Coming: Longer Life Spans: By SENATOR ALAN CRANSTON

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

The Old Testament set the length of man’s natural life-span at threescore years and ten, of fourscore “by reason of strength.”  Some 3000 years later, Elizabethan scholar Francis Bacon saw no reason to update the figure.  “From the time of Moses to these our days the term of man’s life hath stood about fourscore years of age.”

Neither Bacon nor the Old Testament sages confused that 80-years “term” with life expectancy.  A lucky few might live 70 to 80 years if they survived the army of diseases that preyed on infancy, youth and middle life.  But life expectancy—the time a person would live if he had average luck—was a different matter.  In the Bonze and Iron stages, encompassing Old Testament times, it was about 18 years.  And in Bacon’s time it was below 35.

Today, medical advances have more than doubled life expectancy in the world’s wealthier nations.  In this century alone (almost entirely through the eradication of diseases of the young) more than 20 years have been added to the average American’s life—now about 74 years for women and 70 for men.  Nevertheless, most people feel that life span is a different matter—fixed, constant, forever beyond human tampering and medical intervention.

I am convicted they are wrong.  New developments in gerontology, the science of aging, suggest that one day soon we will be able to push our natural span beyond the limits so long considered immutable.

In 1973 I conducted Senate hearings at which scientists discussed the possibility of people enjoying health and mental vitality beyond the age of 100.  When the hearings were over and Congress has set up a National Institute of Aging within the National Institutes of Health, I conducted to keep in touch with developments in the field.  Regularly, I invite groups of gerontologists and biomedical experts to informal sessions in my Capitol office.

What I learn from these encounters is mind-blogging.  Researchers across the nation are probing ever deeper into the mysterious biological activity—breakdown and mutation in cells and molecules—that we call the aging process.  They have already convinced a majority of gerontologists that we will be able to restructure the human aging process to our own benefit.  The question is not whether we will be able to control aging but when.

In the United States, medical science has already pushed life expectancy very close to life-span figures by destroying disease.  But the limits are not far ahead.  National life expectancy, which jumped 17 years between 1900 and 1950, inched up a mere three in the next quarter century.  The last appreciable gains we can expect will come when cancer and cardiovascular disease, today’s deadliest killers, are finally tamed.

Yet, even in a world liberated from cancer, heart attack and stroke, old people will continue to die (even if a little later) from the cumulative physical and mental collapse we call old age.  And what if killer diseases are eliminated but no remedy is found for the degenerative processes of old age.  We could be faced with a mushrooming population of dependent old people.

The prospect of life prolonged—but not enhanced—by dragging out its darkest years is chilling.  Fortunately, the aim of gerontologists is not mere prolongation of life; it is the prolongation of life’s most productive, satisfying years.  “Old age itself will not be longer, only later,” says British gerontologist Alex Comfort, “from 80 to 90, say, instead of 70 to 80.”  Or, as science writer Albert Rosenfield defined it, gerontology’s basic goal “is to keep people fully functional and in possession of all their faculties until very end.”  If gerontologists can pinpoint whatever it is that triggers and regulated its speed, the ability to extent human life and its good years will be in their grasp.

How close are they to this goal?  Scientists already posses the ability to extent life—and have done so repeatedly in experiments on laboratory animals.  But they are not certain just how the experiments worked.  Although they have manipulated the aging process, they have so far failed to define it.

But theories of aging are beginning to coverage in the notion that every living creature within it a biological “clock” that genetically programs the rate at which the organism will age.  As this clock ticks on, cells mysteriously loose their immunity to invasion and disease, their vitality ebbs, and eventually—along with the rest of the organism—they die.

Some researchers have suggested that the clock of aging is located in genetic material housed in the nucleus of every cell.  Others believe it may operate through the release of s-called death hormones” that remorselessly wear down the body’s maintenance-and-repair cells.  It may have multiple locations) cellular nuclei), or it may operate from a master control center such as the hormone-producing pituitary gland.  Though the clock’s location remains elusive, researchers claim its existence is confirmed every time their experiments successfully manipulate the aging rate in animal cells.

Denham Harman, University of Hebraska biochemist, believes aging result from wear and tear inflicted by “free radicals,” broken-off cellular debris that clusters on cells, clogging of “rusting” them and ultimately putting them our of action.  Herman’s experiment indicated that diet and antioxidant compounds such as vitamin E would offset free-radical damage.  In the rests he administered, the lives of laboratory rats were considerably lengthened.

Another supporter of the free-radical theory, Richard Hochschild of the University of California at Irvine, reports a series of experiments with mice, age 70 in human terms, were given substances that help to repair the membranes after free-radical damage.  The mice lived an average of 49 percent beyond their natural life spans.

Believers in hormone-triggered aging point to laboratory successes of their own.  Removing or retarding the action of certain glands has altered the aging process in test animals—often dramatically—.  For instance, removing the fish’s adrenal gland has eliminated the rapid spawn-age-and-die cycle in Pacific salmon.  Gerontologist W. Donner Denkla removed the pituitary glands from the brains of aged rats, then administered thyroxin and other vital hormones.  Close monitoring showed that a variety of the rats’ body functions had returned to “juvenile competence.”  Their coats were again thick and glossy, their movements quick and energetic.  The rats showed no signs of age or debility until almost at the point of death.

No doubt the methods to these biomedical pioneers will one day seem absurdly primitive.  But even these first steps have yielded effective techniques and drugs, already in limited use on humans in the treatment of advanced senility and otherwise incurable genetic disorders.

As methods are refined and targets narrowed, gerontologists may be able to reset man’s biological clock with precision to stretch out the young and middle years and minimize the period of decline leading to death.  We are on the brink of a major leap forward in medical science—nothing less than a profound redefinition of human life.

How soon?  An optimistic few believe we may hold the keys of life-span extension before the end of the century.  Others speculate that even without mastering all the secrets of aging we will learn enough to achieve major clinical breakthroughs in the next few decades (much as we practiced vaccination long before we understood the hows and whys of immunization).  Onesuch breakthrough would be elimination of the remorselessly slow degenerative aliments of old age; people would live free of illness or infirmity right up to the end of their span and then, with little advance warning, simply die.

Luck as well as individual and collective brilliance will determine whether or not our children or we will inherit the life-span revolution.  The rate of progress also hinges on availability of funds and the scope of the programs we launch.  “The control of the human rate of aging is going to happen,” says Alex Comfort.  “How soon it will happen depends upon the social pressure for research and the wisdom with which that research is applied.”

All too many promising leads and experiments are shelved for want of funds or public interest.  One reason is simply the credibility gap surrounding the notion of an increased life span.  Another is the reluctance of institutions to nurture ideas that challenge established assumptions or that fail to guarantee a return on investment.

In 1979 the federal government spent nearly $900 million in cancer research and almost $500 million in heart-and lung disease research.  Not everyone, fortunately, suffers from these diseases.  But aging—the one affliction that affects all of us—will get about $37 million for federally sponsored research.  Much of that will go for social, psychological and statistical studies of the elderly.  Only a portion will finance biological studies of the aging process—and just the smallest fraction of that will finance research aimed at extending life span.

Are we dragging our feet because we are afraid?  Could we be thinking of the strain that even a ten-years increase in life span would put on our overburdened social welfare and health services?  We should think again.  When our productive years fill out most of our life span, the social and economic dependence of age will be diminished problem.  With age freed of its present stigma and infirmity, society might at last profit from the wisdom and experience we now thoughtlessly throw away.

New Help of Dyslexia: By WARREN R. YOUNG

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

One child in every ten has it, to some degree, often with tragic impact on his schooling and life.  It probably kept inventor Thomas Edison, General George S. Patton and President Woodrow Wilson crom coping with ordinary schoolwork when they were young.  It made Hans Christian Anderson an atrocious speller all his life, even though he became a magnificent storyteller.  It most likely accounted for the nickname “Mr. Dullard,” give a schoolboy named Albert Einstein.

The specific problem these people have in common is called dyslexia (from Greek roots ‘dys’, “difficulty,” and ‘lexia’, “pertaining to words”).  Although it is unrelated to basic intellectual capacity, the disorder causes a mysterious difficulty in handling words and symbols.  Some subtle peculiarity in the brain’s organizational pattern blocks out an otherwise bright child’s ability to learn how to read, to write legible, to spell pr. Perhaps, to use numbers.  Letters in words perversely transpose themselves, ger reversed or even topsy-turvy—“dog” becomes “god”; “b” changes identity with “d,” and may even masquerade as “p” or “q”; a sign saying “OIL” flip-flops into “710.”  Many dyslexics also have difficulty orienting themselves in the three dimensions of space, which results, sometimes, in boldly awkwardness.

Ever since dyslexia was identified late in 19th century by German and British ophthalmologists, it has been studied and debated.  Because it is unaccompanied by outward scars or detectable neurological damage, and because its bizarre symptoms vary from victim to victim, some professionals insist that the problem doesn’t really exists as a separate entity.  Educators in particular have shown a preference for herding this problem along with others under the broad, vaguely defined umbrella of “learning disabilities.”  Yet frustrated classroom teachers, agonized parents and humiliated victims know that something—something unique devastating—is there.

