September 29, 2025 • 46 mins
America is in the midst of a cardiac health crisis. It’s the height of the Baby Boom, and American children are dying from heart disease in greater numbers than ever before in history. The doctor who sets out to solve this problem may just be the most fascinating man you've never heard of. Racing against his own terminal cancer diagnosis, Dr. Walt Lillehei embarks on an impossible mission: curing congenital heart defects in kids. His proposed solution outrages the medical community, threatens to end his career and risks the lives of both his young patients and their parents. But it opens the door to a new frontier of medicine.
Presented by: Chris Pine
Written and Narrated by: Jamie Napoli
Executive Producers: Cristina Everett for iHeartPodcasts; Dub Cornett and Jason Ross for OSO Studios; Gerald Imber; Eric A. Rose, M.D.; John Mankiewicz; Joshua Paul Johnson; and Jamie Napoli
Supervising Producer: James A. Smith
Editing and Sound Design by: Joshua Paul Johnson
Composer: David Mansfield Cover Artwork by: Alexander Smith
Production Companies: iHeartPodcasts, OSO Studios, and 13th Lake Media
Production Legal Services: Jacqueline Eckhouse & Mel Pudig, Sloss Eckhouse Dasti Haynes LawCo; and Lincoln Bandlow, Lincoln Bandlow Law
Archival Materials Courtesy of: The University of Minnesota Archives, University of Minnesota - Twin Cities; Special Collections, University of Rhode Island Library; and G. Wayne Miller, author of "King of Hearts: The True Story of the Maverick Who Pioneered Open Heart Surgery"
Additional Archival Materials Courtesy of: "The Dick Cavett Show" (ABC 1970); "The Twentieth Century" (CBS 1966); "March of Medicine" (NBC 1954); KGU; C-SPAN; "Nova" (WGBH Boston & PBS 1988 & 1999); "The Vision of Perseus: Norman Shumway" (Stanford University Libraries 1993); and the Minnesota Historical Society.
Additional Music & Stock Media Provided by: EdRecords / Pond5; EpicRecord / Pond5; Music Bed; Premium Beat; Storyblocks; Artlist; APM; Envato Market; Tribe of Noise; ccMixter (TuneTrack); Incompetech; and Podcast Music.
This podcast was recorded under a SAG-AFTRA collective bargaining agreement. For more information on the history of open heart surgery, check out Dr. Gerald Imber's book "CARDIAC COWBOYS: The Heroic invention of Heart Surgery."
Copyright 2025, TTB, LLC. All rights reserved.
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the wild West of American medicine. I'm Chris
Pine in This is Cardiac Cowboys, the gripping true story
behind the birth of open heart surgery and the Maverick
surgeons who made it happen. Lymon Glidden is still conscious
(00:21):
when they wheel him into the operating room. He's thirty
nine years old, rugged and strong from years spent working
in the iron mines of northern Minnesota. He's as healthy
as they come. But Lyman's health isn't the reason he's
here today. A few feet away from Lyman's operating table
(00:42):
is a scrawny, thirteen month old boy who lies unconscious
on a second operating table. This is Gregory, the youngest
of Lyman's ten children. Gregory was born with a whole
in his heart, the likes of which no child has
ever survived. He's about to have open heart surgery. The
(01:03):
problem is this is nineteen fifty four, and outside of
these walls, the field of open heart surgery doesn't exist.
The anesthesiologist begins hand pumping cyclopropane gas into Lyman's lungs.
As he feels himself slipping out of consciousness, his eyes
drift to the small machine that sits between him and
(01:26):
his son, Gregory. It's a prototype built with scavenged parts
from a dairy pump and plastic beer tubes, and never
before tested on a human patient. The machine was designed
to circulate blood between a parent and child during open
heart surgery. If it works, it might just save Gregory
(01:48):
from a slow and agonizing death.
Speaker 2 (01:50):
If it doesn't, it could kill.
Speaker 1 (01:52):
Not just Gregory, but his father too.
Speaker 3 (01:58):
There rarely were no edisons, no devices, and no procedures
that could help a patient more than minimally.
Speaker 1 (02:06):
In the fifties, that's cardiologist doctor J. Phillip Saul.
Speaker 3 (02:10):
All a cardiologist could do was take a picture and diagnose.
They couldn't treat anything.
Speaker 1 (02:17):
In the early nineteen fifties, young families around the world
faced a medical crisis.
Speaker 2 (02:23):
Thanks to the baby boom.
Speaker 1 (02:25):
Infants were being born in higher numbers than ever before
in history. Millions of them suffered from congenital heart defects.
Children's wards were filled with kids who'd never lived to
see adulthood. Just like Gregory Glidden, these children gasped for breath,
their tiny chests pounding with heart murmurs.
Speaker 2 (02:44):
It could feel through their ribs.
Speaker 1 (02:46):
Their desperate parents drove them back and forth to local
hospitals for bouts of pneumonia and heart failure, but there
was nothing the doctors could do for them. The solution
lay in a new field of medicine. Before nineteen fifty,
surgeons considered the living heart off limits. Less than twenty
(03:09):
years later, doctors weren't just transplanting hearts, they were building
artificial ones. The maverick surgeons who blazed this trail wouldn't
come from the Ivy League or the great European medical institutions.
They were a motley crowd. Doctors scattered across the Midwest
in Texas, forged in the crucible of World War II.
(03:31):
Commanders of their earliest mash units. They came back ready
to take on the next great fight of their lives.
For the next two decades, these heart surgeons competed and feuded,
racing to.
Speaker 2 (03:43):
Be the first, the best, the most prolific.
Speaker 1 (03:47):
Some appeared on the covers of Time and Life magazine,
operated on kings, and advised presidents. Others ended up disgraced, penniless,
convicted unfelony charges. To get they ignited a revolution in medicine.
Speaker 4 (04:03):
He removed the heart from a twenty five year old
girl and transplanted into the chest of a fifty five.
Speaker 2 (04:07):
Year old man.
Speaker 5 (04:08):
All of the men waging the battle are the bake
Dan Cooley and Houston.
Speaker 6 (04:11):
Doctor C. W.
Speaker 5 (04:12):
Lellahigh, the surgeon who keptained the research team and performed.
Speaker 7 (04:15):
The operation, Thomas Edison, Walter Reid, and Jonas Salk.
Speaker 5 (04:19):
Today we gather to recognize that Michael de Bakey's name
belongs among them.
Speaker 4 (04:23):
We welcome doctor Christian Barnard.
Speaker 1 (04:29):
Who were these daring surgeons who willed an entire medical
field into existence?
Speaker 2 (04:36):
How did they achieve so much in such a short.
Speaker 1 (04:39):
Span of time, and why his history left them behind?
Formoso's Studios. This is Cardiac Cowboys, a podcast about life,
death and innovation in the American heartland. Episode one, the
(05:09):
starting gun. For the last two years, writer and executive
producer Jamie Napley is tracked down what remains of the
Cardiac Cowboys. He interviewed the living surgeons, their patients, and
their families to bring you this story. Here's Jamie Napley.
Speaker 8 (05:28):
Throughout history, the heart has been thought of as the
seat of the soul, the source of romantic love. A
heart can be heavy or heard melted or broken. But
all the heart does really is pump blood. Dark rust
colored blood, starved of oxygen, flows into the right side
(05:49):
of the heart. From there it's pumped to the lungs.
When the blood returns, it's bright crimson and oxygen rich.
Left side of the heart then pumps it through the
aorta and out to the rest of the body. And
it does this over and over again, one hundred thousand
(06:10):
times a day. But for the one in every hundred
children born with the defect, it doesn't work that way.
Holes in the atria the upper chambers, or the ventricles
the lower chambers, allow the oxygenated and deoxygenated blood to mix,
forcing the heart and lungs to work harder. Imagine trying
(06:34):
to drink water through a straw with a hole in it.
Surgeons hypothesized that some of these holes could be sown
shut with a few carefully placed sutures. But there's a problem.
Speaker 5 (06:48):
The hardest pumping blood at five liters a minute, and
you open it up and it is still working. It's
a blood path.
Speaker 8 (06:54):
That's medical historian and plastic surgeon doctor Gerald Imber.
Speaker 5 (06:59):
For two thousand years, since the time of Apocrates, the
rule has been you don't mess with the heart, because
if you touch the heart, you kill the patient.
Speaker 8 (07:09):
In the nineteen forties, when C. Walton Lillehigh and F.
John Lewis were starting out at the University of Minnesota,
no surgeon dared to cut into the living heart. Every year,
thousands of newborn infants were condemned to live short, excruciating lives.
All that was about to change. In less than a decade.
(07:33):
Lillhigh and Lewis would overturn thousands of years of convention
and open the door to a dangerous new frontier of medicine.
Speaker 9 (07:54):
We have with her mooring the falling out.
Speaker 8 (07:59):
By December seventh, nineteen forty one, like many American boys,
after the bombing of Pearl Harbor, U of M medical
school classmates, Walt Lillehigh and John Lewis signed up together
for the Army Reserve. They were activated on the same day.
(08:22):
After the war, they returned to their alma mater to
begin their surgical residencies.
Speaker 7 (08:28):
It was a special time in the history of surgery.
Speaker 8 (08:32):
That's an archival recording of John Lewis.
