Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and His Work with Alfred Blalock : An Autobiography

By Vivien T. Thomas | Go to book overview
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14

Dr. Jerome H. Kay, a graduate of the University of California at San Francisco, came to work in the laboratory as of July 1, 1950. He already had four or five years of post-doctoral (surgical house staff) training in Dallas under Dr. Carl Moyer. He began working with me on a cardiac project that was in progress, but Dr. Blalock wanted him to have a project of his own. He wanted the Fellows to have ideas and interests that they would like to investigate, some question to which they would like to find the answer. Dr. Blalock considered this a year during their training when they could read, think, study, and work. No other year of training would offer these combined opportunities.

Cardiac arrest may occur in any type of surgery under anesthesia. Considering the amount of cardiac surgery that was being performed at Hopkins and elsewhere and the relatively high incidence of cardiac arrest then occurring in those cases, Dr. Kay began to read about the subject. Cardiac arrest may occur in either of two forms: (1) ventricular standstill in which there is little or no contraction of the muscle fibers or (2) ventricular fibrillation in which there is uncoordinated contraction or twitching of the muscle fibers. He found that clinical cases of successful resuscitation had been reported. The earliest report was in 1947 by Dr. Claude Beck of Western Reserve University at Cleveland, Ohio. Numerous investigators had done research on the problem, for which there were two existing approaches: (1) the use of electric shock and (2) the use of drugs or cardiac stimulants. No one seemed to have an organized plan of attack. With various methods being used and advocated, Dr. Kay set out to determine the most satisfactory procedure for restoring an effective heart beat.

In searching through the literature, Dr. Kay came upon the name of William B. Kouwenhoven. While discussing cardiac arrest with Dr. Blalock, Dr. Kay asked if he knew Kouwenhoven. Dr. Blalock thought that Kouwenhoven had been a professor of electrical engineering at the University but was probably retired. Kay followed up the lead and found that Dr. Kouwenhoven was still on the Homewood campus as Dean of the School of Engineering and Professor and Chairman of Electrical Engineering. Dr. Kouwenhoven, Dr. Orthello Langworthy, and Dr. Donald Hooker had done research on defibrillation of the heart by the use of an electric current in the 1920s and early 1930s. They had confirmed the

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