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The 'Man Who Touched His Own Heart' Changed Medicine

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The 'Man Who Touched His Own Heart' Changed Medicine

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The 'Man Who Touched His Own Heart' Changed Medicine

The 'Man Who Touched His Own Heart' Changed Medicine

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Melissa Block talks to Rob Dunn about his new book, The Man Who Touched His Own Heart, a history of science and medicine's efforts to understand the working of the human heart.

MELISSA BLOCK, HOST:

A lot of lousy ideas have been spouted by people sitting at a bar. But we're going to hear now about a great one, an idea generated by a guy hunched over his drink at a bar in Germany in 1929, an idea that ended up revolutionizing medicine. It's a story that gives the title to a new book by evolutionary biologist Rob Dunn. It's called "The Man Who Touched His Own Heart." That man was a young German Doctor named Werner Forssmann, just 25 years old, who came up with this crazy idea. And at that bar, he started boasting about it.

ROB DUNN: And the idea was that maybe it would be possible to send a catheter up a vein or, later, an artery, into the heart in order to see the heart in living patients. And he thought, if you could get a catheter into the heart, then you could take an x-ray and you could see where the catheter was and perhaps detect some of the problems.

BLOCK: This was revolutionary, right? Nobody had done this before.

DUNN: Oh, no. I mean, nobody had seen - the idea that you would see a living heart in a patient without cutting them open was totally revolutionary. And before this idea, Forssmann had spent all of his time with cadavers in the basement of his hospital. He was the low man on the totem pole in the hospital, and so he had to through the cadavers trying to figure out what had happened. And he saw in the hearts all of these problems that he thought, maybe, someday somebody could fix if you could see them in the living patients, but nobody could. And so here he is at the bar thinking that, if his new technique is right, he could revolutionize medicine for the future of humanity. And then, like all great ideas, his idea has to be confronted with reality. And the reality is he goes back to the hospital the next day and he tells his boss, look, I'm going to send a catheter into the vein of one of the patients to see if can get it into their heart and then take an x-ray of it. Is that OK? And his boss says of course it's not OK. And then Forssmann says, well, I tell you what, I'll do it on myself. And his boss says no, no. You know, I know your mother and she wouldn't like that. And so he goes home sulking. And then he decides that he's going to do it anyway.

BLOCK: And this is what's so remarkable about this story because, as you describe it in your book, Dr. Forssmann enlists a nurse to help him, right? He tells her he's going to perform the procedure on her and she agrees, but it's all a ruse. He does this procedure, this catheterization, on himself.

DUNN: He does. And he enlists her, realistically, because he needs her to help him because he's so low on the totem pole that he doesn't even have access to the cabinets with catheters in them. And so there's this amazing moment where she thinks that, you know, this procedure is going to happen on her.

BLOCK: She's strapped to a table, right?

DUNN: Yeah. And so she's ready, and she's going to do this for science. And then all the sudden, she looks over and he's sneaking the catheter into his own arm and she screams to stop him and he won't stop. And he pushes it and he flinches because it hurts. It's actually a urinary catheter, so it's huge. And then there's this incredible realization. It's sort of a twofold realization - maybe he's done it, you know, he's made it all the way to his heart. And the other realization is that they've chosen a room in which they can't take a photograph of the x-ray.

BLOCK: You mean there was no x-ray machine in the room where he was doing this procedure?

DUNN: No. I mean, he just - he just made a terrible choice in which room he chose. And so now they've got to walk out of this hospital room with this little catheter bobbing in his heart, down two flights of stairs, and the nurse is helping to drag everything along. And, finally, they get to the room where they can take a picture and one of Forssmann's colleagues is there and is so mad and frustrated with what he views as Forssmann's madness, that he actually tries to physically rip the catheter out. And Forssmann pushes him out of the way - and how aggressive this all is varies in the telling - and they take the picture. And when they do, they can see that it's almost all the way into the heart. And so he pushes it a little bit further and they take the picture again. And there its, and he's done it. And so it's just this amazing moment in the history of medicine that he's done what nobody thought was possible. And at that moment he feels heroic.

BLOCK: Was it recognized right away that this was a huge moment for medicine, the birth of a whole new field of medicine - of cardiology?

DUNN: No. In fact, Forssmann couldn't, you know, get a surgery job like he hoped for. As time passed, he became ever more marginal. And so whatever heroism he had hoped for began to slip away.

BLOCK: Yeah. Well, the years go by. He - Dr. Forssmann serves for the Germans as a medic in World War II. And the story you tell about what happens - it's 26 years after he performs this procedure - catheterizes his own heart. You describe him sitting in a pub and getting a phone call. Its 1956.

DUNN: Yeah. And, amazingly, he gets a phone call in the bar, and it's from its wife. And he says that someone's called the house and it seemed important. Forssmann brushes it off and he goes back to drinking. Later that night, he gets home and there's another call and it has a foreign accent, and he brushes that one off, too. And then he goes into work the next day, and it's only at work that he realizes what these calls have been about, that he's been awarded the Nobel Prize. He thought he was lost, that everyone had forgotten him. He really didn't understand at this point that his technique, even though he'd not been allowed to do more with it, had been used in the U.S. and other scientists - other doctors had gone on to develop new technologies in the basis of this original technique. And so it had expanded dramatically. And so he was sharing the Nobel Prize with other people he didn't really even know of. And he was beyond himself.

BLOCK: You know, it's striking. In reading about Werner Forssmann and a number of the other doctors, surgeons whom you profile in this book, that a lot of them are marginal figures. They're sort of on the fringes of medicine, right? They're outsiders. And I wonder if that freed them up to be risk takers, to make these advances that we're talking about.

DUNN: I think that's, for sure, true. I mean, my first thought is to think of Daniel Hale Williams, an African-American doctor in Chicago, working in the 1890s, who performed really the first surgery on a heart. And he did it in part because he was working in a hospital with few resources where he had just developed the ability to do really hard and impossible things. And so the fact that he was a little bit marginal made - allowed him to do what others couldn't. And I think that story occurs again and again. And I think that the tendency and the story of surgery and the story of science and the story of a heart, in particular, you know, is for a lot of energy and money to be dedicated straight ahead, you know, at what the next most obvious thing. But I think these big discoveries often come from the folks who are working off to the side.

BLOCK: I wonder, in the course of writing this book, if you became much more mindful of your own heart, your pulse and the coursing of blood through your veins.

DUNN: Yeah. I think it's impossible not to write about the heart and study it and become conscious every day of what it's doing. I mean, you can put your fingers up to your carotid artery and feel that pulse. And, you know, you're going to get, in a lifetime, 2.5 billion of those beats if you're lucky. And so to feel them ticking away, I think I'm very conscious of that and to know how elaborate each one of those beats is and yet how much we take them for granted. I'm very aware of that.

BLOCK: Will, Rob Dunn, thanks so much for talking with us.

DUNN: Oh, thanks so much, Melissa. It's really been a pleasure.

BLOCK: Rob Dunn is the author of the book "The Man Who Touched His Own Heart: True Tales Of Science, Surgery And Mystery."

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Clarification Feb. 11, 2015

This piece states that Werner Forssmann was a medic during World War II. It would be more accurate to describe Forssmann as a medical officer. In 1939 he enlisted in the German armed forces. He eventually reached the rank of surgeon-major. In his autobiography, Forssmann describes his duties as being those of a field doctor — sometimes in hospitals associated with particular invasions, and in other cases stationed at hospitals to which the injured would be brought.