Speaker 7 (08:34):
Due to the Army experienced, blood transusions became much safer
than they were, and his caesiology became much better than
it was. Things became possible it's never been possible before.
Speaker 8 (08:48):
As friends, Lillehigh and Lewis made for an odd pair.
Lewis was tall and lanky, with warm features, horn rimmed glasses,
and a bow tie permanently fixed to his collar. Lilahigh,
stocky with slicked back hair, had a gaze so piercing
it would stop people in their tracks. Lewis was witty
(09:09):
and intellectual. He spent his time outside of the hospital
writing poems, painting still lifes, and playing classical music. Lilahigh
preferred drinking at an all night jazz club. If Louis
was butch cassidy for bose and funny, Lilahigh, reserved and
chillingly intense, was the sundance kid.
Speaker 10 (09:32):
He had the most beautiful color of stilly blue eyes,
so intense that you were just mesmerized immediately. I was
always just totally smitten by him.
Speaker 8 (09:46):
That's Sea Bollman, a nurse who worked with Walt Lillahigh.
Speaker 10 (09:49):
He absolutely was fascinated about how things fit together and
how things actually work.
Speaker 8 (10:00):
Lilla High was a born tinkerer. As a child, when
his parents refused to help him buy a motorcycle, Lilla
High started building his own from spare parts. By fourteen,
he had at least three different bikes that he'd zip
around on through the Minneapolis suburbs. He met his future wife,
Kay Lindberg when she was working as a nurse at
(10:21):
the Minneapolis General Hospital. Kay found him intense and very
much a loner, but she was attracted to how this strong,
silent type could show so much empathy for his patience.
Speaker 11 (10:36):
It's really what drew my mother to him.
Speaker 8 (10:38):
That's Walt and Kay's son, Doctor Craig Lilihi.
Speaker 11 (10:42):
Dad was a compassion man and not an outwardly or
a showy sort of way. She remembers him as an
intern and resident to sitting down at the bedside and
talking with families.
Speaker 8 (10:55):
The U of M Hospital wasn't particularly well regarded in
the early fifties, but for those in the know, this
was where all of the most exciting cardiovascular developments in
the world were taking place. Lille High and Lewis's boss,
doctor Owen Wangenstein, had spent the last two decades revamping
(11:16):
the surgical department according to his own wildly ambitious vision.
Wangenstein aimed for nothing less than the Nobel Prize. To
that end, he recruited an eclectic team of brilliant young
surgeons from all over the country, tinkerers, outside the box, thinkers,
and rule breakers. Here's doctor Gerald Imber again.
Speaker 5 (11:40):
Owen Wangenstein was the chief of surgery at Minnesota, and
in nineteen forty nine he established a department of cardiac surgery.
When there was no such thing as cardiac surgery.
Speaker 8 (11:54):
Wangenstein wanted his surgeons to define the future of medicine.
In his mind, that future lay in the living heart.
All of the early attempts at open heart surgery ended
with patients dead on the operating table. In nineteen fifty two,
Wangenstein asked thirty five year old John Lewis to take
(12:17):
up the gauntlet. Lewis would lead the department's pioneering attempt
at open heart surgery, but first he'd need to find
a way to keep his young patients from bleeding out
mid operation. He became fascinated by a technique called hypothermia.
Speaker 12 (12:35):
I was sitting beside him actually at that meaning. The
presentation was by doctor William Biglow from Toronto, Canada.
Speaker 8 (12:42):
That's an archival recording of Walt Lillehigh.
Speaker 12 (12:45):
He had pointed out that the limit the brain could
go without blood safely was four minutes, but you could
double that time if you reduced the body of temperature
put in the brain. He felt that that was ample
time for the simple defect inside the heart. Doctor Lewis
and I and both in the audience were very impressed,
but we said that's a place to be young.
Speaker 8 (13:11):
On a chilli morning in September nineteen fifty two, Lewis
brought five year old Jacqueline Johnson into the operating room
to lower her body temperature. Lewis wrapped Jacqueline in a
rubber cooling blanket for two hours. Nurses monitored her temperature closely.
(13:33):
If it dropped too low, her heart could fibrillate, its
rhythm growing fast and out of sync in a time
before clinically available to fibrillators. This would be a death
sentence for young Jacqueline Johnson. When the thermometer hit twenty
eight degrees centigrade, Jacqueline was laid out on the operating table.
(13:54):
At this temperature, Lewis estimated her brain needed about fifty
percent less ox and the normal. Flanked by his assistants
Richard Varko and Walt Lilleheigh. Lewis raised his scalpel and
sliced into her chest.
Speaker 4 (14:10):
The incisions used for those early operations were all horizontal.
Speaker 8 (14:15):
That's cardiac surgeon doctor Eric Rose.
Speaker 4 (14:17):
They required division of multiple muscles to get through, division
of arteries, which now are very important to leave for later.
Speaker 13 (14:24):
Use and painful.
Speaker 4 (14:27):
These were primitive incisions.
Speaker 8 (14:29):
Jacqueline had been tentatively diagnosed with an ASD, an atrial
septal defect, the simplest kind to repair, but the surgeons
wouldn't be able to confirm the diagnosis until they saw
for themselves.
Speaker 4 (14:44):
After spreading the ribs and exposing the pericardium, surgeons need
to do an incision in order to see the actual heart.
The heart itself is completely exposed.
Speaker 8 (14:54):
At that point, Lewis conjectured that hypothermia bought him about
eight minutes before Jacqueline suffered permanent brain damage. Eight minutes
to enter the heart, locate the whole, sew it shut,
and then resuscitate her. The surgeons clamped off the blood
vessels leading into and out of Jacqueline's heart. When it
(15:19):
stopped beating, Lewis made his first incision. As he spread
open the heart wall, he could see immediately that the
diagnosis was correct. There was a small hole in the
heart's upper chamber. He quickly and carefully sewed it shut,
and then Lilla High and Varco rushed to restart Jacqueline's heart.
(15:42):
But after the clamps were removed from her blood vessels,
her heart still refused to pump blood. Louis began massaging
it with his hands, and then it started to beat
on its own. Here's Walt Lilla High again. I remember
looking at but the clift.
Speaker 11 (16:00):
It was about ten minutes to ten point.
Speaker 8 (16:02):
The heart took over.
Speaker 12 (16:03):
I said, this is it, John, We're into the art
to state.
Speaker 8 (16:08):
John Lewis had just performed the first successful open heart
operation in history. He was thrust into the spotlight, and
over the next year he performed a series of ASD
repairs using hypothermia. Lilihigh was happy for his friend. By
(16:30):
all accounts, the man didn't have a jealous bone in
his body, but he saw a problem.
Speaker 4 (16:39):
Hypothermia requires being able to do things exceedingly fast. You
could do surgery inside the heart closing relatively simple defects,
but any more complex procedure really was not doable reproducibly.
Speaker 8 (16:54):
Across the street from the o RS where Lillihigh and
Lewis worked stood the brand new Variety Club Heart Hospital.
At the time, it was the only medical institution in
the world dedicated to the heart, and its children's ward
was overflowing with sick kids suffering from more complex defects
no doctor could fix, at least not using hypothermia. John
(17:20):
Lewis had taken the first step into the new frontier
of open heart surgery, but Lilahi could see that to
make any more progress, a new approach was needed, and
children would continue to die by the thousands until he
found it. Two hundred miles north of Minneapolis, a rugged
(17:46):
mine worker named Lyman Glitton and his wife Francis, gave
birth to their tenth child, a boy. They named him Gregory.
Like many parents in the nineteen fifties, and Frances already
had one child with a congenital heart defect.
Speaker 6 (18:05):
But Donna, we called her Donna. Nobody really talked a
lot about her affliction, which was a hole in her heart.
Speaker 8 (18:13):
That's Shirley Gliddon'spinelli, the fourth of Lyman and Francis's children.
Speaker 6 (18:18):
She was not able to go to school because she
just didn't have the energy to go. Donna and I
slept in the same bed, and we'd actually sleep with
our arms around each other. We just were very, very
close as sisters. Once Saturday morning, my mother she looked
in our room and I don't know what she noticed,
(18:42):
but she cried for my dad. Chick Chick that was
his nickname. My sister Donna had died during the night.
She looked so peaceful. I was not aware. I was
what ten or eleven years old laying there next to her,
and she had already died.
Speaker 8 (19:01):
In the spring of nineteen fifty three, when baby Gregory
began showing similar symptoms to his sister LaDonna, Lyman and
Francis feared the worst. It would be months before doctors
confirmed what the parents already knew. Gregory had a hole
in his heart. Left untreated, it would kill him, just
(19:22):
like it did his sister. The Glittons were lucky, they
were told in that they lived just a day's drive
from the only city in the world where doctors were
repairing heart defects like Gregory's. They made the trek down
to the Variety Club Heart Hospital, where they heard all
about the miracles being performed by the Great John Lewis.
(19:47):
But when Gregory underwent a heart catheterization, Lyman and Francis
were told that, like most of the children at the hospital,
their son's defect was too complex to be fixed. There
was nothing John Lewis could do for them. In his
laboratory across the street, Walt Lillihigh was working tirelessly on
(20:12):
a miracle of his own. The pace of medical progress
is often slow and plodding, but time was something Gregory
Gliddon didn't have, and neither did Walt Lillehigh. Three years earlier,
Lillahigh had noticed a small rubbery bump by his left ear.
