Medicine: Plastic Lane

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Six weeks ago a retired janitor named Albert H. Grimes was slowly starving to death in Baltimore's Sinai Hospital. A cancerous growth in his esophagus had blocked off the passageway from his mouth to his stomach. He could eat no solids, and only a thin trickle of liquid was getting through.

In such cases, it is possible for surgeons to cut out most of the tubelike gullet, pull the stomach high into the chest cavity and connect it directly to the back of the throat. Such an operation, however, can take up to seven hours to perform. The chances of 75-year-old Grimes surviving it were slight. Sinai Staff Surgeon Edgar Frank Berman decided to try something else.

For nearly two years Surgeon Berman had been busy fitting laboratory dogs with new gullets made of the same light, pliable plastic (polyethylene) found in drugstores as bottles for deodorant sprays. They worked fine. Within three days after the operations, Dr. Berman's dogs were wolfing down normal meals. Later examinations showed the surgeon that tissue and some mucous membrane had grown up along the outer walls of the plastic tubes, giving the dogs what amounted to new esophagi.

By the time Albert Grimes came to his attention, Dr. Berman was ready to carry his experiment a step further. It took the surgeon just over an hour to cut out six inches of Grimes's cancerous gullet and sew a plastic tube into its place. Within a month his patient, back on a soft diet, had begun to recover from the effects of starvation and to gain back some of the 40 pounds he had lost. Last week, still at the hospital, but spry and full of jokes about his lack of front teeth, Patient Grimes was looking forward to a Christmas dinner of turkey and all the trimmings.