Heinlein, Robert A – Expanded Universe

bored because the image enhancer included closed-circuit television of the

fluoroscopy with the screen right up here”-witness indicates a spot just above and

to the left of his head-“above me, where the radiologist and his team, and the

patient-I- could see it.

“How many people ever get a chance to watch their own hearts beat? Utterly

fascinating! I could see my heart beating, see my diaphragm rise and fall, see my

lungs expand and contract, see the dye go up into my brain. . . see the network of

blood vessels in my brain suddenly spring into sharp relief. It was worth the trip!

“They spotted what was wrong; my left internal carotid was totally blocked.

So the left half of my brain was starved for oxygen, as it was receiving only what

leaked over from the right side or from the vertebrals where the network

interconnected, principally at the Circle of Willis under the brain.

“But this is your speech center”-witness touches left side of skull above

ear-” your word processor, the place where a writer does all his work. No wonder I

was dopey-could not write, could not study, could not read anything difficult.

“My left internal carotid is still blocked; the stoppage is too high up for

surgery. So they sent me to Dr. Chater at Franklin Hospital, who moved my left

superficial temporal artery to feed the left side of my brain. This operation is

pictured on pages 62 and 63 of the April 1978 Scientific American, so Twill omit

grisly details; if surgery interests you, you can look them up there.

“The procedure is this: Scalp the patient from the

left eyebrow, going high and curving down to a spot behind the left ear back of the

mastoid. Cut away from the scalp the temporal artery. Saw a circular hole in the

skull above the ear. Go inside the brain into the Sylvian fissure, find its main

artery, join the two arteries, end to side. The left anterior lobe of my brain is

now served by the left external carotid via this roundabout bypass. Dr. Chater did

the hookup under a microscope with sutures so fine the naked eye can’t see them.

“Check by Doppler ultrasound to make sure the bypass works, then close the

hole in the skull with a plate that has a groove in it for the moved artery. Sew

back the scalp-go to lunch. The surgeon has been operating for four hours; he’s

hungry. (The patient is not.)

“They placed me in a cardiac intensive-care room. When I woke, I found in my

room a big screen with dancing lights all over it. Those curves meant nothing to me

but were clear as print to the T.C. nurses and to my doctors-such things as EKG,

blood pressure, respiration, temperature, brain waves, I don’t know what all. The

thing was so sensitive that my slightest movement caused one of the curves to spike.

“I mention this gadget because I was not wired to it. “Another

space-technology spinoff: This is the way Dr. Berry monitored our astronauts

whenever they were out in space.

“Colonel Berry had to have remote monitoring for his astronaut patients. For

me it may not have been utterly necessary. But it did mean that I was not cluttered

with dozens of wires like a fly caught in a web; the microminiaturized sensors were

so small and unobtrusive that I never noticed them-yet the nurses had the full

picture every minute, every second.

“Another advantage of telemetered remote monitoring is that more than one

terminal can display the signals. My wife tells me that there was one at the nursing

supervisor’s station. Dr. Chater may have had

a terminal in his offices-I don’t know. But there can’t be any difficulty in

remoting a hundred yards or so when the technology was developed for remoting from

Luna to Houston, almost a quarter of a million miles.

“Space spinoff in postoperative care: a Doppler ultrasound stethoscope is an

impressive example of microminiaturization. It is enormously more sensitive than an

acoustic stethoscope; the gain can be controlled, and, because of its Doppler

nature, fluid flow volume and direction can be inferred by a skilled operator. Being