(20:34):
He had another surgeon biopsy the growth and sent it
to a pathologist. The results would change his and his wife,
Kay's lives forever. Here's an archival recording of Kay Lillahigh.
Speaker 9 (20:50):
My husband was jagnosed with nymphos sarcoma. I remember looking
it up in a dictionary and sent to most fato
tech answer, I need to be homely.
Speaker 12 (21:02):
You know, he wasn't going to live that much.
Speaker 8 (21:03):
Shiner lymphosarcoma is an obsolete term for non Hodgkin lymphoma,
a rare and deadly cancer that was growing in the
prodded gland in Lilahi's left cheek. The prognosis was grim.
Lillehigh was unlikely to survive the next five years. Surgical
(21:26):
chief Owen Wangenstein assembled a cracked team of doctors to
operate on his young protege. On June first, nineteen fifty,
Lillahi entered the OAR at the University Hospital for the
first time as a patient.
Speaker 5 (21:43):
Wangenstein was a particularly aggressive cancer surgeon.
Speaker 8 (21:48):
That's doctor Gerald imber again.
Speaker 5 (21:50):
And it was said that Wangenstein hated cancer so much
because it was the only thing.
Speaker 13 (21:55):
They killed more patients than he did.
Speaker 8 (21:59):
Lillehi was on the table for more than ten hours.
Multiple surgeons worked on him, including his good friend John Lewis.
Speaker 9 (22:08):
He did drastic surgery, ticked out that kind of mass
a big muscle alumnick, and then down into the chest
until they were no more cancer cells. He ended up
with around nick you know.
Speaker 8 (22:26):
Over the next four months, Lila High remained bedridden in
the duplex he shared with Kay and their daughter Kimberly,
just a short drive from the university. But even as
he struggled to recover from the operation, Lila High knew
there was no cure for lymphosarcoma. How much time could
he have left?
Speaker 13 (22:46):
We always live with that threat.
Speaker 9 (22:49):
We were at first house that we advised to I've
been asking to much money.
Speaker 11 (22:53):
I leave something for you.
Speaker 6 (22:55):
That was the threat always.
Speaker 11 (22:57):
He really believed that he was living on time.
Speaker 8 (23:00):
That's doctor Craig Lillihaigh Again.
Speaker 11 (23:03):
That certainly had an impact on him in realizing that
the time was it was limited. Life was a gift.
Speaker 8 (23:12):
Lilihigh returned to work a changed man. He was noticeably thinner,
He'd lost muscle mass during his recovery, his head and
neck were forever tilted to the side, and at age
thirty two, he didn't think he'd lived to see the
end of the decade if he was intensely focused on
his work before now. Postop, Lilihi's drive was peter natural.
(23:39):
So as the world celebrated John Lewis for curing one
very particular type of heart defect, Lilihi was using every
precious waking moment to do his friend one better, to
find a way to buy surgeons more time inside the heart,
to cure more and more complicated defects, to save the
(23:59):
live of more dying kids, kids like Gregory Lytton. Lillahi
was having a drink with his lab assistants Herb Warden
and Morley Cohen after another late night in the lab.
(24:19):
When the men arrived at a simple but revolutionary idea.
Speaker 5 (24:24):
One of his assistants mentioned that his wife was pregnant
and they were talking about the fact that in pregnancy,
the placenta was providing oxygenated blood to the brain of
the fetus, and then loves didn't have to do anything,
and all.
Speaker 13 (24:38):
Of a sudden, Lila Hijas zones out, just.
Speaker 5 (24:43):
Why don't we use another animal circulation to bypass the
heart so that oxygenated blood would go to the brain
and you would have time to do what you needed
to do.
Speaker 8 (24:56):
They called it controlled cross circulation, a and heart lung machine.
Someone with a matching blood type, ideally a parent whose
heart and lungs could oxygenate the child's blood while the
surgeon operated. Just like in pregnancy, a parent would act
as a sort of temporary life support for their child.
(25:19):
Lillihigh and his assistants began scavenging for spare parts to
assemble their prototype beer hose and a sigma pump utilized
by the dairy industry. These men were tinkerers. They used
whatever did the job.
Speaker 14 (25:34):
People of Lola High's generation, especially the cold weather states
in the Midwest, made do with what they had, and
if they didn't have something, they made it themselves. They
didn't look for someone else to solve the problem.
Speaker 8 (25:46):
That's ROBERTA. Beach, a coordinator at the Variety Club Research Center.
Speaker 14 (25:50):
Here you have a man who survived war, and he
survived cancer, and that made him willing to do things
that other people perhaps would not do.
Speaker 8 (26:02):
After a successful round of tests in the animal lab,
Lilli High and his team began looking for their first
human candidate. In order to prove the advantage of cross
circulation over hypothermia. Lilihigh needed a patient with a more
complex defect than anything his friend John Lewis had ever
attempted to fix.
Speaker 5 (26:23):
He went around the hospital to try to identify a
child with a serious ventricular cental defect and identified a
boy named Gregory Glidden. The couple had already lost a child,
and they were certainly loath to have the child operated upon.
Speaker 8 (26:43):
Lilli High spent time with the Gliddons, working to earn
their trust. He listened to their concerns and talked through
the risks. Lyman, who was a blood match for his son,
would need to act as Gregory's heart lung donor there
was a chance the operation could result in the deaths
(27:03):
of both father and son. It was a leap of faith.
Speaker 13 (27:10):
They finally agreed to leave Gregory.
Speaker 5 (27:12):
At the hospital for care and allow him to have
surgery if they thought he was a suitable candidate.
Speaker 8 (27:22):
Getting the approval of hospital administrators proved to be the
far greater challenge. Wangenstein and Lillahi shared a close bond,
made closer by the disfiguring cancer operation Wangenstein had performed
on him. Wangenstein would do anything to see Lila High succeed,
but there was a system in place. John Lewis had
(27:44):
made history a year earlier, earning the hospital publicity and
a fortune in donations. If anyone was going to attempt
the much more complicated ventricular septle defect or VSD repair,
it would have to be Lewis.
Speaker 5 (28:04):
John Lewis was very successful fixing ASD atrial septal defects.
In fact, he was the only person in the world
who was doing it for a year. The ventricular septal
defect is larger, it's more difficult to get to, and
it was more time consuming. The issue became much more
complex when they attempted to fix a VSD.
Speaker 8 (28:28):
Lewis's first VSD patient turned out to be a misdiagnosis.
The defect was even more complicated than anyone realized. Lewis
ran out of time trying to repair it, and the
young patient died on the table. Lewis made a second attempt,
with Lilli High assisting. The diagnosis was correct, and yet
(28:50):
Lewis again found himself running out of time.
Speaker 5 (28:54):
Lillie High was by his side and trying to help him,
and Lewis began to perspire and began to panic. He
realized he was losing his patient and it just drove
him to despair. The child died, and the idea of
repairing VSDs under iplothermia died with him.
Speaker 8 (29:18):
In short order, Lewis's research funding was cut and Lili
High's was increased. The following year, in Lewis's words, he'd
be booted out by Wangenstein. For Lewis, it was a
swift and painful coup. He told one of his residents,
it is difficult to tolerate the success of a friend.
(29:40):
Lilla High now had the full backing of his mentor,
and he got to work.
Speaker 13 (29:46):
His team would go on Saturdays down to Mayo.
Speaker 8 (29:49):
That's doctor Paul Isisio, a professor at the U of
M's Visible Heart Laboratories.
Speaker 3 (29:54):
They watched surgery, and then they would visit Justin Edwards,
who had a heart library there he can shuttle specimens.
Speaker 8 (30:02):
Lili High and his team spent hours in the pungent
from maldehyde suffused lab at the Mayo Clinic, just a
ninety mile drive south of Minneapolis. The cardiac pathologist there,
Jesse Edwards, kept thousands of preserved human hearts in barrels,
and Lilihi dug through them, studying every type of heart
(30:23):
defect for which there existed a specimen. Whatever he'd find
beating in Gregory Glyndon's chest, he wanted to be ready for.
Back in Minneapolis, news of Lili High's procedure was causing
a growing panic among the hospital administrators. Lila High saw
(30:43):
his chance to save Gregory's life disappearing before his eyes.
Speaker 5 (30:49):
It was enormous pressure on Wangestein not to allow him
to do it. Weangestein had a visitor from Chicago, Willis Potts,
a very famous PDA Patrick the surgeon said, congratulations, You're
about to be the first surgeon to have a two
hundred percent mortality.
Speaker 13 (31:08):
It was meant, of course, as the ultimate insult.
Speaker 5 (31:10):
So the administrators of the hospital, hearing some famous surgeons
say oh my god, how can you do this, try
to stop them from doing it.
Speaker 8 (31:23):
The administrator's concerns were not unjustified. With its beer tubes
carrying blood around ther its potential for two hundred percent mortality,
cross circulation seemed more carnival side show than modern medicine.
Not only could it fail, it could discredit the university.
(31:46):
March twenty fifth, nineteen fifty four, the day before Lilli
High was scheduled to operate on Gregory Glidden, administrators stormed
into the office of hospital director Ray Amberg. They wanted
to shut la High down, and Wangenstein was called in
to defend his protege. Litla Hi's future and Gregory Glyndon's
(32:07):
life hung in the balance.
