Surgery: The Best Hope of All

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used until the biochemistry of the body itself was understood.

With their new machines and new skills, surgeons know practically no limits to the range of patients they can help. Operations once regarded as foredoomed to failure and fatality if attempted in the very young, in the aged, or in those seriously weakened by illness are now carried out on the youngest of babies or on the oldest and sickest of patients.

Repairing Nature. For a child born a "blue baby," the surgeon's probing hands delve into the innermost recesses of the heart, open up valves that nature has botched, and sew in patches where nature has left something out. They put artificial valves into hearts scarred by rheumatic fever. In an old man's belly, they implant an electrical pacemaker, the size of a railroad conductor's watch, with electrical leads to spark a faltering heart. They thrust a thin tube through the brain and freeze to death a tiny bundle of nerve cells to relieve the tremors of Parkinson's disease. They take a beam of fierce laser light and aim it into the eye to cement a detached retina back into place.

They remove a kidney from a healthy donor and transplant it into a patient who would otherwise die of chronic kidney failure. And to make such a transplant work, they wash out the body's liquid wastes, rebalance its acids and alkalies, lower its potassium—biochemical feats no less remarkable than all their surgery.

Abdominal Drain. On the average, one out of eight operations today is of a type that could not have been done at the end of World War II. At the Brigham recently, there have been as many as ten such new operations a week. Notable among them, besides the kidney transplants: open-heart procedures to repair mitral and aortic valves, removal of aneurysms from brain arteries and the aorta, insertion of pacemakers for the heart, removal of both adrenal glands to check a spreading cancer, removal of a cancerous pancreas, and placement of an "abdominal drain plug" for periodic washing out of the body's metabolic poisons. Several of the most promising and significant forms of today's advanced surgery are shown in color on the following pages.

Already able to treat some types of atherosclerosis (the deadliest form of hardening of the arteries), surgeons are confident of finding effective ways to deal with this disease where it wreaks its greatest destruction—in the coronary arteries of men in their prime. Soon they will open the skull to correct an ever wider variety of brain-artery defects and to remove tumors, while patients are chilled to a temperature of 42°F. and their hearts are stopped for as long as an hour.

However drastic the operation he undergoes, today's patient knows an intensity of care unheard of a few decades ago. Instead of being purged, and carried dehydrated and half dead to an operating theater to be dosed with chloroform or ether, he is gently sedated hours before the operation. The actual anesthesia, usually with a mixture of gases including cyclopropane or halothane, is far easier on him. He is not nearly so likely to suffer shock. All the while, from preoperative preparation through postoperative care, his surgeon watches over his welfare.

The Great Man. The very thought of such surgical treatment becomes possible because the split that separated surgeons