Authors: Richard Hollingham
The first thing he worked out was how to stop the flow of blood
without damaging the vessel. Using bands of cloth, he would gently
squeeze vessels shut and successfully hold back the blood. If he
rolled back the edges of a cut vessels so that they resembled cuffs,
he could sew the cuffs together without the usual leaks or damage
that led to clots. But it was Carrel's final discovery that was his most
masterful. He called it the 'triangulation method' of suture.
First, he joined the ends of the blood vessel together by placing
three stitches equal distances apart around its edge. For each stitch
he left a short piece of silk thread attached. The blood vessel was
thus joined at three points. Now here's the clever bit: when he
pulled tight on all the threads at the same time he created a straight
line between each one. He had turned the circular vessel into a
triangle. He could then sew along the straight lines between the
threads. It was a remarkably simple idea, but extremely effective. He
had overcome the problem of trying to sew around a circular vessel
by doing away with the circle. Once he had sewn along the first line,
he moved on to the second and the third. When he released the
threads, he was left with a neat sutured join in the blood vessel. It
was such a simple technique that even the surgeons he held in
contempt would be able to manage it.
It was no great surprise to anyone when Carrel failed to receive
promotion at the hospital in Lyon, and it was probably best for all
concerned when he left for the United States to pursue his research.
In Chicago he teamed up with Charles Guthrie, a similarly obsessed
medical researcher, and together they improved Carrel's technique
with ever finer needles and thread. They stitched severed veins and
arteries, and joined the two together. Usually the veins and arteries
belonged to a dog, sometimes a cat, or occasionally a guinea pig.
Some animals survived the procedures, some didn't. Carrel was
unsentimental about any creatures that might suffer in the name of
medical progress.
*
Armed with his new surgical techniques, he had
a much greater purpose in mind: transplantation.
*
The animals would have been anaesthetized, and there is no evidence that they were
mistreated. Whether the experiments themselves amounted to mistreatment is a matter for debate.
Rockefeller Institute for Medical Research,New York, June 1938
Dr Alexis Carrel was now considered one of the world's most
eminent and famous scientists. Surgeons, politicians and celebrities
came to seek his advice or expert opinion. This month he was even
on the front page of
Time
magazine. The reporter had been lucky to
secure an interview – Carrel was usually hidden away in his laboratory,
guarded by his protective secretary, as devoted to his work as
ever. Since winning a Nobel prize in 1912 for his work on 'Suture of
Blood Vessels and Transplantation of Organs', Carrel had
conducted thousands of transplantation experiments. He had transplanted
limbs from dogs, kidneys from cats and testicles from
rabbits. He had taken lungs from guinea pigs, heads from dogs,
ovaries from cats and thyroids from kittens (the attrition rate of
kittens was particularly high). He had swapped the leg of a black
dog with the leg of a white dog and replaced the head of one dog
with the head of another.
*
He had grafted kidneys, livers and lungs;
he had transplanted organs, glands and legs. He had swapped skin,
rearranged veins and added hearts. No animal, it seemed, was safe
from Carrel's increasingly bizarre research.
*
Carrel wasn't alone. In 1954 a Russian transplant surgeon, V.P. Demikhov, went even
further, transplanting the head of one dog on to the back of another to create a monstrous twoheaded
creature. This disturbing experiment was brought to an end after the two heads started
fighting each other.
Carrel's laboratories were every bit as sinister as the experiments.
Built on the top floor of the Rockefeller Institute, they
were reached from an anteroom by a narrow spiral staircase.
Here Carrel's fanatical team of researchers worked in sterile
windowless labs. They were lit by roof lights and electric bulbs in the
plainest of shades. Everything else was in varying tones of black –
from the matt black floors to the bare grey walls. Even the cloths
on the operating tables were black. There was no colour, no
dust and no reflections. Dracula couldn't have conceived a more
suitable lair.
