One of the last living connections to one of the 20th century’s most important medical achievements was severed Feb. 19 with the death of Dr. Merel Harmel in Chapel Hill.
Harmel, 97, served as professor and chairman of the anesthesiology departments at State University of New York-Downstate Medical Center, the University of Chicago and Duke University. He became part of medical history in 1944, when headed for a career in surgery he developed inflammatory bowel disease. His professors told him that the physical rigors of a surgical career were out-of-the-question and Harmel moved into a residency in anesthesiology.
Dr. Helen B. Taussig was a pediatric cardiologist at Johns Hopkins who overcame a severe hearing loss to become a renowned diagnostician. Taussig built upon the work of the Canadian pathologist Dr. Maude Abbott who had developed a detailed classification system of congenital heart disease. Taussig had observed many children born with a congenital heart defect which starved the body of oxygen. These so-called “blue babies,” named for their bluish color produced by the poor oxygenation of their blood, died quickly. Taussig had noted that blue babies who also had a second congenital heart defect called patent ductus arteriosus lived longer than those who did not. Taussig broached the idea of a surgical corrective procedure based upon her observation to Johns Hopkins’ Chief of Surgery, Alfred Blalock, and his laboratory assistant, Vivien Thomas. Blalock and Thomas, working in the animal laboratory, developed the procedure.
The idea of doing cardiac surgery on a baby was viewed as madness by many. Indeed, several surgical interns and residents refused to scrub-in on the proposed operation, thinking it would end their careers. The intern and resident who agreed to participate in the operation, Drs. Denton Cooley and William Longmire, Jr., would both go on to distinguished surgical careers.
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But who would be tasked with the delicate matter of anesthetizing the baby? Harmel took up the assignment. He modestly told me years after the event “I was the low man on the totem pole, I couldn’t say no.”
On Nov. 29, 1944, at Johns Hopkins Hospital, Blalock performed the world’s first successful palliative surgical procedure for children born with severe heart defects with Thomas, Cooley, Longmire and Taussig in the operating room and Harmel at the head of bed, administering anesthesia. The operative procedure they pioneered is referred to today as either the “Blalock-Taussig Shunt” or the “Blalock-Thomas-Taussig Shunt”.
When I arrived at Duke University Medical Center in 1983, I proposed changing the policy of irradiating young children requiring anesthesia from three treatments per week to five in order to reduce the long term side-effects of historically used high dose per fraction radiation therapy. A dignified yet cheerful, gray-haired man responded to my request. Other than seeing Cary Grant sport the outfit in the movies, Merel Harmel was the only man I ever saw wear a blue blazer and an ascot, and look perfectly natural doing so. It would be some time before I realized that I was working with the founder of the subspecialty of cardiac anesthesiology and being in his presence meant that I was in the presence of greatness.
There are many thousands of children alive today because of the heroic work of Harmel, Blalock, Thomas, Abbott, Taussig, Cooley, and Longmire. The passing of Merel Harmel is worth our notice and respect.
Edward C. Halperin is the chancellor and CEO at New York Medical College and Provost for Biomedical Affairs at Touro College and University in Valhalla N.Y.