A Revelation in the Operating Room

A Revelation in the Operating Room December 20, 2020

 

Dr. Nelson at work
Russell M. Nelson, M.D., Ph.D.
Provenance of photo unknown, available online

 

But first, a new item appeared yesterday on the website of the Interpreter Foundation:

 

“Book of Moses Essays #34: Moses 1 in Its Ancient Context: Moses in the Spirit World (Moses 1:1–8)”

 

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Nelsonworld
Both the mitral valve and the tricuspid valve are shown in this Wikimedia Commons public domain diagram of the human heart

 

I’ve been very much enjoying Sheri Dew, Insights from a Prophet’s Life: Russell M. Nelson (Salt Lake City, Deseret Book, 2019), and I’ve decided to share a story from it, told on pages 68-72:

 

A Brother Lyman, a stake patriarch who was living in southern Utah, came up to Salt Lake City in hopes that Dr. Nelson could help him.  Examination indicated that the patient suffered from two principal problems: mitral stenosis and tricuspid valve regurgitation.  What that means in everyday English is that Brother Lyman had two faulty heart valves.  It was 1960; cardiac surgery was less than a decade old.  The first of the two problems could be surgically repaired at that time.  But the second, the tricuspid valve, could not.

 

Russell Nelson was still a young physician.  He had only performed seventy-three heart operations by that stage in his life  For the period, that was a significant number, and he had been a pioneer in the field.  Today, though, a cardiothoracic surgeon will have completed three hundred or more such operations by the end of his or her medical residency.  Moreover, Dr. Nelson had performed only eight surgeries on the mitral valve.  And the tricuspid valve was uncharted territory.

 

Dr. Nelson declined to operate.  He felt it neither responsible nor ethical to subject a patient to the rigors and risks of open heart surgery when it wouldn’t actually solve the problem or save a life.

 

Brother Lyman left, disappointed, but returned later that day to ask a second time.  And, again, Dr. Nelson said No.

 

But Brother Lyman returned a third time.  With strong emotion, he said:

 

Dr. Nelson, I have prayed for help and have been directed to you.  The Lord will not reveal to me how to repair that second valve, but He can reveal it to you.  Your mind is so prepared.  If you will operate on me, the Lord will make it known to you what to do.  Please perform the operation that I need, and pray for the help that you need.

 

Later, Dr. Nelson — by then an ordained apostle — would explain that “his great faith had a profound effect upon me.  How could I turn him away again?”  So the date of 24 May 1960 was set for the operation.

 

Don’t think I didn’t pray about that procedure.  I prayed and prayed and got absolutely zero.  As we opened Brother Lyman’s chest, my resident, Dr. Maunsel B. Pearce, looked at me and asked, “What are you going to do for his tricuspid regurgitation?” and I said, “I don’t know.  I have no idea.”

 

They first took care of the obstruction in the reparable mitral valve.  Then they exposed the second valve and found it intact.  But it was badly dilated.

 

I could put my whole hand in his tricuspid valve orifice instead of three fingers, which is what it should have been.

 

Still, the tissue was good.  Other than the enlarged hole, there was really nothing wrong with Brother Lyman’s tricuspid valve.  But that enlargement was a serious, unsolved, and seemingly insoluble challenge.

 

It was while Dr. Nelson surveyed this situation that he had a distinct impression:  “Reduce the circumference of the ring.”  His immediate thought was: “I don’t know how to do that.  If it were a pair of pants, I’d tighten the belt.  But you can’t put a belt around the heart.”

Then a diagram appeared in his mind showing him where to place sutures to essentially do a series of tucks and pleats that would reduce the circumference so that the valve tissue would cover the hole.  It was roughly comparable to cinching up the belt on a pair of trousers worn by someone who has lost weight.

“I still remember that mental image — complete with dotted lines where sutures should be placed,” he explained years later.  He completed the repair on the tricuspid valve as it was diagrammed in his mind.  As the surgical team tested the valve and concluded the procedure, Dr. Pearce said, no doubt speaking for everyone in the room, “It’s a miracle.”  Russell responded simply, “It’s an answer to prayer.”  He knew exactly from Whom the help had come.

