Few of the great stories of medicine are as palpably dramatic as the invention of open-heart surgery, yet, until now, no journalist has ever brought all of the thrilling specifics of this triumph to life.
This is the story of the surgeon many call the father of open-heart surgery, Dr. C. Walton Lillehei, who, along with colleagues at University Hospital in Minneapolis and a small band of pioneers elsewhere, accomplished what many experts considered to be an impossible feat: He opened the heart, repaired fatal defects, and made the miraculous routine.
Acclaimed author G. Wayne Miller draws on archival research and exclusive interviews with Lillehei and legendary pioneers such as Michael DeBakey and Christiaan Barnard, taking readers into the lives of these doctors and their patients as they progress toward their landmark achievement. In the tradition of works by Richard Rhodes and Tracy Kidder, King of Hearts tells the story of an important and gripping piece of forgotten science history.
From the Hardcover edition.
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From the Hardcover edition.
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King of HeartsThe True Story of the Maverick Who Pioneered Open Heart Surgery
By G. Wayne Miller
Three Rivers PressCopyright © 2000 G. Wayne Miller
All right reserved.
On the day that some feared he crossed over into madness, the surgeon C. Walton Lillehei woke at his usual time, about six o'clock. He ate his ordinary light breakfast, read the morning paper, kissed his wife and three young children goodbye, then drove his flashy Buick convertible to University Hospital in Minneapolis. The first patients of the day were already unconscious when Lillehei dressed in scrubs and entered the main operating area. It was March 26, 1954.
Lillehei walked into Room II, where the doctors who would assist him were preparing two operating tables for the baby and the grownup who would soon be there. Nearly all of the doctors were young -- younger even than Lillehei, who was only thirty-five. Most were residents -- surgeons still in training who were devoted to Lillehei not only because he was an outstanding surgeon, but also because he seemed to live for risk and he overflowed with unconventional new ideas.
Lillehei checked on the pump and the web of plastic tubes that would connect the grownup to the baby. He confirmed that two teams of anesthesiologists were ready, that the O.R. supervisor had briefed the many nurses, and that the blood bank was steeled for possible massive transfusions.
He confirmed that the grownup -- who was the baby's father -- had not changed his mindabout their being the subjects of this experiment, which no doctor had attempted before.
It looks good, said Lillehei. I think we're ready to go.
Elsewhere in University Hospital, a nurse roused the baby.
Fourteen-month-old Gregory Glidden was an adorable boy with big ears and a fetching smile that had endeared him to the staff during the three straight months they had cared for him. He was unusually scrawny, but at the moment there was no other outward sign that he was sick. His appearance was deceiving. Gregory had been born with a hole between the lower chambers of his heart -- a type of defect that no surgeon had ever been able to fix. In fact, Gregory was dying. Dr. Lillehei doubted he would last the year.
Unlike many nights in his short life, Gregory had slept well and he awoke in good spirits. The nurse cleansed his chest with an antibacterial solution and dressed him in a fresh gown, but she could not give him breakfast; for surgery, his body had to be pure. A resident administered penicillin and a pre-operative sedative, and the baby became drowsy again. Then an orderly appeared and spoke softly to Gregory about the little trip he would be taking -- that he would travel safe in his crib, with his favorite toys and stuffed animals.
One floor below his son, Lyman Glidden was also headed for surgery. His wife, Frances, had come by to see him off, and as they waited for Lyman to be wheeled away, they were thinking not only of Gregory. They were remembering their daughter LaDonnah, who had been born with the same defect as their little boy. Somehow LaDonnah had survived, in relatively good health, until the age of twelve. Then, in the spring of 1950, she became gravely ill, and one night that September, she died in her sleep.
The Gliddens could never forget finding her body, cold and rigid in her bed.
It was half past seven. In the operating room next to Lillehei, Chief of Surgery Owen H. Wangensteen was cutting into a woman he hoped to cure of cancer. Wangensteen had not checked on Lillehei, nor had he told the young surgeon yet of the ruckus that had developed yesterday afternoon, when another of University Hospital's powers -- Chief of Medicine Cecil J. Watson, an internist often at odds with Wangensteen -- had discovered what Lillehei intended to do.
Watson already knew that Lillehei had joined the quest to correct extreme defects inside the opened heart -- a race that so far had produced only corpses, in Minneapolis and elsewhere. He knew of Lillehei's dog research -- of how the surgeon and his young disciples regularly worked past midnight in their makeshift laboratory in the attic of a university building. He'd heard of Lillehei's new open heart technique, in which the circulatory systems of two dogs were connected with a pump and tubes; thus joined, the donor dog supported the life of the patient dog, enabling Lillehei to close off the vessels to the patient dog's heart, open the heart, and repair a life-threatening defect. But until yesterday afternoon, when today's operating schedule had been distributed, Watson did not know that Lillehei -- with Wangensteen's blessing -- was taking cross-circulation into the operating room.