The late Nelson A. Rockefeller was one of lthe most eminent dyslexics.  “I often see letters and numbers backwards, “he once said, ‘or even think them backwards.”  A few lines from his boyhood diary, written when he was 11, include such revealing notations as “lunc,” “picknick Lunch,” “Uncle Harold,” “engen repar schop,” “parak”(for park), and three tries at recording the disease his sister Abby had come down with –“mealess,” “measless” and “misless.”  Rockfeller never mastered spelling.  Yet he graduated cum laude from Dartmouth College, and earned a Phi Beta Kapp key.

There was no secret cure behind Rockefeller’s success in overcoming his handicap.  The key was simply learning to cope.  Coping to him meant concentrating very hard when something had to be read; he let aides fix up his spelling and he rehearsed speeches carefully before delivering them.

Other dyslexics also achieved celebrity status by adapting to the realties of their difficulty.  Woodrow Wilson did not learn the alphabet until he was nine, didn’t read until he was 11, and was considered by relatives to be dull and backward.  At Princeton University, his grades were only fair, but his brilliant oratorical style began to blossom at the same time, paving the way for his two distinguished presidencies—of Princeton and of the United States.

General Patton had even harder sledding.  At 12 he still could not read.  It took him five years to get through West Point, and at that he made it only by laboriously memorizing his textbooks word for word.

Not all dyslexics are so fortunate, or so tenacious.  Taunted by classmates, treated as lazy, stupid or mentally disturbed by teachers and parents, humiliated by schoolwork other children do so easily; many of them not only fail miserably in class but also become filled with frustration, rage and pain.  It is liter sting to note that the telltale signs of the problem can be detected in the diary of Lee Harvey Oswald.

Trying to pin down the precise cause of dyslexia involves a number of basic riddles.  How, really, do our minds work?  How do we learn to read and write?  How can intelligent child—or even an adult creative genius—look straight at a word and interpret some of the letters backward, upside down or transposed?  Why does the problem appear to turn up three times as often among boys as among girls?  There are a dozen theories to explain dyslexia, but final verdict is not yet in.

Ever since the turn of the century, one guess has been that defective vision must be to blame.  This idea was based in part on the fact that poor readers employ inefficient eye movements.  But experts now regard faulty eye movements as the result, not the eye that learns to read.  So the question remains: what goes wrong in the brain?

Some early experts thought brain damage was responsible, since it was known that some victims of head injuries lost their reading and writing skills.  But autopsies and brainwave studies tend to rule out injury as a common cause of dyslexia.

If detectable brain damage is not the cause, shat about more subtle insults to the prenatal of infant brain?  Some studies seem to show that lead in the air, physical trauma or oxygen deprivation during birth can sometimes affect language-learning capability.  However, careful tracings of family trees suggest that the problem may more often be a matter of heredity.

A sizable body of opinion clings to the “late-bloomer” theory, which holds that for no particular reason some children simply do not mature the reading-readiness stage as early as others.

The theory that still probably comes closest to explaining dyslexia was developed many years ago by Dr. Samuel Torrey Orton, then director of the lowa State Psychopathic Hospital.  While screening mental-health problems, Orton became interested in children who not only repeatedly reversed letters of words, but also had a talent for “mirror-writing.”  Some of them could actually write better from right to leave, with letters oriented backward and in reverse order, so that a mirror held alongside would show the words as they are normally written.

Orton knew that mirror writing came more naturally than regular writing for many left-handers or partial left-handers.  Leonardo da Vinci, who was ambidextrous, often sket5ched with his right hand, while setting down notes mirror-fashion with his left hand.  Orton, an expert neurologist, reasoned that while each half of the brain controls various natural activities, only one side becomes dominant in the use of language.  If, in learning the artificial skill of recognizing symbols and translating them into words, both hemispheres persisted in taking part, they might somehow compete and interfere with each other, leading to reversed or jumbled perception.  Orton concluded that it was not being left-handed that caused the problem, since many dyslexics are right-handed; rather, it was confused or mixed dominance of the brain’s hemispheres.

But recent examination of the brain a dyslexic revealed an abnormality in the left hemisphere, which is now believed to have predominant control over the language function.  This examination is part of a long-term, systematic study, now underway, of the anatomical differences between the dyslexic’s brain and that of the non0dyslexic.  Dr. Albert M. Calaburda and Dr. Thomas L Kemper, who are conducting this study, hope to determine the causes of dyslexia so that proper therapy can be prescribed.

Fortunately, even the victim of severe, classic dyslexia can now learn, with the proper help, how to read at a decent speed and to write legibly.  But parents should be wary.  Still-unproven methods, as well as thoroughly discredited techniques, are also being offered, including everything from bouncing on trampolines and avoidance of food additives to psychotherapy and elaborate eye exercises.

The experts’ consensus is that the best solution is educational: careful, systematic, on-to-one tutoring on a regular basis to teach the dyslexic child the principles of phonics—the letter sounds that make up words.  What the dyslexic child needs is to be shown how to decode the sounds for which single letters and combinations of letters stand, and how to fit them together into words.  Since every dyslexic child’s problems are different, individual tutoring techniques must also vary.  Often, modern phonics specialists reinforce the child’s familiarity with the shape of a letter or the sound of a word fragment by putting to work more than one of his senses.  They might have a child look at a letter, say it aloud, trace its shape in the air and on the blackboard, and feel a 3-D cutout of the letter.  Once the skill of decoding (and the reverse process, encoding) is mastered, a child can read and write any word.

The encouraging prognosis for properly tutored dyslexics was firmly documented in study by language consultant Margaret Byrd Rawson.  She carefully followed a group of 20 boys with moderate to severe dyslexia, all of whom had been given structured, multi, and sensory language training, to see exactly what happened after they grew up.  All but one went to college; 18 earned degrees, then went on to obtain a total 32 postgraduate professors, on a school principal, three teachers, two research scientists, three owners of businesses, three junior business executives, one an actor, one a skilled laborer and one a factory foreman.

Not all properly tutored dyslexics no longer need fail simply because of language problem.

Does Your Child have Dyslexia?

Your child may need specialized help in overcoming the handicap of dyslexia if he or she shows some of these signs: Reading difficulty; persistent spelling errors (especially misspelling the same familiar word different ways; reversed or upside-down letters, or reversed sequence of letters within words; uncertain preference for right-or left- handedness after age five or six; badly cramped, scrawled of illegible handwriting; confusion about left and right, up and down, tomorrow and yesterday; delayed mastery of spoken language, trouble finding the “right” word when talking; inadequate in written composition; personal disorganization 9losing or leaving possessions, inability to stick to simple schedules, repeatedly forgetting).

Few dyslexics show all these symptoms; and children who are not dyslexic may show some.  But a pattern of these signs—especially a reading or spelling problem—means you would be wise to get a professional opinion.  Talk with your child’s teacher, school psychologist, learning-disabilities specialists or pediatrician as soon as possible, and request a full battery of diagnostic tests.  If your child is definitely dyslexic, he or she will probably heed careful, long-range one-to-one tutoring on a regular basis.  But avoid signing up for remedial help—particularly any non-tutoring scheme—without first getting trustworthy expert advice.

For further information on dyslexia, write:

The Orton Society, inc.,

8415 Bellona Lane, Towson, Md. 21204;

Or

The Association for Children With Learning Disabilities,

4156 Library Rd., Pittsburgh, Pa. 15234,

Please enclose a stamped self-addressed envelope and a check for $1.00 to cover handling and mailing costs

“You May Marry My Daughter, the Day You Can Walk Up the Aisle”: by ELISE PIQUET

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

On July 9, 1976, in the Chicago suburb of Bellwood, the car 21-year-old Peter Saraceno was driving suddenly skidded.  It hit a utility pole, then smashed into a large advertising-sign pole and was demolished.  Peter was critically injured when he was thrown 66 feet into the pavement.

Peter’s widowed mother, Louise, rushed to nearby West lake community Hospital to find the emergency-room staff working feverishly to save her son.  It was a near-impossible task; Peter was in a deep coma, and there was severe damage to the area of the brain that controls muscle coordination and tone, speech and memory.  The doctor’ prognosis was “guarded.”

  Even if he lived, they said, peter would probably remain paralyzed, speechless and totally dependent on others for care.

Peter had excellent doctors, devoted nursing care, the most modern equipment and medical attention possible.  But for Louise Saraceno it was not enough.  A lawn chaise was moved into Peter’s room, and for the next four months Louise never left her son.  It was as if she had a sick and helpless baby—a-six-foot-one-inch, 208-pound baby.

Louise’s job had been to make a home for her five children, helped by Social Security and a large Italian-American family.  Now, her oldest daughter, 20-year-old Ammamarie, quit her job to care for her three younger sisters.

Louise also counted as part of her family 21-year-old Linda Frachalla, who had become engaged to peter three years earlier.  Linda had a full-time job with Presbyterian-St. Luke’s hospital in Chicago, where peter had been a security guard at the time of his accident.  He had recently finished a hitch in the Marine Reserves and was waiting to be accepted into the police academy.  Peter idolized Linda and, in turn, he was her whole world.