The outfit the scientists wore might have been designed by a
fetishist. The researchers were known as the Black Gang. They
worked in black gowns and black trousers. Their heads were
covered in black linen balaclavas. The headgear was square in shape
– like a welder's helmet – with only a narrow slit for the eyes. On
their hands the scientists wore thick, black rubber gloves. These
shadowy, featureless men would be the last thing most of their
experimental animals ever saw.
There was a good reason for all the black. Carrel had designed
the labs to minimize reflection and glare from the lights – vital, he
believed, to help the researchers see what they were doing, particularly
when they were working on such tiny bodies (such as those of
kittens, rabbits and guinea pigs). The all-enveloping outfits were
designed to minimize infection. Joseph Lister would have been
proud of the lengths to which Carrel had gone to keep the place
aseptically clean (see Chapter 1), although Lister might have
preferred a cheerier colour. The odd thing was that the only one
who wasn't dressed entirely in black was Carrel himself. He had
taken to wearing a peculiar white hat that resembled a bandage
stretched over his bald head.
In the late 1930s most of Carrel's laboratory was devoted to his
'perfusion' experiments. He had gone beyond simply transplanting
organs to removing them altogether. His aim was to keep organs –
eventually human ones – alive and functioning in a totally artificial
environment. For the last three years he had been working with his
close friend, Charles A. Lindbergh, the first man to fly across the
Atlantic. Although it might seem an odd partnership, the celebrity
aviator and eccentric French scientist had much in common.
Lindbergh shared many of Carrel's political views, they were similarly
driven, and both were ambitious to advance medical science.
In 1938 Carrel and Lindbergh were celebrating the publication
of a book they had written together,
The Culture of Organs
. In it they
outlined the 'cultivation' of organs using the Lindbergh pump. The
pump was designed to bathe living tissue in nutrients to keep it
alive, and looked exactly like the sort of thing a scientist working in
a sinister black laboratory would devise. The contraption consisted
of a series of pumps, bottles, gauges, valves and odd-shaped glass
flasks all connected with lengths of rubber tubing.
The pump, the culmination of years of effort, was really an early
type of heart-lung machine – it kept organs alive, nourishing them
and providing them with oxygen. At around the same time, surgeon
John Gibbon (see Chapter 2) was also developing a heart-lung
machine, only his aim was to keep entire organisms alive – eventually
humans – while life-saving surgery was carried out. By the late
1930s Gibbon could sustain the life of a cat. In comparison, Carrel's
motives were far more scientifically detached. He was able to sustain
the life of a disembodied cat's heart. Improving treatments or saving
people's lives wasn't enough for him. He had far loftier ambitions.
For a start, the Lindbergh pump was to be used to study organs
outside the body. It allowed Carrel to examine the nutritional
requirements of a particular organ, or study the chemical processes
taking place. He could assess the production of insulin in the
pancreas, urine excretion in the kidneys or the life cycle of cells.
With the techniques he developed, Carrel took the creation of
'cultures' of living tissue to a whole new level. On one bench in his
black laboratories he grew cells taken from the heart of a chicken
embryo. So far he had managed to keep successive generations of
these cells alive for twenty-six years.
This was all very well, but it was only incidental to his life's work
on transplants. Carrel planned to remove damaged organs from a
patient's body – a diseased kidney, for instance – place the organ in
the pump apparatus and treat it in this artificial medium until it
healed. Once the organ had been cured, he would replace it in the
patient using the techniques he had first developed in Lyon. It
didn't even need to be a kidney – it could be a leg, an arm or even
a brain. If Carrel's laboratory was nightmarish now, imagine what it
would be like lined with bottles of bubbling glass jars filled with
dismembered limbs, diseased hearts and cancerous lungs.
But even this wasn't enough for Carrel. In what he called his
'new era' of surgery he foresaw a time when human organs could be
grown in the lab and used to manufacture drugs such as insulin. He
never made it clear who might provide these organs, but the ethics
of his work always came second to scientific progress. As the reporter
from
Time
magazine suggested, Dr Carrel was 'looking for the fountain
of abundant, replaceable age'. But probably not for everyone.
