Assisting with Open Heart Surgery at 16Posted: September 11, 2012
My father had an extraordinary knack for finding summer jobs for his kids. When I was 16, I had an interest in biology and medicine, and Dad managed to get me a job as a lab assistant with his friend Jack Gibbon, who headed the Department of Surgery at Jefferson Medical University in Philadelphia. Even at minimum wage (then $1 an hour), it was the most astonishing job a teenager could have.
Dr. Gibbon and his wife Maly developed the external heart-lung machine to provide a mechanism to pump and oxygenate blood outside the body so surgery could be performed on the heart. The machine was perfected by performing operations on experimental animals, mostly dogs. Dr. Gibbon performed the first successful human operation in 1953.
By the summer of 1959, when I started at Jefferson, new uses for the heart-lung machine were being developed, specifically techniques for rerouting blood to bypass blocked vessels that impeded the supply of blood to the heart muscles. The heart had to be stopped during such surgery. To do this, the chest was cut open, a tube was inserted into one of the largest veins, the blood was routed outside the body through a large external pump and then oxygenated in an artificial lung tank and pumped back into the body by another tube inserted in a major artery. Just before cutting into the heart, the blood was pumped through a coil immersed in a tank of ice. When the blood temperature got low enough, the heart stopped spontaneously and the body relied entirely on the external heart-lung machine to survive. After heart surgery was completed, the blood was pumped through the same heat exchange coil, now immersed in a tank of warm water, and when normal body temperature was reached the heart would either start spontaneously or be started by the surgeon applying the electrodes of a defibrillator directly to the walls of the heart. The human operations were performed by a team of two to six surgeons and more than 20 technicians and would last as much as 12-14 hours.
I was part of a team of four that cleaned, assembled and monitored the heart lung machine. Before an operation this meant we wheeled large carts of equipment from the surgery lab to the operating suites, assembled the complicated machinery, and read gauges and provided reports to the surgeons. After the operation, we would have to take all the equipment back to the lab and disassemble the whole apparatus. I was assigned the slightly revolting task of carefully scrubbing the residual blood out of the many meters of tubing and the complex screens and valves of the artificial lung and then wrapping the parts to be sterilized in a steam autoclave. My work was mostly manual labor that required more muscle and endurance than intelligence. But it was an extraordinary experience to observe this fantastic surgery and to have conversations with some of the most brilliant scientists and surgeons in the world.
I worked at the surgical research lab for two summers. In the first year, all the operations were performed on dogs and, sadly, none of them survived. Just one year later, the procedures had been perfected to the point where I assisted as a machine technician during the operations on ten human patients, all of whom would have died without this surgery, which was then brand new and cutting edge. The procedure is now known as coronary bypass surgery or triple bypass surgery and over the last 50 years has saved the lives of millions of victims of heart disease around the world.