Linda drove to Westlake Hospital each day after work to help Louise with the unconscious, immobile peter.  Many times during the night, they would struggle on the high bed to bathe and powder him and to rub on lotions.  Linda manicured Peter’s nails, and when the bandages from his head were removed, she had a stylist cut his hair.  “I wanted to dress him up so that when he regained consciousness, he’d feel good,” Linda explained.

Louise and Linda brought in Peter’s favorite Italian dishes, knowing how important food had always been to him, and they would hold them under his nose hoping the smells would penetrate his subconscious memory.  And all along, the two women talked to peter, as he lay deep in his coma.  Over and over, for hours on end.  “Peter,” they would say, “you’ve been in a terrible accident, and you can’t talk or move, but it’s not going to be like this forever.  We’re right here.  Don’t be afraid.”

Then one night in September, Louise put on the television and switched to one of Peter’s favorite programs. “Kojak.”  As she adjusted the colors of the set, she saw Peter’s eyes blink and move.  She flicked the set again.  He blinked again.  Louise ran down the corridor calling the nurse.  After 2 ½ months, Peter was coming to!

By October, as he gradually became fully conscious, his eyes would follow Linda or his mother around the room and he could be fed baby food.  He had to speech.  His body, arms and legs were paralyzed, but he could move his right hand ever so slightly, and extend the index finger on command.  And he used that finger to push letters on a magnetic blackboard that Louise had brought him.  With Peter tied and propped in his wheelchair, she would ask, “Who am I, Peter?” “Mom,” she would answer, pinching his lips to form the shape of the sound as Peter grunted a response.  “Spell it, Peter,” Haltingly, Peter would move his hand to the board in his lap and with one finger crookedly spell M-O-M.

This was all Peter could do in January 1977 when he entered the Rehabilitation Institute of Chicago (RIC) for intensive therapy.  He was put in the charge of Dr. Bhupendra K Agarwal, a physiatrist—a doctor especially trained in rehabilitation.  Working with home were nurses, psychologists, vocational counselors and RIC’s bioengineering center.

Although he knew where he was, Peter tended to fade in and out of consciousness.  But as his damaged brain began to heal itself, he was given daily physical, occupational and speech therapy.  He perked up most when Louise came for visits three or four times a week of when Linda arrived each night from work.  Eight times Lind took him in his wheelchair to see his favorite movie, ‘Rocky’.

The first vocal sound he made came in February.  It was “Ah.”  Peter’s speech disorder was sysarthria, a type of oral muscle weakness or paralysis.  It takes over a hundred muscles to form the words we say aloud, and Peter had to relearn the motor movements.  By March, he could say three words: no, any, Ma.  The sounds were flat, toneless and very hard to understand.  But they were words.

Peter was also learning to hold up his head, by wearing a fitted radio hat with a biofeedback control.  The radio played music as long as his head remained upright.  The music stopped when his head tilted, a constant reminder to keep it steady.  His comprehension was growing, and he was becoming impatient to go home for a visit.

On March 8, 1977, Peter saw his home for the first time in eight months.  The house was filled with 142 relatives, friends and neighbors.  Even a blind aunt who hadn’t been out of her house in five years came.  “When she bent down to touch Peter’s face as he lay on his cot, we all cried,” says Louise.  Even Peter, for the first time since the accident, cried out loud.  Later a cousin started singing “My Way,” and the others jointed in.  Peter, who couldn’t sing a word, kept time with his hand.  Then everybody broke down and embraced all over again.

After that celebration Peter’s spirits soared.  He began to work in phrases and was able to feed himself with a spoon in a special holder strapped like a splint to his hand.  During physical therapy, he would roll over on a floor mat to push himself into a sitting position.  He exercised his arms by lifting weights strapped to his wrists and, to strengthen his hands, he worked with a material similar to Silly Putty.  By May, Peter was allowed to work at home.

Linda withdrew her savings and brought a 28-foot pool for her mother’s back yard.  Then she quit her hob, and with one of her last paychecks she brought Peter five bathing suits and two floating mattresses.  “I wanted to be with him, to help him do the exercises and everything.  But I wanted it to be fun.”

Fun it wasn’t, but at least Peter was home.  Linda stayed in Louise’s house, working with her to help with Peter’ feeding, hygiene, exercise and emotional support.  Relatives were in and out of the house, and Peter’s friends were always on hand to lift him from bed to wheelchair to couch, and to drive home to the pool at Linda’s house.  After sex weeks he returned to RIC for more intensive therapy.

Back at RIC in December, Peter was beginning to be his old self again, laughing and teasing as he whizzed around in his wheelchair—feeling impulsive, affectionate, competitive, and male.  He also felt that he was in the home stretch as an inpatient.

He was right.  There were just two more hard months at RIC, months in which his speech improved ad he began to walk again.  This was what Peter was most eager for, and he nagged everyone for an aluminum walker.  He earned it after weeks of walking for ten feet between parallel bars.  And once the walker was his, the only way to stop him from practicing was to remove it forcibly.  He was determined to walk again because Linda’s father had told him, “The day you can walk up the aisle with her, you may marry my daughter,” peter knew the church; it had a long aisle.

On February 21, 1978, Peter left RIC in his walker.  He would return for checkups every three months.  Day after day, his speech improved.  His appetite for work was enormous.  So was his appetite for food.  By summer he weighed over 200 pounds, up from 140 only a year before.  He was strong and healthy—and readily to walk up that aisle.

On July 16. 250 joyful relatives and friends watched as Peter entered the side door of Our Lady of Pompeii Church on his walker.  Tears streaming down her face, Louise stood in a front pew and watched bridesmaids walk past her.  ‘Smile, honey, smile,” she kept saying, wanting them to show on their faces all that she felt beneath her tears.  In her bridal finery, supported on her father’s arm, Linda smiled through her tears as she passed Louise.  She walked under an arch of flowers to Peter.  Then together, with his best man supporting him, they climbed three steps to the altar.

When the ceremony ended, with Linda next to him, Peter slowly began the long walk up the aisle in his walker.  Almost everyone was crying now.  From a side aisle of the church floated a young soprano voice: “I took the good times, I’ll take the bad times.  I’ll take you just the way you are.”

Peter and Linda are now living an apartment in Melrose Park, with their baby daughter, Nicole Annette Saraceno, born September 14, 1980.  As Peter continues to improve, his doctors are amazed at his progress.  He can now get around without the aid of his walker of cane, event though his walking will never be completely normal.  In addition, his speech has improved considerably.  As Dr. A. Afshar, Peter’s doctor at Westlake Community Hospital once said, “The case of Peter Saraceno is more than a miracle of modern medicine.  It is an awesome triumph of the human spirit.”

A Boy’s Trial by Fire: By JOSEPH P. BLANK

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

“After the second explosion, I ran out of my house and looked down Avenue O,” a neighbor of the Von Kamps said  “About 50 yards away I saw a ball of fire moving toward me.  Then I looked closer and saw that the ball of fire was a boy!”

The neighbor grabbed the boy, Bobby Von Kamp, and rolled him on the road to smother the flames.  Then he tore off the boy’s charred clothing.  As he worked, he could hear the clang of approaching fire and ambulance sirens.

Bobby Von Kamp, two weeks away from his 11th birthday, lived across the street from a gasoline storage tank on the Houston, Texas, waterfront.  At 7 p.m on January 24, 1961, he was watching television with his 14-year-old brother Edward and a 12-year-old friend, Herman Halocombe.  His father, a seaman, was on a ship off the coast of Florida, his mother had just gone to the grocery store and his two older brothers were out for the evening.

As the Bugs Bunny cartoon was going off the air, the boys smelled gas.  High-octane gasoline had been leaking out of the storage tank across the street.  Suddenly the vapors exploded.  Clouds of flame boiled through the air, licked through the open windows.  The three boys dashed for the front door.  Eddie held open the screen door as another explosion whoop the street.  He caught a burst of flames on his back.  Part of the screening in the door simply melted into nothing.

The boys ran.  Eddie slipped and fell.  Herman said, “I’ll stay,” and knelt by his friend.  Bobby yelled, “I’ll get help!”  He ran down the street with flames streaming from his clothing.

As soon as ambulances arrived, Bobby and Eddie were sped to the Texas Children’s Hospital.  Herman, the least burned, was taken to another hospital.

As she entered the emergency room of Texas Children’s Dr. Alice Miller, (a pseudonym to conform with regulations of the Harris Country, Texas, Medical Society), a pediatric surgeon, saw Bobby, a “charred statue.”  He was conscious, able to answer questions.  Dr. Miller found that he was burned over 98 percent of his body—70 percent third-degree (deep) burns, 20 percent second-degree, and 8 percent first-degree.  Only the soles of his feet had escaped the flames. (Extensive third-degree burns are a near-overwhelming insult to the blood and every organ of the body.  Few people have survived 50 percent third-degree burns.)

