When the Curtains of Death Parted By MARTIN C. SAMPSON, M.D.

Courtesy: From Reader’s 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.

When the Curtains of Death Parted

By MARTIN C. SAMPSON, M.D.

It was a hot Philadelphia summer day, and the air in the old Pennsylvania Hospital hung heavy and still.  I had been up all night in a vain fight to save a little girl from meningitis.  In reaction of her death I was feeling completely disheartened.  As a young intern I had seen so much of dying in the past months that life seemed fragile and meaningless.  I was face to face with cynicism.  Faith seemed to exist only to be mocked by death.

The first patient I was to examine that morning was a man I shall call John Bradley.  He was in his late 40s, with deep-set brown eyes and a gentle face.  During the few weeks since his admission his condition had declined steadily.  As I looked through the window of his oxygen tent I saw that his lips were blue, his breath fast and strained.  I knew that his heart had been weakened by rheumatic fever in his youth, and that in recent years hardening of the arteries had taxed it even more.

I couldn’t help thinking of his wife, a small, white-haired woman with a face in which the shadows of work and sorrow mingled with faith and trust.  She and her husband had constantly looked to me for help.  Why, I thought bitterly, did they ask so much of me?

I went over Bradley’s medications again in my mind, hoping to think of something new to relieve his suffering.  He was getting digitalis to control his failing heart, an anti-coagulant to prevent the formation of clots in its damaged wall, and injections to help rid his body of excessive water.  The amount of oxygen being pumped into his tent had been increased.  This day, as on many previous days, I inserted a needle to draw off any fluid that had accumulated in his chest.  Still, when I left him I had the feeling that all my efforts were fruitless.

Shortly after six o’clock that evening the nurse in charge of Bradley’s ward called me to come at once.  I reached his bed within seconds, but already his skin was ashen, his lips purple and his eyes glazed.  The pounding of his heart could be seen through the chest wall, and the sound of his breath was like air bubbling through water.

“One ampoule of lanatoside C and start rotating tourniquets, quickly,” I said to the nurse.

Intravenous lanatoside C would give the rapid action of digitalis.  The tourniquets would keep the blood in his legs from circulating and temporarily relieve the failing heart—but only temporarily.

An hour later Bradley began to breathe more easily.  He seemed aware of his surroundings and whispered, “Please call my family.”

“I will,” I said.

He closed his eyes.  I was just leaving when I heard a deep gasp.  I wheeled and saw that he had stopped breathing.  I put my stethoscope to his chest.  The heart was beating, but faintly.  His eyes clouded over, and after a second or two his heart stopped.

For a moment I stood there, stunned.  Death had won again.  In that moment I remembered the little girl who had died the night before and a wave of fury came over me.  I would not let death win again, not now.

I pushed the oxygen tent out of the way and started artificial respiration, meanwhile asking the nurse for adrenalin.

When she returned, I plunged the syringe full of adrenalin into the heart.  Then I whipped the needle out and listened through my stethoscope again.  There was no sound.  Once more I started artificial respiration, frantically trying to time the rhythm of my arms to 20 strokes a minute.  My shoulders were aching and sweat was running down my face.

“It’s no use,” a flat voice said.  It was the medical resident, my senior. “When a heart as bad as this one stops, nothing will start it again.  I’ll notify the family.”

I knew he had the wisdom of experience, but I had the determination born of bitterness.  I was desperately resolved to pull Bradley back though the curtains of death.  I kept up the slow rhythmic compression of his chest until it seemed so automatic it was as if a force other than myself had taken over.

Suddenly there was a gasp, then another!  For a moment my own heart seemed to stop.  Then the gasps became more frequent.  “Put the stethoscope in my ears.” I said to the nurse, “and hold it to his chest.”  I kept pumping as I listened.  There was a faint heartbeat!

“Oxygen!”  I called triumphantly.

Gradually the gasps lengthened into shallow breaths.  In a few minutes Bradley’s breathing grew stronger and so did his heartbeat.

Just then the screen around the bed was moved slightly, and Mrs. Bradley stood beside me.  She was pale and frightened.  “They told me to come right away.”

Before I could answer, Bradley’s eyelids quivered.  “Helen,” he murmured.

She touched his forehead and whispered.  “Rest, John, dear—rest.”

But he struggled for speech.  “Helen, I told them to call you.  I knew I was going.  I wanted to say good-bye.”

His wife bit her lip, unable to speak.

“I wasn’t afraid,” he went on painfully. “I just wanted to tell you—“ he paused, his breathing heavier,”—to tell you that I have faith we’ll meet again—afterward.”

His wife held his hand to her lips, her tears falling on his fingers.  “I have faith, too.”  She whispered.

Bradley smiled faintly and closed his eyes, a look of peace on his face.

I stood there, filled with a mixture of exhaustion, wonder and excitement.  The mystery of death was right on this room.  Could I, in some way, begin to understand it?  I leaned forward and very softly asked, “John, do you remember how you felt?  Do you remember seeing or hearing anything just now, while you were—unconscious?

He looked at me for a long moment before he spoke.  “Yes, I remember,” he said.  “My pain was gone, and I couldn’t feel my body.  I heard the most peaceful music.”  He paused, coughed several times, and then went on: “The most peaceful music.  God was there, and I was floating away.  The music was all around me.  I knew I was dead, but I wasn’t afraid.  Then the music stopped, and you were leaning over me.”

“John, have you ever had a dream like that before?”

There was a long, unbearable moment; then he said, with chilling conviction, “it wasn’t a dream.”

His eyes closed, and his breathing grew heavier.

I asked the ward nurse to check his pulse and respiration every 15 minutes, and to notify me in case of any change.  Then I made my way to interns’ quarters, fell across my bed and was instantly asleep.  The next thing I heard was the ringing of the telephone beside my bed.

“Mr. Bradley has stopped breathing.  There is no pulse.”

One glimpse of his face told me that death had won this time.

Why, then, had the curtains of death parted briefly to give this patient another few minutes on earth?  Was that extra moment of life the result of chance chemical factors in his body?  Or did it have a deeper, spiritual meaning?  Had his spirit been strong enough to find its way back from death just long enough to give message of faith and farewell to his wife?  Could it also have been meant to give a small glimpse of eternity to a troubled and cynical young intern?

Whatever the meaning, and whether of not it had a purpose, the incident made a deep impression on me.  This was my first step toward acceptance of certain mysteries as an essential part of life.  This acceptance, the gift of a dying patient whom I could not save, put me on the road back to faith.

Medical Mystery of the Placebo By NORMAN COUSINS with SUSAN SCHIEFELBEN

Courtesy: From Reader’s 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.

