Inside a beating heart: 75 years ago, a surgeon's race against time and failure
Charles Bailey was desperate. His experimental heart operation to correct mitral stenosis had already killed three people and resulted in his dismissal from two hospitals.
Word of his failures had spread. Behind his back, some called him “the Butcher.”
Bailey still had privileges at two hospitals, but worried these would discharge him as well if he failed once more.
So, to maximize his chance of success, he scheduled two operations on June 10, 1948. That way, even if his first patient died, he would still have time to dart across town and operate again before someone stopped him. If both patients died he would likely be finished, with no hospital willing to accept him.
Bailey’s patients faced almost certain death from mitral stenosis — a narrowing of the valve separating the heart’s left atrium and ventricle. This bottleneck caused fluid to back up into the lungs and impaired breathing.
Bailey’s plan was simple. He would make an incision in the atrium, stick his finger inside, and poke it through the narrowed mitral valve to widen it.
The risks were enormous and largely unknown. What if his finger upset the heart’s rhythm and caused ventricular fibrillation and death? How would he know how hard to poke? Or if he’d poked enough?
His first patient had bled to death before Bailey even had a chance to use his finger inside the heart.
The second patient survived the surgery, but died within two days. On his third try, Bailey separated the fused mitral valve leaflets, but inadvertently damaged them, converting mitral stenosis to mitral insufficiency. That patient also died.
Now Bailey prepared himself for what he feared might be his last chance.
His first patient of the day, at Philadelphia General Hospital, died on the table. Feeling the gravity of the moment, he drove to Episcopal Hospital and operated on a 24-year-old woman. The surgery seemed to go well. He widened the mitral valve and no major hemorrhaging occurred.
It worked. The patient ultimately lived to age 62.
Bailey’s reputation was resurrected, but he failed far more often than he succeeded.
This was a groundbreaking moment in medical history. We owe a debt to Charles Bailey and the courageous patients whose sacrifices continue to serve us all.
Andrew Lam is an author and a retina surgeon from Longmeadow, Massachusetts. His latest book, "The Masters of Medicine," tells the stories of some of the greatest discoveries in medical history.