JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, TX –
Almost 60 years ago, a young surgical resident at Fitzsimons
Army Hospital, Colo., was assigned a daunting task. He was given three months
to learn how to set up and operate a new piece of equipment that would save
many lives in the years to come.
Similar equipment was being used at a few medical facilities
throughout the U.S., but not at an Army hospital.
Now in his late-80s, retired Maj. Gen. Floyd Baker, former
Brooke Army Medical Center commander, recalls the event as if it happened
yesterday. He even has pieces of the original machine and a collection of
photographs to document his achievement.
“In 1956, I was the first to set up and run a pump
oxygenator in the Army,” Baker said. “We were doing some open heart surgery a
Fitzsimons using hypothermia to cool the body down so we could close an atrial
septal defect, but we only had four or five minutes to do it.”
An atrial septal defect is a hole in the wall that separates
the top two chambers of the heart.
A select few surgeons at the University of Minnesota, Mayo
Clinic, Cleveland Clinic and a few other places were beginning to do open heart
surgery using a pump-oxygenator machine, the general said.
A pump-oxygenator is a machine through which the blood is
temporarily diverted, especially during heart surgery, to oxygenate it and pump
it throughout the body. It is also called a heart-lung machine.
“So our boss decided that we needed to do it,” Baker said.
“For some reason or another they picked me. I was a first-year surgical
resident.”
Baker visited the University of Minnesota and the Mayo
Clinic to see what they were doing before spending months in the lab learning
how to run the new machine.
“We did the first case on July 27, 1956. Regrettably the
patient died, but then the next two lived,” Baker said. “In the beginning, the
cardiologists were only giving us patients who were near death, so
unfortunately out of the first 15 cases we lost nine of them.”
After the first few cases, Baker realized running the venous
blood through the pump didn’t make sense and was causing extra damage to the
patient’s blood. They tested the machine again in the lab, doing away with the
venous pump and letting the blood run out by gravity.
“Unfortunately we never wrote that up, but that became the
standard,” he said.
Baker worked with the machine shop at Fitzsimons Army
Hospital to design parts for the pump-oxygenator to make it run more
efficiently. He even used his wife’s sewing machine to make a modified filter
because the original filter was too harsh on the blood.
“The utilization of cardiopulmonary bypass using a
pump-oxygenator machine has expanded dramatically since the early days of
cardiac surgery described by Dr. Baker,” said Army Col. (Dr.) Jeffrey McNeil,
chief of cardiothoracic surgery at San Antonio Military Medical Center.
In 2013, more than 500,000 cardiac operations were performed
with the assistance of cardiopulmonary bypass and more than 100 were performed
at SAMMC.
“Like many areas of surgery, the technology has improved
dramatically leading to better outcomes. Compared to the high mortality rates
in the early days, with modern equipment and techniques, the risk of death with
most types of heart surgery is less than 3 percent,” McNeil said.
“Today surgeons are able to perform much more complex operations
than was ever envisioned when surgeons began operating on the heart.”
“Military medicine is much better because of pioneers like
Gen. Baker,” said Army Col. Evan Renz, BAMC commander. “If brave leaders didn’t
take chances, we would not have the technologies we have today.”
“All of the capability we have today is possible because of
the early heroic work performed by General Baker and others who were pioneers
in the development of cardiac surgery,” McNeil added.
Baker received the Army Commendation Medal because of the
work he did with the pump-oxygenator.
“Back then, junior officers never got awards, and residents
never ever got awards – it was unheard of,” he said. “I am more proud of that
Army Commendation Medal than any other award, including the Distinguished
Service Medal I received when I retired.”
Baker’s career as a general surgeon in the Army spanned more
than 30 years. He was the BAMC Commander from 1974 to 1978 and commanding
general of U.S. Army Health Services Command at Fort Sam Houston from 1983 to
1986.
“I think I did something that really contributed to Army
medicine,” Baker said proudly.