Medical Mystery of the Placebo

By NORMAN COUSINS with SUSAN SCHIEFELBEN

Not long ago, two patients on anti-depressant drugs were each given the same pill, described to them as a new promising preparation.  The first patient was told that the pill would sharply reduce her bleak feeling and help her general physical condition.  The second patient was told that the pill was still experimental, would probably have some adverse side effects, but was worth taking nonetheless.

Each patient reacted in line with the predicted expectations.  How could the same pill produce such different effects?  The pill wasn’t a drug at all, but a placebo—an innocent milk sugar capsule.

The study of this strange-sounding agent [pronounced plahase-bo, from the Latin verb “to please”] is opening vast areas of knowledge about the way in human body heals itself and about the mysterious ability of the brain to order biochemical changes that are essential for combating disease.  In the classical sense, a placebo is an imitation medicine—generally a nocuous milk-sugar tablet dressed up likes an authentic pill.  Today, it is used most often in the testing of new drugs.  Effects achieved by the preparation being tested are measured against those that follow the administration of a “dummy drug,” or placebo.

But today the once lowly placebo is receiving serious attention from medical scholars.  Investigators have found substantial evidence showing that the placebo can actually act like an authentic therapeutic agent.  While the way it works inside the body is still not completely understood, some researchers theorize that placebos activate the cerebral cortex, which in turn may switch on the endocrine system.  Whatever the precise pathways through the mind and body, enough evidence already exists to indicate that placebos can be as potent as—and sometimes more potent than—the active drugs they replace.

It is obviously absurd to say that doctors should never prescribe pharmacologically active drugs.  There are times when such medications are absolutely essential.  But the good doctor is always mindful of their power.  There is almost no drug that does not have some side effects.  And the more vaunted the prescription—antibiotics, cortisone, tranquilizers, anti-hypertensive compounds, anti-inflammatory agents, muscle relaxers—the greater the problem of adverse side effects.

Moreover, studies show that most patients who reach out for medical help are suffering from disorders well within the range of the body’s own healing powers.  The good physician tries to distinguish effectively between the large number of patients who can get well without heroic intervention and the much smaller number who can’t.  Such a physician loses no time in mobilizing all the scientific resources available when they are necessary, but he is careful not to slow up the natural recovery process of those who need his reassurance more than his drugs.  He may, for such people, prescribe a placebo—both because the patient feels more comfortable with a prescription in his hand and because the doctor knows that the placebo can actually serve a therapeutic purpose.

The placebo, then, is not so much a pill as a process.  The process works not because of any magic in the tablet but because the most successful prescriptions are those filled by the human body itself.  The placebo is powerful not because it “fools” the body but because it translates the will to live into a physical reality by triggering specific biochemical changes in the body.  Thus the placebo is proof that there is no real separation between mind and body.  Illness is always an interaction between both.  Attempts to treat most mental diseases as through they were completely free of physical causes and attempts to treat most bodily diseases as though the mind were in no way involved must be considered archaic in the light of new evidence about the way the human body functions.

Placebos will not work under all circumstances.  The chances of successful use are believed to be directly proportionate to the quality of a patient’s relationship with a doctor.  The doctor’s attitude toward the patient and his ability to convince the patient that he is not being taken lightly are vital factors in the treatment of illness in general.  In the absence of a strong relationship between doctor and patient, the use of placebos may have little point or prospect.  In this sense, the doctor himself is the most powerful placebo of all.

How much scientific laboratory data have been accumulated on placebo efficacy?  The medical literature in the past quarter century contains numerous impressive studies, including these three:

·       An anestheologist at Haward is considered the results of 15 students involving 1082 patients.  He discovered that 35 percent of the patients consistently experienced “satisfactory relief” when placebos were used instead of regular medication for a wide range of medical problems, including severe post-operative wound pain, seasickness, headaches, coughs and anxiety.

·       During a large study of mild mental depression, patients who bad been treated with anti-depressants were taken off the drugs and put on placebos.  The patients showed exactly the same improvement as they had gained from the drugs.

·       Eighty-eight arthritic patients were given placebos instead of aspirin or cortisone.  The number of patients who benefited from the placebos was approximately the same as the number of benefiting from the conventional anti-arthritic drugs

Inevitability, the use of the placebo involves built-in contradictions.  A good patient-doctor relationship is essential to the process.  But what happens to that relationship when one of the partners conceals important information from the other?  Is it ethical—or wise—for the doctor to nourish the patient’s mystical belief in medication?  An increasing number of doctors believe they should not encourage their patients to expect prescriptions, for they know how easy it is to deepen the patient’s physiological and phychological dependence on drugs—or even on placebos, for that matter.  If enough doctors break this habit, there is hope that the patient himself will come to regard the prescription slip in a new light.

In the end, the greatest value of the placebo is what it can tell us about life.  For what we understand ultimately is that the placebo is only a tangible object made essential in an age that feels uncomfortable with intangibles.  If we can liberate our selves from tangibles, we can directly connect hope and the will to live to the ability of the body to meet threats and challenges.  Then the mind can carry out its difficult and wondrous missions unprompted by little pills.

Blood Pressure: Zero!: By THOMAS DEFOREST BULL

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 day I “died” began badly.  I had returned to my doctor for the results of exhaustive tests the previous weekend—the findings on which my life would depend.  He looked troubled, embraced.  “We can find absolutely nothing wrong with you,” he said.

“Nothing wrong with me?  Doctor, what about the pains in my legs and chest, the weakness, shortness of breathe, blackouts?  Something’s very wrong.  I think I’ll be dead within 48 hours.”

He reiterated: “You have no adverse symptoms.  I suggest that you get a through mental examination.”

So, he thinks it’s all psychosomatic.  Thanks a bunch.

I said good-bye as gracefully as possible and hailed a cab back to my hotel.  At the steps to the lobby I had a premonition.  The steps looked like Mount Everest.  I climbed them slowly.  Made it!  Now pull the door open.  Good.  Now to the elevator.  Oh, oh….

I lunged for a lobby sofa, missed it and wound up on the floor staring at the elegant chandelier hanging from the ceiling.  The lights turned brown, then reddish-brown, then dark-red.  Then they went out.

I’m blind!  And I can’t hear anything.  Take stock.  What’s left?  You can think.  Good.  Wiggle your toes?  Good.  Move your legs?  Nope.  Arms?  Good.  Now slide your left fingers along your right wrist. Good.  Now….Not so good.  There was discernible pulse.  I cursed my heart, furious at it for letting me down.  Pump, damn you, pump!  After five minutes or so I could hear voices.  Things turned from black to brown to light again.

The emergency room was stark and unimpressive.  But more disturbing was the youthfulness of the resident and two interns on call.  All three combined could not have had the total medical experience of the middle-aged Ivy League-trained man I’d seen earlier.  Would these men too be persuaded that the problem was mental?  They exchanged significant glances and the slightest of nods as I answered their questions, but I saw to sign of derision.

