Warm Water, Warm Heart

When police found William Flanagan in a Philadelphia gutter, he was barely conscious and obviously suffering from long exposure to the frosty night air. At Hahnemann Hospital, Intern Edward Brunner was still examining Flanagan, 43, a 6-ft.-3-in. laborer, when the patient's heart stopped. Dr. Brunner slit open Flanagan's chest, and began massaging his heart. (It was the first time that Dr. Brunner. 30, had had to open a chest.) Surgeon Frank Sterba put a tube down the patient's windpipe, hooked it to a mechanical ventilator to take care of his breathing.

Flanagan's off-again-on-again heart stubbornly refused to resume its normal beat, though five doctors massaged it in relays for three hours. Adrenaline and other heart stimulators failed. So did electric shock. The trouble. Dr. Francis Coughlin Jr. decided, was that although heated blankets and hot-water bottles were warming Flanagan's outer layers, the blood in the heart was still chilled. So he had six quarts of warm, sterile saline solution poured into the open chest, onto the heart, while he and his colleagues continued the massage. Flanagan's heart responded with two or three normal beats, then fluttered wildly again. There was no time to heat more sterile saline. Dr. Coughlin ordered pots and pans, buckets and basins filled with warm tap water, sloshed this into Flanagan's chest for half an hour.

When 20 gallons of tap water had done its work, Flanagan's heart picked up with a firm beat, quickly cleared his head. Having had no anesthesia, he promptly tried to climb off the table, had to be restrained until his chest could be sewn up. A World War II top kick, Flanagan was soon sitting up, eating three squares a day, expected to go home next week.

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