Tuesday, 7 February 2012

Cardiac Surgery And Downton Abbey - The Magic Of Serendipity

In the first episode of the second series of Downton abbey, there is a scene with the  “feather girls” – women who, during the First World War, would approach any man who hadn’t joined up and present him with a white feather, symbolising cowardice. If the great poets of WW 1 are to be believed, serving soldiers did not quite share the sentiment of their womenfolk back home. I was recently giving a talk to a local theatre group on the history of surgery, in particular that of cardiac surgery. I mentioned to the audience that I originally came from Malta. At the end of the talk, a woman came up to me to explain how during World War 1, her great uncle, who hailed from the same suburb of Sheffield (Yorkshire, England) where I lived, had lied about his age and joined up when he was 15 . He did this after some feather girls approached him in the post office. He joined the British army in 1915 and was injured at Salonika and evacuated to Malta. He sustained an gunshot injury and had had the bullet removed from his heart during surgery carried out in Malta. I was to my shame initially sceptical about this story - all the medical history books tell us that the first real heart operations did not take place until the 1920s in London and Boston when rheumatic mitral valve stenosis was treated by surgery. The woman kindly sent me copies of contemporaneous newspaper cuttings from Sheffield and Malta and after further research on my part, I did confirm that during the first world war, British Army surgeons had carried out multiple heart operations to remove projectiles from the heart. The procedure used to treat the great uncle of the woman who had spoken to me was quoted in a textbook on military surgery published by the Royal Army Medical Corps in the 1920s. 
The other interesting cardiology related fact about the first world War (hat tip to Muir Gray) was that young men with systolic heart murmurs were not allowed to join up. This screening procedure turned out to be very effective as these men were spared an environment with a 50% mortality. As the great Richard Doll said - the most successful screening programme ever!'