Carrel's collaboration with Lindbergh underlay a much deeper
moral purpose. The two men were out to change the human race.
Three years before, in 1935, Carrel had published his philosophical
treatise
Man, the Unknown
. It was widely read and drew acclaim
from scientists, statesmen and intellectuals around the world. In it
Carrel outlines his views on everything from future scientific
progress to the role of women in society. He was convinced that
man was in a state of physical, mental and moral decline and
needed to be 'remade'.
'For the first time in the history of humanity, a crumbling civilization
is capable of discerning the causes of its decay,' Carrel
wrote. 'For the first time, it has at its disposal the gigantic strength
of science.' The recent political and economic turmoil had demonstrated
the failings of democracy; he wanted to see a new social
order. Countries should be run by a ruling elite, their standing in
society determined by biological worth. Man had the power to transform
himself, to control his genetic destiny. Only the strong should
be genetically perpetuated.
The irony that a short, balding, myopic Frenchman (with
different-coloured eyes) should be calling for the creation of a
master race was lost on Carrel. But his call for the introduction of
eugenics was well received. The idea that only the genetically
'superior' should be allowed to breed (or encouraged to breed) was
something that many in power had been thinking for some years. At
various times everyone from Winston Churchill to George Bernard
Shaw and H.G. Wells had flirted with the philosophy of eugenics. In
six American states laws had been in place for decades to allow the
forced sterilization of the insane and 'mentally deficient', and in
Germany Carrel's scientific standing added credibility to the philosophy
of the Nazi government. In the German edition of his book,
he even went so far as to endorse Nazi policies.
Carrel probably had little knowledge of what was really going
on in Nazi Germany, despite having travelled and lectured there
in 1936. By the mid-1930s eugenics was at the heart of German
government policy. Hitler was oppressing opposition groups,
people of Jewish faith, ethnic minorities, homosexuals and
gypsies (among others). The government had set up concentration
camps, as well as secret extermination centres where the mentally
and physically disabled were being killed. At the same time women
of Aryan descent were being encouraged to have as many children
as possible.
However, while Carrel advocated preventing the criminal or
insane from breeding, he shied away from destroying 'sickly or
defective children as we do the weaklings in a litter of puppies'.
Instead he felt the only way to 'obviate the disastrous predominance
of the weak is to develop the strong'. Among his suggestions was the
proposal to remove the sons of rich men from their families so that
they could 'manifest their hereditary strength'. And although he
believed childless women were 'not so well balanced', unlike many
misogynists he was a firm believer that women should be highly
educated, 'not in order to become doctors, lawyers or professors,
but to rear their offspring to be valuable human beings'. As for his
treatment of criminals, those who couldn't be conditioned with a
whip should be 'humanely and economically disposed of in small
euthanasic institutions supplied with proper gases'. You can see why
the Nazis were so taken with his views.
Not everyone was impressed. There were rumours that 'occult
practices' were taking place in Carrel's black laboratories. Even that
Lindbergh was planning to have his heart removed so that it could
be replaced by a mechanical device of Carrel's creation. This wasn't
so far from the truth: the two men
were
operating in a scientific
hinterland. Lindbergh was fascinated by questions of life and
death, and had contemplated immortality. Carrel was a believer in
clairvoyance and telepathy, and an advocate of the power of prayer
(he even wrote an article about it for the
Reader's Digest
).
On 28 June 1938 Carrel was sixty-five years old and the strict rules
of the Rockefeller Institute meant that he was forced to retire. For
someone so passionate about his work, this was incredibly frustrating,
but perhaps now was the time to realize his life's ambition and set up
his own institute devoted to the study of man. An institute that would
build on his theories outlined in
Man, the Unknown
. An establishment
that would set mankind on a triumphant path to the future.