Wednesday, July 7, 2010

Beating Heart, Still Heart

I've been on cardiac surgery for a few days now. The surgeries are simultaneously the most barbaric and the most elegant procedures I've ever seen.  Cardiac surgery is a strange beast- because it requires stopping the heart to be able to work on a still, clean, bloodless surgical field.  How do you stop a heart?  By injecting it with the same solution that they use for lethal injection.  Sure, there's a bypass machine that is pumping the blood and adding oxygen to it- but in my book, a still heart looks a lot like a dead heart.  I even saw one surgery where we went on "circulatory arrest", meaning that we stop the heart, and THEN we stop the bypass machine too.  Both were off for 49 minutes.  Luckily, we cool the patient's body to 70 degrees, so their metabolic activity is low enough that their cells don't die even though there's no blood.  There is an old saying "You're not dead until you're warm and dead."  Amazingly, we warmed her up and her heart started beating again. 

I still have this thought during every surgery-  at the end of the surgery when we stop the bypass machine, if we can't restart the heart, then we will have been operating for 2 hours on a corpse.  It's odd, the patient is in a strange limbo during the surgery: if their heart restarts, then I'll say that they were alive the whole time, but if their heart doesn't' restart, then I would say that they'd been dead the whole time.  So during the surgery, I'm never quite sure if we're saving a life, or starting an autopsy.

As I said,  it's simultaneously the most barbaric and the most elegant thing I've ever seen.


  1. I can't begin to imagine what it is like to operate on a heart. Thanks for sharing your experience - it amazes me.

  2. You come up with such deep thoughts during surgery - when you watch it on TV shows they seem so cavalier about it. I definately want you there if that day ever comes about!