Was Gabriel Brownstein born under an unlucky star, or the opposite? A fifty-four-year-old novelist and teacher, Brownstein suffers from a rare and strangely literary-sounding congenital coronary syndrome known as the tetralogy of Fallot, a perfect storm of coronary defects that includes a hole in the center of his heart, a narrowed pulmonary valve, a displaced aorta, and an enlarged right ventricle. Named for a nineteenth-century French physician, the condition was long considered untreatable and sufferers—called “blue babies” for the bluish cast that poor circulation gives their skin—rarely survived adolescence. In The Open Heart Club, Brownstein relates the biography of his heart problem, and a lot more.
The Open Heart Club charts the history of congenital heart defects and of the medical science that arose to comprehend and ultimately correct them. Brownstein delves into the Europe of four centuries ago to serve up lively accounts of groundbreaking physicians like William Harvey, who studied animal physiology and theorized that blood circulated through the body—an idea his contemporaries considered blasphemous—and Nicolaus Steno, a Danish polymath who first described the tetralogy, and whose research, delivered in lectures to large audiences of medical students across the continent, dramatically advanced the study of coronary anatomy. These Reformation-era anatomists, driven by furious curiosity about the workings of the heart, held that to know nature was to know God—that “one sins against the majesty of God,” as Steno wrote, “by being unwilling to look into nature’s own works.”
Brownstein rounds out the saga with a surprisingly diverse cast of modern characters. We meet such figures as Vivien Thomas, a Black medical technician who achieved prominence at Johns Hopkins in the 1940s—despite being refused use of the main hospital entrance and having to drink from the “Colored” water fountain—and who devised a shunt that enabled “tet” patients to survive. Or Maude Abbott, a McGill University medical museum curator and disciple of famed doctor William Osler, the father of modern medical education. Denied admission to med school, Abbott nonetheless managed through sheer persistence to become the world’s foremost expert on congenital heart deformity, publishing (in 1936, at age seventy) The Atlas of Congenital Cardiac Disease, a pioneering text in pediatric cardiology that Brownstein says “literally saved my life.”
The story of advances in cardiac care moves forward via relentless resourcefulness and DIY improvisation. Vivien Thomas, known for fashioning spatulas for home cookouts out of surgical clamps, invented an array of specialized instruments specifically for pediatric cardiac surgery. The developers of a blood oxygenator to facilitate open-heart surgery jury-rigged the device using a dairy pump and a coil of beer-keg tubing. The Open Heart Club sets out to bolster your faith in medical science and in progress, especially the American, greatest-generation variety—hailing the advent of open-heart surgery in the 1950s, for example, as “a postwar American invention as miraculous as space travel.” Brownstein provides a catalogue of innovations and breakthroughs: cardiac catheterization; heart-bypass surgery; the pacemaker; the implanted defibrillator. They all add up to a lot of lives saved. When the author was born, in the early 1960s, congenital heart disease was one of the top ten causes of death in the United States. Today, 85 percent of children with defects survive.