The resident, Dr. Ted Kinney, moved the stethoscope gently, sensitively in continuous, ever-expanding circles.  He stopped at the spot where the pain had been so many times.  The abrupt return to the original starting point, the same continuous outwardly spiraling movement, and the exact same stopping place.  He invited the two interns to listen.

“We’re pretty certain you have a pulmonary embolism,” Dr. Kinney said.  “That’s a clot that gets loose in the blood stream.  They are about five inches long and….”

“Thanks, I know.  My father was killed by one.”

They took me to the hospital’s Cardiac Care Unit.  Periodically, the public-address system would advise of an emergency involving, a “43-year-old male with acute pulmonary embolism.”  “The poor guy.” I thought absently.  Then, with an undeniable feeling of self-importance, it dawned that they were talking about me.

While I was being wired, probed and thumped, phone calls were being made all over greater Boston to bring back the essential people, who had left for the day.  In a surprisingly short time, they were introduced to me:  Dr. Roberts, chief of cardio thoracic surgery; Dr. Herbert, the general surgeon; Dr. Emerson, the cardiologist; Dr. Thee, a Korean female anesthesiologist, and Dr. Farrell, whose spatiality is the angiogram.

My angiogram involved tuning a flexible probe through a vein in the forearm into the heart.  A radio-opaque dye was injected through the probe, and the heart and lungs were X-rayed.  It showed two emboli [clots], one in the heart and one entering, plus many emboli clogging the lungs.  Then doctors unanimously recommended an immediate operation.  There was no time to lose; more emboli might well be en route and even one could spell finis.

No sooner had agreed than a young woman arrived to urge me to have the chaplain with me during the operation [the national average for survival in pulmonary embolectomies is 43 percent].  Infirmly declined.  I hope she understood.  I planned to do my own praying.

Dr. Rhee quietly told me that I was going to get very light anesthesia.  No need to ask why.  I knew my nose was barely above the water as it was.  She gave me a few deep whiffs of gas.  Minutes later the skin on my stomach went ice cold.  They were scrubbing it with antiseptic, preparatory to tying off the inferior vena cava.  The vein—the body’s largest—routes emboli from the legs [where they are formed] to the heart’s right atrium, where they become deadly serious problems.  If all went well and the emboli already past the vena cava behaved themselves, open heart-lung surgery would not be necessary.  If things went wrong, the heart-lung machine was standing by, primed with blood.

Things went wrong.  When the antiseptic scrubbing stopped, nothing happened.  A voice I recognized as Dr. Emerson’s was reading, matter-of-factly, various figures.  Like a laundry list.  None of the items interested me especially, except the last “Blood pressure: zero.”

Zero blood pressure!  He’s got to be kidding.  That’s impossible.  You’re hearing things.  There’ll be a repeat performance.  Pay closer attention next time.  And within the minute, he was reading the same laundry list, again with the same last item: “Blood pressure: zero.”

Well, that’s that.  What a shame.  They tried so hard.  I felt somehow as if I had let them down.  No panic, not even anxiety.  Just a sense of sadness, of loss, of resignation.

The next voice was Dr. Robert’s.  Same calm, laundry-list tone:  “We’d better hurry; we could lose this one.

Everyone moved in a different direction atones.  The heart-lung machine was wheeled toward me.  At the same time, my upper-feet inner thigh was scrubbed with cold antiseptic.  Are they going to cut me there?  What the hell for? In my ignorance, I had assumed that the heart pump would be hitched up somewhere near the heart, and not, as is the case, to the leg’s femoral artery and vein.  The scrubbing stopped and, all too soon, I saw Dr. Herbert bend over his target.

When the fiery cut came, it was mercifully swift.  I bit my tongue.  The pain was nearly as much as I could bear in silence but no more.  From then on, it was pause, cut, and pause, cut.  As the knife went deeper into the muscle, the pain diminished.  I eased up on my tongue.  Then the surgeon decided to widen the incision a little.  Searing pain all over again.  Damn it, Herbert, if you wanted to cut it that wide shy didn’t you do it in the first place?

Then a lightning bolt exploded in my leg, raced up my feet side and smashed into my brain.  A minor nerve had been cut.  An involuntary moan escaped from deep inside me.  This had two immediate results.  First, tubing from the lung-machine was forced down my throat, effectively preventing any further outbursts.  Second, there were more anesthesias—and suddenly the table seemed to be on wheels, whirling around in a circus ring, counterclockwise.  To add to the carnival atmosphere, the doctors and nurses were cracking jokes, having a good laugh for themselves.  This is [pardon the expression] standard operating procedure for maintaining alertness and morale.  But in my paranoia, it seemed they were laughing at me in my anguish.  What the hell’s so funny?  I hope this happiness to you, every damn one of you.  Each time the table completed its circle; Dr. Herbert would lean over and make another slash.  More pain, more laughter.  Herbert, you son of a bitch, if you’re going to kill me, you’d better make a good job of it, cause if you don’t I’ll sure as hell kill you.

Now the anesthesia was wearing off, the circling table slowed, then stopped, and the pain was getting worse.  I began to pray in earnest: Spare me, Father, if it is your will.  I want to serve you.  There were more slashes, more obscene observations on Dr. Herbert’s parentage, then more prayers.

Then there must have been more anesthesia.  Paranoia, pain and disorientation were pushing my mind near the point of no return.  It was as if there was a slender silver cord from the brain to the neck.  It was stretched to the breaking point and it is snapped, there could be no rejoining of it, I felt sure, Father, if I lose my sanity, don’t let me live.  Then I passed out.

Dr. Roberts splitting my chest down the middle with what looked like a giant old-fashioned can opener revived me.  This was too much.  That silver cord was being stretched to a fine, fragile filament, Dear God, help me!

Help came immediately.  Someone I couldn’t see was putting a finger into my mouth, adjusting the tract tubes.  I was sure it was Dr. Herbert, and I was filled with joy.  Okay, you bastard.  You’ve had a ball hurting me.  Now you’re ready to get some of your own medicine.  I waited until the finger moved back to the molars.  Now!  I bit with all May strength, yearning for the agonized scream.  To my humiliation, I was rewarded only with a peal of female laughter.  A masked face appeared over mine and, even upside down, there was no mistaking those compassionate oriental eyes.  I had bitten Dr. Rhee.  She seemed to be reading all my fears.  “Are you in much pain?”  I nodded.  “Are you scared?”  Very vigorous nods.  “Okay, hold on.  We’ll take care of you.”

Instantly, reality snapped into place.  Dr. Roberts, Dr> Herbert and the others weren’t carving me up for the fun of it.  People in that OR were making a superhuman effort to save my life, and with a full heart I loved them for it.

