![]() In these cases, parents served as the living bypass machines for their children, quite literally allowing their hearts to beat as one, with their fates irrevocably entwined. And who could not be moved by the first attempts at open heart surgery done by C Walton Lillehei, in which parents' systemic arteries and veins were directly anatomised to their children with congenital cardiac defects. In this bizarre manner, Forssmann performed the world's first cardiac catheterisation, for which he later received the Nobel Prize. (A nurse had tried to stop him from performing this reckless experiment on himself, but he subdued her and tied her to an operating table.) He then walked a flight of stairs to a radiology machine, and took a radiograph of himself showing that the end of the catheter really had reached his heart. Correctly surmising that a tube inserted into a vein in the arm could get to the heart in 1929, the eccentric German physician Werner Forssmann inserted a long urinary catheter deep into a vein in his own arm, until he thought it reached its destination. ![]() Although she became almost completely deaf, she compensated by using her fingers to feel the sounds.Ĭonsider, also, the things people will do to learn the secrets of the heart, to unlock its meanings, to set it right. Helen Taussig, the pioneer of paediatric cardiology, had even more impressive diagnostic powers, since she had to make her diagnoses in the 1940s without echocardiograms. For prairie dwellers and young persons who have never heard a steam engine on an upgrade, the grunt made by older persons of Mediterranean stock as they settle their arthritic joints into a chair is a passable substitute.” And of course, listening to the world isn't only an acoustic skill, but one that is so subtle as to be almost emotionally ethereal. For example, in his classic treatise The Art and Science of Bedside Diagnosis, Joseph Sapira offers the following advice to the budding clinician, “The murmur of aortic stenosis has been likened to the sound of a steam engine chugging up a hill. Listening isn't easy, and requires an active intelligence from the listener. These sounds are difficult to describe, and some resort to curious and sometimes inadvertently hilarious analogies. Almost every event that occurs-blood entering a chamber, a heart valve opening or closing, or an extra blood vessel where it shouldn't be-leaves acoustic evidence that can be collected with a stethoscope, still another reminder that one must, first and foremost, listen to the patient. A small trill, an extra reverberation, or a miniscule click provides important supporting information about possible structural problems with the heart. And yet it also leaves acoustic evidence that, to the trained ear, makes every heartbeat into a diagnostic fugue. But the heart more or less pumps blood day in and day out, without engaging in extraneous activities. The pancreas regulates body sugars and makes a bevy of substances to help us digest foods. The liver makes cholesterol, detoxifies wastes, and makes salts to break down fats. The kidneys produce urine, but also regulate blood pressure, help mineralise bones, and even determine the amount of blood the bone marrow manufactures. The heart is a highly disciplined structure, performing its task over and over again. It's an unlikely teacher, this organ to which I devote my life's work. The Lancet Regional Health – Western Pacific.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.
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