Bobby’s entire spine, all his joints and the tendons of his hands, forearms, feet and legs were exposed.  “Where are you going to find the skin to cover him?’ a colleague asked Dr. Miller. Mrs. Van Kamp, numbed by the horror of the tragedy, heard someone say, “It’ll be a miracle if either of the boys lives.”

Dr.Miller says, “I don’t believe anything is hopeless until it’s proved hopeless.  I keep trying.  In a serious burn case doctors and nurses have to care very deeply.”

After Bobby was wheeled into the operating room, he lapsed into unconsciousness.  His arms were so burned that the doctor was unable to take his blood pressure to estimate the depth of shock.  His entire body was oozing liquids, joint fluids and blood chemicals.  At any moment the kidneys might stop functioning—from lack of fluid, caused by oozing, or from inadequate blood circulation, caused by shock.  Bobby required injections of drugs, liquids and blood chemicals, but his body was so burned that Dr. Miller had to search for a good vein.  She finally found one in the left shoulder.  At the same time he was given antibiotics to control infection.  Bits of cloth and dirt were removed from the burns; each finger and tow was dressed separately.  Then Bobby was placed on a Stryker frame, a special apparatus designed for minimum contact with the body.

Eddie meanwhile was receiving similar treatment from a general surgeon. (No doctor can do justice to the care of two such patients at one time and still carry on a practice)  Eddie was, from the first, only semiconscious; he never did become rational.

Dr. Miller worked on Bobby throughout the night.  For several days she examined him every two of three hours.  “Although he could move only his eyelids,” the doctor said. “I could see that he knew what was happening.  And I also saw that he had spunk and determination.  This was important.  He would be on the edge of death for a long time, and he would need the will to live.”

Pain became a way of life for the boys.  Each hypodermic injection was excruciating.  Nurses had to change the boys’ position every few hours, and whenever they were touched their screams could be heard on other hospital floors.  In addition, blood transfusions were a source of constant anxiety.  The boy sometimes received 20 to 30 pints of blood a week, and each new transfusion carried the potential of fatal shock.

“Bobby knew how badly his brother and he were hurt,” nurse Rae Whittaker said.  “He kept trying to encourage Bobby.  It’ll be better for Eddie to have a private room.”

Before he was moved to his new room, Bobby was first taken to the operating room to have his dressings changed, a two-or three-times a week procedure so painful that it had to be done under general anesthesia.  While Bobby was in the operating room, Eddie died.

That night Bobby’s temperature dipped to 94.4 degrees and his white-blood-cell count doubled, signs of a massive infection.  The doctor suspected the onset of fatal septicemia—blood poisoning.  Laboratory work to determine the specific material required 48 hours.  If the infection proved to be blood poisoning, Bobby would be dead by the time of the report.

Dr. Miller decided not to wait.  When administered a highly potent drug, one known to be very dangerous to the kidneys—which in this case already had undergone assault from the effects of the burns.  It was a risk based on educated guesswork and hope.  The gamble paid off.  Within 24 hours Bobby’s temperature, blood count and pulse returned to normal.

In his new room, Bobby waited more than a week before he could bring himself to ask about Eddie.  The loss shook him profoundly.  He felt that his brother, by waiting to hold open the screen door, had sacrificed his life for him.

He also knew that his own survival was uncertain.  Once he asked Dr. Miller, in a tone that combined pleading and challenge, “You’re not going to let me die, are you?”

“No, Bobby, we’re not,” she assured him.

He asked to have his cowboy boots placed on a table where he could see them.  “I’m going to wear those boots some day,” he said.

A little more than five weeks after the accident, Dr. Miller began skin grafts.  Third-degree burns are so deep that the body can’t build new skin; the skin must be replaced.  In the first operation she cut thin, almost transparent patches of skin from the thighs of Bobby’s brother William, and sutured them to the patient’s thigh, leg, arm and hand.  Skin from another person’s body won’t graft, but it will last tow or three weeks before being rejected.  During that time it will protect the surface from infection and reduce the loss of body fluids through oozing.

Then from Bobby’s first-and second-degree burn areas, which do heal themselves, she cut postage-stamp-size pieces of skin.  These she attached to the critical joint areas, suturing the larger pieces but simply placing the smaller “stamps” on the wounds and applying a pressure bandage to keep them in place.

The long procedure—it took nearly seven hours—was a tremendous undertaking for Bobby, and on the following day he weakened.  His temperature rose to more than 104 degrees.  His pulse quickened. His neck veins became distended.  He appeared to be going into heart failure.  The cardiologist could not determine what was happening inside his heart, however, because there was no place on his body to put the leads of an electrocardiogram machine.  Dr. Miller assumed that an infection was taking over all his body, and she put him on a regimen of antibiotics.  For several hours he teetered between failure and improvement, then gradually his pulse, breathing and temperature to normal.

Week after week the struggle to keep Bobby alive continued.  As soon as the thighs of his older teen-age brothers William and Sarry healed, the boys returned to the hospital to donate more skin.  Bobby’s own body contributed bits of skin for permanent grafts.  The joints of one finger on the left hand and two on the right hand were so hopelessly burned that amputation was required, but from these fingers the doctor salvaged little pieces of skin for grafts.

In the tenth week Bobby began to slide into a deep emotional reaction against his ordeal.  He refused to take injections.  He didn’t want to eat.  Since burn cases require an intake of protein to build tissue, the nurses spent hours cajoling, pleading and persuading him to take a few bites of meat.  Sometimes they would retire to an office and cry, in frustration, before returning to Bobby and trying again.

The memory of the explosion and the fire now overwhelmed him.  When a child popped a balloon in the hospital corridor, he shook and cried.  Lighted matches disturbed him.  He asked his father not to wear a favorite yellow shirt.  At night he had horrible dreams.  “Eddie, I smell gas!” he shouted in his sleep.  “Let’s get out of here! I’m on fire!”  Then he awoke screaming.

These psychological problems were as dangerous to Bobby as infection.  A clinical psychologist induced hypnosis without Bobby’s being aware of it.  “Though a process known as hypnotic desensitization,” the psychologist explained, “Bobby began to understand that the fire was past and couldn’t hurt him now.  He was in the hospital.  He was safe.

It worked.  Bobby never had another nightmare.  His determination and optimism returned.  He continued to improve.  Then the evening at home, Dr. Miller received the news that Bobby’s temperature was zooming, his stomach was distended and he was vomiting.  The hospital resident ventured that it could be intestinal block.

Dr.Miller rushed at once to the hospital, examined Bobby, and then questioned him about the food he had eaten the past two days.  Well, he had had some candy that afternoon.  Candy?  How much?  Four, maybe five bars.

The doctor immediately ordered an enema, and then gave Bobby a blistering scolding.  When she was through, he said, “I know I’m going to live now.  You wouldn’t have given it to me lied that if you thought I was going to die.”

The skin grafts were now taking beautifully, but the unexpected was always routine.  Infections flared and subsided.  Bobby’s lower right leg had been burned to the bone.  Since there was no base to tissue on which to place skin, the orthopedic surgeon recommended amputation.  But Dr. Miller was reluctant; she decided to try to save the leg.  She drilled tiny holes through the bone into the marrow; the granulating tissue grew through these openings and eventually covered the bone.  She had a base on which to graft skin, the skin took and the sag was saved.

“Everything worked,” Dr. Miller said,  “We could have lost Bobby at any time.  Septicemia.  Other infections.  Kidney shutdown.  Heart failure.  Rejection of grafts.  He was transfused with thousands of pints of blood, and he went through some 70 major operations.  He could have failed during any one of these procedures, but he didn’t.  In everything we did, we seemed to have the touch of god.”

She had estimated that Bobby would spend more than a year in the hospital.  But six months from the day of admission, his parents helped him to wheelchair and took him home.  Shortly afterward he began walking by grimly holding onto the wheelchair and pushing it ahead of him.  A few weeks later, when he first came back to see Dr. Miller, he pushed himself out of the wheelchair in the hospital corridor and then, wobbling and perspiring, walked without support into her office.  The two embraced.

A year and a half later, Bobby walked and ran with a slight limp.  He played ball, rode a bicycle.  Except for a scar near his left ear, his face shows no sign of the ordeal.  His body shows scars and grafts, but he’s not self-conscious about them.

Several times a year he returned to the hospital for more grafts.  Grafted skin won’t grow, so until he reached maturity additional skin had to be grafted to match his growth.  When hospitalized, he likes to spend his time with sick and injured children.  Once he stayed awake through the night, trying to give comfort to a girl who had been burned.  “When I see that I make somebody feel a little better,” he told me, “I feel a little better.  I tell them how bad off I was, and how I am now.  I’m not going to let what happened to me stop me from doing what I want to-do.  I’m just walking on.”

“Bobby will make it, “Dr. Miller said.  “He is proud of his life.”

Anorexia Nervosa and the Girl Who Wouldn’t Grow Up: By JOSEPH P. BLANK.

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

Nobody, neither family nor friends nor doctors, recognized the onset of Stephanie’s disturbance.  But Stephanie knew, two years before the crisis, at the age of 13, that something overwhelming, confusing and mysterious had taken hold of her.