The giant can opener ceased it prying, and the first wave from the anesthesia washed over me.  Then came pure terror.  Not imagined now, but real and valid.  In altering Dr. Rhee, I had committed a colossal blunder.  I was going to lose consciousness.  That meant no more praying, no more fighting and no more life.  Because, tight or wrong, I was absolutely convinced then [as I am today] that that double-edged sword was, up to this point, all that stood between me and the crematorium.  In silence, I cried out, Lord, they’re going to put me out.  Lord, I can’t fight.  I can’t pray.  Dear Lord, will you pray for me?

The miracle, that followed is difficult to describe.  Skeptics will term it a hallucination induced by fear and anesthesia.  I do not blame you.  I was once one of you.  But was there, totally alert.  More significant, I am here, against all odds.

A warm, gossamer-light, love-filled blanket of Divine Grace descended upon me and protectively covered me.  Two strong arms enfolded me.  At my left ear, I seemed to hear two words filled with a love beyond all understanding,  “I will.”

No words express what I felt so well as a beautiful line by Carl Sandberg, for in that moment I “held in my heart and mind the paradox of terrible storm and peace unspeakable and perfect.” Those two words carried a promise:  I would live.  I whispered, “Abba, Lord.”

From time to time throughout that long night of the long knives, I would resurface, seemingly at will, to check on the progress of things.  Or sometimes the pain of a new incision—there were nine in all—would shock me into wakefulness.  Finally, I heard Dr. Robert say, “Well, I guess we can wrap this one up.”  The wall clock said 5:30 in the morning.  Almost everyone had been on his feet nearly 24 hours, some 36.  Silently I gave thanks.

I spend 11 days in Intensive Care, battling for life.  After 90 minutes on a heart lung machine, brain damage can begin: I was on it for four and half hours, and the price was descent into temporary madness.  Like the day soon after the operation when a stranger walked into my room, carrying a coil of rope with a noose around his neck.  Without so much as a “Do you mind?” he pushed a stool center stage, mounted it, tied the rope to a hook in the ceiling, kicked away the stool and hanged himself.  Or the lovely, lithe—and totally nude—young nurse who dropped in for a delightful visit.

But most of the time I was lucid. And 22 days after I “died,” I walked out of the hospital.  I climbed the steps to the lobby of my hotel and crossed to the elevator.  David, the operator who had seen me carried out, and said,  “You sure look a lot better than when you left, Mr. Bull.”

“Thank God, David,” I said.  “Thank God.”

Turn Your Sickness Into an Asset: By LOUIS E. BISCH, M.D., Author of “Be Glad You’re Neurotic”

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

Only yesterday you were marching in health and vigor, sickness was a far-off shadow.  Then suddenly illness unhinged your knees, brought you limply to bed.  And now you are a horizontal citizen of sickroom, an unwilling initiate into the fellowship of pain.

Your reaction is to rail fretfully against fate, to recent bitterly such untimely interference with life’s routine.  Yet your illness can confer substantial benefits—and not just in the realm of job-like piety, either.  An enforced holiday in bed blamelessly releases us from a too busy world, sharpens our mental and spiritual perceptions, and permits a clearer perspective on our lives.  An illness should be regarded as an opportunity to gather dividends and generate energies that mere health cannot possibly bestow.

I am not speaking of those chronic sufferers whose illness dooms them to a life of invalidism, and whose heroic readjustments lift them above the rank of ordinary men.  The American historian Francis Parkman is a triumphant prototype of all such conquerors of pain.  During the great part of his life, Parkman suffered so acutely that he neither could nor work for more than a half hour at a time.  His eyesight was so wretched that he could scrawl only a few gigantic words on a manuscript.  He was racked by major digestive trouble, crippling arthritis and agonizing headaches.  Physically, everything was wrong with him, yet he contrived to write nearly 20 magnificent volumes of history.

But our interest here centers on the ordinary mortal stricken less harshly.  These sic-chamber casuals rarely learn to make the most of illness, regarding it only as a visitation of bad luck.  Yet thousands actually have found themselves for the first time during sickness.  The ‘beloved physician,’ Dr. Edward Livingston Trudeau, was sent, as a young doctor, to the mountains, where he expected to die of tuberculosis.  But he did not die.  As he lay in bed he had a vision of a great hospital where he could rebuild other sufferers.  Flat on his back at times, he examined patients not as ill as himself.  He raised money and labored until his dream became the great sanatorium at Saranac Lake, New York, that helped thousands of tuberculosis patients.  Trydeay’s affection turned an unknown doctor into a physician of worldwide fame.

Engene O Neill was an utter drifter with no plan of life until he was 25.  A serious illness, tuberculosis, gave him the requisite leisure, he said later, “to evaluate the impressions of many years in which experiences had crowded one upon the other, with never a second’s reflection.”  It was in the sanatorium that had he first began to write his plays.

Like any other major experience, illness actually changes us.  How?  Well, for one thing we are temporarily relieved from the pressure of meeting the world head-on.  Responsibility melts away like snow on an April roof; we don’t have to catch trains, tend babies of wind clocks.  We enter a realm of introspection and self-analyses.  We think soberly, perhaps for the first time, about our past and future.  Former values are seen to be fallacious, habitual courses of action appear weak, foolish or stubborn.  Illness gives us that rarest thing in the world—a second chance, not only at health but also at life itself!

Illness knocks a lot of nonsense out of us; it induces humility, cuts us down to size.  It enables us to throw a searchlight upon our inner selves and to discover how often we have rationalized our failures and weaknesses, dodged vital issue and run skulkingly away.  Mistakes made in our jobs, marriage and social contacts stand out clearly.  When we are a bit scared the salutary effect of sickness is particularly marked.  For only when the way straitens and the gate grows narrow do some people discover their soul, their God, their life work.

Florence Nightingale, too ill to move from her bed reorganized the hospitals of England.  Semi-paralyzed, and under the constant menace of apoplexy, Pasteur was tireless in his attack on disease.  Innumerable illustrations might be cited.  And the testimony from humbler sources is just as striking.  A young man in a hospital for two weeks discovered that he had always wanted to be a research worker in chemistry.  Until then he had been ‘too busy’ as a drug salesman.  Today he is making a splendid to of his new job.  While recuperating from scarlet fever, a woman in her 40s vanquished the terrors she had felt about approaching middle life.  “I am not going to return to my former state of feeling superfluous,” she resolved.   “My children are married and can take care of themselves.  I’m going to start a millinery shop and make then like it.”  She did, and needless to say, they do.