Later, Dr. Nelson admitted:  “I had no idea what I was going to do as I began that operation.  Today there are all sorts of ways to reduce the circumference of the ring, but I knew none of those procedures at the time.  I had not experienced pure revelation like that, surgically, before.  But that was pure revelation.  I had that man’s heart open, and if that revelation had not come, he would have died.” . . .

Precisely as Brother Lyman had declared at the outset, it was Dr. Nelson’s rare combination of knowledge and ability to receive inspiration that led to this surgical discovery — and success.  Brother Lyman lived many more years.

It all began, however, with the faith of the patient that inspired his surgeon to try.  “It was a step into the dark,” Russell said.  “I thought about Joshua coming back into the Promised Land with his people and crossing the waters of the River Jordan at flood time.  It wasn’t until they put their feet in the water that they saw the hand of the Lord manifest in their lives.  And that is what I experienced that day.”

 

The medical significance of Dr. Nelson’s surgical innovation is laid out in Austin A. Robinson and Curtis T. Hunter, “Discovering a Surgical First: Russell M. Nelson and Tricuspid Valve Annuloplasty,” BYU Studies 17/3 [1977], 319-337.  At the time their article was published, Austin A. Robinson was a resident in the Department of Internal Medicine at Yale University School of Medicine and Yale–New Haven Hospital, and Curtis T. Hunter was Associate Clinical Professor of Surgery in the Division of Cardiothoracic Surgery at UCLA as well as Co-Director of Cardiac Surgery at St. John’s Health Center in Santa Monica, California:

 

Nelson’s annuloplasty technique would prove a remarkably effective solution to the problem of tricuspid regurgitation, one that would anticipate problems with contemporary approaches years before they were appreciated by the surgical community at large.  In the intervening . . . decades medical science has progressed considerably. . . .  However, as a group of modern surgeons recently noted, the message impressed on the mind of a scrubbed-in, nervous surgeon as he peered into a dilated right atrium in 1960 has remained a fundamental principle in surgical correction of tricuspid insufficiency through the present day: reduce the circumference of the ring.  (cited on pages 71-72)

 

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Reading of this experience early in the medical career of the man whom Latter-day Saints around the world revere today not only as the President of the Church of Jesus Christ of Latter-day Saints but as the Lord’s chosen prophet, seer, and revelator, I could not help but recall certain ancient and modern precedents:

 

According to the Hebrew Bible, the Lord not only ordered Moses to construct the tabernacle in the wilderness but, as recorded in Exodus 25-27, gave him specific instructions on Mount Sinai as to its details.

 

“Look that thou make them after their pattern, which was shewed thee in the mount,” he said to Moses (Exodus 25:40).  The sanctuary should be constructed “according to all that I shew thee, after the pattern of the tabernacle” (Exodus 25:9).

 

The Lord also gave specific directions to King David for the building of the temple that his son Solomon eventually constructed in Jerusalem:  “The Lord made me understand in writing by his hand upon me, even all the works of this pattern” (1 Chronicles 28:19).

 

So, too, in the Restoration.  The Lord revealed the details of temple construction to his modern servant, Joseph Smith, said Joseph’s prophetic successor, Brigham Young:

 

The Church, through our beloved Prophet Joseph, was commanded to build a temple to the Most High, in Kirtland, Ohio.  Joseph received not only revelation and commandment to build a temple but a pattern also, as did Moses for the tabernacle and Solomon for his temple; without a pattern, Joseph could not know what was wanted, having never seen a temple and having not experienced its use.

 

For a brief discussion of that fascinating and significant story, see my 2015 Deseret News column “The inspired plans for the Kirtland Temple.”

 

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I’ll be looking for it, so I hope that the sky will be clear:

 

“Do you see what I see? Planetary alignment to create a ‘Christmas star’: Astronomers have floated the idea that a similar conjunction of planets could be a scientific explanation for the star of Bethlehem in the Christmas story.”

 

 


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