Pioneers of Cardiac Surgery

Richard A. DeWall, MD

100 Pioneers of Cardiac Surgery Richard A. DeWall, MD (b. 1926) My device was a kind of Rube Goldberg affair with a bunch of tubes gathered in a heap and on a stand, but every curve and bend and piece had a purpose. A lot of people would think, “I can do better than that,” and have it changed by the time they got on the plane to go home. Of course, they had disasters. — On the evolution of the bubble oxygenator Interviewed May 3, 2003 I grew up on the western prairies of Minnesota , in a little country town 150 miles west of Minneapolis. I had a brother who was thirteen years older than me and two sisters, nine and ten years older. I grew up virtually as an only child, because my brothers and sisters were gone by the time I had grown to any extent. I had a very happy childhood and a good education. The major event in my life, though, was the death of my father when I was fourteen. He had an adhesive obstruction of the small intestine. He was operated on by a country general practitioner surgeon, who opened him up, didn’t know what he saw, sewed him back up, put him to bed, and let him die. Of course his death bothered me greatly, but later I was even more disturbed when I came to realize that Dr. Wangensteen at the University of Minnesota had developed an international reputation for the use of nasogastric tubes, the Wangensteen suction system, to relieve bowel obstruction. He was world famous for the treatment of bowel obstruction. I had a great deal of animosity toward that local GP who had allowed my father to die at the age of fifty-three. The unnecessary death of my father put thoughts of medicine in my mind at an early age. At first I was more interested in orthopedic surgery and the more mechanical aspects of medicine. When I graduated from high school, World War II had begun, but I was only seventeen and too young to go immediately into the service. I went down to the University of Minnesota because it was quick and easy. After a year there, I turned eighteen and had to go into the service. I was in the navy for a little less than a year, and then the war was over. I immediately came back to Minnesota and started at the university again in January 1946. As an undergraduate I took pre-engineering and premedical courses. As time went on, I realized that I was just not that strong a student in mathematics and engineering, but the biologic sciences came easy to me, and I was interested in biology. I started out as a bacteriology major, slid off into premed courses, and ended up in medical school at the University of Minnesota. The Korean War was in progress during the last two years that I was in medical school. At that time, if you had not been in World War II for at least two years, you were subject to recall for the Korean War. Since I had been in World War II for a little less than a year, I knew for sure that I was going to be called up. I had been in the navy before , and so I ended up in the United States Public Health Service, which took care of the Coast Guard, some of the merchant marines, The Early Years 101 the naval patrol, and so on. I was sent to Staten Island Hospital in New York City. One of my patients there made an indelible impression on me. He was a teenage boy who was literally dying of rheumatic heart disease, with mitral insufficiency and heart failure. I was partially responsible for caring for him. It began to occur to me that the heart is a pump, and in this boy the pump had a defective valve. Well, I thought, why don’t we just open up the pump and replace the valve as people have been doing with pumps for two thousand years? You opened it up, and you fixed it. But, of course, at that time it was not possible to fix a heart valve like that. I finished my internship in the Public Health Service, and I went back to Minnesota because that was where my roots were, and I really didn’t have any other place to go. I found...