In talking with patients, I find that many who have sojourned in “the pleasant land of counterpane” say that for the first time they learned the true meaning of friendship, often undecipherable in the complex pattern of this modern world.  They say also that they discovered secret depths of their own life-stream.  “After a few days in bed, “writes one of them, “Time becomes an unimagined luxury.  Time to thin, time to enjoy, time to create, time at last to express the best and deepest part of human nature.  Illness is one of the great privileges of life; it whispers that man’s destiny is bound up with transcendental powers.  Illness pares and lops off the outer parts of life and leaves one with the essence of it.”

Even pain confers spiritual insight, a beauty of outlook, a philosophy of life, an understanding and forgiveness of humanity—in short, a quality of peace and serenity—that can scarcely be acquired when we are in good health.  Suffering is a cleansing fire that chars away triviality and restlessness.  Milton declared, “Who best can suffer, best can do.”  The proof is his ‘Paradise Lost’ written after he was stricken blind.

In illness you discover that your imagination is more active than it ever has been; unshaken by petty details of existence, you daydream, build air castles, make plans.  As your physical strength returns, your fantasies are not dulled; rather they become more practical, and you definitely decide upon the things you will put into action when you recover.

Your concentration improves tremendously.  You are astonished to find how easly you can think a difficult problem through to its solution.  Why?  Because your instincts of self-preservation are speeded up, and nonessentials are eliminated.  It is interesting, too, that your reactions to what you see and hear are more acute.  A robin at the window, a fleeting expression on a friend’s face, are delicately savored as memorable experiences.  Illness sensitizes you; that is why you may be irritable.  You may even weep at the least provocation.  But this sensitivity should be turned to better uses.  Now is an excellent time to develop yourself along a special line, to read widely of to create orginal ideas.  Contrary to an old belief, a sick body does not necessarily make a sick mind, except in those who try to make their illness an excuse of laziness.  No one honestly can use an ordinary illness as an excuse for ineffectualness.

If you have never been sick, never lost so much as a day in bed—then you have missed something!  When your turn comes, don’t dismayed.  Remind yourself that suffering may teach you something valuable, something that you could not have learned otherwise.  Possibly it may change for the better the entire course of your life.  You and those around you will be happier if you can look upon any illness as a blessing in disguise, and wisely determine to make the most of it.  You can turn your sickness into an asset.

Our Amazing “White Bloodstream - Medical Miracles, from Readers Digest 1981.

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.

 “Our Amazing “White Bloodstream”:  By J.D. RATCLIFF

It is one of the world’s rivers of mystery—sluggish, largely unmapped, many miles long.  A remote Amazon tributary?  No, the lymphatic system of your body. 

The lymphatic system has puzzled physiologists since early Greek times.  Only now is the ‘white bloodstream’ beginning to yield up its secrets—thanks to new tools and laboratory techniques.  One thing becomes increasingly clear: our healths, even our lives, depend on how well this complex system functions.

In contrast to the bloodstreams, which follows a swift-flowing closed circuit from arteries to capillaries to veins and then back to arteries, the lymphatic system flows slowly in a single direction.  Its initial rivulets—microscopic in dimension—originates in intercellular spaces.  Fluid gathered here passes through ever-enlarging ducts until it reaches the lower neck region, where it empties into veins leading to the heart.

Much of the mystery surrounding the lymphatic system traces to the fact that most of its ducts are so fragile that they are invisible—the smallest have walls of only one-cell thickness.  And the fluid they carry is ordinarily almost clear as water.  Moreover, at the touch of a probe, all bug the largest lymphatic vessels collapse, as they’d at death.  Exploring such a gossamer stream has called for supreme ingenuity which cast shadows on X-ray films, second, radioactive isotopes, which leave a track of telltale radiation.

Explorations via these and other techniques reveal fascinating insights into the ‘geography’ of the body.  In many respects the body is like a vast swamp.  Its trillions of fluid bathed cells live an aquatic life.  The lymphatic network, it can now be seen, provides an all-important drainage system.  To nourish cells, blood capillaries constantly leak minerals, fats, vitamins and sugars, along with fluids and blood proteins.  Much excess fluid, together with cellular wastes, passes back through capillary walls to be carried away bye veins.  But not all.  If the lymphatic system did not carry a large portion of their remaining seepages back to the bloodstream, we would all ‘bleed’ to death internally in a matter of hours.

Loss of blood proteins through capillary walls would be particularly disastrous.  Dr. H.S.Mayerson, of Tulane Medical School, tagged blood proteins with radioactive iodine, then measured the rate at which they passed into lymph vessels.  Calculations indicated that half of our blood protein is lost every 24 hours!  But for the prompt retrieval of the protein by the lymphatic system this constant loss would spell catastrophe.  The route of return is reasonably well known.  A gathering system of minute lymph capillaries collects fluid—how, no one knows—and passes it along until it finally reaches the right lymphatic duct or the thoracic duct.  The later is the largest vessel in the lymphatic system; soda-straw-size, it passes some 16 inches upward through the center of the body, finally emptying into the bloodstream.

What propels this great lymphatic system?  Reptiles and fish have lymph ‘hearts’—pulsating tubes—to move fluid along.  Man does not.  Apparently—this is one of the lymphatic system’s mysteries—lymph is propelled mainly by muscular contractions from breathing, walking, of internal pulsations.  As muscles tighten, lymph vessels are squeezed, and fluid is pushed along.  Backflow if prevented by flap valves located at regular intervals in the larger lymphatic.

The lymphatic network has other jobs besides drainage and maintenance of fluid balance.  Spaced along the channels are hundreds of nodes—bean-shaped masses of tissue that range from pinhead size up to an inch long.  They serve as filters, removing dangerous impurities much as an oil filter does in a car.  These lymph nodes are so numerous that, if one fails, another a few inches farther along is likely to do the job.  This filter system traps almost anything that is potentially harmful—dead red-blood cells, chemicals, even excess tattoo dye.  Lymph modes in the lung areas of city dwellers are often dark form soot filtered out of murky city air.

Suppose you cut your finger or step on a nail.  Inevitably, bacteria are carried into the body.  They could be lethal but for the lymph nodes that strain them out, then destroy them.  Generally, these filters are so efficient that the lymph they finally deliver to the bloodstream is clean and safe.

Still, they can be overwhelmed.  The most dramatic examples are offered by that terror of a disease, bubonic plague.  Here the lymph nodes struggle valiantly to filter out and destroy the invading organisms, but it is a losing battle.

On a less dramatic scale, we have all seen evidence of lymph-node difficulties.  It may seem odd, for example that an infected finger causes pain and swelling in the armpit; of that an infected toe similarly affects the groin.  But concentrations of lymph nodes are located in these areas, and discomfort there announces that a battle royal against bacterial invaders is under way.

While lymphatic filtering action is one of the body’s greatest protective mechanisms, it can also lead to trouble.  Striving to trap anything that would be harmful in the bloodstream, the lymph nodes trap cells shed by cancers.  These cancer seeds often sprout and grow there; indeed, this appears to be one of the chief routes of cancer spread.  This is why surgeons always pay particular attention to the lymphatic system near a primary cancer.  In breast removal, for example, the greatest care is exercised to remove lymphatic and lymph nodes in all surroundings areas, particularly the armpit.