This was madness!
Watson went to University Hospital's director, who alone had authority to stop an operation. The director summoned Wangensteen, and the three men had it out.
How could such an experiment be allowed? Watson demanded to know. For the first time in history, one operation had the potential to kill two people. Yet, paradoxically, how could the Gliddens refuse? They lived in the north woods of Minnesota, where Lyman worked the mines and Frances stayed home with their many children. They lacked the guidance of a human-experimentation committee, for none existed in 1954. They would never consult a lawyer, for they were willing to try almost anything to spare their baby their dead daughter's fate.
And was it any wonder that Wangensteen had blessed Lillehei? Of all the resplendent surgeons on Wangensteen's staff, Lillehei was unquestionably the crown prince -- the most likely to bring the University of Minnesota a Nobel prize, which the chief of surgery all but craved. Blue-eyed and blonde -- a man who liked all-night jazz clubs and pretty women -- brilliant Walt could do no wrong in Owen's eyes.
The chief of medicine was appalled. Had they forgotten the girl who had preceded Gregory Glidden in University Hospital's Room II, poor Patty Anderson, who'd been lost in a river of blood?
Gregory was brought into Room II and transferred to one of its two operating tables. His crib with his toys and stuffed animals was sent back into the hall and he was in the company of masked strangers. A doctor placed an endotracheal tube down his throat and turned the gas on.
Asleep, Gregory was stripped of his gown and left naked under the glare of hot lights. How small he was -- smaller than a pillow, smaller than most laboratory dogs. His heart would be a trifle, his vessels thin as twine.
All set? Lillehei said.
The people with him were.
Lillehei washed Gregory's chest with surgical soap. With a scalpel, he cut left-to-right on a line just below the nipples.
Observers in Room II's balcony leaned forward for a better look. On the operating room floor, a crowd of interns and residents climbed up on stools.
Lillehei split the sternum, the bone that joins the ribs, and opened a window into Gregory with a retractor.
Nestled between his lungs, Gregory's plum-colored little heart came into view. It was noisy; with his hand, Lillehei felt an abnormal vibration.
Still, the outside anatomy appeared normal: the great vessels were in their proper places, with no unnatural connections between. So far, no surprises.
It looks okay, Lillehei said. You may bring in the father now.
From the Hardcover edition.
Excerpted from King of Hearts by G. Wayne Miller Copyright © 2000 by G. Wayne Miller. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
- Prologue: Red Alert
- Chapter 1: A River of Blood
- Chapter 2: Surgeon-Scientists
- Chapter 3: Invasive Procedures
- Chapter 4: Blue Babies
- Chapter 5: Animal Testing
- Chapter 6: A 10 Percent Solution
- Chapter 7: The Human Candidate
- Chapter 8: Brave Hearts
- Chapter 9: Zero Time
- Chapter 10: Lourdes in Minneapolis
- Chapter 11: Needles and Bubbles
- Chapter 12: One Red Rose
- Chapter 13: Moral Considerations
- Chapter 14: New York Medicine
- Chapter 15: Bread Upon the Waters
- Epilogue: The Right Stuff
- Source Notes
- Chapter 1: A River of Blood
What People are Saying About This
By telling the story of Walt Lillehei, Wayne Miller has captured a vital piece of medical history. Miller's tale of the pioneers of open heart surgery is a compelling life-and-death drama--a great read about surgeons who made a lasting difference to their profession and to humanity.
Dr. Walt Lillehei was one of the unsung heroes of surgery in the twentieth century. King of Hearts is a fascinating and suspenseful inside portrait of how this pioneer blazed a trail for all heart surgeons. It is a story of historical importance, and Wayne Miller tells it with precision and great spirit.
Most Helpful Customer Reviews
As a gamily member of a heart patient baby this is a book thay was an absolute could not put down. Amazing.
This is a great book for anybody you dont have to be a docter to read this amazing story
From the opening paragraph, the author captivates the reader. I couldn't put the book down. The book reads like a novel, and then you remember this is non-fiction.
Although I have not read this particular title, I wonder why the work of Vivien Thomas and Dr. Alfred Blalock was not included? Under the description of the book's content, these two pioneers were not even mentioned. However, Dr. Blalock and Thomas were first to do ANY heart surgery. Have they been forgotten?