(*)  I had a problem that I was afraid of getting fat, so I decided to exercise more but still eat the same amount.  I didn’t tell anyone and no one knew; they would have laughed anyway because I was underweight at the time.  This went on for two years, getting worse and worse inside.  Each day I ate a little less and a little less, and then we went to England for our summer holidays and I told them [her mother and father] my worry and they said how ridicules it was and so I shut up and ate less.

Stephanie’s father, Timothy Parsons, a professor at the University of British Columbia, finally did notice her thinness.  At the beach that summer in England, he looked around for Stephanie and saw a girl in a bathing suit standing some distance away with her back to him.  ‘That can’t be Stephanie,” he remarked to his younger daughter Allison.  “She’s far too thin.”  Them the figure turned and it was Stephanie.

That evening—although Stephanie had had a normal medical checkup a few months earlier—Tim and his wife, Anne, dedicated to have her checked again on their return to Canada.  Because of professional duties, Tim made a trip ahead of his family.  At home, he happened upon an article in Time entitled “The self-starves.”  It described an emotional disorder called anorexia nervosa that is especially prevalent among teen age girls form middle-and upper-income families.  The physiological source of the problem is fear.  Unable to control this fear, the victim demonstrates another kind of control by dieting to the point of starvation.

Tim grew alarmed.  Was it possible that his lovely, sensitive child, with her ash-blond hair and deep-blue eyes, had ‘anorexia nervosa?’  According to the article, early attention to the disorder was important; unless the anorexic can work out her emotional problems, or obtain effective psychiatric treatment, the strange malady can be fatal.

When the Parsons family returned from England, it was clear to Tim that Stephanie’s troubles had intensified, and he and Anne decided to seek the help of a psychiatrist.  Their daughter was thinner than ever, and grew more so each day.  She skipped meals of ate only a few mouthfuls of food.  Exercise became an obsession.  She bicycled for miles, ran, did pushups and sit-ups.  She couldn’t relax.  At the movies, she incessantly rattled her heels and jigged her knees.  It was difficult for her to fall asleep, and look of fear haunted her eyes.  She wrote:

I lost 30 pounds in two years and I had dizzy spells.  I felt guilty if I sat down for just a minute.  I had to keep on exercising.

One reason for Stephanie’s unhappiness was that life was not nice and lovely the way she wanted it to be.  She worried about starving children in underdeveloped countries, and about the killing of whales.  She became upset when a friend or relative fell ill.  After snowstorms, she shoveled the walks of elderly neighbors.  She loved to do things for people, to see others happy.

Another love was nature.  She tramped through the woods tape-recording birdcalls.  One winter day she brought home pine cones because “they were sitting in the snow and terribly cold.”  She enjoyed drowning and spent many solitary hours each week working on cartoon stories for which she invented characters and created stories.  Tim says, “In her drawings she created a place in which people were kinder and nicer than they are in the real world.”

(*)  I draw to express my feelings.  When I’m mad I’ll go to my room and draw till I’ve quieted down.  Drawing cheers me up.  There are few words with my drawings; the words are in my head.  I tell the figures what to do.  It’s like a king ruling a country.

As Stephanie enjoyed some aspects of life, so did she intensely fear much of it?

I wonder if the world will last

Or will it all go to war

We’ll all kill each other

Then there will be no one left

To see the end

She read about deranged person who had imbedded razor blades in Halloween apples—and thereafter she always cut up her own apples to check for blades.  News of a car accident made her fear that her mother would be hurt in one.  She worried about her father dying in an airliner crash.  She cut out scores of newspaper headlines and assembled them into a montage of horror: “Four Die in Freezer!” “Three Perish in Student Mobbing!” “Sex Slaying!” “Murder” And so on.

One night when she and Allison were in their beds, Stephanie asked her sister, “Why am I so afraid of things and you’re not?”

“I don’t see a reason to be afraid.”

“Oh, I do, I do.”

I don’t want to grow up.  I don’t like the idea of college and handling big affairs.  I would like to remain young because you have someone to protect you.  I’m so afraid of getting old and stiff and not being able to run around and fly kites.

At times Stephanie felt as bad about herself as about life.

To tell the truth, I hate myself.  I want to be somebody I like.  I want to like myself most of the time but I don’t at all.  That’s probably why I’m starving myself—because I hate myself.

Paradoxically, Stephanie enjoyed everything about food except eating it.  It was fun to bake, to help prepare meals and shop.  “You talk about food is such an enjoyable way,” Allison said.  “Why don’t you eat?”

“I know it’s wrong” Stephanie admitted.  “But one part of me says, ‘Eat’ and the other part says, ‘don’t eat!” and the “Don’t!’ is the one I have to listen to.”

Her parents implored her to eat.  “We love you,” her mother said plaintively. “Please eat!”  When pleading failed, Tim became stern.  “You sit there until you’ve eaten half of what’s on your plate!” he ordered.  After an hour she did eat a few mouthfuls, the went immediately to her room to do push-ups.

Stephanie knew that she was destroying herself and causing her parents terrible pain and despair.  She did not want to do this.  “Daddy, can’t you help me?” she pleaded.

“If only I could,” Tim said with a breaking heart. “You know what you have to do to help yourself.  Eat Stop exercising!”

“I try.  I can’t.”

In her despair Stephanie told a friend,  “I don’t know what’s happening to me.  I want to please the people who love me, but I can’t.  Oh, why don’t we end this and let me die.”

When school opened, Stephanie’s teachers talked with her and tried to persuade her to eat, but it was futile.  “You could feel the child’s tension,” says teacher Kathryn Hurwitz. “Day by day I could see her slipping away.”  The family physician tried to reason with Stephanie.  Her response: “it’s my body, and I can do what I want with it.”

Stephanie’s psychiatrist, recognizing that his patient had reached a critical stage, undertook intensive treatment directed at getting her to understand her fears and put them into perspective.  He also gave her tranquilizer, hoping to reduce her frenzied compulsion to exercise.

But therapy takes time.  Stephanie did not immediately eat more or exercise less.  In less than a month the psychiatrist realized that, under existing conditions, Stephanie’s survival was at stake.  She had to take food, had to stop exercising.  He recommended that she be hospitalized.

A few days later, Stephanie told her friend Leila Christensen, “I’m going to the hospital.  It’s all over with me.”

“Don’t talk like that, Leila objected.  ‘They’re going to help you get better.”

“No, it’s all over with me.”

On October 8, Tim and Anne drove Stephanie to the hospital.

Today was the worst day of my life.  Ma and I had breakfast together in bed.  I felt happy with ma’s arm around me.  At the hospital I pledged with Ma and Pa for another chance.  They left, and I cried bitterly.  I feel like a cone without ice cream, a human without a heart.

At this point Stephanie weighed just 67 pounds.  Eight days after entering the hospital she suffered abdominal pains.  A gastric ulcer (which can develop very quickly) had perforated, and she required immediate surgery.  Ulcer-related infections then set in, and she did not have the strength to fight them.  Tow days later, Stephanie Parsons was dead.

Friends of the Parsons’ in Japan sent money to he used for a remembrance.  Tim arranged to have a Katsura tree planted in a beautiful garden on the campus of the University of British Columbia.  In the fall, a time when Stephanie loved to tramp through woods, the Astsura’s bluish-green heart-shaped leaves turn red, orange, pale yellow, mauve and pink.  Then they drop to the earth and partially obscure plaque that reads:

STEPHANIE PARSONS, 1959-1975.

(The italicized excerpts are taken from Stephanie’s diary and other writings.)

What is Anorexia nervosa?

 In the following interview, Dr. Hilde Brush, professor emeritus of psychiatry at the Baylor College of Medicine and author of The Golden Cage: The Enigma of Anorexia Nervosa (Harvard University press, 1978.), answers some basic questions about the strange malady that took the life of Stephanie Parsons.

What is anorexia nervosa?  A psychosomatic illness that selectively befalls the daughters, and extremely rarely the sons, of well-to-do and educated families.  The families tend to be success, achievement and appearance-oriented.  The chief symptom of the condition is a devastating weight loss from self-inflicted starvation.

What is the incidence of the disorder?  In the risk populating of high school and college girls, the incidence may be as high as one in 200.  And it is definitely on the increase.

Why?  For one thing, our society places enormous and unrelenting emphasis on slimness.  Also, these girls tend not to see the new freedom for women to use their talents and abilities as “lineation.”  To them, it represents a frightening obligation to be special and outstanding.

What have you found at the root of this problem?  In general, these youngsters have struggled in childhood to appear “perfect” in the eyes of others.  When adolescence arrives, with its heed for independence and self-assertion, these girls cannot break out of dependency and submissiveness.  They don’t have the necessary control, and this lack of control is the basic psychological issue.  But they can control their own bodies, and the exercise this control through self-starvation.

What other symptoms can alert a family?  Interest in food combined with a denial of hunger.  Excessive exercising.  Eating binges, them removal of food through self-induced vomiting, laxatives and other means.  Failure to menstruate or cessation of menstruation.  Excessive devotion to school work.  Sleep problems.