Speaker 11 (32:10):
How confess, cross circulation was very much viewed as heresy.
Speaker 8 (32:14):
That's doctor Craig Lillihigh again.
Speaker 11 (32:17):
It was an idea that even today feels a little radical.
Speaker 8 (32:22):
As Wangenstein was arguing lil High's case to the hospital director,
Lila High went about his other work. If he was
anxious in the hours leading up to the operation, nobody
could tell. When Lillahigh returned to his office after performing
an abdominal surgery, he found a note on his desk
from Wangenstein. Dear Walt. It read, by all means go ahead.
(32:52):
By now, Gregory was thirteen months old, and he'd spent
three of those months in the Variety Club Hart Hospital.
To help shed light on Gregory's experience at the hospital,
here's doctor Pamela Evans. Lila High repaired a defect in
doctor Evans's heart not long after Gregory's operation.
Speaker 15 (33:12):
My pediatrician told my parents about the hard hospital at Minnesota.
There was a playroom that we could play in. I
remember the children having wheelchair races.
Speaker 8 (33:28):
Early on the morning of March twenty sixth, Gregory was
wheeled tor number two in his crib, surrounded by his
stuffed animals.
Speaker 15 (33:37):
To this day, when I'm in a hospital or I
have to have like a procedure or something, if I'm
on the gurney, I still recall watching the lights flash
by as they.
Speaker 5 (33:48):
Were wheeling me to the operating room.
Speaker 14 (33:50):
It's very very vivid.
Speaker 5 (33:52):
Boom boom boom.
Speaker 8 (33:58):
In ther Ggory was moved to an operating table as
the anesthesiologist prepared the cyclopropane gas to put him under.
Speaker 15 (34:07):
I know, I was really really cold. I kept saying, mommy, mommy,
I'm so cold. I'm so cold, and I mean I
had nothing on, no sheets or anything.
Speaker 8 (34:19):
Once Gregory was unconscious, Lillehei began the operation. He cut
open the boy's chest and spread his ribs. The surgeons
inserted narrow tubular canulas into Gregory's aorta, as well as
the superior and inferior vena cava in his neck. Through
these canulas, Gregory's blood would be diverted from his heart
(34:43):
through plastic beer tubes into the small sigma pump and
then into Lyman's blood vessels. Threw an incision in the
inner thigh, Lilihaigh gave the command pump on. At the
flip of a switch, the machine hummed to life. Blood
began to flow between father and son. Gregory's tiny heart stopped,
(35:07):
and Lymans picked up the slack, pumping blood for both
of them. Lilahaigh sliced into Gregory's heart, a two and
a half centimeter cut into the right ventricle. Surgeon Richard
Varko pulled apart the sides of the incision, but it
was too dark to see inside. Shortly before the operation,
(35:27):
Lili High had the idea to borrow a headlamp from
an ear nose and throat doctor at the hospital. Without
the support of the sternoclidomastoid muscle in his neck, just
keeping the lamp upright was a struggle for Lillihigh. He
aimed its dim beam of light into the lower chamber
of Gregory's heart.
Speaker 5 (35:46):
Lila High actually manually stuck his finger in and found
the hall.
Speaker 8 (35:50):
That's doctor Gerald Imber again.
Speaker 5 (35:52):
The diagnosis, which is not always correct, was correct. This
time a child did have a ventricular septal defect. He
was able to run a series of silk sutures through it.
Speaker 8 (36:04):
And here's cardiac surgeon doctor Eric Rose again.
Speaker 4 (36:07):
It's remarkable that he was able to get them closed
with relatively primitive needles and primitive suture material that now
we take for granted entirely.
Speaker 8 (36:18):
At twelve minutes and fifteen seconds past zero time, Lilihigh
had soon shut the hole between Gregory's ventricles. As the
boy lay there unconscious, lili High could feel his heart
beating more powerfully than it ever had in his thirteen
months of life.
Speaker 5 (36:37):
He closed the defect, and then he closed the heart,
and then they closed the chest, and they reached over
to shake one another's hands.
Speaker 13 (36:45):
They had detached the father from the son.
Speaker 5 (36:47):
They had a living child who was crying a normal
post operative cry.
Speaker 8 (36:51):
At the end of surgery, when Lyman regained consciousness, his
wife Francis gave him the good news. Every doctor they'd
spoken to over the last year had told them Gregory's
defect would kill him. Walt Lillahi had just saved the
boy's life. Over the next few days, Gregory's condition steadily improved.
(37:17):
Lilahi was cautiously optimistic for a quick recovery, but his
optimism soon faded.
Speaker 5 (37:28):
Everything was wonderful until it wasn't. He became ill. Twice,
he ran a fever. The child Gregory needed to have
a tracheostomy performed so that they could suck a mucus
out of his lungs.
Speaker 8 (37:43):
Gregory's health took agonizing swings over the next week. He
grew dangerously ill, with pneumonia. Some days, his breathing and
heartbeat appeared normal. Other days he gasped for breath and
didn't recognize his own parents unflagging, checking in at all
hours of the night, and performing an emergency tracheostomy to
(38:05):
help Gregory breathe, but nothing he did seemed to improve
the boy's condition. On April sixth, Gregory took one more
turn for the worse. By nine point fifteen in the morning,
the boy was dead.
Speaker 2 (38:22):
Walt Lilla High.
Speaker 8 (38:23):
Had to do the hardest part of any surgeon's job.
He had to break the news to the family.
Speaker 4 (38:29):
I would say that there are many many surgeons of
that era who just in view it as part of
their job to explain things and to mourn with families
when they lost kids. Whether that empathy originates with his
own illness, I think it's impossible to say, But it's
just an incredible gift being able to communicate and being present,
(38:53):
just being present with those families.
Speaker 8 (38:57):
Lila High's experimental procedure had ended in failure. If the
career of John Lewis were any indication, Lilli Hi's fight
to cure heart defects in children would soon be at
an end.
Speaker 5 (39:17):
The administrators and the heads of medicine and pediatrics now
really had ammunition. They didn't want the university to be
open to criticism, and they didn't want more people to die.
They thought this was a terrible idea.
Speaker 8 (39:31):
But Lilihi was determined to figure out where he'd gone wrong.
After Gregory's death, he took an unusual extra step. He
asked Lyman and Francis for consent to perform an autopsy.
Lilahi looked on as the pathologist opened Gregory's chest and
(39:54):
removed his tiny heart. Once again, Lilihei made an decision,
and Gregory's right ventricle.
Speaker 5 (40:04):
He looked, and he saw that his repairs VSD repair
had completely healed. He didn't know whether to laugh or
cry because there was a dead baby on the table,
but he knew he had cured his problem, and the
child had died from pneumonia.
Speaker 8 (40:26):
Lilahei may have failed to save Gregory, but the boy's
death would not be in vain. Lilahi's procedure had worked,
and it could work again if only he were given
another chance. The door to open heart surgery had just
(40:46):
been blown wide open, but no one outside of Walt
Lillaheigh knew it.
Speaker 15 (40:52):
I see him as this genius in some ways, like
a Vincent van Doll or something. You know, their troubled soul,
but they're trying to do the best that they can.
Speaker 8 (41:05):
Sixty eight years after Gregory Glyndon's death, Pamela Evans reflects
on what his family sacrifice has meant for her and
for the world.
Speaker 15 (41:15):
I'm seventy two years old. I should be dead. The
loss of that child's life led me to forty four
years in academia, where I impacted thousands of young adults.
I would thank them, and I would say that child
(41:38):
not only saved me, but it saved other children as well.
Speaker 8 (41:52):
At the Maple Hill Cemetery in Hibbing, Minnesota, a small
headstone marks the burial site, chaired by Gregory Glidden and
his sister LaDonna. Under Gregory's name is an epitaph which reads,
his little heart changed the world. That change wouldn't come
without a fight. Willehei knew that he'd face a sharp
(42:16):
backlash after Gregory's death. To move forward, he'd need to
take matters into his own hands.
Speaker 5 (42:26):
Walt did the kind of thing that Walt always did.
He waited until he administrators out of Town. He scheduled
two more surgeries, because when something's got to be done,
it's got to be done.
Speaker 8 (42:37):
These next two operations would determine the future of open
heart surgery. Once news of cross circulation spread outside of Minnesota,
Walt Lillehigh, a man with no experience in the spotlight,
would find himself in the crosshairs of some of the
most powerful figures in medicine.
Speaker 4 (42:56):
It's very easy to criticize an effort that results in
a dead show, very easy, But part of Walt's genius
was a persistent.
Speaker 8 (43:06):
Lil High's radical cross circulation procedure was the spark that
ignited a revolution in heart medicine. He'd fired the starting gun,
and soon surgeons all across the world would join the
race in Houston, New York, Halo Alto, and Cape Town,
South Africa. This is the story of the brilliant, fearless,
(43:28):
and deeply flawed men and women who looked past the
accepted medical wisdom of their age and reached into the future.
The doctors and nurses who risked their careers, the patients
who gave their lives, the towering achievements and unimaginable sacrifices.
The rise and fall of the heart surgeon as God
(43:51):
and the brutal Bloody an ultimately triumphant road to medical progress.
Speaker 1 (44:05):
On our next episode, two of the country's most ambitious
surgeons joined forces to make Houston, Texas, the new cardiovascular
capital of the world, but a friendly competition turns them
from close colleagues to fierce rivals next time on Cardiac Cowboys.
