Tracheotomy

Tracheotomy

This article relates to Good and Evil and Other Stories

In "An Eye in the Throat," the centerpiece of Samanta Schweblin's Good and Evil and Other Stories, a young boy named Elias puts a battery in his mouth. This being in the days before a bittering agent was added to batteries to discourage such behavior, he swallows it and causes terrible damage to his body: "The body's internal moisture has activated the battery's current, which has perforated the esophagus with a deep, dark burn." All that can be done is to perform a tracheotomy, a medical procedure which will allow Elias to breathe (if not speak) through his tracheostomy (the hole created by the procedure, also called a stoma). Lines are drawn between the literal wound in his throat and the psychic wound the incident has caused his parents: "There is…a hole in my body that hurts theirs."

A tracheotomy is performed on a person who can't breathe through their nose and mouth normally—​once done, the person will be able to breathe through the tracheostomy. If you've never seen someone who has a tracheostomy in person, you've likely seen a former smoker breathing through one in an anti-smoking PSA.

Although Elias ultimately doesn't speak in "An Eye in the Throat," preferring to communicate through sign language when he gets older, it is, in fact, possible to speak with a tracheostomy. It involves blocking off the plastic tube (called a tracheal tube) installed during the procedure and speaking, although this can be rather stressful due to the blocking off of airflow. There are also special devices called "speaking valves" which can be placed over the hole.

Elias' fate is ultimately more positive than those in anti-smoking PSAs: he grows up to be an intelligent, thoughtful young man who "lives in a spacious apartment with three stealthy cats," with a passion for reading and physics. While there are potential complications, it is entirely possible to live a happy, fulfilling life with a tracheostomy.

Figure A shows the installation of a tracheal tube during a tracheotomy; Figure B shows an external view of a patient who has a tracheostomy. Diagram courtesy of Wikimedia Commons

Filed under Medicine, Science and Tech

This article relates to Good and Evil and Other Stories. It first ran in the October 8, 2025 issue of BookBrowse Recommends.