This is probably the moment when the study of defective hearts began: a day in 1899 when Canadian physician Maude Abbott found an unusual medical specimen and wondered What in the world is this?
Recently named Assistant Curator of the Medical Museum of the McGill University Medical School, Abbott was appalled at what she found. A properly organized Medical Museum was a valuable resource to a medical school of the 19th century. Students could go down to the museum and study preserved organs and cadavers to learn about the workings of the human body. McGill’s facility hardly deserved the title; it was more like a giant linen closet full of surplus body parts.
“Let’s organize and catalog our exhibits,” Abbott suggested. “Find out exactly what we have.” Her boss glanced at the calender on the wall, figured three weeks before his retirement was not the time to begin a major project, and said no. He wasn’t interested, but if Maude wanted to, go right ahead. And that was what Maude Abbott was doing when she found it.
What in the world is this? It was a heart, obviously, but it was unlike any heart she had ever seen. There were two Atriums but only one Ventricle. No, there were two Ventricles, but one was so tiny that she almost missed it. Two valves drained into the same ventricle, leaving the other one isolated. The specimen container was labeled Ulcerative Endocarditis. That was almost certainly what led to the owners death; experts have speculated that the specimen was a Cor Triloculare Biatraitum heart, a very rare defect.
No one knew anything about this heart, other than the fact that it was obviously deformed. Abbott thought of someone who might know, Dr. William Osler. Now a major figure at the new Johns Hopkins Hospital in America and one of the world’s most respected doctors, Osler had graduated from McGill. She had met him in Baltimore the year before, perhaps he would answer a letter from someone at his old medical school.
Not only did Osler answer, he seemed to know the item Abbott had asked about. Osler described the heart and referred to it as the “Holmes Heart” because it had been donated to the museum in 1822 by the Dean of the medical school, Dr. Andrew Holmes. Holmes had also documented the heart in an article that had appeared in the Edinburgh Medical Journal.
Abbott began to search for that issue of the EMJ. Finding a 75 year old medical journal wasn’t easy, but she located one. She was stunned to read that the heart had been removed during the autopsy of a 22 year old man. Someone had lived 22 years with this heart? How?
Since the heart had been “lost” for an unknown amount of time, Abbott revised the article, documented the recovery of the heart, and submitted it to the McGill Medical Journal under her own name.
But she was left with this strange heart and the thought that someone had actually lived to adulthood with it beating inside their body. It must have struggled to produce every beat. Already an noted expert on hearts who had produced a major work on heart murmurs, Abbott decided to study defective hearts in more detail.
And this could have been the starting point of Congenital Cardiology – a malformed heart floating in a sealed glass container, sitting on a shelf for over 70 years.