Transport is one of the lymphatic system’s big jobs.  Mounting evidence indicates that this is probably the route by which some of the critically important hormones are distributed through the body.  Another of the system’s intriguing activities is the handling of dietary fats.  Proteins and carbohydrates are absorbed directly into the bloodstream along the digestive tract.  Most fats are not directly absorbed—and with good reason: in heavy concentration, fats are injurious to red-blood cells.  The lymphatic system solves this problem by absorbing fats from the intestine and dribbling them into the bloodstream in amounts that can be safely handled.

The lymphatic system also produces antibodies, which destroy invading bacteria, and it manufactures at least one fourth of the infection-fighting white cells that circulate in the blood stream.  Whenever infections develop, the lymphatic system goes into frantic activity, producing white cells by the tens of thousands and rushing them to the scene of trouble.

Usually, the lymphatic system performs so efficiently that we are hardly aware of its existence.  Still, from time to time it does announce its presence.  On long plane rides and in theaters, women sometimes kick of their shoes.  Reason: when the feet are inactive, fluid stops flowing and collects; feet5 swell.  During surgery, lymph channels are inevitably severed, where upon fluid collects in intercellular spaces, swelling follows in the surgical area and persists until new lymph channels sprout.  Children after suffer from ‘swollen glands,’ particularly in the neck area.  This means that lymph nodes “glands” are inflamed.

At times, too, the system lacks the reserve capacity to handle jobs thrust upon it.  In the lungs, for example, blood vessels may ooze fluid faster than the lymphatics can carry it away.  This can happen in pneumonia, in certain type of heart disease or when irritating chemicals damage lung tissue.  Unless the lymphatic system can meet the challenge, the victim may drown in his own juices.

The lymphatic system has its own special disease problems.  It is the chief target of lymphatic leukemia, and of Hodgkin’s disease—a cancer like illness marked by enlargement of nodes.  Until lately, medical texts said that the latter disease was always fatal.  Recent advances offer some hope of changing the picture, however.  High-voltage radiations appear to destroy the lymph system.  In one recently reported series of cases, where treatment was begun early, two thirds of those treated in this manner were alive at the end of five years—the usual yardstick of cancer cure.

Other studies suggest a link between lymphatic difficulties and deposition of fat in artery walls—which can lead to blockage of heart arteries and to death.  Similarly, there may be a link between lymphatic disorders and serious malfunction of the kidney.

Thus, this great river of mystery may well hold the key to dozens of disease riddles.  As it is given-increasing research attention, discoveries of vital importance to all of us will inevitably be made along its banks.

Medical Miracles, from Readers Digest 1981. November - The Boy With the No-Name Disease

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 Boy With the No-Name Disease:  By JOSEPH P. BLANK

No one could help Jerad.  For 2 ½ years the Reismans had been driving their little son from their home near Sacramento, California, to specialists around the western United States.  They had seen 27 physicians.

Anguished and desperate, they had reached the end of their search for a medical solution to the child’s terrible sickness, termed by one physician as a mysterious “one-of-a-kind disease.”  Now they could turn obey them.

Jared was born on August 15, 1972, pink and beautiful after an easy delivery.  He was a bright, outgoing infant—his mother called him “super baby”—walking by his ninth month, pedaling a tricycle eight months later.

When he was a year and half old, Marlene and Barry Reisman took him and his six-year-old brother, David, to Disneyland.  There Jared caught a cold, which developed into a strange and persistent illness.  His lips were swollen.  Mucus ran from his nose to profusely during the night that his crib sheet would be drenched.  Pain contorted his face and he cried for hours.  He acted as if the had lost most of his hearing.

A pediatrician suspected a nasty cold or teething.  Then black-and-blue marks appeared on the child’s body and legs.  Any scratch of cut produced heavy bleeding.  The pediatrician became concerned, but test showed that Jared did not have hemophilia or leukemia.

The doctor recommended that allergy and hearing specialists examine Jared.  The boy’s ears were found to be filled with fluid, and scratch tests indicated that he was sensitive to airborne substances such as pollen, dust, dander and mold.  The allergist prescribed antihistamines daily and an anti-allergy injection each week.

The medications caused havoc.  Did the original symptoms flourish, but Jared’s coordination became so poor that he would stumble and fall; he couldn’t even sit in a chair.  He lost his appetite.  Yet, sometimes, he would turn into a hyperactive, wild little animal.

Other medications were tried.  Nothing helped; everything induced terrifying reactions.  Once, after taking a quarter-tea-spoon of antihistamine, Jared became delirious, then slept for 36 hours.  Marlene and Barry were afraid that medications would kill their son, so they stopped giving them to him.

During his first year of misery, Jared’s symptoms subsided twice, for periods of about three weeks.  He stopped crying and played happily with his toys.

But the good periods inexplicably ended while Jared was outdoors.  He staggered, fell down, and all the old symptoms immediately flared.

The child’s suffering drove his parents to despair.  With Barry at work, Marlene took the brunt of the boy’s cries and screams, restraining him from madly dashing around the house to escape his pain, and holding him, with a towel over his shoulder to absorb the mucus, for into the right when he couldn’t sleep.

When Jared was three, an allergist told the Reismans that the suspected an unknown range of allergies, but he didn’t know how to deal with it.  He mentioned seeing a television drama about a Houston boy with an immune deficiency who was placed in a plastic-bubble isolator.  There he lived, played and developed normally.  Maybe such contraption would help Jared.  But at the time the Reismans didn’t take the notion seriously.

Jared’s hearing had grown worse now, and he had stopped talking.  A hearing specialist recommended that drainage tubes he placed in Jared’s ears, under anesthesia.  Told about the boy’s reaction to even the smallest amount of medication, however, he refused to undertake surgery.  Have Jared examined by the Mayo Clinic in Rochester, Minnesota, he urged.

In April 1976, the Mayo staff made exhaustive tests of the boy.  They could find no identifiable disease of disorder, except for a borderline reaction to ‘cladosporium’, a common airborne mold.  Clinically, Jared was healthy; actually, he was terribly sick.  The examiners were concerned and baffled.  One physician later said Jared might not live beyond the age of eight and added that he obviously had “something” no one else had.

That summer, Jared sank deeper into sickness.  He couldn’t walk.  He just lay there, totally unresponsive.  The Reismans wanted to take him back to Mayo, but were afraid he would not survive the trip.

They resumed visits to local doctors.  Several diagnosed Jared as mentally retarded.  When it was pointed out that the boy had been fine during the first 18 months of his life, and had since had periods of being alert and active, the doctors didn’t believe it.