What treatment should be sought?  Psychotherapy aimed at resolving the underlying psychological problems, and restoration of normal nutrition.  If at all possible, professional help should be sought before the crisis stage.  As soon as the family or physician recognizes the symptoms of anorexia nervosa, treatment by and experienced psychiatrist should be insisted on.  Therapy must encourage the patient to become more aware of and to act on the impulses.  Feelings and needs originating within herself.  She then becomes capable of living as a self-directed, competent individual who can enjoy what life has to offer.

Computers: New Dimension in Patient Care: By WALTER S. ROSS

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

The doors of the intensive-care unit (ICU) at the University of Alabama Hospital in Birmingham swing wide and a new patient—male, 42—is rushed in.  He has just spent 67 minutes “on the pump” (heart-lung machine) while surgeons replaced a section of damaged coronary artery.

In a kind of controlled frenzy, eight doctors, nurses and technicians join in a flashing ballet of arms, reaching across one another in a seemingly aimless tangle, attaching electrical leads, placing tubes and bottles, pushing buttons.  In five minutes, the patient is hooked up to instruments that will monitor, second by second, four vital blood pressures via catheters placed inside his heart and arteries during surgery.  Tubes from his chest lead to a bottle on an automatic scale that weighs blood drainage; a similar device measure urine output.

All these data are fed into a computer that has been programmed to continuously monitor and compare key factors in the patient’s condition, and measure them against a program of symptoms selected by the surgeon.  To do this, it must make 50 to 100 complex computations every 120 seconds.  The results are displayed on a television screen.  A nurse or doctor can “ask the machine by means of buttons below the screen how the patient is doing, and get a visual report of any of his vital signs, calculated at five-minute of half-hour intervals since he entered the ICU.

The computer, however, does much more than merely monitors the patient’s condition.  It can recommend treatment and even actually treat the patient.  If he isn’t putting out enough urine, the screen signals, “Give a dose of 15-percent mannitol.”  And when detects an internal blood loss, a pump infuses precisely measured amounts into a vein.  This infusion is repeated every two minutes whenever is necessary.  Should the machine’s supply he used up, it flashes: “need more blood.”

Since the system was started, in 1966, it has been used for about 14,000 open-heart-surgery patients.  Dr. john W. Kirklin, the surgical chief who created the computer programs our of his experiences at that time with some 8000 open-heart operations, estimates that the computer has helped to save the lives of countless critically ill patients.  It can do this because it monitors every sign that the surgeon orders, forgets nothing, never get tired and makes no mistakes.

The computerized ‘nurse” was developed to meet a specific need.  University Hospital serfes as the open-heart-surgery referral center for the Southeast states, a region with a perennial shortage of skilled nurses and technicians.  To meet the rising demand for open-heart operation, the hospital would have needed additional personnel and intensive-care spares that were simply not available.

The computer had relieved the problem.  With a new ICU, the hospital has increased its heart operations from 150 a year to over 1800.  Under manual care, patients spend three to five days recovering from surgery.  With the computer’s help, the average adult open-heart patient usually is out of intensive care in 16 to 24 hours.

“Before we had the computer,” says nurse Sharon Shaw, “we would barely finish one set of exams before having to start the next.  There was no time to talk to frightened and disoriented patients coming out of surgery.  Now we can claim and measure them; it helps them get better so much faster.”

Of course, nurses watch the computer’s TV screen constantly, for there are, deliberately, no warning bells of lights.  If anything happens to the computer, nurses must be alert to take over, even though it has a 99 percent success rate.  And while computerized ICU care costs perhaps $40 extra per day per patient, it eliminates about two days of intensive care—than saving about $450 per patient.

Computers have thus far moved slowly into medicine, braked by the profession’s conservatism, by a fear of malpractice wits that might result from handling over life-and-death decisions to machinery and, perhaps, by some resentment toward an automated challenge to doctors’ expertise.  But the climate is changing as computers prove just how helpful they can be.

For example, computers are now used routinely to select from among perhaps 20,000 different patterns of radiation treatment the handful likely to produce the best results for a particular patient, an almost impossibly tedious task for a human.  They can “read” electrocardiograms (EKGs)—ordinarily a time consuming job—in only a minute to determine whether they are normal or not.  Since about 40 million EKGs had to be read in 1973 alone, the potential time saving is enormous.

Some computer programs are phenomenally accurate.  A heart program developed by IBM was tested on 1435 EKGs, 1008 of which were abnormal.  The computer was correct 97 percent of the time in classifying cases as normal of abnormal, and it analyzed with great precision the reasons for the abnormalities.  Another computer, at the University of Missouri Medical Center, has been programmed to scan X rays and diagnose rheumatic heart disease.  In one test, the machine was matched against a team of ten radiologists.  The computer was 73-percent accurate against the radiologists’ combined score of 62 percent.

Theoretically at least, there is no limit to the number and complexity of problems a computer can handle.  For example, a group of pediatric specialists has programmed a computer to assist in diagnosing more than 3000 significant childhood alignments.  The idea is not to replace the doctor, but to jog his memory, reassure him that he hasn’t overlooked anything and, if necessary, furnish him with leads to information about disease that he may never have seen or studied.

Any physician can consult the computer by dialing the hospital neatest him that has a teletypewriter.  The program can be particularly useful to isolated doctors and hospitals without access to expert consultants.

Computers are providing to be the means to meet another growing public demand: that medicine prevent, not merely cure, disease.  People are beginning to see health as a basic right, like education.  This means regular physical checkups for every man, woman and child.  Yet there simply aren’t enough doctors or nurses to accomplish this.  The answer?  Computers, linked to automated, foolproof testing equipment.  There are already hundreds of major Automated Multiphase (handling a verity of different examinations) Health Testing Units at work in this country, giving complete physical exams in one to two hours.

I visited three clinics where the units are in use.  At one, in Philadelphia, the physical begins with a typist checking you into the computer with such basic information as name, address, sex and age.  Then the machine takes over.  I put or earphones and listened to a man’s voice asking me tape-recorded questions about my heath (the tapes are available in foreign languages, too), and then pressed one of several buttons: a yellow for “Don’t Know Answer: beige, “Sometimes”; red “No”; green, “Yes”; a pure white for “Don’t Understand Question”; a blue for “Repeat Last Question”; and an orange for “Next Question Phase.”

At the French-polyclinic health Evolution Center in New York, similar queries are flashed on a television screen.  This system employs “branching logic.”  If the machine asks if you get headaches, and you punch “no,” it will skip more headache questions and to on to others—usually about 250 in all.  Most doctors do not have time to take an oral history as complete as this.  And patients like the system—the machine does not hurry them and they can take time to think, or revise their answers.

After your history is taken, you move on to the actual examination.  In the nearing test, for instance, you are put on earphones, press a button when you hear a sound and release the button when you stop hearing it.  The results are recorded by the computer and stored in its memory.  Blood pressure and EKG are taken automatically.  Technicians take blood samples and send them to an automated laboratory, where machines can check as many as 20 different body chemistries on as many as 300 samples per hour—at a cost of about one-quarter that of manual analysis.  When all the tests, including X rays, are completed and the computer has digested the results, it prints out a chart with your abnormalities flagged for a physician.

At IBM, where to date 185,000 employees have received such voluntary health examinations, Dr. John C. Duffy, medical director, says, ‘in about a third of the cases we discover some medical condition previously unknown to employee.”  Some two and half percent of all examinations detect conditions that are really serious: diabetes and silent heart attacks are the most frequent.

One man had a normal printout from his first checkup in 1969, when he had just turned 40.  Four years later, although he felt fine, his second exam reveled serious heart abnormalities.  Cardiologist verified the computer analysis, and the employee was told to see his own doctor.  He underwent open-heart surgery to replace a damaged aortal valve and clean out blocked arteries, and is now backing at work.  The staff doctor believes that if the checkup hadn’t uncovered his heart condition, the man would not be alive today.

Employees’ health records remain in the computers’ memory bank for instant printout and comparison with subsequent examinations, so that trends can me spotted.  This may become the most important part of the service.  As Gerald Hillman, manager of the IBM medical-system department, says, “Many doctors now believe that each of us is programmed to get some disease.  It’s like and intercontinental ballistic missile—if you can spot the trajectory, you may be able to shoot it down before it his the target.”

One Day in the Life of a Heart Surgeon: By DON A. SCHANCHE

Courtesy: Medical Miracles, from Readers Digest 1981. November.

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

Selected and edited by the editors of Readers Digest

Today is Tuesday. Like many days in the life of Dr. Michael Ellis DeBakey, 72-year-old dean of the world’s heart surgeons, it had no proper beginning, because yesterday never ended.  But if he had to say when it started, he would choose the emergency call just before midnight.

Monday, 11:55 p.m.:  Dr. DeBakey, who had been working continuously since 4:30a.m. Should be too tired to move.  But he half-shrugs the starched white hospital coat from his angular shoulders, ready to drive to his nearby colonial home for a short nights’ sleep.  Suddenly the telephone console behind the cluttered desk in his then-cramped first-floor office at Methodist Hospital in Houston jangles like a fire alarm.  It is the intensive care unit on the third floor calling.  Guiseppe Caccione, a charity patient from Genoa, Italy, is dying.

