"We seldom get into trouble when we speak softly. It is only when we raise our voices that the sparks fly and tiny molehills become great mountains of contention."
Russell M. Nelson's On-the-Fly Heart Surgery Innovation: An Example of How Detailed and Technical Personal Revelation Can Be
by Jeff Lindsay
When
people talk about receiving guidance from God, the details are highly
diverse.
Frequently
it's just a feeling, a prompting, that tugs at them to lead in a
certain direction. Other times unexpected external events may point
them in a new direction and help reveal a path to take. Sometimes a
passage of scripture seems to come alive with guidance for a specific
occasions. Sometimes there may be a dream a voice in their mind or
apparently a real voice that gives information.
As
we ponder how Joseph Smith translated the Book of Mormon, for
example, it is still unclear what happened as he looked into the
seerstone that allowed him to dictate text hour after hour.
We
now debate over whether the text was revealed to him as an impression
to be expressed in his own words ("loose control") or
whether their was often "tight control" governing many
aspects of word choice. We really don't know how it worked.
One
example of personal revelation from a modern man can show just how
detailed and specific personal revelation can be. In this case, a
revelation was given in 1960 to a young heart surgeon, Russell M.
Nelson, in the early days of open heart surgery as he attempted in
faith to help a patriarch with an inoperable heart problem with no
known surgical solution.
The
revelation he received on the fly as he looked at a failing, highly
dilated tricuspid valve included specific technical instructions and
even an image in his mind with dotted lines showing where sutures
needed to go. It's an amazing story of just how detailed revelation
can be.
The
extensive technical details of the story are provided in a recent BYU Studies
article, "Discovering
a Surgical First: Russell M. Nelson and Tricuspid Valve Annuloplasty"
by Austin A. Robinson and Curtis T. Hunter, BYU Studies, 54:1. A brief
overview can be read on the BYU Studies
website, and you can download the full PDF for $0.99 (better yet,
just go ahead and subscribe to this excellent journal!).
As
Austin Robinson mentions in his overview, the details of this
remarkable event have not been widely appreciated. Most of what we
knew came from Elder Nelson's description of the event in his
April 2003 General Conference addresses,
where spoke of an incident "during the early pioneering days of
surgery of the heart" when a stake patriarch from southern Utah
suffered much because of a failing heart.
He
pleaded for help, thinking that his condition resulted from a damaged
but repairable valve in his heart.
Extensive evaluation
revealed that he had two faulty valves. While one could be
helped surgically, the other could not. Thus, an operation was not
advised. He received this news with deep disappointment.
Subsequent
visits ended with the same advice. Finally, in desperation, he spoke
to me with considerable emotion: "Dr. Nelson, I have prayed for
help and have been directed to you. The Lord will not reveal to me
how to repair that second valve, but He can reveal it to you.
Your mind is so prepared. If you will operate upon me, the Lord will
make it known to you what to do. Please perform the operation that I
need, and pray for the help that you need."
His
great faith had a profound effect upon me. How could I turn him away
again? Following a fervent prayer together, I agreed to try. In
preparing for that fateful day, I prayed over and over again, but
still did not know what to do for his leaking tricuspid valve. Even
as the operation commenced, my assistant asked, "What are you
going to do for that?"
I said, "I do not know."
We began the operation. After relieving the obstruction of
the first valve, we exposed the second valve. We found it to be
intact but so badly dilated that it could no longer function as it
should. While examining this valve, a message was distinctly
impressed upon my mind: Reduce the circumference of the ring.
I
announced that message to my assistant. "The valve tissue will
be sufficient if we can effectively reduce the ring toward its normal
size."
But how? We could not apply a belt as one would
use to tighten the waist of oversized trousers. We could not squeeze
with a strap as one would cinch a saddle on a horse.
Then
a picture came vividly to my mind, showing how stitches could be
placed — to make a pleat here and a tuck there — to
accomplish the desired objective. I still remember that mental image
— complete with dotted lines where sutures should be placed.
The
repair was completed as diagrammed in my mind. We tested the valve
and found the leak to be reduced remarkably. My assistant said, "It's
a miracle."
I responded, "It's an answer to
prayer."