But now the Reismans were wondering if there was something in the air that was destroying their child.  They had consulted by telephone with an ear specialist, who told them that a home air-filtered system had helped his own allergic children.  Barry checked manufacturers and found in air-cleaning system that removed 94 percent of the particles in air.  It cost $575 so he asked a doctor if it was worth installing.  He was told, “You don’t treat retardation with a filter.”

Jared’s last visit to a physician was in August 1976.  “Your son is severely retarded and autistic,” the doctor told Marlene.  “There’s no point in your coming back.”

The Reismans had run out of doctors.  Three weeks later, Jared went outdoors and collapsed.  He became delirious.  Marlene put him in the car and, weeping and near hysterics, drove around aimlessly for three hours.  There was no place to take him for treatment.  She could do nothing to help.  Feeling defeated, she finally carried Jared into the house.

When Barry came home, Marlene said, “Let’s go ahead with the filters.  It’s up to us to find a way to save our son.”

Two weeks later a high-efficiency system, designed to filter mold, spores, dust, pollen and other particles from their house air, was installed.  The night it hummed into operation Jared went to bed with his usual wheezing.  The Reismans cried themselves to sleep.

In the morning Barry left for work, and Marlene waited for Jared to announce his waking crying.  At ten she still heard no sound from his room.  She finally worked up the courage to go in.  Jared was sitting up in bed, smiling.  His breathing was even.  The crib sheet was dry.  To Marlene, it was “a miracle.”  Her son had become a little boy.

And a little boy he remained.  He slept long and peacefully.  He enjoyed food.  His symptoms, one by one, disappeared.  And Jared reentered the world of sound with curiosity.  In the shower he loved to listen to the splashing water.  He was overjoyed to learn that speech comes from the mouth and kept touching his mother’s lips, silently asking her to talk.  But he felt no need to talk himself.  He could express his wishes with his hands.

Marlene decided to play dump to his gestures and force him to use words.  Whenever Jared motioned for something, she responded with, ‘what did you say?”  Jared grew frustrated and threw tantrums.  But one night, when his mother had been telling him it was time for bed, the silent boy suddenly spoke.  “Go to bed,” he said—and the sound of his own voice so shocked him that he toppled over, and then began crying out sheer happiness.  After that, he talked more and more each day.

Jared’s zest for life was insatiable.  He had been locked in a dark closet, and now he was free.  He watched ice cubes melt.  He was fascinated by steam from a kettle, talking apart and reassembling tables, bookcases, and faucets.

His parents knew he would soon have to get out into the world.  “He should be with kids his own age,” Barry said.  “I would play with his little sister, Alicia, on the front lawn,” Marlene added, “and I saw Jared at the window, watching us longingly.”

Barry called allergy centers for advice.  A nurse at a Denver hospital told him, “You can’t escape what’s in the air unless you go to the moon.”

The Barry began calling manufacturers of safety respirators.  He was told that the expert on air filters was Bruce Held, at nearby Lawrence Livermore National Laboratory.  Held listened to Barry, asked a few questions, the said, “Would you like me to build your son a portable, battery-powered air purifier?”  Tears came to Barry’s eyes.  He chocked out a “Yes, yes, thank you!”

Held’s purifier consisted of a motor-driven fan, a rechargeable battery that lasted about four hours, a filter, and a hose that carried 99-percent filtered air to a child’s crash helmet, draped with transparent plastic, tied at the neck with a drawstring.  Pressure inside the headgear was higher than normal atmosphere, thus preventing dirty air from leaking in.  The five-pound power unit was carried in a knapsack strapped to the back.

The Reismans helped Jared into the helmet and went outside with him for a half-hour.  The system worked perfectly.  Jared’s outside time was gradually extended to the full four-hour life of the battery.  The rode his trike, watered the lawn, climbed the monkey bars in the park, went shopping.

Time had not dimmed his memory of the pain and sickness, however.  Once he came tunning out of his room, his eyes wide with fear, saying, “The filters aren’t working!”  His parents could not tell the difference, but Barry called in a repairman.  Sure enough, a belt was slipping on the air conditioner, which blew air through the unit.  The filter was working at only 50-percent efficiency.

Within a few months, it became obvious that Jared’s helmet alone was not enough to ensure total comfort.  Particulates in the air continued to cause itching on his body.  The solution was comparatively easy: and astronaut-like space suit.  Inquires led Barry to a Cambridge, Massachusetts, engineering firm that developed such suits.  There the Reismans got invaluable advice in securing an outfit for their son.  The suit made for Jared criminated his itching, and a newly designed clear head bubble gave him better visibility.

Today, Jared is not the least self-conscious about his gear.  He just smiles when another youngster suddenly sees this creature from outer space and darts away.  He amiably chats with the kid who approaches him and says, “Boy, that’s neat.  Where cans I Buy one?”

On turning six Jared was enrolled in a regular school.  He does most of his work in a home study program, since the short life of his battery backpack prevents him from remaining at school full time.  At the end of the first grade his report card read “Excellent” in all subjects.  In his second year the teacher wrote: “Jared’s work is superb.”

And Jared’s future?  “No one knows what will happen,” Marlene centaurs.  “He may outgrow his sensitivity to air particles.  I believe that when Jared is in his teens he will take over the job of finding a solution to his problem.  He’s far too thrilled by life to accept his disability.”

One night, after a downpour had drenched the area, Marlene and Barry heard their front door close.  They checked the house.  Jared was gone, and his helmet and power pack were still in his room.  Something had awakened the child, and he sensed that the heavy rains had cleansed the air so that he was free.

Barry followed him to a park two blocks away.  There he watched Jared roll on the grass like a puppy.  Then the little boy out of the dark closet exuberantly kissed the grass and shouted, “World, I love you!”

CPR—The Lifesaving Technique Everyone Should Know: By WARREN R. YOUNG

Courtesy: Medical Miracles, 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

 “Help!  The man needs help!”  The frantic cry shattered the Sunday afternoon serenity on Seattle’s Jackson park golf course.  Form the elevated fifth tee, four startled hi school boys saw tow youngsters hovering over the crumpled form of a man on a nearby fairway.

“Let’s go!” shouted 18-year –old Craig Larson.  Sprinting downhill to the stricken victim, the four boys saw that he had turned dark blue—obviously from lack of air.  One of those who had shouted—15year-old Neil Ratty, a boy scout—was already trying to tip the man’s head back to open a clear mouth-to-lungs airway.  Craig flopped to the ground and shoved his forearms beneath the base of the man’s neck so that the others could tilt his head far enough back to assure an open air passageway past the tongue.  Mike Merkley, 17, quickly but carefully looked at the man’s chest and felt the air in front of his nose and mouth for any signs of breath  none!  The man was then given four quick breaths.  Pressing fingers gently to the side of the man’s neck, Mike sought any indication of a pulse.  Again, none!  Technically, the man was ‘dead.’

