The Man Who Should Have Died

Merchant Seaman Gerald Gormley was practically dead on arrival at Detroit's Receiving Hospital. While fighting off street-corner hoods, he had been stabbed in the back, and the knife blade had slit right through his descending aorta, the main artery that carries blood to the trunk and legs. He was losing blood so fast that his heart stopped beating while he was on the operating table. Though surgeons managed to sew up the aorta and got his heart pumping once more, seven months passed before Gormley left the hospital.

He was still in miserable shape: his weight was down from 180 lbs. to 117 [ thought I had only six or seven months to live," he says. Though he lived longer, his health continued to deteriorate. He underwent surgery for intestinal trouble, and for a while he was in traction because of a slipped spinal disk. On top of all that, it was clear to his doctors that four years after the stabbing, Gormley had a heart problem. They sent him to National Jewish Hospital in Denver, where "None may enter who can pay, none can pay who enter " By the time he got to Denver a month ago, Gormley could not climb a flight of stairs without distress, and he complained that his legs kept "going to sleep." His blood pressure had soared to 240/140. Doctors could feel no pulse in his legs. Chief Surgeon Melvin Newman and his assistants at N.J.H. figured that their patient was suffering from a partial obstruction of his descending aorta-- scar tissue, perhaps, from his knife wound.

When Dr. Newman's team operated they were startled to find not a partial obstruction but a complete blocklage of the aorta. Scar tissue was there as they had suspected, but it had evidently formed slowly, in successive layers. While it was forming, a dozen minor blood vessels on each side of the chest had had time to enlarge and supply "collateral circulation" to the lower part of the body (see diagram). Over the years, the blood vessels had quadrupled their capacity; they had shunted enough blood around the aorta block to keep Gormley alive.

Dr. Newman and assistant surgeons cut out the clot-plugged section of aorta and replaced it with a Dacron graft. Now Gormley's feet and legs are no longer cold. His blood pressure is down to a healthy 130/80, and last week he was recuperating in Ogden, Utah, taking short walks to rebuild his strength. The man who should have been dead had made medical history. His is the first known case in which such generous collateral circulation compensated for a complete shutdown in the aorta.

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