Bolting across the halfway, DeBakey hits the stairwell door with enough force to hurl it to the limit of its hydraulic spring and takes the steps two at a time.  Before the door swings shut, he is on the third floor, running for Caccione’s bed.

Above the right-hand rail of the bed, the screen of an electrocardiograph monitor casts a ghostly pallor on the faces of an intern and a nurse who stare like children at a horror show.  Te chaotic signals on the screen mean that Caccione’s heart is fibrillating, quivering with imminent death in its pericardial sac, like a dying animal in a burrow.

Wordlessly, DeBakey shoulders the intern aside.  He grabs two spoon-like defrillating paddles; trailing wires to an electric console, and slaps them against the dying man’s bared chest,  “Hit it!” he calls to the nurse.

As she presses a switch on the console, DeBakey looks up at the screen.  Bushy, gray-black eyebrows rise high above his tragic brown eyes—witness to more human grief than the saddest among us ream of—and send a ripple of worry lines, like a moving escalator, from his horn-rimmed glasses up the long arch of his balding brow.  For a deathly-still moment the quivering green scrawl of light on the electrocardiograph monitor hesitates, like a hummingbird in flight.  Suddenly, struck by the jolt from the electric paddles, it leaps almost off the screen.  The it settles into the patterned dance of life, tracing the normal peaks and valleys of a healthy, pulsating heart.  The escalator of wrinkles collapses, and DeBakey says softly, for the intern’s benefit, “Any doctor who doesn’t feel a sense of humility at a time like this should not be practicing medicine.  We’ve saved his life.”

Perhaps DeBakey is recalling another incident in this same hospital, nearly ten years ago, when he cried unashamedly at the foot of a bed as six of his associates tried vainly to sustain a dying heart.  The patient was Diana Cooper DeBakey, his wife of 35 years; strong, gracious, compassionate mother of his four sons, and victim, at 62, of a heart attack to massive that, despite the efforts of the best doctors in the most modern cardiovascular center in the world, she died.

Tuesday. 12:01a.m, The surgeon stands at the bedside of the Italian workingman, who has regained consciousness, smiled in bewilderment over the activity around him and lapsed into peaceful sleep.  DeBakey sights an almost inaudible, “Okay,” to the nurse, and moves away with a triumphant spring in his step.  He is not a surgeon who accepts a saved life as a matter of routine; the face and personality of each of his patients remain vivid in his memory.  He grieves, often to the point of a crushing migraine headache, when a heart that his hands have but still…DeBakey stops and turns to the intern.  “I’ll sleep in my office tonight,” he drawls in the sugar-cane accent of his native Louisiana.  “Call if you need me.”

The moment after he stretches out on the couch in his office and closes his eyes, he is asleep.

3:45a.m:  Debakey awakes as if responding to an internal alarm.  He fumages about his breakfast: a cup of heavily sugared coffee and a banana.

Every morning, usually after only three hours of sleep, Debakey writes. (He has published more than a thousand articles and essays—more than most professional writers manage in a lifetime.)  Today’s literary effort is on more testimonials to the human right he believes in above all others: that every person has a right to the best health care medicine can provide.  About half of his patients, like Caccoine, get free surgery.  Those who can pay, or who are insured, contribute more that a million dollars a year to his practice.  But DeBakey takes only a small share.  He gives the rest to Methodist Hospital, to the Foundren-Brown Cardiovascular Research and Training Center there, and to Baylor College of Medicine (where he is both chancellor and chairman of the department of surgery)

6:15a.m.  the lean figure in green surgical clothes and white coat bends into a rapid stride, like Groucho Marx breasting a stiff wind.  Trotting to keep up behind DeBakey is Dr. Richardo Labat, an argentine who was on a three-month study fellowship.  Labat was a qualified thoracic surgeon, but gladly accepted the role of student under the master and carried the metal-sheathed book containing vital data on the 92 DeBakey patients in the hospital.  Behind Labat hurries chief nurse Sylvia Farrell, who cheerfully hovers over the 45 doctors, nurses, medical technicians and helpers on DeBakey’s personal surgical team.

The three are on hospital rounds, and have already visited 37 patients in 30 minutes.  Some are recovering from surgery, others awaiting it; many are still asleep and require only a glance and a quick look at Labat’s thick book.  Patient 38 is Mrs. Rosemary Kelley, 74, who sits upright in bed; a tremor of apprehension upsetting the innate beauty and dignity of her lightly lined face.

“I have you scheduled for surgery first thing this morning.” DeBakey says.  “You’re strong enough, and everything’s going to be fine.”

“Dr. Debakey, I didn’t sleep very well last night, because I was thinking,” she begins.  “Maybe somebody cans use…my kidneys, my eyes….”

“You’re the one who is going to need them, Mrs. Kelley,”DeBakey replies reassuringly.  He puts a hand on her arm.  “Listen, dear, you have 13 grandchildren and one great-grand-child looking forward to being with you when you get our of here.” (Lismat’s eyebrows rise in wonder that DeBakey knows these personal details; they are not on Mrs.> Kelley’s medical chart.)  “I want you think about getting well and being with them, not about a possibility that is very remote.  Believe me.”

“I do believe you,” she says with renewed assurance.  “But I think I’d feel better if I signed some kind of release, so that if anything happens I can at least leave something behind to help someone else.”

“All right, dear,” DeBakey ways with a broad grin.  “I’ll have the forms send up here right away.  But you’re going to be fine.”

Patient 39 is a former baseball pitcher, famous for his fastball in the 1920s.  DeBakey has cut into his neck and cleansed out a disease-choked carotid artery, an essential blood way to the brain.  Now, instead of nodding with the dim bemusement of a stroke victim as he dies ten years ago, the long-retired big-league player is as alert as a boy.

“You’re strong enough to throw that fastball again,” DeBakey says, chucking, as his lean, delicate fingers trace the pattern of scars left by the sutures.  “You know, when I was a boy, you were my hero.  I wanted to pitch like you.  Instead, they made me a catcher.”

“Well, now you’re my hero, young fellow.  Anytime you want to go on the mound, just say the word.”

7:12a.m:  Rounds finished, DeBakey pauses briefly to examine his personal surgery schedule in his sanctum sanctorum—which no one enters without invitation—within the crowded suite of offices that he shares with two associates, Dr. George Noon and Dr. Malcolm Daniel; his former chief resident surgeon, and current director of the trauma center, Dr. Kenneth Mattox; two other residents and four visiting fellows; two interns and four third-year medical students; two volunteer social workers and seven devoted medical secretaries.  Few hospitals venture more than one intricate cardiovascular operation a day; DeBakey and his team routinely perform from four to a dozen—today it’s nine.

He is interrupted by a call.  A woman whose husband is scheduled for an operation today blurts out her opposition to the impending surgery.  “I saw him this morning,” he replies calmly. “He wants the operation, and he’s ready for it.”  She talks on, and DeBakey replies in a patient, gentle voice as if he, already late for surgery, has nothing else to do except restore her confidence.

7:25 a.m.:  DeBakey’s gleaming-white rubber surgeon’s boosts squeak like erasers on the polished vinyl floor of the third-floor surgical wing of Fondren-Brown.  Eight ultra-modern operating rooms surround a computerized, glass-enclosed monitoring area that looks like the traffic tower of a busy airport.  Drs. Noon and Daniel are busy preparing patients in Rooms 2 and 3, and Dr. Mattox, in Room 4, is getting Mrs. Kelley ready to have three new vessels grafted to her failing heart.

Mrs. Kelley, already anesthetized, lies draped in sterile green sheets.  The leads of an electrocardiograph trial for he chest to a TV-like monitor, and a plastic tube to an arm provides her with intravenous feeding.  A scythe-shaped sterile table covered with hundreds of special surgical instruments—most of them invented be DeBakey—is ready at the foot of the operating table.  Dr. Mattox has begun removing a 16-inch length of unneeded saphenous vein from Mrs. Kelley’s right leg, to use for the heart grafts.

Abruptly, DeBakey backs through the swinging doors into the room, water glistering on his fleshy scrubbed, upraised arms.  Already wearing an old-fashioned cotton surgical cap and face mask, he thrusts his arms into the sleeves of sterile gown which surgical scrub nurse Ellen Morris raises in front of him, then forcefully rams his hands one after the other into open rubber gloves that she holds ready for him.  It is all a continuum of motion, like an actor’s advance to center stage, which ends with DeBakey standing at Mrs. Kelley’s right side, prepared to open her chest.

A less experienced surgeon would pause now to survey the field and brace himself for the intrusion of Mrs. Kelley’s body.  DeBakey does not hesitate.  His gleaming scalpel rapidly traces a line from the base of her neck almost to her navel, then retraces its lower extremity, laying open an inch of fatty tissue.  Picking up an electric cauterizing scalpel, he now seals each bleeding vessel exposed in the long incision, sending up tiny eddies of smoke.

