Medicine: The Heart in Surgery

Dramatic accounts of heroic emergency measures undertaken when a patient's heart stops in the middle of an operation, usually because of some condition unrelated to the heart, are becoming commonplace—too common, in the opinion of Surgeon William E. Bomar Jr. of Greenville, S.C. In the A.M.A. Journal, Dr.

Bomar and colleagues review 30 such instances at Greenville General Hospital, conclude that anesthesia is not the only villain as often as some surgeons would like to think. On the contrary, they suggest, advances in anesthesia have produced so strong an "anesthesia is safe"attitude that surgeons fail to take full precautions against operating-table crises for weakened patients.

Of the 30 Greenville cases, heart massage was tried in 18. Though only two patients survived (fortunately without brain damage). Dr. Bomar believes that all should have had an equal chance. Therefore, he suggests, no surgeon should be I allowed in an operating room, no matter what his specialty or what part of the body he is to work on, unless he is thoroughly familiar with emergency measures to get a stopped heart going again.