Winter 1999

 

 

  
 
Looking to the Future

At first, Cohn's spoon worked only for arteries on the front of the heart because they were accessible. More recently, surgeons have developed techniques to lift the heart up and turn it over to reach the arteries on the back without affecting the heartbeat. "So here's a heart, hanging halfway out of a person's chest while maintaining good circulation," he says, gesturing to a video he refers to as 'one of the stabilizer's greatest hits.' "With that technology, suddenly we can do the same thing we did on the front of the heart anywhere on the heart."

Still, he recognizes that many questions still exist. His early experiences point out the major advantages of using the procedure, but he doesn't yet have data about long-term effects. Random trials will help him and other surgeons who are investigating beating-heart surgery to understand which patients are the best candidates for the "spoon" operation.

What's next in the field of heart surgery? Cohn foresees that angiogenesis--tricking the body into growing new blood vessels to bypass clogged arteries--and artificial hearts will be the next wave. "The first generation of mechanical hearts was fairly primitive, but the ones currently being developed are an order of magnitude more sophisticated and incredibly high-tech," he says.

Not surprisingly, he's fascinated by the concept of robots in the O.R. Like something out of a futuristic video game, bypass surgery can now be performed by tiny little robotic claws which are directed by the surgeon using a controller that looks suspiciously as though it came from a Nintendo 64, he says. Rather than splitting the patient's breastbone to expose the entire heart, the robot's pinchers are inserted into the chest cavity through several small incisions. "The surgeon can be across the hall in another room. He can even be in another city!" marvels Cohn, his voice rising in excitement.
 

A Hedonist and a Humanitarian

One of Cohn's organic chemistry professors at Oberlin was P.J. Hawkins, who was involved in Shakespearean theater whenever he wasn't teaching. "I remember thinking, what a Renaissance guy," Cohn says. Hawkins' attitude made quite an impression on his student, who still believes in the importance of having a variety of interests--some serious, some not-so-serious.

"I believe life should be fun, and I'm a hedonist in the true sense of the word in that I try to keep myself continually entertained," Cohn says. His interest in inventing, in fact, grew from his need to entertain himself. He has another product undergoing FDA testing now, but doubts he'll hit another one out of the park as he did with the soup spoons.

Life at home is not dull either. He and his wife Shaun have four children and are expecting another. Shaun coordinates the Beth Israel Deaconess' hospitality program that helps find accommodations for patients and their families who travel to Boston for medical care. The Cohns have been hosting families for nearly four years. "What a great program," he says. "Our guests are just folks facing a hard time far from home. I'm glad to help them out where I can."

And how does he feel about having made such a tremendous contribution to medicine? "It's very rewarding. Once you taste that, you want to do it again.

"And this says it all," he grins, picking up a framed thank-you note from the original Bozo the Clown, whose reoperative coronary artery bypass was done with Cohn's stabilizer. "The idea that thousands of people every month are having heart surgery with this thing that I made--and some of them do much better, or live when they would have died, otherwise--that's a great feeling."
 

Stefanie Doebler is a freelance science writer based in Cambridge, Massachusetts.

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