Journal of Emergency Nursing
Volume 37, Issue 1 , Pages 59-63, January 2011

“Stand Clear!” Tracing the Practice and Principles of Human Revival☆☆☆

  • Keith Stephens-Borg

      Affiliations

    • Corresponding Author InformationFor correspondence, write: Keith Stephens-Borg, Honeywell Cottage, Milltown Muddiford, Barnstaple, North Devon, England

Received 5 January 2010; received in revised form 2 February 2010; accepted 3 February 2010. published online 08 March 2010.

Article Outline

 

In essence, people often stumble across discoveries of scientific significance during a caprice of Mother Nature, aided by our extraordinary drive forward in the quest for immortality. The moral fiber of human intuition impels us to preserve hopes and dreams by passing on the baton of knowledge gathered in our lifetime and by joining pieces of a jigsaw, assembling the means to continue our existence.

Besides having access to a wealth of treasures stored in vast libraries, we are fortunate to share a World Wide Web of processed information. The unpredictable approach of surfing the Internet may perhaps create startling revelations, as it did for me while I was searching for a replacement cell phone battery. What I never expected to discover was a “buy it now” cardiac defibrillator complete with instructions and “guaranteed not to be DOA!” The device, about the size of an encyclopedia, was so compact that in the film Casino Royale the fictional James Bond was able to place it in the glove box of his Aston Martin.1

An earlier, equally charismatic character was the true-life American statesman Benjamin Franklin,2, 3 who was spellbound by a new world of gadgetry. He conducted frequent experiments with electricity in 1752. At the heart of this new era, Franklin also experienced the birth of a independent nation, altering history on an incredible scale. Furthermore, he realized that the potential of harnessing electrical energy would rule and even prolong life but was also capable of extinguishing it.

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The Key to Raising Life 

Experience at first sight the breathtaking geography of the United States ascending the entire length of the Yellowstone River; the splendor intensifies as the landscape continues in concert with the awe-inspiring mountains of Southern Montana. There elevated peaks meet the clouds and raise the never-ending question as to the glorious force responsible for such beauty. Large quantities of these clouds appear to float elegantly across the sky, transforming images that kindle our imagination. The darker, heavier rain clouds often are accompanied by fierce thunderstorms, enough to inflict fear on modern-day people, let alone early civilizations.

If you are fortunate enough to survive a lightning strike, you will experience life drawn from you, then given back. Relating to one encounter with the force of nature, American topographer Henry Gannett (1846-1914)4 enlightens us with an account of how he and his team survived a lightning strike in 1872 while surveying a mountain, now known as “Electric Peak.” Gannett claims that the expedition to record and map high ranges in Yellowstone National Park was literally stunned by a severe electrical discharge,5 leaving extreme tingling sensations throughout their limbs that painfully forced them to the ground.

Speculation on how this event occurs was published on a British Institute of Physics Web site,6 with clouds being described as enormous particle accelerators. I myself believe that clouds are simply batteries with a positive at the top and the negative on the bottom. Because a build-up of ice crystals form together with rising warm water droplets, the friction caused allows enormous energy to discharge. Lightning travels at more than 130,000 mph with a temperature of 30,000°C; some people believe that cloud to ground strikes are attracted by the silica in the soil, but not everyone supports this theory. The ancient Greeks observed this natural occurrence much earlier and reproduced static charge by rubbing amber on cloth. They called it “elektron.”

Many years later, the curiosity of Benjamin Franklin (1706-1790) about lightning and electricity lead to many controversial experiments. (Many persons would argue that this experimentation was meddling with the power of creation and was an affront to God.) In an article in The Pennsylvania Gazette2 in 1752, he describes an experiment in which a kite soars high into thunderclouds, attracting electrical energy along a hand held twine to a metal key (Figure 1). “At this key the phial (A Leyden jar)7 may be charged; and from electric fire thus obtained spirits may be kindled,” wrote Franklin.

  • View full-size image.
  • Figure 1. 

    “From electric fire thus obtained Spirits may be kindled.” A quote by Benjamin Franklin during his kite experiment in 1752, demonstrating static charge from a key attached to a twine. (Photograph by Ellen Stephens-Borg.)

