his class, he won the opportunity to attend Harvard Medical School. Harken remained at Harvard as a graduate, spending part of his surgical residency in Boston and later New York before winning a grant from the New York Academy of Medicine to develop his interests abroad in a location and specialty of his choosing. Ambitious but not wishing to compete with the likes of Allen Whipple, Edward Delos Churchill, and Elliott Carr Cutlerâtitans of general surgeryâHarken decided to take a gamble and specialize in the newly emerging field of thoracic surgery. This was a bold move in an era that valued the gifted generalist more highly than the narrowly skilled specialist. Nevertheless, Harken chose to travel to England and take up a visiting fellowâs post at the Royal Brompton Hospital with Arthur Tudor Edwards.
Tudor Edwards was one of the few thoracic surgeons, if not the only one, in the world at the time of Harkenâs secondment. His caseload was principally concerned with the treatment of tuberculosis. Assisting in the operating room, Harken marveled at Tudor Edwardsâs skills as a technician, watching keenly as he carefully explored the contents of his patientsâ chests and pared back tuberculous tumors, liberating blood vessels and elements of the branching bronchial tree from their encasement.
Yet Harken couldnât help but wonder why, when confronted with the diseased heart, which was in his eyes a mechanical entity, Tudor Edwards and his colleagues remained reluctant to operate, despite the pioneering work of Grey Turnerâs generation. So when the outbreak of the Second World War interrupted his apprenticeship with Tudor Edwards, Harken returned to Boston to begin his own experimentation.
â
B ACTERIAL ENDOCARDITIS, AN INFECTION of the inner surfaces of the heart and its valves, was an almost invariably fatal affliction in Harkenâs time. In the absence of antibiotic therapy, the bacterial infection would disintegrate the heartâs internal structures. Worse, the pumping action of the heart would seed infection and emboli throughout the body. Harken sought to combat this formidable enemy. In theory, surgical removal of the focus of infection would arrest the process and give the afflicted patient the opportunity to survive. But at a time when the world remained reluctant to enter the cavities of the heart, Harkenâs hypothesis needed the support of hard evidence before he could attempt it in human patients.
He began by working on dogs. He operated on canine hearts and attached metal clips to the surface of their mitral valves. He found that this intrusion always led to infection and the onset of bacterial endocarditis. This approach provided a model of the disease he sought to treat, allowing him to simulate naturally occurring bacterial endocarditis in dogs, and it also gave Harken confidence that the cavities of the living, beating mammalian heart could be entered and repaired without immediate fatality.
However, Harkenâs work was once again interrupted by the events of war, as he was returned to England in 1943 and posted at Grosvenor Square under the command of General Paul R. Hawley, chief surgeon in the European theater of war. Here, anticipating a flood of casualties with penetrating chest wounds, he and Tudor Edwards campaigned successfully for the establishment of specialist thoracic units.
In the first half of 1944, presumably in preparation for the imminent Allied invasion of Europe, several specialist thoracic units were set up throughout England. In May 1944, Dwight Harken was released from his office post in Grosvenor Square and, to his delight, made director of the 15th Thoracic Center at the 160th U.S. General Hospital in Cirencesterâa thousand-bed facility complete with a nearby runway to receive casualties from the battlefront. For Harken, this was a happy release from the burden of his administrative role at Grosvenor Square, letting him
Tudor Edwards was one of the few thoracic surgeons, if not the only one, in the world at the time of Harkenâs secondment. His caseload was principally concerned with the treatment of tuberculosis. Assisting in the operating room, Harken marveled at Tudor Edwardsâs skills as a technician, watching keenly as he carefully explored the contents of his patientsâ chests and pared back tuberculous tumors, liberating blood vessels and elements of the branching bronchial tree from their encasement.
Yet Harken couldnât help but wonder why, when confronted with the diseased heart, which was in his eyes a mechanical entity, Tudor Edwards and his colleagues remained reluctant to operate, despite the pioneering work of Grey Turnerâs generation. So when the outbreak of the Second World War interrupted his apprenticeship with Tudor Edwards, Harken returned to Boston to begin his own experimentation.
â
B ACTERIAL ENDOCARDITIS, AN INFECTION of the inner surfaces of the heart and its valves, was an almost invariably fatal affliction in Harkenâs time. In the absence of antibiotic therapy, the bacterial infection would disintegrate the heartâs internal structures. Worse, the pumping action of the heart would seed infection and emboli throughout the body. Harken sought to combat this formidable enemy. In theory, surgical removal of the focus of infection would arrest the process and give the afflicted patient the opportunity to survive. But at a time when the world remained reluctant to enter the cavities of the heart, Harkenâs hypothesis needed the support of hard evidence before he could attempt it in human patients.
He began by working on dogs. He operated on canine hearts and attached metal clips to the surface of their mitral valves. He found that this intrusion always led to infection and the onset of bacterial endocarditis. This approach provided a model of the disease he sought to treat, allowing him to simulate naturally occurring bacterial endocarditis in dogs, and it also gave Harken confidence that the cavities of the living, beating mammalian heart could be entered and repaired without immediate fatality.
However, Harkenâs work was once again interrupted by the events of war, as he was returned to England in 1943 and posted at Grosvenor Square under the command of General Paul R. Hawley, chief surgeon in the European theater of war. Here, anticipating a flood of casualties with penetrating chest wounds, he and Tudor Edwards campaigned successfully for the establishment of specialist thoracic units.
In the first half of 1944, presumably in preparation for the imminent Allied invasion of Europe, several specialist thoracic units were set up throughout England. In May 1944, Dwight Harken was released from his office post in Grosvenor Square and, to his delight, made director of the 15th Thoracic Center at the 160th U.S. General Hospital in Cirencesterâa thousand-bed facility complete with a nearby runway to receive casualties from the battlefront. For Harken, this was a happy release from the burden of his administrative role at Grosvenor Square, letting him
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