As
with many faith-promoting stories, things are often more complicated
than they seem. There are many details related to the specific
procedure that Elder Nelson invented on the fly, plus details of what
was revealed to him, the relationship to other heart procedures that
were known, and the technical matters related to the condition he
faced.
When
these are considered, a cool faith-promoting story blossoms into an
incredible, gritty, granular episode that almost overwhelms me.
Please take a look at this account.
Doctor Nelson had been
part of the team that developed the first successful heart-lung
bypass machine at the University of Minnesota, work that was the
basis of his Ph.D. dissertation. After Doctor Nelson came back from
further training at Harvard's Mass. General Hospital, he brought the
technique to Salt Lake City in 1955, making Utah the third state in
the nation with open-heart surgery capabilities.
This
technique allowed surgeons to see the living heart in action and
understand the many mysteries of valve function and other details of
the heart, one of the most brilliantly designed organs of the human
body.
Yes,
of course it's designed. Intricately, carefully, brilliantly —
it's amazing that it's even possible. Reading the details discussed
in this article should further increase your appreciation for the
majesty of this vital part of the Lord's Creation.
In spite of
the potential offered with new techniques, the tricuspid vale had
received very little attention among surgeons by the late 1950s. Most
of the problems people had were with the other side of the heart in
the mitral valve, where rheumatic fever was a common factor causing
valve failure.
When
Doctor Nelson decided to operate on what medical science then
declared was an inoperable condition, he did not have the benefit of
the experience of other surgeons in operating on the tricuspid
valve.
As he started the surgery on May 24, 1960, he found the
mitral valve had the "stenosis" he expected and he was able
to treat it with known techniques. Then he turned to the right side
of the heart and its tricuspid valve, where he found the kind of
inoperable damage he expected to find. He could thrust all five
fingers of his right hand through the greatly dilated valve into the
right ventricle.
As
he pondered the severe damage, he had a critical impression: reduce
the circumference of the ring. But how? People who had tried
constricting ligatures on the mitral or aortic valves had resulted in
spectacular failures and death.
Purse-string
sutures into the external heart tissue would eventually tear through
the heart. Belt and strap approaches had also failed. It would be
impossible to simple apply mitral valve techniques to this very
different system. There was nothing to guide him — except
God.
At this point an image was placed in Nelson's mind
that gave detailed instructions about how to apply sutures to the
flaps of the valve to pull them together and reduce the annulus
diameter, restoring valve function. Brilliant.
He
drew upon all that he knew, wisely selecting silk sutures and bits of
Ivalon sponge to help reduce the risk of the sutures tearing through
tissue, but he was working outside the realm of medical knowledge of
the day, yet had miraculous success.
This innovation was done
on the fly, without years of animal testing and analysis. It didn't
take a series of patient deaths after the animal tests, as in other
heart innovations, before it began to work. It was successful on the
first try. Truly a miracle.
The article is heavy in technical
detail and was a bit overwhelming at times, but well worth the
exploration and learning. Enjoy!
This may also be helpful in
understanding just what can happen when there is "tight control"
in revelation. Certainly shows the extremes that the Lord can achieve
in giving revelation. It's not all just warm fuzzies.
Jeff Lindsay has been defending the Church on the Internet since 1994, when he launched his
LDSFAQ website under JeffLindsay.com. He has also long been blogging about LDS matters on
the blog Mormanity (mormanity.blogspot.com). Jeff is a longtime resident of Appleton,
Wisconsin, who recently moved to Shanghai, China, with his wife, Kendra.
He works for an Asian corporation as head of intellectual property. Jeff and Kendra are the parents of 4 boys, 3 married and the the youngest on a mission.
He is a former innovation and IP consultant, a former professor, and former Corporate Patent
Strategist and Senior Research Fellow for a multinational corporation.
Jeff Lindsay, Cheryl Perkins and Mukund Karanjikar are authors of the book Conquering
Innovation Fatigue (John Wiley & Sons, 2009).
Jeff has a Ph.D. in Chemical Engineering from Brigham Young University and is a registered US
patent agent. He has more than 100 granted US patents and is author of numerous publications.
Jeff's hobbies include photography, amateur magic, writing, and Mandarin Chinese.