On the day of surgery, Thomas, who had been working with an experimental method of aiding cardiac function, inserted a helium-driven counterpulsation balloon into Walter’s aorta. Anticipating trouble with Walter’s left ventricle, Thomas wanted to be prepared.
Only after the operation had begun did the reality of the situation dawn on him. Excitement had changed to anxiety as Thomas began to follow the plan he had outlined in his mind. He would never forget the sensation he experienced when he stopped Walter’s heart and held the quivering mass of sick muscle in his hand. At that moment he knew it was in his power to restore life. Refusing to consider the possibility of failure, Thomas first performed a bypass, an experimental procedure in those days. Then he excised the ballooned area of Walter’s heart, oversewing the defect with rows of heavy silk. Finally, he replaced both the mitral and aortic valves.
The instant the repair was complete, Thomas tried to take Walter from the heart-lung machine. By this time, unknown to Thomas, a significant audience had gathered. There was a murmur of sadness when it was obvious that Walter’s heart did not have the strength to pump the blood.
Undaunted, Thomas started the counterpulsation device he had positioned before the operation.
He would always remember his elation when Walter’s heart responded. Not only was Walter taken off the heart-lung machine, but three hours later in the recovery room even the counterpulsation assist was no longer needed. Thomas felt as if he had created life. The excitement was like a fix. For months afterward he was carried away by open-heart surgery.
Reaching in, touching the heart, defying death with his own two hands-it was like playing God. Soon he found he became deeply depressed without the excitement of several such operations a week. When he went into practice he scheduled one, two, three such procedures a day. His reputation was so great that there was an endless stream of patients. As long as the hospital allowed him sufficient time in the OR, Thomas was supremely happy. But if another department or the boys in full-time academic medicine attempted to cut back his operating hours, Thomas became as tense and angry as an addict deprived of his daily drug. He needed to operate in order to survive. He needed to feel Godlike in order not to consider himself a failure. He needed the awed approval of other people, the unquestioning approval that was in Larry Owen’s eyes this moment as he asked, “Have you decided if you’re going to do a double or triple bypass?”
The question brought Thomas back to the present.
“It’s a good exposure,” said Thomas, appreciating Larry’s work. “We might as well do three provided you got enough saphenous vein.”
“More than enough,” said Larry with enthusiasm. Prior to opening the chest, Larry had carefully removed a length of vein from Mr. Campbell’s leg.
“All right,” said Thomas with authority. “Let’s get this show on the road. Is the pump ready?”
“All ready,” said Phil Baxter, checking his dials and gauges.
“Forceps and scalpel,” said Thomas.
Swiftly but without haste, Thomas began to work. Within minutes the patient was on the heart-lung machine. Thomas’s operative technique was deliberate and without wasted motion. His knowledge of the anatomy was encyclopedic, as was his sense of feel for the tissue. He handled sutures with an economy of precise motion that was a joy for the aspiring surgeons to watch. Every stitch was perfectly placed. He’d done so many bypass procedures, he could almost function by rote, but the excitement of working on the heart never failed to stir him.
When he was through and convinced the bypasses were sound and there was no excessive bleeding, Thomas stepped back from the table and snapped off his gloves.
“I trust you’ll be able to put back the chest wall the way you found it, Larry,” said Kingsley, turning to leave. “I’ll be available if there is any trouble.” As he left, he heard an audible sigh of appreciation from the residents.
Outside the operating room, the corridor was jammed with people. At that time of day, midafternoon, most of the thirty-six operating rooms were still occupied. Patients, either going to or coming from their surgery, were wheeled through on gurneys, sometimes with teams of people in attendance. Thomas moved among the crowd, occasionally hearing his name whispered.