Speaker 8 (44:34):
Cardiac Cowboys is a production of iHeart Podcasts, OsO Studios
and Thirteenth Lake Media. We're presented by Chris Pine and
written and narrated by me Jamie Appley. Our executive producers
are Christina Everett for iHeart Podcasts, Dub Cornette and Jason
(44:54):
Ross for OsO Studios. Doctor Gerald Imber, author of Cardiac Cowboys,
is the heroic invention of heart surgery, Doctor Eric A. Rose,
John Mankowitz, Joshua Paul Johnson, and myself. James A. Smith
is our supervising producer. Editing and sound design by Joshua
(45:15):
Paul Johnson. Our composer is David Mansfield. Our cover artwork
is designed by Alexander Smith. Archival materials courtesy of the
University of Minnesota Archives. University of Minnesota, Twin Cities Special Collections,
University of Rhode Island Library, and g Wayne Miller, author
(45:36):
of the Walt Lilla High biography King of Hearts, the
true story of the maverick who pioneered open heart surgery.
For more information on the first cardiac surgeons, check out
doctor Gerald Imber's book Cardiac Cowboys, The Heroic Invention of
Heart Surgery.
Welcome to the wild West of American medicine. I'm Chris
Pine in This is Cardiac Cowboys, the gripping true story
behind the birth of open heart surgery and the Maverick
surgeons who made it happen. Lymon Glidden is still conscious
(00:21):
when they wheel him into the operating room. He's thirty
nine years old, rugged and strong from years spent working
in the iron mines of northern Minnesota. He's as healthy
as they come. But Lyman's health isn't the reason he's
here today. A few feet away from Lyman's operating table
(00:42):
is a scrawny, thirteen month old boy who lies unconscious
on a second operating table. This is Gregory, the youngest
of Lyman's ten children. Gregory was born with a whole
in his heart, the likes of which no child has
ever survived. He's about to have open heart surgery. The
(01:03):
problem is this is nineteen fifty four, and outside of
these walls, the field of open heart surgery doesn't exist.
The anesthesiologist begins hand pumping cyclopropane gas into Lyman's lungs.
As he feels himself slipping out of consciousness, his eyes
drift to the small machine that sits between him and
(01:26):
his son, Gregory. It's a prototype built with scavenged parts
from a dairy pump and plastic beer tubes, and never
before tested on a human patient. The machine was designed
to circulate blood between a parent and child during open
heart surgery. If it works, it might just save Gregory
(01:48):
from a slow and agonizing death.
Speaker 2 (01:50):
If it doesn't, it could kill.
Speaker 1 (01:52):
Not just Gregory, but his father too.
Speaker 3 (01:58):
There rarely were no edisons, no devices, and no procedures
that could help a patient more than minimally.
Speaker 1 (02:06):
In the fifties, that's cardiologist doctor J. Phillip Saul.
Speaker 3 (02:10):
All a cardiologist could do was take a picture and diagnose.
They couldn't treat anything.
Speaker 1 (02:17):
In the early nineteen fifties, young families around the world
faced a medical crisis.
Speaker 2 (02:23):
Thanks to the baby boom.
Speaker 1 (02:25):
Infants were being born in higher numbers than ever before
in history. Millions of them suffered from congenital heart defects.
Children's wards were filled with kids who'd never lived to
see adulthood. Just like Gregory Glidden, these children gasped for breath,
their tiny chests pounding with heart murmurs.
Speaker 2 (02:44):
It could feel through their ribs.
Speaker 1 (02:46):
Their desperate parents drove them back and forth to local
hospitals for bouts of pneumonia and heart failure, but there
was nothing the doctors could do for them. The solution
lay in a new field of medicine. Before nineteen fifty,
surgeons considered the living heart off limits. Less than twenty
(03:09):
years later, doctors weren't just transplanting hearts, they were building
artificial ones. The maverick surgeons who blazed this trail wouldn't
come from the Ivy League or the great European medical institutions.
They were a motley crowd. Doctors scattered across the Midwest
in Texas, forged in the crucible of World War II.
(03:31):
Commanders of their earliest mash units. They came back ready
to take on the next great fight of their lives.
For the next two decades, these heart surgeons competed and feuded,
racing to.
Speaker 2 (03:43):
Be the first, the best, the most prolific.
Speaker 1 (03:47):
Some appeared on the covers of Time and Life magazine,
operated on kings, and advised presidents. Others ended up disgraced, penniless,
convicted unfelony charges. To get they ignited a revolution in medicine.
Speaker 4 (04:03):
He removed the heart from a twenty five year old
girl and transplanted into the chest of a fifty five.
Speaker 2 (04:07):
Year old man.
Speaker 5 (04:08):
All of the men waging the battle are the bake
Dan Cooley and Houston.
Speaker 6 (04:11):
Doctor C. W.
Speaker 5 (04:12):
Lellahigh, the surgeon who keptained the research team and performed.
Speaker 7 (04:15):
The operation, Thomas Edison, Walter Reid, and Jonas Salk.
Speaker 5 (04:19):
Today we gather to recognize that Michael de Bakey's name
belongs among them.
Speaker 4 (04:23):
We welcome doctor Christian Barnard.
Speaker 1 (04:29):
Who were these daring surgeons who willed an entire medical
field into existence?
Speaker 2 (04:36):
How did they achieve so much in such a short.
Speaker 1 (04:39):
Span of time, and why his history left them behind?
Formoso's Studios. This is Cardiac Cowboys, a podcast about life,
death and innovation in the American heartland. Episode one, the
(05:09):
starting gun. For the last two years, writer and executive
producer Jamie Napley is tracked down what remains of the
Cardiac Cowboys. He interviewed the living surgeons, their patients, and
their families to bring you this story. Here's Jamie Napley.
Speaker 8 (05:28):
Throughout history, the heart has been thought of as the
seat of the soul, the source of romantic love. A
heart can be heavy or heard melted or broken. But
all the heart does really is pump blood. Dark rust
colored blood, starved of oxygen, flows into the right side
(05:49):
of the heart. From there it's pumped to the lungs.
When the blood returns, it's bright crimson and oxygen rich.
Left side of the heart then pumps it through the
aorta and out to the rest of the body. And
it does this over and over again, one hundred thousand
(06:10):
times a day. But for the one in every hundred
children born with the defect, it doesn't work that way.
Holes in the atria the upper chambers, or the ventricles
the lower chambers, allow the oxygenated and deoxygenated blood to mix,
forcing the heart and lungs to work harder. Imagine trying
(06:34):
to drink water through a straw with a hole in it.
Surgeons hypothesized that some of these holes could be sown
shut with a few carefully placed sutures. But there's a problem.
Speaker 5 (06:48):
The hardest pumping blood at five liters a minute, and
you open it up and it is still working. It's
a blood path.
Speaker 8 (06:54):
That's medical historian and plastic surgeon doctor Gerald Imber.
Speaker 5 (06:59):
For two thousand years, since the time of Apocrates, the
rule has been you don't mess with the heart, because
if you touch the heart, you kill the patient.
Speaker 8 (07:09):
In the nineteen forties, when C. Walton Lillehigh and F.
John Lewis were starting out at the University of Minnesota,
no surgeon dared to cut into the living heart. Every year,
thousands of newborn infants were condemned to live short, excruciating lives.
All that was about to change. In less than a decade.
(07:33):
Lillhigh and Lewis would overturn thousands of years of convention
and open the door to a dangerous new frontier of medicine.
Speaker 9 (07:54):
We have with her mooring the falling out.
Speaker 8 (07:59):
By December seventh, nineteen forty one, like many American boys,
after the bombing of Pearl Harbor, U of M medical
school classmates, Walt Lillehigh and John Lewis signed up together
for the Army Reserve. They were activated on the same day.
(08:22):
After the war, they returned to their alma mater to
begin their surgical residencies.
Speaker 7 (08:28):
It was a special time in the history of surgery.
Speaker 8 (08:32):
That's an archival recording of John Lewis.
Speaker 7 (08:34):
Due to the Army experienced, blood transusions became much safer
than they were, and his caesiology became much better than
it was. Things became possible it's never been possible before.
Speaker 8 (08:48):
As friends, Lillehigh and Lewis made for an odd pair.
Lewis was tall and lanky, with warm features, horn rimmed glasses,
and a bow tie permanently fixed to his collar. Lilahigh,
stocky with slicked back hair, had a gaze so piercing
it would stop people in their tracks. Lewis was witty
(09:09):
and intellectual. He spent his time outside of the hospital
writing poems, painting still lifes, and playing classical music. Lilahigh
preferred drinking at an all night jazz club. If Louis
was butch cassidy for bose and funny, Lilahigh, reserved and
chillingly intense, was the sundance kid.
Speaker 10 (09:32):
He had the most beautiful color of stilly blue eyes,
so intense that you were just mesmerized immediately. I was
always just totally smitten by him.
Speaker 8 (09:46):
That's Sea Bollman, a nurse who worked with Walt Lillahigh.
Speaker 10 (09:49):
He absolutely was fascinated about how things fit together and
how things actually work.
