next day... However, violent headaches, many sore throats, arthritis attacks, weight loss, general debility, and sensitivity to pneumonia and similar respiratory illnesses are all the result of my disability."
His colleagues write: "He often seemed on the verge of collapsing when he left the office to go home or to the hospital... to be treated. There were times when the pain brought him down, and Mrs. Ackland had to come and drive him home." Jack "was hospitalized again in March 1961. This time, he was placed in isolation, which broke his heart as he felt contagious to his family and friends, leading to significant psychological distress... Jack said he felt 'a burden to his family.'"
"On Father's Day, and my brother's sixth birthday, Dad was too ill to accompany the rest of the family to Elitch Gardens amusement park. The next morning, at dawn, Mom woke me and said, 'Len, Len, your father is gone; he didn’t come home, and he has a gun.' It was a .22 caliber handgun he had purchased a year earlier... I jumped out of bed, quickly dressed, and took the little Pontiac Tempest to look for him. He had taken our second car... I drove north for a few miles to our usual shooting spot. Nothing. Then, on the way back, I spotted the Buick in the line of parked cars... a place where he undoubtedly expected a stranger to find him. Instead, it was me."
"Eleven months after Dad's death, the VA reversed its decision. Based on the evidence of the case, the agency clinically noted that Jack's pain had a psychological impact. They 'determined that there was a definite change in personality with behavioral disturbances and psychiatric manifestations symptomatic of an acquired mental disorder that caused psychological distress. This mental disorder existed at the time of the suicide. This mental disorder was recognized as being directly related to the consequences of sinusitis and bronchitis.'"
This article, written in 2018 by Len Ackland, a journalist and the son of a World War II veteran, recounts the journey and suffering of his father, Jack Ackland, who fell victim to Empty Nose Syndrome. The journalist investigates the causes of his father's suicide, who underwent a turbinectomy performed by the same ENT surgeon in 1943, followed by a Caldwell-Luc operation. Jack Ackland aspired to become a fighter pilot but suffered from barometric sinusitis, leading to frontal pressure, neuralgia, and sinus problems. Under pressure from his superiors, Jack underwent a turbinectomy, a procedure that left him disabled and ultimately ended his military career. Len Ackland describes the ordeal his father courageously endured for 18 years until he took his own life in 1962 at the age of 42. Terms such as "atrophic rhinitis," "empty nose syndrome," "submucosal resection," "removal of nasal cartilage and bone," "turbinectomy," "disability," and "psychological distress" are mentioned. Although his disability was linked to these surgeries, he was repeatedly denied the benefits he was owed. Seventy-five years later, what has changed? Turbinectomies are still being performed today. In April 2020, Marcio Goulart committed suicide following a turbinectomy performed two years earlier, during which the ENT surgeon resected nearly all of his turbinates. Marcio Goulart took his life because he could no longer endure his suffering; he was born on October 9, 1988, and was only 32 years old. On the Empty Nose Syndrome Awareness Forum, on April 26, 2020, Mari Garb wrote: "Hi, I come to inform you that the funeral of our dear friend Marcio is scheduled for 3 PM in the state of Minas Gerais in Brazil. May we bring prayers and a lot of light to him and his family in this sad moment of farewell."
