The Resurrection Machine: Death Deferred
On January 2 of this year, Buffalo Bills defensive player Damar Hamlin tackled a Cincinnati Bengals wide receiver, stood up, then fell to the ground. Not breathing, without a pulse, Hamlin was technically dead at twenty-four. The Bills’ medical team rushed onto the field. A trainer performed cardiopulmonary resuscitation (CPR). Emergency personnel then applied a device to Hamlin’s chest. An instant later, he was restored to life.
The machine that saved him is known by the awkward term “defibrillator,” which sounds like it might refer to a piece of farm equipment. The history of how it came to be available on that Monday night takes us back almost a hundred years and shines a light on an inventor whose genius has saved thousands of lives.
The effect of electricity on living things is a fascination that goes back even further. Ben Franklin received a shock that almost killed him while trying to electrocute a turkey in 1752. Although clearly dangerous, electricity was also seen as a possible miracle cure. It was proposed as a remedy for everything from mental depression and back ache to loss of sexual vitality.
The name William Kouwenhoven is familiar to few outside the world of resuscitation science. An electrical engineer at Johns Hopkins University rather than a medical man, Kouwenhoven became interested in the effects of electricity on human physiology in 1928. That year, the New York utility Consolidated Edison began searching for a way to save the lives of linemen. While stringing wires, they too often received a shock that killed them instantly.
The heart keeps its own time with an internal metronome, a system of nerves that maintains an electrical beat to stimulate the muscular pump. A shock or some other disturbance can make that pacemaker go haywire. In Hamlin’s case, it was a hard blow to his rib cage. Such a trauma delivered at exactly the right instant can be fatal. It causes the heart to lose its normal rhythm and to quiver like a sack of worms, a pattern known as ventricular fibrillation. The organ ceases to pump blood and the patient quickly dies.
Born in 1886, only a few years after Edison invented the light bulb, Kouwenhoven was fascinated by the potential of electricity. Working on the Con Edison project, he hit on the notion that a second surge of electricity applied to the heart could restore a normal beat. He called it a counter-shock. It did not, as some imagine, replicate jump-starting a car. Instead, the second shock froze the heart muscle, providing a pause during which its natural pacemaker could, with luck, kick back in.
Through experimentation, Kouwenhoven calculated the proper dosage of electricity needed. During this early research, the principle was tested in the operating room, with electrodes applied directly to the heart muscle. It worked.
The next step was to figure a way that the current could be applied to injured utility workers quickly enough to save them. The ingenious Kouwenhoven — he was known to colleagues as “Wild Bill” — worked out a way to send a pulse of high-voltage electricity through a person’s torso so that just enough of the current shot across the heart to accomplish the trick.
In 1957, the inventor, working with a group of researchers, came up with a 200-pound device, a “closed chest” defibrillator that proved itself by restoring the life of a 42-year-old man. The machine was practical only for hospital use, so Kouwenhoven’s team continued to experiment. By 1961 they had a suitcase-sized device that operated on battery power, the first truly portable defibrillator. Kouwenhoven, then in his seventies, toured the country to promote use of the machine.
Heart disease had become the leading killer of Americans, and many of the victims dropped dead from fibrillation — known as “sudden cardiac arrest.” A problem remained. If nothing was done, the victim died within ten minutes. Somehow, first responders had to buy time in order to get the portable defibrillator to the patient.
In his earlier research on animals, Kouwenhoven had noted that when he pressed electrodes against a dog’s chest, sensors showed a spike in blood pressure. From this observation came the idea for CPR, a technique that could keep the patient’s heart viable for considerably longer. Various researchers took the idea, developed it into a protocol of rapid chest compressions, and began to urge the general public to learn the technique.
Kouwenhoven died in 1975 at the age of eighty-nine. In the late 1970s, computer technology was applied to portable defibrillators, making them safe and easy to use. The Automated External Defibrillator, or AED, gradually become ubiquitous, appearing in public venues, from gyms to grocery stores, around the world.
After his remarkable recovery, football player Hamlin joined with the American Heart Association to encourage more folks to learn CPR. This summer, he resumed practicing with the team and hopes to continue his athletic career. Looking back on his brush with death, Hamlin said that on waking in the hospital, his first concern was about the game. Did we win? he asked a doctor.
“He said, Yes, I won — I won the game of life.”
Humor and history. Always a ‘Joy’ to read your articles.
Thank you.
Thanks, Jack, once again you have filled in how something I know nothing about and take for granted had its beginning. Some people's brains are so extraordinary.