Without Franklin's achievements, several terms used today would not exist, such as battery, conductor, condenser, positive and negative charge, and finally, the electric shock. As Franklin became America's ambassador to France, an understanding and experience of the power of the electric spark spread to Europe and soon became the focus of healing remedies for arthritis. The mathematician and statesman James Logan (1674-1751) was himself treated with shocks by Franklin in an effort to stimulate a cure following a stroke.8

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The Kiss of Life 

As popular curiosity increased regarding this new science, an event occurred in 1774 that would direct interest in the use of electricity in medicine for the foreseeable future. In the city of London, a building in St. Paul's Churchyard witnessed a change of title from a chapter coffee house to The Humane Society,9 initially known as the “Institute for Affording Immediate Relief for Persons Apparently Dead from Drowning.” Within a few months a member of the newly formed organization was called upon to care for a 3-year-old child, Catherine Sophie Greenhill, who was discovered apparently lifeless near Pudding Lane, having plummeted several floors from an open window. Records from The Humane Society of July 16, 1774, proclaimed that the child was given numerous shocks to the chest with a portable electrostatic generator by a man named Squires, which resulted in normal breathing; the child made a full recovery.

Dr. William Hawes, one of the founders of the society, also granted awards for successful resuscitations. This flourishing order filed a petition to parliament, and in due course, the government of King George III eventually approved of an organization and set up receiving houses (Figure 2) in London's Hyde Park in 1794. Medical students were educated in the principles of human revival, which are predominantly documented and stored in the archives of The Royal Humane Society; alongside a total of 85,000 awards for saving human lives.9

Maintaining a patient's airway was understandably complex as more study was essential to conduct the means of artificial respiration. Eventually, a straightforward practice of “mouth to mouth” resuscitation was developed and was subsequently called “the kiss of life.” Initially, to guarantee success, members of the Society used a technique of applying cricoid pressure exerted by placing a thumb and index finger just below the patient's Adam's apple. Once depressed, the esophagus closes, preventing breathed air by the resuscitator from flowing into and inflating the stomach. This approach is quite different from the technique used today of flexing the neck and lifting the jaw to ensure the flow of air directly to the trachea, therefore inflating the lungs.

Approximately 200 years later the anesthetist Dr. Brian Sellick introduced a reverse method to prevent stomach acid reflux from reaching the trachea, thus avoiding aspiration during rapid sequence intubation. A major airway exercise of applying pressure to the cricoid cartilage during endotracheal tube intubation that is practiced by anesthetists, emergency departments, and during general anesthesia, it is commonly known as “Sellick's maneuver.”

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Supernatural Addiction to Life 

On the Italian lake of Como, the physicist Alessandro Guiseppe Antonio Anastasio Volta (1745-1827)10 invented the battery. Unlike the Leyden jars7 produced in the Netherlands during 1745, which stored static charge through a wire coil in water, a chemical battery could produce energy for an extended period. The Voltaic pile was merely constructed from zinc and copper shaped into discs. Brine-marinated cardboard (basically salt) sandwiched the discs vertically; when prepared, it produced a reasonable flow of electricity (about 1 to 2 volts) based on the number of the discs used as the electrolytes from the brine reacted with the metals. The term “volt” comes from Volta's name.

“Electrolytes” and “electrodes” were terms used by Michael Faraday (1791-1867),11 and they are preserved in our medical and nursing vocabulary on a daily basis. Apart from carrying out his duties as a chemical assistant, Faraday explored the work and achievements made by Volta and continued conducting research into electrochemistry.

Batteries, conductors, and lightning rods inspired the young British author Mary Shelley,12 who found herself encircled by a new culture of the supernatural. She wrote an electrifying novel at the age of 18 years, Frankenstein or the Modern Prometheus, a gothic horror that was published in 1831. (In Greek mythology, Prometheus was the unfortunate son of Iapetus, who deceived the gods by serving them bare bones as an alternative to meat. He was sentenced to an eternal dreadfulness at the mercy of a flying beast that devoured his liver; each day the liver would regenerate, and so it went. Heracles [slayer of the beast] in time saved Prometheus.)13 The main character of Shelley's novel is the sadistic Victor Frankenstein, who displays obsessive behavior with his God-like power to create life.

Even as fiction remained popular within society, physiologists Jean-Louis Prevost and Frederic Batelli14 conducted animal research in reanimation in Geneva, Switzerland; this research was published in 1899 with the title, “On the Effects of Electrical Charges to the Heart of Mammals.” Thanks to James Joule's (1818-1889) unit calculation of electrical charge, experimental trials reached an advanced stage during the 1930s, as awareness of the human mind began.

Sigmund Freud (1856-1939),15 founder of psychiatric therapy, had embarked on a perplexed study into the turbulent world of mental illness. Early methods in treatment became somewhat controversial, which set in motion a practice in the use of drugs, in addition to the appliance of electroconvulsive therapy. During this period, the faith of many confused patients still accepted this treatment as an attempt to expel the demons from within, and over time, electroconvulsive therapy became a widespread solution to severe mental depression with improved results. The customary practice in England today is to attach electrodes to both sides of the head and transmit a series of shocks to a patient who has been anesthetized; this treatment is believed to induce a normal pattern in otherwise chaotic brain activity. According to figures provided by a British Broadcasting Corporation report16 in 2000, 2800 people were treated in England and Wales in the first 3 months of 1999. Most significantly, 59% were treated against their will. Society, in distancing itself from the use of electricity in this way, also acknowledged and exploited the electric chair as a process of capital punishment well into the 20th century, and then once again our principles fell under scrutiny.

