By Pioneering Heart Surgery, She Proved the Medical Establishment Wrong

Helen B. Taussig was the original pediatric cardiologist. She founded a field of study, advancing medical research beyond what was thought possible at the time.

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Helen B. Taussig was the original pediatric cardiologist. She founded a field of study, advancing medical research beyond what was thought possible at the time. Back in the 1940s, Taussig helped develop the concept for a procedure alongside Alfred Blalock and Vivien Thomas which would extend the lives of many children born with blue baby syndrome.

[I]t is perhaps difficult to imagine how daring the concept of cardiac surgery once seemed,”wrote Mike Field of The Gazette. “Almost exactly 100 years ago, British physician Stephen Paget wrote that 'surgery of the heart has probably reached the limit set by nature to all surgery. No new method and no new discovery can overcome the natural difficulties that attend a wound of the heart.'” But in 1944 the field of medicine advanced, and Eileen Saxon would be one of the first to receive an operation to extend her life.

Doctors, like William Longmire, heralded the procedure as “the first stage of the successful development of heart surgery."

Blue baby syndrome stems from a congenital heart defect that causes the fingertips, lips, and toes to appear blue, hence the name “blue baby.” Taussig did extensive research on these “blue babies” and found their condition stemmed from a partial blockage of the pulmonary artery, which was starving organs and tissue of oxygen. She brought her studies to the surgeons Blalock and Thomas where together they developed a surgery to correct this heart anomaly. The end result was a shunt that would redirect blood-flow to correct one of the most common cardiovascular defects that caused baby blue syndrome, Tetralogy of Fallot.

Her legacy is one of chances, pushing beyond what the established science thought possible. Those children who survived past infancy lived half lives. Sandra Stoltz was another child who underwent the procedure in 1945 at the age of 11. She wrote in a testimonial, "I was often short of breath, had limited energy and occasionally fainted. ... I desperately tried to be normal and longed to keep up with the other kids." After the surgery, Stoltz felt she “considered [herself] normal at last."

Taussig was also an advocate against injustice. In the late 1950s and early 1960s, babies were being born with severe limb deformities all over the world. The cause was from a drug called thalidomide. It was marketed as a drug to help alleviate morning sickness. However, if taken in the first 42 days of gestation, it would damage the fetus. Taussig testified before Congress to the Food and Drug Administration. Her efforts helped get the drug banned in the United States and Europe.

Up until her death in 1986, Taussig continued to research and pioneer new techniques that would help advance medical science.

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Photo Credit: The Alan Mason Chesney Medical Archives of The Johns Hopkins Medical Institutions

Natalie has been writing professionally for about 6 years. After graduating from Ithaca College with a degree in Feature Writing, she snagged a job at PCMag.com where she had the opportunity to review all the latest consumer gadgets. Since then she has become a writer for hire, freelancing for various websites. In her spare time, you may find her riding her motorcycle, reading YA novels, hiking, or playing video games. Follow her on Twitter: @nat_schumaker

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  • Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
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The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?

But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.

What's dead may never die, it seems

The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.

BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.

The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.

As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.

The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.

"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.

An ethical gray matter

Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.

The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.

Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.

Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?

"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."

One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.

The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.

"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.

It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.

Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?

The dilemma is unprecedented.

Setting new boundaries

Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."

She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.

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