2001 Thomas G. Wharton Memorial Lecture

“What Will It Take To Meet The Challenges Of This Century?”

Robert C. Groom, C.C.P.
Portland, Maine

Academy members, guests, and friends: it has been a privilege to be president of the American Academy of Cardiovascular Perfusion and to have the opportunity to deliver this lecture in memory of Thomas G. Wharton. As we begin this new century, it is appropriate to consider the question, “What will it take to meet the challenges of this century?”

On January 27, 1901, one hundred years and one day ago, an article appeared in the New York Sun newspaper written by the renowned physician and medical historian Sir William Osler. He wrote:

“For countless generations the prophets and kings of humanity have desired to see the things which men have seen, and to hear the things which men have heard in the marvelous nineteenth century. The spirit of science was brooding in the waters… The most distinguished feature of scientific medicine of the century has been the phenomenal results which have followed experimental investigation.”

If Sir William Osler were alive today, he would probably say the phenomenal results not only continued through the twentieth century, but that the progress has been exponential! He would undoubtedly agree with the late C. Walton Lillehei, who wrote,

“Open heart surgery is widely regarded as one of the most important advances of the twentieth century,” and, “Cardiopulmonary bypass has been the keystone to the astonishing phenomenon.”

What caused open-heart surgery to become one of the most astonishing advances of the last century? What was the driving force to overcome the many obstacles of mechanical cardiopulmonary support?

I am reminded of the story told by Richard Feynman, the Noble Laureate and physicist who worked on the Manhattan Project at Los Alamos. The United States Army had recruited the most talented engineers and scientists from all over the United States to participate in the project. They had the resources of the United States’ government at their disposal. But the Army was obsessed with security about the project and refused to tell the engineers and scientists anything specific about the project they were working on or even what their calculations meant. They did not know that they were building a weapon that could end the war, or even what their calculations meant. They worked slowly and not very well. Feynman, who supervised the technicians, prevailed upon his superiors to tell them what they were doing and why. Permission to lift the veil of secrecy was granted. Oppenheimer, one of the leading scientists involved with the project, gave them a special lecture to explain the nature of the project and the importance of their contribution. There was a complete transformation. According to Feynman,

“They began to invent ways of doing it better. They improved the scheme. They worked at night; they didn’t need supervising in the night; they didn’t need anything. They understood everything; they invented several of the programs that we used.”

Ever the scientist, Feynman calculated that their work increased ten-fold when they understood the importance of their work.

It is crucial that we comprehend the importance of our work. If we understand the importance of our work, we will focus our efforts on the important questions and begin to participate in solving some of the difficult clinical problems. Like the group of scientists at Los Alamos, we will see a dramatic increase in our productivity. We will learn to collaborate. We will be energized. We will stop wasting time finding fault with our national professional organizations. We will make the effort to address the truly important questions. We will find ways to bring about great change.

When you sit behind the console of a heart lung machine, you sit at the controls of life. For a brief period of time you assume the responsibility of sustaining the seven trillion living cells that serve as a vessel for the patient. The patient’s cognitive functions, memory, emotions, and everything about him is contained in that fragile vessel. How you execute this responsibility can make all of the difference in the world for the patient. This awesome responsibility is unparalleled in any other vocation.

It is imperative that we understand the importance of our work. It is only when we understand our essential role that we are able to find the dedication, strength and perseverance to meet the challenges of our profession.

The foundation of our profession was built on the dedication of pioneer researchers that understood the magnitude of the pain and suffering caused by cardiovascular disease, and were willing to fight wholeheartedly against the number one killer of Americans. In 1931, Dr. John Gibbon experienced a defining moment when he was given the task of monitoring a patient with a pulmonary embolism. Surgical embolectomy, the Trendelenburg procedure, carried a high mortality rate and would only be considered if the patient’s condition deteriorated to the point where death was certain. While monitoring this moribund patient, Gibbon was consumed with the plight of his patient. This striving gave birth to the idea, “If only there was a way to saturate the venous blood and transport it to the arteries.” The patient’s condition worsened and an embolectomy was attempted. The patient did not survive. From that moment on, Dr. John Gibbon understood that he must apply himself to the task of saturating venous blood with oxygen, and transporting it into the arteries. His consuming compassion for this patient sent him on a mission that spanned three decades. It was the driving force behind years of research that lead to Gibbon’s first successful use of the heart lung machine on May 6th of 1953. Later Dr. Gibbon’s wife and research assistant Mary Gibbon wrote, “I have often wished that her family might know the thousands of lives that have been saved throughout the world because that woman lived and died where she did.”

Just before the beginning of the last century on October 23, 1896, my grandfather Samuel C. Groom was born. He grew up in western Pennsylvania and went on to become the father of seven children. On December 24, 1931, he had a massive heart attack and collapsed in his home. He was transported by ambulance to Mercy Hospital in Pittsburgh. He did not survive the 17-mile trip to the hospital. He was 35 years, 2 months, and 1 day old. His children lived with the memory of taking down the Christmas tree in their home to make room for the casket. My father John Groom was twelve years old at the time of his father’s death. My father died on October 12, 1984, from cerebral vascular complications following a carotid endarterectomy. He was 65 years old.

Our work is much more than fascination with the wonders of cardiac physiology or the excitement of operating a complex machine. We must approach our work as a professional mission to relieve suffering. Our charge is to fight against the disease that kills babies, children, fathers, mothers, grandmothers, grandfathers, and spouses. We accept this challenge by equipping ourselves to do the very best that we can to care for patients with cardiovascular diseases. Some do this by designing better devices and some accomplish it by managing facilities to build better devices. Other may train students or conduct research. Our efforts in these endeavors serve one purpose: to loosen the grip of our adversary, heart disease.

In 387 BC, the Greek philosopher Plato took a piece of land on the outskirts of Athens donated by the Athenian war hero Academus. He created a place called the Academy. From Plato’s writings we know that the Academy was a place where serious and thoughtful people came to study in an atmosphere conducive to their learning. They then returned to their professions to implement what they were taught by the great philosopher.

In the summer of 1979, Thomas G. Wharton, a man with a vision, donated two thousand dollars to start an organization where serious and thoughtful people could come to exchange ideas in an atmosphere conducive to their learning. They then returned to their professions to implement what they had learned there. The organization was named the American Academy of Cardiovascular Perfusion. Ironically, on March 19, 1980, at the age of 46, Thomas G. Wharton suffered a myocardial infarction and was pronounced dead in the hospital emergency room: another victim of the problem. The American Academy of Cardiovascular Perfusion is an annual gathering where dedicated professionals can come together to create an environment where their understanding can be expanded. Each year members and associates meet to challenge and support one another, and to share ideas, all with the goal of advancing our understanding of the science of perfusion.

I have come to these meetings now for more than 20 years. I have learned much through my affiliation with each of you and will always be grateful for the wisdom and knowledge that I have gained from these meetings. What I have learned has helped me in my endeavor to participate in the fight against heart disease.

If this new century is anything like the last, our progress will be closely linked to our understanding of the importance of the problem before us and our ability to believe in our potential as individuals and as a profession.

Thank you.