North Africa where Allied forces battled those of the legendary Nazi Field Marshal Erwin Rommel. At war’s end he returned with a Bronze Star to enter surgical training with the University of Minnesota’s legendary Dr. Owen Wangensteen.
Inside the hospital Dr. Lillehei was a highly respected surgeon, viewed by his nurses as unusually compassionate, and by surgical colleagues as an innovative genius. But outside the starched hierarchy of the hospital, Walt played by no one’s rules but his own. Whereas Charles Bailey scuffled with society’s norms, Lillehei simply ignored them. Walt shared a second trait with many of the innovators we will meet later. He was an unmitigated risk-taker. Walt lived life at double speed. Lillehei’s days were consumed with thoracic surgery, but his nights were gold chains, a Buick Roadmaster convertible, and late-evening carousing. Early on he discovered that the classic good looks of his Scandinavian heritage, gregarious attitude, personal magnetism, and sensitivity held an irresistible allure for nurses, and throughout his career he was not one to ignore it. “Work hard, play hard,” he urged his friends.
If Walt was hedonistic, he had a compelling reason. In his last year of surgical training, Walt noted a small lump in his neck. The biopsy result was chilling. Lillehei had a deadly cancer: lymphosarcoma of the parotid (salivary) gland, with a predicted five-year survival rate of 5 to 10%. After years of college, medical school, internship, and residency training (mine consumed fifteen years, surgeons need even more time), Walt Lillehei had been dealt life’s cruelest blow, a sentence of premature death. On the last day of his surgical residency training, instead of celebrating, Lillehei lay down on an operating table. His boss Owen Wangensteen slashed away all the lymph nodes on the affected side of his neck. Wangensteen was operating in the now largely abandoned era of radical cancer surgery, so he plunged into Walt’s chest cavity to cut away more tissue. At the end of the surgery the pathologist’s microscope shined an oculus on just a tiny sliver of hope: the cancer appeared only on the nodes in his neck. Surgery complete, Lillehei now underwent a course of radiation therapy. His life was dependent on radiation therapy, but his ambition was set free. Told he probably would not survive five years, any stricture on Walt Lillehei’s mandate to “work hard, play hard” evaporated. He could hardly have foreseen that his single-minded pursuit of that motto would lead to a career unmatched for its peaks and valleys among all whom I have known in cardiovascular medicine.
* * *
IN MEDICINE, WE learn more from our mistakes than from our successes. Error exposes truth. Since we must err, it seems best that our mistakes come first. Bill Mustard’s failed monkey lungs taught a critical lesson: it was possible to oxygenate blood outside a patient’s body, return it to the recipient circulation, and keep a patient alive while operating on an arrested heart. Knowing that, Lillehei’s group made one of those spectacular intuitive leaps of genius that seem obvious in retrospect. Mother Nature offered a better oxygenating system than monkey lungs. When a baby is in a woman’s uterus, it cannot breathe, and so it gets its oxygenated blood from the mother. The ingenious method of blood exchange is through the placenta. The placenta is a highly vascular structure that attaches to the inner surface of the mother’s uterus. A cord of veins and arteries runs from the placenta to the baby’s belly. The placenta collects deoxygenated blood from the baby’s organs, sends it to be reoxygenated in the mother’s lungs, then returns the oxygenated blood to the fetus. The mother “cross-circulates” her blood with the fetus when it is in her uterus.
Lillehei had an intuition. What worked inside the uterus might work outside the uterus. Instead of inserting just a lung into the
Inside the hospital Dr. Lillehei was a highly respected surgeon, viewed by his nurses as unusually compassionate, and by surgical colleagues as an innovative genius. But outside the starched hierarchy of the hospital, Walt played by no one’s rules but his own. Whereas Charles Bailey scuffled with society’s norms, Lillehei simply ignored them. Walt shared a second trait with many of the innovators we will meet later. He was an unmitigated risk-taker. Walt lived life at double speed. Lillehei’s days were consumed with thoracic surgery, but his nights were gold chains, a Buick Roadmaster convertible, and late-evening carousing. Early on he discovered that the classic good looks of his Scandinavian heritage, gregarious attitude, personal magnetism, and sensitivity held an irresistible allure for nurses, and throughout his career he was not one to ignore it. “Work hard, play hard,” he urged his friends.
If Walt was hedonistic, he had a compelling reason. In his last year of surgical training, Walt noted a small lump in his neck. The biopsy result was chilling. Lillehei had a deadly cancer: lymphosarcoma of the parotid (salivary) gland, with a predicted five-year survival rate of 5 to 10%. After years of college, medical school, internship, and residency training (mine consumed fifteen years, surgeons need even more time), Walt Lillehei had been dealt life’s cruelest blow, a sentence of premature death. On the last day of his surgical residency training, instead of celebrating, Lillehei lay down on an operating table. His boss Owen Wangensteen slashed away all the lymph nodes on the affected side of his neck. Wangensteen was operating in the now largely abandoned era of radical cancer surgery, so he plunged into Walt’s chest cavity to cut away more tissue. At the end of the surgery the pathologist’s microscope shined an oculus on just a tiny sliver of hope: the cancer appeared only on the nodes in his neck. Surgery complete, Lillehei now underwent a course of radiation therapy. His life was dependent on radiation therapy, but his ambition was set free. Told he probably would not survive five years, any stricture on Walt Lillehei’s mandate to “work hard, play hard” evaporated. He could hardly have foreseen that his single-minded pursuit of that motto would lead to a career unmatched for its peaks and valleys among all whom I have known in cardiovascular medicine.
* * *
IN MEDICINE, WE learn more from our mistakes than from our successes. Error exposes truth. Since we must err, it seems best that our mistakes come first. Bill Mustard’s failed monkey lungs taught a critical lesson: it was possible to oxygenate blood outside a patient’s body, return it to the recipient circulation, and keep a patient alive while operating on an arrested heart. Knowing that, Lillehei’s group made one of those spectacular intuitive leaps of genius that seem obvious in retrospect. Mother Nature offered a better oxygenating system than monkey lungs. When a baby is in a woman’s uterus, it cannot breathe, and so it gets its oxygenated blood from the mother. The ingenious method of blood exchange is through the placenta. The placenta is a highly vascular structure that attaches to the inner surface of the mother’s uterus. A cord of veins and arteries runs from the placenta to the baby’s belly. The placenta collects deoxygenated blood from the baby’s organs, sends it to be reoxygenated in the mother’s lungs, then returns the oxygenated blood to the fetus. The mother “cross-circulates” her blood with the fetus when it is in her uterus.
Lillehei had an intuition. What worked inside the uterus might work outside the uterus. Instead of inserting just a lung into the
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