The Hypnotized Heart

An unprecedented use for hypnosis--as an essential part of anesthesia in open heart operations--was described by Beverly Hills Anesthesiologist Milton J. Marmer last week. The result, Dr. Marmer told the A.M.A. convention, was to permit the use of chemical anesthesia so light that one teen-age patient could be awakened while the lower right chamber of her heart was open. After the drastic surgery, she made a good recovery with only slight pain.

Great danger in all major operations inside the chest is that the nerve centers controlling breathing and heartbeat will stop. The deeper the anesthesia, the greater the danger. So surgeons and anesthesiologists have tried to develop "light anesthesia" methods, which should be safer. One way of checking whether the anesthesia is light enough, Marmer reasoned, was to make hypnosis a part of it so that the patient could be awakened during the operation.

With Open Eyes. Marmer began his experiments by hypnotizing a 13-year-old boy, found that he withstood the rigors of a heart operation (to enlarge a pulmonary valve narrowed at its base), and recovered without complaining of pain. Then Marmer moved on to a more difficult case: a girl of 14 who had the disadvantage of being deaf, so that a hearing aid had to be used to communicate with her. After several trial runs, he hypnotized her on the morning of the operation, then gave her light chemical anesthesia. When her heart and lungs had been bypassed, their work being done by the heart-lung machine, the surgeon opened her right ventricle. At this moment, speaking through the hearing aid, Marmer asked the girl to open her eyes. She did so at once. He asked her to nod her head if she could hear him. She nodded. To satisfy incredulous observers in the operating theater, Marmer repeated the routine, got the same responses. The surgeon widened the valve and sewed up the girl's heart. Marmer told her to go back to sleep. She slept soundly during the hour or more needed to close the gaping wound on both sides of her chest.

At the end of the five-hour operation, Marmer told the girl to wake up. She did, promptly asking: "Is everything O.K.? Can I have a drink? I'm so thirsty!" The technique, Marmer suggested, should be limited to patients aged seven to 14 because they are the most suggestible subjects, with their "heightened powers of imagination and their ability to play a role or create a fantasy."

Entertainment Barred. The A.M.A.'s house of delegates last week also approved a report by its council on mental health giving a guarded endorsement of the use of hypnosis in medicine, surgery and dentistry. Because hypnosis is such easy "meat for the charlatan," the council insisted that its use should be limited to specially trained doctors and dentists, who must be careful to use it only in the area of their specialty. On the hazards of hypnosis, the council had conflicting evidence and could reach no agreement. But on one point it was dogmatic: "The use of hypnosis for entertainment purposes is vigorously condemned."

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