Closer to the Heart

For 15 seniors taking a Anatomy and Physiology class, Thursday morning, March 17, was a break from the typical review of body diagrams and study of its components. 

By 10 a.m., when some of the students normally would have been sitting in the class — perhaps learning about the heart and its functions — they had already spent an hour and a half observing an open-heart surgery at Allegheny General Hospital on Pittsburgh’s North Side.

The students, whose visit was facilitated by the hospital’s Open Heart Surgery Observation Program, gathered in an observation room situated directly above an operating table. Leaning and peering through a trapezoidal, paned-glass prism that rose from the center of the room, they obtained a bird’s eye view of the surgery — an aortic valve replacement.

“I think learning about something and actually seeing it are two different experiences,” said Megan Cass, a student who had previously observed a triple bypass surgery at the hospital. “You sort of realize how intricate every step of the process is.”

Cass, who plans to become a doctor, said she was still contemplating her career path before her first visit but afterward had decided to enter the medical field.

“I always really liked the sciences, like biology and chemistry,” she said, adding that she is equally interested in caring for others. “The (medical) field’s just so wide. If I decided I liked one thing over the other, I could really go in any direction.”

A reaction like Cass’ is one effect that witnessing open-heart surgery can have on students. But it’s not the only one.

According to Pat Wolf, who coordinates the hospital’s observation program, student reactions can range from enthusiastic to nauseated; sometimes, Wolf said, a student will take repose in a corner of the room. But that didn’t happen during the Baldwin group’s observation.

“Really, for the most part, the kids do very well,” Wolf said. “A lot of these kids are already interested in medicine.”

Wolf said that the hospital takes in student groups from 8:30 a.m. until noon four days per week. The program spans the school year between September and June. 

“We try to explain step by step as things are going on,” Wolf said. “I think they learn that it’s not really like what they see on television.

“They see the team work involved; they see professions that they may not have heard of before.” 

In the observation room, students could not hear the communication happening below. It was quiet, for the most part. The ventilation system whirred while students remarked on the surgery and asked questions of Wolf.

“Do you think they’re all dating down there?” one student joked.

“No, this is not ‘Grey’s Anatomy,’” Wolf replied with a laugh.

Kent Radomsky, who teaches the Anatomy and Physiology class sections from which the students were selected, has been at Baldwin High School for 15 years. For the past three, the school has taken students to Allegheny General for observations.

“We talk about the heart in class,” Radomsky said. But coming to the hospital allows students “to actually see in action the things we talk about.”

Radomsky said that he was interested in going into the medical field before he fell in love with teaching. Bringing the students to the hospital is a way of enhancing their education, he said.

“I love to share my passion for it with the students who take the course,” he said. “I never had this experience when I was in high school.”

The observation program at Allegheny General is provided to schools at no cost. The only expense is transporting the students, and those funds come out of the high school’s Gifted Program’s budget, said Debbie Reynolds, who coordinates that program. 

Reynolds said that Baldwin started bringing students to surgery observations because there was a high level of interest in medical professions, especially among gifted students. In addition to Anatomy and Physiology students, those who study biology or are in the gifted program often attend.

Thursday’s visit was one of four that Baldwin scheduled this year. According to Reynolds, the demand among students is such that the high school had to implement a lottery system in order to decide who will go.

“We have some students who say they are definitely interested in medicine (after the observation),” she said. “And we have some students who say, ‘no.’” 

The aortic valve replacement that the students observed was atypical in that the patient, a Jehovah’s Witness, holds beliefs that prohibit the use of blood transfusion during surgery.

The patient’s blood was collected through tubes and recycled back into the body, and the bags of blood usually suspended near the operating table were absent from proceedings. But other than that irregularity, Wolf said, students gained a sense of how the surgery generally is performed. 

Kevin Helinski, a student who plans to pursue computer science, said that he took Anatomy and Physiology to fill a science requirement because he found the subject interesting. Watching over the procedure was an eye-opening experience, he said.

“I wasn’t exactly sure how they would get past the sternum,” Helinski said. “And (I learned) how they’re tying the arteries down with non-dissolvable sutures.”

After the aortic valve was replaced and the heart was no longer arrested, the students watched it beat on its own again, pulsing around beneath the metal retractor that held the sternum open.

One member of the surgery team used a pen-like implement to cauterize capillaries, stopping blood loss. When he paused, another reached his fingers in and wiggled them to shake the heart.

The sternum would be closed using metal sutures that are about as thick as a large paper clip, Wolf explained. Later, the team would sew up the skin with normal sutures.

Earlier, Wolf used the occasion to prompt discussion about healthy lifestyles, something that she said she always does during observations.

“As you look down there at the patient, does it make you think about your own heart, or keeping your own heart healthy?” Wolf asked.

They all agreed that smoking was out of the question.

“So don’t smoke. What else?” she asked.

“Exercise,” Wolf said, parroting a student. “Eat right — what does that mean?”

“Cheerios,” one student proffered.

Walking from the observation room through the labyrinthine halls and back to the emergency room entrance, one passes a series of paintings, idyllic landscapes, trees and hillsides painted soft and blurry.

It’s almost silent. All that you hear is your own footsteps, maybe your heart beating.

In the emergency room lobby, people talk softly. You can hear the mechanical motions of the automatic door.

Outside, you walk into a cloud of noise. Traffic moves along East North Avenue. 

A LifeFlight helicopter is landing, its blades slicing loudly through the air. The gust blows back your hair.

A few minutes later, a second helicopter appears in the distance. Another emergency has already begun.