medicine

October 31, 1957 – Tragic Power Failure at Minnesota Hospital Spurs Life-Saving Invention

Dr. Walter Lillehei and young patient with portable, battery-powered pacemaker invented by Medtronic’s Earl Bakken. Photo: University of Minnesota Archives

On October 31, 1957 – Halloween! – a rolling blackout across parts of Minnesota and western Wisconsin left Minneapolis’ University of Minnesota Hospital without power for three hours.  The hospital never anticipated such a dire emergency; two separate power plants provided electricity for the facility and it seemed unlikely that both sources could fail at the same time.  One of the most tragic consequences of the hospital’s power loss was the death of a young post-heart surgery patient, whose life was being sustained by an externally-powered heart pacemaker.

When the blackout hit, all the children in the cardiac recovery unit – whose large, cart-borne pacemakers were plugged into wall sockets  – were immediately at great risk.  The children in the unit were temporarily dependent on pacemakers as part of University of Minnesota heart surgeon Dr. C. Walter Lillehei’s new life-saving efforts to surgically treat children affected by blue baby syndrome.  While police officers parked their cruisers outside hospital windows, aiming their headlights inward to provide light, doctors scrambled to administer medication that would hopefully substitute for the inoperative pacemakers.  Their efforts were successful for all but one of the fragile patients.  The trauma of the baby’s death spurred Dr. Lillehei to consult with Earl Bakken, electrical engineer and founder of Medtronic, the then-fledgling medical device development company.  Lillehei asked Bakken, who was still running Medtronic out of his garage, if he could design a portable pacemaker that ran on a battery.  Bakken went to work.

Earl Bakken. Photo: (c) 2009 IEEE

His first design, based on a six volt automobile battery, produced more power than needed.  Then, Bakken remembered a recent article in Popular Electronics about a new metronome circuit and had a brain flash – “a metronome has the same rates as heart rates,” he realized.  The metronome circuit also had a size advantage – it could fit in a box about the size of a paperback book, and sit in bed beside the patient.

Bakken created a prototype and tested in on a dog in the hospital’s laboratory.  It worked.  Bakken headed back to the garage to make another unit for human patients.  When he returned to the hospital the next day, his first unit was already in use in the surgery recovery room.  “There was a child in there with this pacemaker connected to him . . . What a great feeling that is to see here’s something we made with our own hands keeping this child alive, ” he said.  Concerned that the initial prototype wasn’t really ready for the critical job of supporting human life, he asked Dr. Lillehei why he hadn’t waited for Bakken’s more carefully constructed second unit.  According to Bakken, Lillehei replied, “Well as long as this battery-operated pacemaker was available he wasn’t going to risk losing another child to a power failure.”

Bakken was modest about his new invention, claiming that the rapid advances in heart surgery in the 1950’s would inevitably have led to the portable pacemaker’s development.  He acknowledged that the Halloween blackout had highlighted the urgency of creating such a device.  Out of tragedy, and thanks to Dr. Lillehei and Earl Bakken, heart surgery patients young and old now stood a better chance of surviving to lead long, productive, and healthy lives.

October 26, 1957 – First American Woman Nobel Laureate Passes Away

American biochemist and Nobel Prize winner Gerty Theresa Cori. Photo: National Library of Medicine, National Institutes of Health

American biochemist and Nobel Prize winner Gerty Theresa Cori. Photo: National Library of Medicine, National Institutes of Health

On October 26, 1957, biochemist Gerty Theresa Radnitz Cori passed away at home from complications of myelosclerosis. Gerty had been born sixty-one years earlier in Prague. Her father was a successful chemist, inventor, and sugar factory manager and her family participated in a culturally sophisticated circle which included author Franz Kafka. The Radnitz’ were Jewish. Gerty’s uncle, a professor of pediatrics, supported her in her desire to become a doctor at a time when women were discouraged from pursuing a career in science or medicine. In 1914, at age 18, Gerty entered the Karl-Ferdinands-Universitat medical school in Prague. She received her Doctorate in Medicine in 1920 and married fellow student Carl Cori the same year. Gerty was a vital, charming young woman who loved her studies, the outdoors, and mountain climbing. She converted to Roman Catholicism in order to marry Carl within his religious tradition.

Together, Carl and Gerty embarked on careers in research. They began in Vienna, but Gerty’s poor health due to post-World War I food shortages, and the increasing atmosphere of anti-Semitism prompted their emigration to America. First at the State Institute for the Study of Malignant Diseases in Buffalo, New York (now the Roswell Park Cancer Institute) and finally at the Washington University School of Medicine in St. Louis, Missouri, the Coris made investigating carbohydrate metabolism their life’s work. Carl’s opportunities, and pay, were always greater that Gerty’s. Despite repeated institutional pressure to drop her as a research partner, Carl insisted on Gerty’s continued participation. They published many papers together and completed their ground-breaking work on carbohydrate metabolism. In 1947, Carl and Gerty Cori were jointly awarded the Nobel Prize in Physiology or Medicine.

What the Coris discovered – and is now called the Cori cycle – is the reversible process by which our cells break down glycogen into glucose for fuel or reconstitute glucose into glycogen to store for future energy needs. They specifically identified the “Cori ester”, the compound glucose 1-phosphate (and the enzyme that enabled its formation). The Cori ester is the key to the glycogen-glucose-glycogen pathway. Gerty Cori later went on to study diseases attributable to defects in the glucose metabolism-related enzyme, including diabetes.

Gerty won several prestigious awards during her lifetime. As a Nobel Prize winner in 1947, she became only the third woman laureate in history and the first American woman so honored. In 1953, she was elected a Fellow of the American Academy of Arts and Sciences. Two Cori craters – one on the moon, one of Venus – were named after her. In April, 2008, the US Postal Service created a stamp in her memory. The American Chemical Society recognized the carbohydrate metabolism work of Carl and Gerty Cori with National Historic Chemical Landmark status in 2004.

Gerty suffered from increasingly poor health from myelosclerosis – a disease involving loss of bone marrow – during the last ten years of her life. In spite of pain and difficulty, she carried on her work as a professor and researcher at Washington University School of Medicine. Her discoveries, as acknowledged by the postage stamp bearing her likeness, “contributed to the understanding and treatment of diabetes and other metabolic diseases.” She was a pioneer in life and science, an example still of courage, determination, and passionate pursuit of a life worth living.