Speaker 8 (10:00):
Lilla High was a born tinkerer. As a child, when
his parents refused to help him buy a motorcycle, Lilla
High started building his own from spare parts. By fourteen,
he had at least three different bikes that he'd zip
around on through the Minneapolis suburbs. He met his future wife,
Kay Lindberg when she was working as a nurse at
(10:21):
the Minneapolis General Hospital. Kay found him intense and very
much a loner, but she was attracted to how this strong,
silent type could show so much empathy for his patience.
Speaker 11 (10:36):
It's really what drew my mother to him.
Speaker 8 (10:38):
That's Walt and Kay's son, Doctor Craig Lilihi.
Speaker 11 (10:42):
Dad was a compassion man and not an outwardly or
a showy sort of way. She remembers him as an
intern and resident to sitting down at the bedside and
talking with families.
Speaker 8 (10:55):
The U of M Hospital wasn't particularly well regarded in
the early fifties, but for those in the know, this
was where all of the most exciting cardiovascular developments in
the world were taking place. Lille High and Lewis's boss,
doctor Owen Wangenstein, had spent the last two decades revamping
(11:16):
the surgical department according to his own wildly ambitious vision.
Wangenstein aimed for nothing less than the Nobel Prize. To
that end, he recruited an eclectic team of brilliant young
surgeons from all over the country, tinkerers, outside the box, thinkers,
and rule breakers. Here's doctor Gerald Imber again.
Speaker 5 (11:40):
Owen Wangenstein was the chief of surgery at Minnesota, and
in nineteen forty nine he established a department of cardiac surgery.
When there was no such thing as cardiac surgery.
Speaker 8 (11:54):
Wangenstein wanted his surgeons to define the future of medicine.
In his mind, that future lay in the living heart.
All of the early attempts at open heart surgery ended
with patients dead on the operating table. In nineteen fifty two,
Wangenstein asked thirty five year old John Lewis to take
(12:17):
up the gauntlet. Lewis would lead the department's pioneering attempt
at open heart surgery, but first he'd need to find
a way to keep his young patients from bleeding out
mid operation. He became fascinated by a technique called hypothermia.
Speaker 12 (12:35):
I was sitting beside him actually at that meaning. The
presentation was by doctor William Biglow from Toronto, Canada.
Speaker 8 (12:42):
That's an archival recording of Walt Lillehigh.
Speaker 12 (12:45):
He had pointed out that the limit the brain could
go without blood safely was four minutes, but you could
double that time if you reduced the body of temperature
put in the brain. He felt that that was ample
time for the simple defect inside the heart. Doctor Lewis
and I and both in the audience were very impressed,
but we said that's a place to be young.
Speaker 8 (13:11):
On a chilli morning in September nineteen fifty two, Lewis
brought five year old Jacqueline Johnson into the operating room
to lower her body temperature. Lewis wrapped Jacqueline in a
rubber cooling blanket for two hours. Nurses monitored her temperature closely.
(13:33):
If it dropped too low, her heart could fibrillate, its
rhythm growing fast and out of sync in a time
before clinically available to fibrillators. This would be a death
sentence for young Jacqueline Johnson. When the thermometer hit twenty
eight degrees centigrade, Jacqueline was laid out on the operating table.
(13:54):
At this temperature, Lewis estimated her brain needed about fifty
percent less ox and the normal. Flanked by his assistants
Richard Varko and Walt Lilleheigh. Lewis raised his scalpel and
sliced into her chest.
Speaker 4 (14:10):
The incisions used for those early operations were all horizontal.
Speaker 8 (14:15):
That's cardiac surgeon doctor Eric Rose.
Speaker 4 (14:17):
They required division of multiple muscles to get through, division
of arteries, which now are very important to leave for later.
Speaker 13 (14:24):
Use and painful.
Speaker 4 (14:27):
These were primitive incisions.
Speaker 8 (14:29):
Jacqueline had been tentatively diagnosed with an ASD, an atrial
septal defect, the simplest kind to repair, but the surgeons
wouldn't be able to confirm the diagnosis until they saw
for themselves.
Speaker 4 (14:44):
After spreading the ribs and exposing the pericardium, surgeons need
to do an incision in order to see the actual heart.
The heart itself is completely exposed.
Speaker 8 (14:54):
At that point, Lewis conjectured that hypothermia bought him about
eight minutes before Jacqueline suffered permanent brain damage. Eight minutes
to enter the heart, locate the whole, sew it shut,
and then resuscitate her. The surgeons clamped off the blood
vessels leading into and out of Jacqueline's heart. When it
(15:19):
stopped beating, Lewis made his first incision. As he spread
open the heart wall, he could see immediately that the
diagnosis was correct. There was a small hole in the
heart's upper chamber. He quickly and carefully sewed it shut,
and then Lilla High and Varco rushed to restart Jacqueline's heart.
(15:42):
But after the clamps were removed from her blood vessels,
her heart still refused to pump blood. Louis began massaging
it with his hands, and then it started to beat
on its own. Here's Walt Lilla High again. I remember
looking at but the clift.
Speaker 11 (16:00):
It was about ten minutes to ten point.
Speaker 8 (16:02):
The heart took over.
Speaker 12 (16:03):
I said, this is it, John, We're into the art
to state.
Speaker 8 (16:08):
John Lewis had just performed the first successful open heart
operation in history. He was thrust into the spotlight, and
over the next year he performed a series of ASD
repairs using hypothermia. Lilihigh was happy for his friend. By
(16:30):
all accounts, the man didn't have a jealous bone in
his body, but he saw a problem.
Speaker 4 (16:39):
Hypothermia requires being able to do things exceedingly fast. You
could do surgery inside the heart closing relatively simple defects,
but any more complex procedure really was not doable reproducibly.
Speaker 8 (16:54):
Across the street from the o RS where Lillihigh and
Lewis worked stood the brand new Variety Club Heart Hospital.
At the time, it was the only medical institution in
the world dedicated to the heart, and its children's ward
was overflowing with sick kids suffering from more complex defects
no doctor could fix, at least not using hypothermia. John
(17:20):
Lewis had taken the first step into the new frontier
of open heart surgery, but Lilahi could see that to
make any more progress, a new approach was needed, and
children would continue to die by the thousands until he
found it. Two hundred miles north of Minneapolis, a rugged
(17:46):
mine worker named Lyman Glitton and his wife Francis, gave
birth to their tenth child, a boy. They named him Gregory.
Like many parents in the nineteen fifties, and Frances already
had one child with a congenital heart defect.
Speaker 6 (18:05):
But Donna, we called her Donna. Nobody really talked a
lot about her affliction, which was a hole in her heart.
Speaker 8 (18:13):
That's Shirley Gliddon'spinelli, the fourth of Lyman and Francis's children.
Speaker 6 (18:18):
She was not able to go to school because she
just didn't have the energy to go. Donna and I
slept in the same bed, and we'd actually sleep with
our arms around each other. We just were very, very
close as sisters. Once Saturday morning, my mother she looked
in our room and I don't know what she noticed,
(18:42):
but she cried for my dad. Chick Chick that was
his nickname. My sister Donna had died during the night.
She looked so peaceful. I was not aware. I was
what ten or eleven years old laying there next to her,
and she had already died.
Speaker 8 (19:01):
In the spring of nineteen fifty three, when baby Gregory
began showing similar symptoms to his sister LaDonna, Lyman and
Francis feared the worst. It would be months before doctors
confirmed what the parents already knew. Gregory had a hole
in his heart. Left untreated, it would kill him, just
(19:22):
like it did his sister. The Glittons were lucky, they
were told in that they lived just a day's drive
from the only city in the world where doctors were
repairing heart defects like Gregory's. They made the trek down
to the Variety Club Heart Hospital, where they heard all
about the miracles being performed by the Great John Lewis.
(19:47):
But when Gregory underwent a heart catheterization, Lyman and Francis
were told that, like most of the children at the hospital,
their son's defect was too complex to be fixed. There
was nothing John Lewis could do for them. In his
laboratory across the street, Walt Lillihigh was working tirelessly on
(20:12):
a miracle of his own. The pace of medical progress
is often slow and plodding, but time was something Gregory
Gliddon didn't have, and neither did Walt Lillehigh. Three years earlier,
Lillahigh had noticed a small rubbery bump by his left ear.
(20:34):
He had another surgeon biopsy the growth and sent it
to a pathologist. The results would change his and his wife,
Kay's lives forever. Here's an archival recording of Kay Lillahigh.
Speaker 9 (20:50):
My husband was jagnosed with nymphos sarcoma. I remember looking
it up in a dictionary and sent to most fato
tech answer, I need to be homely.
Speaker 12 (21:02):
You know, he wasn't going to live that much.
Speaker 8 (21:03):
Shiner lymphosarcoma is an obsolete term for non Hodgkin lymphoma,
a rare and deadly cancer that was growing in the
prodded gland in Lilahi's left cheek. The prognosis was grim.
Lillehigh was unlikely to survive the next five years. Surgical
(21:26):
chief Owen Wangenstein assembled a cracked team of doctors to
operate on his young protege. On June first, nineteen fifty,
Lillahi entered the OAR at the University Hospital for the
first time as a patient.
Speaker 5 (21:43):
Wangenstein was a particularly aggressive cancer surgeon.
Speaker 8 (21:48):
That's doctor Gerald imber again.
Speaker 5 (21:50):
And it was said that Wangenstein hated cancer so much
because it was the only thing.
Speaker 13 (21:55):
They killed more patients than he did.
