Cold Hearts: The Story of Hypothermia and the Pacemaker in Heart Surgery

Myrna I. Baker, B.Sc.N., M.Sc., lived and worked in Toronto.

Wilfred G. Bigelow is a dedicated heart surgeon who has contributed in many ways to advancements in the field of heart surgery. Born in Brandon, Manitoba, 72 years ago, he pursued his medical education at the University of Toronto, Toronto General Hospital, and Johns Hopkins Hospital from 1938 to 1947, a period interrupted by World War II. In 1958, he ensured the continued development of modern methods of treating heart disease by founding one of the early university training programs for cardiovascular surgeons.

Cold Hearts provides a most interesting historical account of the research leading to advancements in the safety and efficacy of cardiac surgery through the use of hypothermia (low body temperature). The discovery and development of the cardiac pacemaker resulted as a spin-off from the hypothermia research and therefore is an integral part of the Cold Hearts story.

The book is composed of eight chapters. The first four deal with the blossoming of Dr. Bigelow’s interest in hypothermia as a result of his observation that little had been written on frostbite or its management; an account of the many surgeons who were making contributions in the field of cardiovascular surgery and thus provided the foundation of knowledge and the stage upon which Dr. Bigelow’s research interests were built; a chronicle of the pure basic research in hypothermia, which incorporated much work into hibernation research; and an account of the artificial cardiac pacemaker.

Chapter five, a review of advancements in heart surgery in the 1940s and 1950s, recognizes that much of the advancement in cardiac surgical techniques could not have occurred without research concomitantly being carried out in the closely allied fields of blood chemistry, anesthesiology, radiology, physiology etc. Similarly, chapter six discusses the evolution of the modern pacemaker and the refinements that took place during the period 1960 to 1982, which serve as a testimonial to the importance of a link between biological and technological research.

The last two chapters provide an apt conclusion, reviewing the current and future role of hypothermia in open-heart surgery and potential areas of inquiry that are being pursued. Dr. Bigelow closes with some reflections on the origin and process of research leading to discovery, some lessons learned, and his personal beliefs of certain characteristics within the researcher that are important assets for advancement in any field of inquiry.

Cold Hearts captures and maintains the reader’s interest to the end. This may be due to the fact that Dr. Bigelow does not merely present a chronological listing of facts, but weaves in amusing anecdotes that any reader can relate to, thereby adding to the book’s appeal for a wide audience. Highly technical language has been avoided.

In this day and age, when heart surgery and pacemakers have become so prominent in our lives, it is very fitting that this review of two of the most significant contributions in the field of cardiovascular surgery originated in Canada. I would not hesitate to recommend it as supplementary reading for medical students.