The heart was a black box up until a century ago, writes Dunn (Ecology and Evolution/North Carolina State Univ.; The Wild Life on Our Bodies, 2011, etc.). His well-researched text chronicles how the box was opened.
The author opens with an account of how, even with today’s impressive technology and medicine, his mother nearly died from too high a dosage of digitalis, a drug used to slow a rapid heartbeat. The author then recounts an incident in 1893 in which an African-American doctor in Chicago saved the life of a victim of a stab wound to the heart by cutting into the wound and sewing a tear in the pericardium. Then it’s on to ancient history, with nods to da Vinci, Harvey and some others as exceptions to the view of the heart as sacrosanct and inviolable. The modern era began with the derring-do of the titular doctor, Werner Forssmann, who in 1929 inserted a catheter into an arm vein, threaded it to the heart and had it X-rayed, performing the first angiogram. In the 1930s, there were significant improvements in angiography, and succeeding decades saw the advent of heart-lung machines, new diets, drugs and devices (pacemakers, stents), and heart transplants. Dunn profiles the principals, with particular opprobrium for Christiaan Barnard, the South African surgeon ruthless in his zeal to be first to perform a human-to-human heart transplant. As for treatments today, Dunn cites studies showing that patients fare better with medication and diet to treat narrowed arteries, as compared with stents, but the latter are a huge moneymaker for hospitals. Finally, speaking as an evolutionary biologist, the author urges scientists to study the heart in evolution, pointing to striking findings that humans are alone among primates in our suffering from atherosclerosis. It’s complicated, he writes, but we might reap huge benefits in prevention rather than just focusing on repairs.
Credit Dunn with a valuable text that offers something for everyone—patients, practitioners, medical students, historians and policymakers.