The Genome Odyssey: The Promise of Precision Medicine to Define, Detect, and Defeat Disease by Euan Angus Ashley

Author:Euan Angus Ashley [Ashley, Euan Angus]
Language: eng
Format: epub
ISBN: 9781250234995
Google: ThOEzQEACAAJ
Publisher: Celadon Books
Published: 2021-02-23T00:00:00+00:00

History would judge James Curry two hundred years ahead of his time. Those statements about the electrical excitement of the heart and the need to pass the resuscitating current in many directions through the chest were preternatural. Curry’s advice was now broadly actionable, too, thanks to a near portable device invented by his contemporary Charles Kite. In his 1788 “Essay on the Recovery of the Apparently Dead” (they don’t make titles like they used to), Kite described how the device harnessed static electricity from Leyden jars. Reanimation by electricity soon became known as defibrillation, a term first coined by Edmé Vulpian in French literature, and derived from the Latin word fibrilla, meaning a small fiber (in this case, a heart muscle fiber). Although the medical profession itself was slow to realize its importance, society at large took an increasing interest. The most famous example in popular literature comes from Mary Shelley’s 1818 novel, Frankenstein. The protagonist, a young scientist named Victor Frankenstein (contrary to popular misconception, it was the scientist, not the monster, who was named Frankenstein) becomes fascinated by the secret of life and sets about gathering body parts from various places with the idea of stitching them together to create a new life. Searching for the ignition trigger to spark this new being to life, he comes upon electricity: “I succeeded in discovering the cause of generation and life; nay, more, I became myself capable of bestowing animation up on lifeless matter.”

The 1800s saw the first truly portable defibrillators, but society still wasn’t ready to trust this “sorcery” entirely. Citizens wary of being experimented upon by “vigilante galvanists” started sewing labels into their clothing with requests to be left “unelectrified” if they were to be found unconscious. Even in our own times, when patients are advised to place a detailed advance directive in their medical chart regarding their wishes if their heart should stop, some choose to leave nothing to chance. A case report in The New England Journal of Medicine described a seventy-year-old man who arrived at an emergency room in Miami unconscious with a Do Not Resuscitate tattoo emblazoned across his chest at the exact spot you might place the pads for medical defibrillation. After an ethics consult, they did indeed accede to his wishes.

After a fallow period in the early 1900s, 1947 brought another landmark: the first medically documented internal defibrillation during an open heart surgery. When a fourteen-year-old boy’s heart fibrillated during surgery, the surgeon was first forced to perform cardiac massage—a procedure whose soothing name is wildly at odds with its accompanying frenzy. You take the heart in your hand and literally squeeze the blood out. Then repeat. Until you have a better plan. While manually pushing blood out of the boy’s heart provided temporary relief, it didn’t solve the problem. The heart continued to fibrillate. Eventually, as a last-ditch effort, the surgeon decided to try electrical defibrillation. The heart stopped, paused, then promptly started beating normally. The operation concluded, and the boy recovered completely.

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