Electronic Operations

While Dr. Leo M. Taran was gathering ideas for a new operating suite, to be built at St. Francis Hospital and Sanatorium for Cardiac Children at suburban Roslyn, N.Y., he visited dozens of U.S. hospitals and inspected their equipment for delicate heart surgery. Always he ended by asking his hosts: "What's wrong with it?" And always, from their experience, they could suggest improvements. Last week, as medical director of St. Francis, Dr. Taran unveiled the operating suite that he had planned as a result of these studies. It had everything.

The operating room itself, walled in apple-green glass tile, is soundproof, dustproof, conditioned by gravity-fed air, and as nearly germproof and explosion-proof as human ingenuity can make it. Above the operating table, which can be tilted six ways, is a television camera (nested in a battery of lights) with lenses for closeup, normal and wide-view shots. The surgeons, anesthesiologist and physiologist wear combination stethoscope-intercom receivers.

Two-Way Traffic. From the patient on the operating table are leads to an electrocardiograph that projects tracings on a wall screen. Also projected are lines showing the pulse, the heart sounds, and the pressure in each side of the heart. Attached to the table is an X-ray machine that will photograph the heart and major blood vessels after opaque dye is injected into the bloodstream. The surgeon can order these projected on a giant screen within minutes after an exposure in order to keep a running check on the effects of the operation.

Everything can be seen and heard simultaneously by as many as 75 visitors in the adjacent lecture hall. Seated in movie-house chairs, they watch the operation in color on TV repeaters, and see the same charts that the surgeon sees. They plug an electric stethoscope into an outlet in the chair arm. Through this they hear the sound of the patient's heart just as the surgeon does. They also hear whatever the surgeon says to members of his team (picked up by a microphone in his mask) and comments by the leader of the seminar. The surgeon can hear these, too, if he chooses, and ask advice of a guest surgeon--for everyone in the audience also has a throat mike.

Finally, there are the permanent records: the heart indexes on a four-way chart, the sound on a tape, and (if funds become available) a full visual record on Kinescope. Everything can be played back so that physicians and surgeons can devise improvements in their methods.

The ultramodern operating setup was a dream come true, not only for Harvard-trained Dr. Taran, but for Mother Mary of Kevelaer and the 46 sisters of the Franciscan Missionaries of Mary who run the Long Island hospital-sanatorium. When it was founded in 1937, in a rambling mansion and stables given to the nuns by Shipowner Carlos Munson (a Quaker), it was a home for child victims of heart disease, and little more.

The Young Are Different. Mother Mary of Kevelaer, herself a victim of rheumatic fever, teamed with Dr. Taran to build it into an all-inclusive institution for the total care and rehabilitation of children and young adults crippled by heart disorders--some born with defective valves or blood vessels, others damaged in childhood by diseases. They added wing after wing, until now St. Francis has 200 beds, making it the biggest specialized hospital of its kind in the U.S. It is nonsectarian in selection of its patients, most of whom come from poor homes, where rheumatic fever strikes oftenest.

Dr. Taran began by making a sharp distinction between heart disease in the young and in the aged. In the young, he felt, many more disorders were of a type that could be corrected by surgery; gradually the ravages of rheumatic fever (usually scarring and narrowing of valves) were added to the list. But the process is often long and tedious. Many patients at St. Francis stay for two years, and some may be a year or more in a special room, breathing 50% oxygen. No matter how long their treatment may take, the youngsters at St. Francis can count on loving, selfless care, in an atmosphere as homelike as doctors and sisters can make it.

Thanks to penicillin, which makes it possible to prevent many recurrences of rheumatic fever, and to recent advances in surgery, Dr. Taran believes that medical science is well on the way to conquering heart disease in the young. To the surgeons at St. Francis, the new operating theater will be a powerful reinforcement.

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