In 1947 a decision was made to execute an internal electrical charge to a 14-year-old boy whose heart arrested during routine surgery. The scene took place at the University of Cleveland, Ohio, when Claude Schaeffer Beck (1894-1971)17 used a basic transformer as a defibrillator coupled to a 110-volt AC power supply. This instrument was hurried to the operating room along with 2 metal spoons attached to wooden handles, insulating the surgeon's hands. The initiative by Beck to administer 2 shocks was successful in saving the boy's life, and as a result, further study in the physiology of the heart was encouraged. Getting the charge right depended entirely on the technology of variable resistors to control the charge output; constant high power damaged muscles and had even broken ribs in continued attempts to defibrillate patients. Thanks to the balance of knowledge in both cardiac and electroscience, the customary exercises of cardioversions for patients are achievable. The surge of electrical power to shock individual muscle movement of the heart allows normal rhythm to begin.

Technology also produced the ultimate matchbox-sized pulse-generated pacemaker,18 which is used by countless thousands of people. First developed in 1958, bioelectric engineers used a mild stimulating current to regulate a heart's faulty sinus node, thus ensuring a normal sinus rhythm. By the end of that same year, the procedure of implanting pacemakers was frequently in demand.

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Extending Life 

Positive practice in resuscitation also spiraled as new measures continued to be developed, and television took on the role of educating ordinary people about human revival techniques. Medical series such as Ben Casey, filmed in the 1960s, became incredibly popular as repeated episodes of life and death satisfied general curiosity.

In reality and on occasion, an ambitious British surgeon would carry a sharp penknife in the top pocket of a pinstriped suit next to a red carnation for the sole purpose of performing open-chest cardiac massage in communal areas; fortunately, this radical solution was short-lived with the eventual introduction of cardiopulmonary resuscitation (CPR).

With all the ingredients in the pot, the modern-day Prometheus finally arrived in 1967, with the by-chance success of the first heart transplant19 by the South African surgeon Dr. Christian Neethling Barnard (1922-2001). The donor heart came from a young woman, Denise Darvall, who sustained irreversible brain damage as a result of a vehicle collision on December 3. Dr. Barnard arranged the procedure on that same day, and it was performed without the permission of the “Groote Schuur” (large shack) hospital in Cape Town. This surgery may have ended the career of a well-respected cardiothoracic specialist had the operation failed. The patient, Louis Washkansky, lived for 18 days, and during that time the publicity generated hurled Barnard to international fame. Presidents and even film stars from the world of make believe sensed the desire to be linked with a man who dared and ultimately accomplished the impossible—extending life! Although the technique of transplants advanced in later years with the help of improved antirejection drugs, Christian Barnard continued with his personal quest in the search of everlasting life. He died at the age of 78 years following attempts to produce an anti-ageing cream called “Glycel” (Glycosphingolipids) jointly with Swiss cellular biologists. We must raise a question at this juncture: “How could we ever value life, if we no longer feared death?”20

These days a number of persons are denied fundamental life-saving medication in fighting terminal disease, while decisions by executive governments place more value on energy issues. The importance of generating electrical power has been at the forefront of political disagreements over energy, leading some countries to wage war. Nuclear energy satisfies our electrical requirements but leaves behind quantities of the lethal plutonium, a sought-after substance used for triggering explosions of supreme magnitude, extinguishing life on a larger scale.

Our planet's natural climatic changes will no doubt inspire humankind to generate new ideas as we continue to construct technological advances necessary for survival. The energy crisis directs us toward designing equipment requiring less power, such as the more familiar contemporary compact portable defibrillator, applying audiovisual instructions that talk you through its functions.21 In addition to confirming underlying rhythms of the heart, computer software continuously analyze the patient in preparation for rapid operational practice. Defibrillation of the heart remains a journey of fact derived from fiction, moreover taxing our principles in prolonging life with or without the consent of those concerned.

Benjamin Franklin, who lived to the grand old age of 84 years, commented on our quest for immortality through his self-composed epitaph: “Like the cover of an old book, its contents torn out, and stripped of its lettering and gilding, lies here, food for worms. But the work shall not be wholly lost: For it will, as he believed, appear once more, in a new & more perfect edition.” In fact, he appears more than once as his image dominates the American $100 bill, and quite literally he held the key unlocking the secrets of electricity. These actions, inspired by natural phenomena, in addition to the countless pages of historical research by great scientists, led to the manufacture of a compact defibrillator. This convenient device is now used in most hospital departments around the world, as well as by emergency service providers, and will significantly extend the lives of millions of people for generations to come.