But the boys knew that only about a minute had passed since his collapse, and that the human brain can usually survive about four to six minutes without the oxygen that the heart normally pumps to it through the bloodstream.  So they set to work.  Neal helped hold the head there while 17-year-old Dan Fagan prepared to puff lungful of air into the man’s mouth.

Meanwhile, Ross Venema felt the chest to locate the lower tip of the breastbone.  Moving his hands two fingers up from there, Ross placed the heel of one hand on the lower breastbone, and the heel of the other palm atop the first, and began a rhythmic, strong compression of the chest, about once per second.  Each time he pressed down, the man’s heart was squeezed, forcing blood out to his body.  With Craig calling the count, Dan inflated the victim’s lungs once every five times that Ross pressed down on his heart.

Ross was literally substituting for the victim’s heartbeat; Dan was literally breathing for him.  Almost magically, the man’s terrible blue color began to fade away.  He was alive again—although only for as long as the youths continued their successful cardio-pulmonary resuscitation [CPR].

Meanwhile, another golfer had run to the clubhouse to call professional help.  About eight minutes after the man’s collapse, an Aid Car from a nearby firehouse slithered across the damp fairways.  Two firemen took over the CPR efforts, substituting an air-bag device for the mouth-to mouth breathing.

Ten minutes after that, an elaborately equipped hospital rescue van arrived.  Using an electrocardiography oscilloscope to monitor the victim’s heart activity, electric paddles to shock his heart back into normal rhythm, plus various medications, two of Seattle’s specially trained firemen-paramedics worked for 27 minutes until they achieved a slow but stable heartbeat and spontaneous breathing in the still-unconscious victim.  Finally, they were able to transport him in the rescue van to the nearest hospital where a fully monitored coronary-care unit was available.

Three weeks later, the victim, a 54-year-old airline executive, walked cheerfully out of the hospital—with no trace at all of any permanent damage to brain of heart!  A group of schoolboys, using only their own hands and exhaled breath, had brought him back from ‘clinical death’ and safety maintained his life until more sophisticated help could come.  Without their application of CPR—that combination of carefully controlled hand pressure on the chest, originated in 1960 by a Johns Hopkins University medical team, and of mouth-mouth breathing, developed in the late 1950s—there is no question at all hut that the man’s brain cells would have been irreparably destroyed.

Strangely, however, the achievement of bringing the man back to life was noted only briefly in Seattle newspapers.  Shy?  Because that city was on the handful of foresighted communities across the country—Jacksonville, Florida and Grand Rapids, Michigan, were others—which had undertaken to program to make such lifesaving daring-do by ordinary citizens a matter of routine.

The model Seattle plan, jointly implemented in March 1970 by Dr. Leonard A. Cobb, chief of cardiology at Harbor view Medical Center, and the then fire chief, Gordon F. Vickery, combined the city’s once catch-as-catch-can rescue and emergency ambulance services into an  efficient Fire Department function.  A fleet of so-called Aid Cars—swift, rugged, one ton trucks outfitted to transport patients—were readied and manned by firemen, all of whom had been trained in advanced first aid and CPR.  More than 50 firemen who volunteered for 1800-hour special courses were trained as paramedical technicians at Harborview.  Now these experts, in two-man teams, are poised round-the-clock to hurry to the scene of any heart attack, drowning, electrocution of sudden-death emergency in one of the five mobile intensive-care units that have been acquired.

When a rescued patient arrives at the hospital in a mobile unit, he is moved immediately to a bed in a fully monitored coronary-care of care-care unit.  During the first ten years in which Seattle firemen ran rescue missions, about 3000 sudden-death victims were treated.  More than 800 of the victims were successfully received and subsequently discharged from the hospital.  “And it isn’t only these clinically dead who have been saved,” Dr. Cobb points out. ‘thousands of other people suffering less severe forms of heart attack also got rapid assistance, thanks to the same rescue team.

Furthermore, over 200,000 Seattle adults and teen-agers have been taught to perform CPR in three-hour training courses at schools, offices, shopping centers, theaters and homes.  Firemen-paramedics carefully explain how to recognize cardiac arrest and how to perform CPR.  Then each trainee practices CPR on mannequins engineered to respond just like a human body.  Today, two out of every five Seattle citizens have been trained in the CPR technique as the teen-age golf-course heroes were.

The index of teaching the public victims of sudden death back to life by using methods which even doctors didn’t know about until 1960 was clearly a dramatic, even a daring, concept.  There can be pitfalls in performing CPR.  For instance, if a great deal of air is blown into the stomach, it can cause trouble—even a state of near-shock.  Even when done exactly right, CPR may carouse cracked ribs.  And when not done right the arrow-shaped tip of the breastbone or a broken rib can puncture the liver of a lung.

The answer to these worries is proper training, followed by periodic refresher courses.  After all, if nothing is done for a person whose heart and lungs have really stopped, death is sure.

Trained rescue squads and prepared coronary-care hospital units are essential prerequisites if citizen training in CPR is to reach its full potential for saving lives.  Dr. Archer S. Gordon, former chairman of the American Heart Association’s committee on CPR and emergency cardiac care, which has developed the accepted standards for the technique, warns: “any person who requires CPR should also have follow-up medical care.”  But quickness in starting CPR is equally indispensable, and even fireman cannot reach every ‘clinically dead’ victim within minutes.  If no citizen trained in CPR is at hand, a grain damaged human being or a corpse is then the only prospect.

Hence the prestigious 50,000 member American College of Physicians recommended that a nationwide educational program be launched to teach CPR to the general public.  Special emphasis was given to training doctors, nurses, medical students, firemen, policemen, ambulance personnel and lifeguards.  In addition, these specialists argue, CPR should be taught to Scouts, airline stewardesses, ski patrolmen, electric utility workers, members of the armed forces, relatives of anybody with previous heart trouble—and also, in fact, to as many adults and teen-agers as can be reached.  (The American Red Cross, the American Heart Association and other groups are currently conducting a nationwide CPR training program.)

Occasions to use CPR are not likely to be rare.  It is estimated that one in every six deaths in America—or about 350,000 each year—is sudden.  Most of these are caused by heart arracks.  Some involve drowning, electrocutions and other accidents.  Autopsies of the victims in all of these categories have revealed large numbers who surely would have lived on for many years if only they had been helped past their immediate crises.

“I get a funny feeling sometimes,” says one of the high school boys who save the Seattle golfer, “when I think how helpless we would have been if we hadn’t been taught CPR.”  Some experts predict that, when and if CPR training spreads across America, the number of people who will actually be brought back to life could be in the thousands every year