Speaker 8 (21:59):
Lillehi was on the table for more than ten hours.
Multiple surgeons worked on him, including his good friend John Lewis.
Speaker 9 (22:08):
He did drastic surgery, ticked out that kind of mass
a big muscle alumnick, and then down into the chest
until they were no more cancer cells. He ended up
with around nick you know.
Speaker 8 (22:26):
Over the next four months, Lila High remained bedridden in
the duplex he shared with Kay and their daughter Kimberly,
just a short drive from the university. But even as
he struggled to recover from the operation, Lila High knew
there was no cure for lymphosarcoma. How much time could
he have left?
Speaker 13 (22:46):
We always live with that threat.
Speaker 9 (22:49):
We were at first house that we advised to I've
been asking to much money.
Speaker 11 (22:53):
I leave something for you.
Speaker 6 (22:55):
That was the threat always.
Speaker 11 (22:57):
He really believed that he was living on time.
Speaker 8 (23:00):
That's doctor Craig Lillihaigh Again.
Speaker 11 (23:03):
That certainly had an impact on him in realizing that
the time was it was limited. Life was a gift.
Speaker 8 (23:12):
Lilihigh returned to work a changed man. He was noticeably thinner,
He'd lost muscle mass during his recovery, his head and
neck were forever tilted to the side, and at age
thirty two, he didn't think he'd lived to see the
end of the decade if he was intensely focused on
his work before now. Postop, Lilihi's drive was peter natural.
(23:39):
So as the world celebrated John Lewis for curing one
very particular type of heart defect, Lilihi was using every
precious waking moment to do his friend one better, to
find a way to buy surgeons more time inside the heart,
to cure more and more complicated defects, to save the
(23:59):
live of more dying kids, kids like Gregory Lytton. Lillahi
was having a drink with his lab assistants Herb Warden
and Morley Cohen after another late night in the lab.
(24:19):
When the men arrived at a simple but revolutionary idea.
Speaker 5 (24:24):
One of his assistants mentioned that his wife was pregnant
and they were talking about the fact that in pregnancy,
the placenta was providing oxygenated blood to the brain of
the fetus, and then loves didn't have to do anything,
and all.
Speaker 13 (24:38):
Of a sudden, Lila Hijas zones out, just.
Speaker 5 (24:43):
Why don't we use another animal circulation to bypass the
heart so that oxygenated blood would go to the brain
and you would have time to do what you needed
to do.
Speaker 8 (24:56):
They called it controlled cross circulation, a and heart lung machine.
Someone with a matching blood type, ideally a parent whose
heart and lungs could oxygenate the child's blood while the
surgeon operated. Just like in pregnancy, a parent would act
as a sort of temporary life support for their child.
(25:19):
Lillihigh and his assistants began scavenging for spare parts to
assemble their prototype beer hose and a sigma pump utilized
by the dairy industry. These men were tinkerers. They used
whatever did the job.
Speaker 14 (25:34):
People of Lola High's generation, especially the cold weather states
in the Midwest, made do with what they had, and
if they didn't have something, they made it themselves. They
didn't look for someone else to solve the problem.
Speaker 8 (25:46):
That's ROBERTA. Beach, a coordinator at the Variety Club Research Center.
Speaker 14 (25:50):
Here you have a man who survived war, and he
survived cancer, and that made him willing to do things
that other people perhaps would not do.
Speaker 8 (26:02):
After a successful round of tests in the animal lab,
Lilli High and his team began looking for their first
human candidate. In order to prove the advantage of cross
circulation over hypothermia. Lilihigh needed a patient with a more
complex defect than anything his friend John Lewis had ever
attempted to fix.
Speaker 5 (26:23):
He went around the hospital to try to identify a
child with a serious ventricular cental defect and identified a
boy named Gregory Glidden. The couple had already lost a child,
and they were certainly loath to have the child operated upon.
Speaker 8 (26:43):
Lilli High spent time with the Gliddons, working to earn
their trust. He listened to their concerns and talked through
the risks. Lyman, who was a blood match for his son,
would need to act as Gregory's heart lung donor there
was a chance the operation could result in the deaths
(27:03):
of both father and son. It was a leap of faith.
Speaker 13 (27:10):
They finally agreed to leave Gregory.
Speaker 5 (27:12):
At the hospital for care and allow him to have
surgery if they thought he was a suitable candidate.
Speaker 8 (27:22):
Getting the approval of hospital administrators proved to be the
far greater challenge. Wangenstein and Lillahi shared a close bond,
made closer by the disfiguring cancer operation Wangenstein had performed
on him. Wangenstein would do anything to see Lila High succeed,
but there was a system in place. John Lewis had
(27:44):
made history a year earlier, earning the hospital publicity and
a fortune in donations. If anyone was going to attempt
the much more complicated ventricular septle defect or VSD repair,
it would have to be Lewis.
Speaker 5 (28:04):
John Lewis was very successful fixing ASD atrial septal defects.
In fact, he was the only person in the world
who was doing it for a year. The ventricular septal
defect is larger, it's more difficult to get to, and
it was more time consuming. The issue became much more
complex when they attempted to fix a VSD.
Speaker 8 (28:28):
Lewis's first VSD patient turned out to be a misdiagnosis.
The defect was even more complicated than anyone realized. Lewis
ran out of time trying to repair it, and the
young patient died on the table. Lewis made a second attempt,
with Lilli High assisting. The diagnosis was correct, and yet
(28:50):
Lewis again found himself running out of time.
Speaker 5 (28:54):
Lillie High was by his side and trying to help him,
and Lewis began to perspire and began to panic. He
realized he was losing his patient and it just drove
him to despair. The child died, and the idea of
repairing VSDs under iplothermia died with him.
Speaker 8 (29:18):
In short order, Lewis's research funding was cut and Lili
High's was increased. The following year, in Lewis's words, he'd
be booted out by Wangenstein. For Lewis, it was a
swift and painful coup. He told one of his residents,
it is difficult to tolerate the success of a friend.
(29:40):
Lilla High now had the full backing of his mentor,
and he got to work.
Speaker 13 (29:46):
His team would go on Saturdays down to Mayo.
Speaker 8 (29:49):
That's doctor Paul Isisio, a professor at the U of
M's Visible Heart Laboratories.
Speaker 3 (29:54):
They watched surgery, and then they would visit Justin Edwards,
who had a heart library there he can shuttle specimens.
Speaker 8 (30:02):
Lili High and his team spent hours in the pungent
from maldehyde suffused lab at the Mayo Clinic, just a
ninety mile drive south of Minneapolis. The cardiac pathologist there,
Jesse Edwards, kept thousands of preserved human hearts in barrels,
and Lilihi dug through them, studying every type of heart
(30:23):
defect for which there existed a specimen. Whatever he'd find
beating in Gregory Glyndon's chest, he wanted to be ready for.
Back in Minneapolis, news of Lili High's procedure was causing
a growing panic among the hospital administrators. Lila High saw
(30:43):
his chance to save Gregory's life disappearing before his eyes.
Speaker 5 (30:49):
It was enormous pressure on Wangestein not to allow him
to do it. Weangestein had a visitor from Chicago, Willis Potts,
a very famous PDA Patrick the surgeon said, congratulations, You're
about to be the first surgeon to have a two
hundred percent mortality.
Speaker 13 (31:08):
It was meant, of course, as the ultimate insult.
Speaker 5 (31:10):
So the administrators of the hospital, hearing some famous surgeons
say oh my god, how can you do this, try
to stop them from doing it.
Speaker 8 (31:23):
The administrator's concerns were not unjustified. With its beer tubes
carrying blood around ther its potential for two hundred percent mortality,
cross circulation seemed more carnival side show than modern medicine.
Not only could it fail, it could discredit the university.
(31:46):
March twenty fifth, nineteen fifty four, the day before Lilli
High was scheduled to operate on Gregory Glidden, administrators stormed
into the office of hospital director Ray Amberg. They wanted
to shut la High down, and Wangenstein was called in
to defend his protege. Litla Hi's future and Gregory Glyndon's
(32:07):
life hung in the balance.
Speaker 11 (32:10):
How confess, cross circulation was very much viewed as heresy.
Speaker 8 (32:14):
That's doctor Craig Lillihigh again.
Speaker 11 (32:17):
It was an idea that even today feels a little radical.
Speaker 8 (32:22):
As Wangenstein was arguing lil High's case to the hospital director,
Lila High went about his other work. If he was
anxious in the hours leading up to the operation, nobody
could tell. When Lillahigh returned to his office after performing
an abdominal surgery, he found a note on his desk
from Wangenstein. Dear Walt. It read, by all means go ahead.
(32:52):
By now, Gregory was thirteen months old, and he'd spent
three of those months in the Variety Club Hart Hospital.
To help shed light on Gregory's experience at the hospital,
here's doctor Pamela Evans. Lila High repaired a defect in
doctor Evans's heart not long after Gregory's operation.
Speaker 15 (33:12):
My pediatrician told my parents about the hard hospital at Minnesota.
There was a playroom that we could play in. I
remember the children having wheelchair races.
Speaker 8 (33:28):
Early on the morning of March twenty sixth, Gregory was
wheeled tor number two in his crib, surrounded by his
stuffed animals.
Speaker 15 (33:37):
To this day, when I'm in a hospital or I
have to have like a procedure or something, if I'm
on the gurney, I still recall watching the lights flash
by as they.