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References 

  1. Casino Royale [film]. Los Angeles and Culver City, CA: Metro-Goldwyn-Mayer and Columbia Pictures; 2006;
  2. The Historical Society of Pennsylvania. Web site. http://www.hsp.org/Accessed August 14, 2009
  3. The Library Company of Philadelphia . Web site. http://www.librarycompany.org/Accessed August 14, 2009
  4. Gannett H. Boundaries of the United States and of the Several States and Territories. Washington, DC: U.S. Geological Survey; 1885;
  5. The Hayden Expedition. Government explorations in Colorado. Prof. Hayden's surveys—important results of the season's work—wonders of electricity. Electricity in the mountains. New York Times. November 3, 1874. http://query.nytimes.com/mem/archive-free/pdf?_r=1&res=9B06EFDF1030EF34BC4B53DFB767838F669F. Accessed November 22, 2009.
  6. James D. Thunderclouds accelerate cosmic electron. [Physics review letters, July 8, 2009] http://physicsworld.com/cws/article/news/39784Accessed October 11, 2009
  7. History of electrostatic generators. The leyden jar. Hans Peter's Mathematical, Technical, Historical and Linguistic Omnium Gatherum Web site. http://www.hp-gramatke.net/history/english/page4000.htm Accessed February 20, 2010.
  8. Whitaker H, Smith C, Finger S. Benjamin Franklin and the Electrical Cure for Disorders of the Nervous System, Brain, Mind and Medicine: Essays in Eighteenth Century Neuroscience. Boston, MA: Springer US; 2007;
  9. The Royal Humane Society. Web site. http://www.royalhumanesociety.org.uk/Accessed February 20, 2010
  10. Pancaldi G. Volta: Science and Culture in the Age of Enlightenment. Princeton, NJ: Princeton University Press; 2003;
  11. British Broadcasting Corporation . Web site. http://www.bbc.co.uk/history/historic_figures/faraday_michael.shtmlAccessed October 6, 2009
  12. Shelley MWG. Frankenstein, or the Modern Prometheus. London,England:H Colburn and R Bentley; 1831.
  13. Green RL. The story of Prometheus. In: Tales of the Greek Heroes. London,England: Penguin Books; 1958;p. 29–43
  14. Provost JL, Batelli F. Sur quelques effects des decharges Electriques sur le Coeur des Mammiferes [On the effects of electrical charges to the heart of mammals]. Geneva, Switzerland: C R Science Acad J; 1889.
  15. Freud Museum London . Web site. http://www.freud.org.uk/Accessed October 7, 2009
  16. British Broadcasting Corporation . Electro-convulsive therapy. http://news.bbc.co.uk/1/hi/health/medical_notes/1079436.stmAccessed September 28, 2009
  17. Dittrick Medical History Center . Claude Beck, defibrillation and CPR. http://www.cwru.edu/artsci/dittrick/site2/museum/artifacts/group-c/c-8defrib.htmAccessed October 2, 2009
  18. St. Jude Medical. Pacemakers. St. Jude Medical Web site. http://www.sjm.com/resources/learnmoreabout.aspx?section=CardiacPacemakerSystem Accessed February 20, 2010.
  19. Gateway Government Information Services . Chris Bernard performs world's first heart transplant. http://www.capegateway.gov.za/eng/pubs/public_info/C/99478Accessed October 2, 2009
  20. Hazlitt W. On the fear of death. Quotidiana Web site. http://essays.quotidiana.org/hazlitt/fear_of_deathAccessed February 20, 2010
  21. Physio Control . Lifepak defibrillators. Physio Control Web site. http://www.physio-control.com/products/defibrillatorsAccessed November 20, 2009

Keith Stephens-Borg is Anesthesia Practitioner, North Devon District Hospital, North Devon, England.

☆ Section Editors: Reneé Semonin-Holleran, RN, PhD, CEN, CCRN, CFRN, CTRN, FAEN, and Andrew Harding, RN, MS, CEN, NEA-BC, FAHA

☆☆ Submit descriptions of procedures in emergency care and/or quick-reference charts suitable for placing in a reference file or notebook toReneé Semonin-Holleran, RN, PhD, CEN, CCRN, CFRN, CTRN, FAENorAndrew Harding, RN, MS, AIF, CEN, NEA-BChttp://ees.elsevier.com/jen

PII: S0099-1767(10)00066-8

doi:10.1016/j.jen.2010.02.011

Journal of Emergency Nursing
Volume 37, Issue 1 , Pages 59-63, January 2011

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