Nurse Morris hands him an electric saber saw, which he inserts in the incision at the base of Mrs. Kelley’s sternum, or breastbone, the forcibly pushes against the bone.  It is hard going, like making a length-wise saw cut through green wood.  As the sternum splits open, he puts aside the saw and cauterizes again where newly severed vessels have begun to ooze blood.  The he takes a heavy steel retractor and, by turning a small crank which opens the retractor’s box like steel framework like an auto jack, pries the rib cage apart.  Quickly, he moves into the eight-inch opening and cuts through the pericardial sac, laying its edge aside with three heavy black threads that stretch like tent lines against the tug of restraining forceps.

Mrs. Kelley’s heart, exposed, is pulsing rhythmically, Golden traces of fat and varicolored blue-reds of muscle fiber glisten like the warm hues of sunrise.  “The most beautiful sight in nature,” DeBakey murmurs softly.

Wordlessly, Dr. Mattox and Ellen Morris hand over instruments, hold the loose ends of retraining threads and suction away the trickle of blood that leaks into the heart cavity.  DeBakey inserts two stout plastic tubes into the main vessels leading from the pulsing heart and another into the femoral artery of Mrs. Kelley’s right thigh.  The tubes lead behind him to the heart-lung machine, a gleaming stainless-steel apparatus from which a large, sterile plastic bag hangs.  The bag is the oxygenerator through which the blood will pass when DeBakey temporarily stops the heart.  On a console beneath the oxygenerator are the controls that regulate three DeBakey-designed pumps, the unique mechanical muscle that will substitute for Mrs. Kelley’ heart when it must be stilled for the surgeon’s knife.

For the first time, DeBakey takes his knife to the pulsing organ.  He draws a fine, shallow scalpel line across its right surface and exposes the first of Mrs. Kelley’s three sick arteries, snaking like a gnarled root through the heart muscle.  Highly sophisticated X rays, called arteriograms, have shown that all three of the major heart arteries have been dangerously narrowed by arteriosclerosis and are admitting only a trickle of blood instead of the strong flow that the heart muscles needs.  As a result, Mrs. Kelley’s saphenous vein that Dr. Mattox removed and use them to bypass the disease-choked parts of the three arteries.

Working on a coronary artery while the heart is still throbs is like dissecting a moving snake on a vibrating table; by the surgeon’s steady hands make the challenge seem easy.  He clamps off the artery, makes a tiny longitudinal slit in it with his scalpel and, with a delicate pair of scissors, lengthens the incision to the size of a small buttonhole.  Next, he clasps a curved needle to bigger than an eyelash in the teeth of a long pair of forceps and threads a polypropylene luture as this as a split hair through the base end of the small incision.

Mattox holds the loose end of the suture as DeBakey accepts the waiting saphenous vein from Ellen Morris.  DeBakey deftly trims the end of the vein with a pair of scissors so that it will match the buttonhole on Mrs. Kelley’s coronary artery, then pierces it with the eyelash needle and draws the two vessels together with the hair-thin thread.  Quickly and surely, he circles the vein with continuous series of 30 even stitches, drawn to exactly the same tension—as if placed there by some extraordinary delicate machine capable of sewing together the hollow stems of to dandelions.

Now DeBakey snips away the excess vein and prepares to graft the freshly cut end to the aorta, just as he grafted the other end to the coronary artery.  He repeats the delicate needlework.  In seven minutes the suturing is done.  The clean new bypass artery is swollen with blood, pumping unobstructed from the aorta to the right side of Mrs. Kelley’s heart muscle.

When DeBakey confirms that the heart pumps are in action, he clamps off the aorta to stop the heart.  It quivers uncertainly, the goes still in the first rest it has ever had.  Working more smoothly now on the remaining two coronary arteries.

To bring to an end his life-saving encroachment on Mrs. Kelley’s heart, DeBakey picks up two defibrillating paddles, identical to those used on Coccione during the night.  Carefully, he slips one paddle under the heart and lays the other above it.  “Hit it!” he calls.  Like a sleeping cat awakening in fright Mrs. Kelley’s heart jumps abruptly at the electric shock, then settles into a steady, rhythmic pulsing action.

The surgeon’s final professional salute to Mrs. Kelley’s heart is to cradle it gently in his left hand.  The three new bypass arteries are fat with flowing blood.  After years of almost fatal starvation, Mrs. Kelley’s heart muscle is at last getting a healthy, continuing meal—one that will probably sustain her for quiet a few years of active life.

9:53 a.m.:  In Room 3, a patient’s abdomen has been opened and his intestines have been lifted to one side on a damp, sterile towel by Dr. Noon.  An aneurysm has stretched part of the exposed aorta to the thinness of a rubber balloon, in danger of bursting.  A freshly scrubbed DeBakey joints Noon at the operating table, finger the offending bulge in the aorta and clamps it off.  He cuts it out quickly, as if snipping away the worn-out length of hose.  The fist-size aneurysm bounces like a ball when he drops it into a pan.

With practiced teamwork, DeBakey and Noon alternate at stitching to bridge the missing segment of aorta with ribbed Dacron tube (another DeBakey’s invention) that branches like a wishbone at its base to connect to the left and right femoral arteries.  The two branches of the graft will restore the flow of blood to the patient’s lower abdomen and to his legs, which have been all but useless for months.  The patient will walk again in week.

10:47 a.m.:  Debakey joints Dr. Daniel in Room 2 and cleans a dam of atheroscloerotic fat from a carotid artery.  And so it goes: working steadily for the next four hours, he performs four coronary-artery bypasses.  As quickly as Drs. Noon, Daniel or Mattox can prepare a patient, DeBakey is at work.  Finished, he ducks down to the reception room to reassure anxious relatives, and then goes on to the next operation.

Only once is the smooth routine interrupted—when an assistant carelessly relaxes the grip of his forceps on a patient’s femoral artery while DeBakey is inserting one of the tubes of the heart-lung machine.  The open artery spurts with the force of a fire hose, splashing blood directly in DeBakey’s face and momentarily blinding him.  Ellen Morris quickly grabs the spouting artery in her loved hand to stop the flow.  While another nurse cleans his glasses, a glowering DeBakey tounguelashes the humiliated offender.  Without another word spoken across the table, the operation proceeds to a successful conclusion.

3:25 p.m.  After a hamburger and black coffee at his desk, DeBakey dictates a clutch of letters and memoranda into a recorder and takes a phone call about his promising research program on an artificial heart.  The only remaining barrier to success is the development of pump materials that will pulse in the human chest for many years without breaking down or damaging delicate blood cells.  DeBakey is confident that before he retires from active surgery, he will be using such mechanical pumps to replace worn-out hearts as routinely as he now replaces worn-out arteries.

3:55 p.m.:  The surgeon slips behind the wheel of a white Maserati, gift of a patient whose life he saved, and races like a Grand Prix driver to a meeting of a Baylor faculty executive committee.  Presiding over the 660-student medical college and its $55 million research programs on the run, as DeBakey does, draws raised eyebrows from some administrators, but it works.  Since DeBakey jointed Baylor in 1948, it has grown from a minor medical school to one of America’s top five, in both teaching and research.

4:30 p.m.:  DeBakey leaves his office and returns to the operating table, teaming with Dr. Noon for two intricate aortic valve replacements.  Near the climax of the first, half-dozen surgeons, anesthesiologists and nurses who have finished their work in the other rooms gather silently in the background.  Overhead, an audience of medical students clusters around a glass observation dome—to watch what is literally a work of art as the two surgeons, their fingers twirling and dipping with the perfect coordination of classic ballet, tie down the plastic and-steel valve with 192 knots in 48 sutures deep within the heart.

During the second operation, there are few spectators—most of the staff has gone home.  It is 9:30 when DeBakey and Noon finally send the patient to intensive care.

10:15 p.m.:  DeBakey picks at the last cold shreds of a hospital meal.  Now, for the first time since his brief sleep early this morning, he relaxes.  Normally a man who utters only the words that are necessary to his work or to the comfort of his patients, he is uncharacteristically voluble tonight.  All of the day’s nine patients are doing well, and he feels understandably good.

“People say I let myself get too involved, that I’m a perfectionist,” he says to a visitor.  “I suppose I am.  In fact, I know I am.  I have to be.  I’m dealing with lives, you know.  If people think I can do that without becoming personally involved with the patients, they’re wrong.  You cannot be more intimately involved with a person than when you literally enter his heart.  That’s why I get furious is a resident or a nurse or anyone makes a mistake.  That’s a person on the table, a living person.  A single mistake can kill him.”

“But doesn’t your perfectionism cause you a lot of unnecessary pain and anguish?”

“Pain and anguish?  Yes.  Unnecessary?  I don’t know.  Maybe it’s necessary.  I do know this, though.  If I ever have to have surgery, I want a perfectionist to do it.”

11:25 p.m.:  Debakey shrugs off his white coat, ready at long last to go home, when the emergency ring of the telephone slices the silence of the room like a cleaver.  The day that had no proper beginning will have no discernible den.