Speaker 5 (33:48):
Were wheeling me to the operating room.
Speaker 14 (33:50):
It's very very vivid.
Speaker 5 (33:52):
Boom boom boom.
Speaker 8 (33:58):
In ther Ggory was moved to an operating table as
the anesthesiologist prepared the cyclopropane gas to put him under.
Speaker 15 (34:07):
I know, I was really really cold. I kept saying, mommy, mommy,
I'm so cold. I'm so cold, and I mean I
had nothing on, no sheets or anything.
Speaker 8 (34:19):
Once Gregory was unconscious, Lillehei began the operation. He cut
open the boy's chest and spread his ribs. The surgeons
inserted narrow tubular canulas into Gregory's aorta, as well as
the superior and inferior vena cava in his neck. Through
these canulas, Gregory's blood would be diverted from his heart
(34:43):
through plastic beer tubes into the small sigma pump and
then into Lyman's blood vessels. Threw an incision in the
inner thigh, Lilihaigh gave the command pump on. At the
flip of a switch, the machine hummed to life. Blood
began to flow between father and son. Gregory's tiny heart stopped,
(35:07):
and Lymans picked up the slack, pumping blood for both
of them. Lilahaigh sliced into Gregory's heart, a two and
a half centimeter cut into the right ventricle. Surgeon Richard
Varko pulled apart the sides of the incision, but it
was too dark to see inside. Shortly before the operation,
(35:27):
Lili High had the idea to borrow a headlamp from
an ear nose and throat doctor at the hospital. Without
the support of the sternoclidomastoid muscle in his neck, just
keeping the lamp upright was a struggle for Lillihigh. He
aimed its dim beam of light into the lower chamber
of Gregory's heart.
Speaker 5 (35:46):
Lila High actually manually stuck his finger in and found
the hall.
Speaker 8 (35:50):
That's doctor Gerald Imber again.
Speaker 5 (35:52):
The diagnosis, which is not always correct, was correct. This
time a child did have a ventricular septal defect. He
was able to run a series of silk sutures through it.
Speaker 8 (36:04):
And here's cardiac surgeon doctor Eric Rose again.
Speaker 4 (36:07):
It's remarkable that he was able to get them closed
with relatively primitive needles and primitive suture material that now
we take for granted entirely.
Speaker 8 (36:18):
At twelve minutes and fifteen seconds past zero time, Lilihigh
had soon shut the hole between Gregory's ventricles. As the
boy lay there unconscious, lili High could feel his heart
beating more powerfully than it ever had in his thirteen
months of life.
Speaker 5 (36:37):
He closed the defect, and then he closed the heart,
and then they closed the chest, and they reached over
to shake one another's hands.
Speaker 13 (36:45):
They had detached the father from the son.
Speaker 5 (36:47):
They had a living child who was crying a normal
post operative cry.
Speaker 8 (36:51):
At the end of surgery, when Lyman regained consciousness, his
wife Francis gave him the good news. Every doctor they'd
spoken to over the last year had told them Gregory's
defect would kill him. Walt Lillahi had just saved the
boy's life. Over the next few days, Gregory's condition steadily improved.
(37:17):
Lilahi was cautiously optimistic for a quick recovery, but his
optimism soon faded.
Speaker 5 (37:28):
Everything was wonderful until it wasn't. He became ill. Twice,
he ran a fever. The child Gregory needed to have
a tracheostomy performed so that they could suck a mucus
out of his lungs.
Speaker 8 (37:43):
Gregory's health took agonizing swings over the next week. He
grew dangerously ill, with pneumonia. Some days, his breathing and
heartbeat appeared normal. Other days he gasped for breath and
didn't recognize his own parents unflagging, checking in at all
hours of the night, and performing an emergency tracheostomy to
(38:05):
help Gregory breathe, but nothing he did seemed to improve
the boy's condition. On April sixth, Gregory took one more
turn for the worse. By nine point fifteen in the morning,
the boy was dead.
Speaker 2 (38:22):
Walt Lilla High.
Speaker 8 (38:23):
Had to do the hardest part of any surgeon's job.
He had to break the news to the family.
Speaker 4 (38:29):
I would say that there are many many surgeons of
that era who just in view it as part of
their job to explain things and to mourn with families
when they lost kids. Whether that empathy originates with his
own illness, I think it's impossible to say, But it's
just an incredible gift being able to communicate and being present,
(38:53):
just being present with those families.
Speaker 8 (38:57):
Lila High's experimental procedure had ended in failure. If the
career of John Lewis were any indication, Lilli Hi's fight
to cure heart defects in children would soon be at
an end.
Speaker 5 (39:17):
The administrators and the heads of medicine and pediatrics now
really had ammunition. They didn't want the university to be
open to criticism, and they didn't want more people to die.
They thought this was a terrible idea.
Speaker 8 (39:31):
But Lilihi was determined to figure out where he'd gone wrong.
After Gregory's death, he took an unusual extra step. He
asked Lyman and Francis for consent to perform an autopsy.
Lilahi looked on as the pathologist opened Gregory's chest and
(39:54):
removed his tiny heart. Once again, Lilihei made an decision,
and Gregory's right ventricle.
Speaker 5 (40:04):
He looked, and he saw that his repairs VSD repair
had completely healed. He didn't know whether to laugh or
cry because there was a dead baby on the table,
but he knew he had cured his problem, and the
child had died from pneumonia.
Speaker 8 (40:26):
Lilahei may have failed to save Gregory, but the boy's
death would not be in vain. Lilahi's procedure had worked,
and it could work again if only he were given
another chance. The door to open heart surgery had just
(40:46):
been blown wide open, but no one outside of Walt
Lillaheigh knew it.
Speaker 15 (40:52):
I see him as this genius in some ways, like
a Vincent van Doll or something. You know, their troubled soul,
but they're trying to do the best that they can.
Speaker 8 (41:05):
Sixty eight years after Gregory Glyndon's death, Pamela Evans reflects
on what his family sacrifice has meant for her and
for the world.
Speaker 15 (41:15):
I'm seventy two years old. I should be dead. The
loss of that child's life led me to forty four
years in academia, where I impacted thousands of young adults.
I would thank them, and I would say that child
(41:38):
not only saved me, but it saved other children as well.
Speaker 8 (41:52):
At the Maple Hill Cemetery in Hibbing, Minnesota, a small
headstone marks the burial site, chaired by Gregory Glidden and
his sister LaDonna. Under Gregory's name is an epitaph which reads,
his little heart changed the world. That change wouldn't come
without a fight. Willehei knew that he'd face a sharp
(42:16):
backlash after Gregory's death. To move forward, he'd need to
take matters into his own hands.
Speaker 5 (42:26):
Walt did the kind of thing that Walt always did.
He waited until he administrators out of Town. He scheduled
two more surgeries, because when something's got to be done,
it's got to be done.
Speaker 8 (42:37):
These next two operations would determine the future of open
heart surgery. Once news of cross circulation spread outside of Minnesota,
Walt Lillehigh, a man with no experience in the spotlight,
would find himself in the crosshairs of some of the
most powerful figures in medicine.
Speaker 4 (42:56):
It's very easy to criticize an effort that results in
a dead show, very easy, But part of Walt's genius
was a persistent.
Speaker 8 (43:06):
Lil High's radical cross circulation procedure was the spark that
ignited a revolution in heart medicine. He'd fired the starting gun,
and soon surgeons all across the world would join the
race in Houston, New York, Halo Alto, and Cape Town,
South Africa. This is the story of the brilliant, fearless,
(43:28):
and deeply flawed men and women who looked past the
accepted medical wisdom of their age and reached into the future.
The doctors and nurses who risked their careers, the patients
who gave their lives, the towering achievements and unimaginable sacrifices.
The rise and fall of the heart surgeon as God
(43:51):
and the brutal Bloody an ultimately triumphant road to medical progress.
Speaker 1 (44:05):
On our next episode, two of the country's most ambitious
surgeons joined forces to make Houston, Texas, the new cardiovascular
capital of the world, but a friendly competition turns them
from close colleagues to fierce rivals next time on Cardiac Cowboys.
Speaker 8 (44:34):
Cardiac Cowboys is a production of iHeart Podcasts, OsO Studios
and Thirteenth Lake Media. We're presented by Chris Pine and
written and narrated by me Jamie Appley. Our executive producers
are Christina Everett for iHeart Podcasts, Dub Cornette and Jason
(44:54):
Ross for OsO Studios. Doctor Gerald Imber, author of Cardiac Cowboys,
is the heroic invention of heart surgery, Doctor Eric A. Rose,
John Mankowitz, Joshua Paul Johnson, and myself. James A. Smith
is our supervising producer. Editing and sound design by Joshua
(45:15):
Paul Johnson. Our composer is David Mansfield. Our cover artwork
is designed by Alexander Smith. Archival materials courtesy of the
University of Minnesota Archives. University of Minnesota, Twin Cities Special Collections,
University of Rhode Island Library, and g Wayne Miller, author
(45:36):
of the Walt Lilla High biography King of Hearts, the
true story of the maverick who pioneered open heart surgery.
For more information on the first cardiac surgeons, check out
doctor Gerald Imber's book Cardiac Cowboys, The Heroic Invention of
Heart Surgery.
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