 Good morning and good day to everyone. I would just like to first begin by stating Appreciate very much being a part of the program today leading with the heart with high prominent relevance to women in medicine and perfusion and I'll do my best to make a tribute to their legacy and not disappoint and as we begin the presentation uh, I would like for you to uh recognize the fact I have no declarations and I use may ought here the goddess of truth justice wisdom and so on to uh, kind of symbolize the female emphasis history teaches everything including the future is the quotation by lay martin on and he stated that trends in and events such as Economic social cultural so on and so forth Not only connect The past with the present but the past with the future as well And I hope you draw that conclusion by the end of the presentation I've tried to do an effective job at illustrating that point and women as healers uh, is something that uh, you really can zoom in on for Their contributions to medical history as gatherers They founded agriculture They also understood the botanicals for not only healing purposes But for nutritional, uh, overall health needs and then the tomb of Shubat of air uh, contain clay biscuit pads That had a approximately around 800 prescriptions and surgical tools along with flint and bronze uh instruments Her ornate headdress is on display at the British Museum and you see the emphasis indicating botanical healing symbols in the leaf and uh, plant-like structure And it might be notable and interesting to some to uh Here in the 1920s excavators analyzing the geologic rock formations and so Arrangements and so on and so forth believed the site Revealed evidence for the great flood of the book of genesis and the epic of Gilgamesh Plenty the elder is uh known for having made the following quote Women should be as quiet and inconspicuous as possible in their business of healing So that they Are so that after they are dead No one would know that they ever lived and they very nearly accomplished this task until you uh Reach the point that uh scholars and So and so forth can decipher the tablets of creed It's the oldest known medical text and anticipated to reveal prominently the role of women in medicine from This ancient text and then if you look at 2600 bc repression of women as healers Emerge with semitic invasions of Sumer and then around 1000 bc Women it's women were excluded from education 700 bc Women neither cited as were neither cited as scribes or doctors And then in 620 ad uh Aslamia was the first female nurse and surgeon in the aslamic world which is Very uh deep in their history And then in 1540 ad henry da proclaimed No carpenter smith weaver or women Shall practice surgery He also granted the charter the company of the barbers And women were barred from the organization There were many first of course and believe me My attempt today is not to recognize every single one of them because you can imagine what a Daunting task that would be but first around europe and asia In 1873 the first woman was admitted to the british medical association 75 Madeline bray was the first french woman to obtain a medical degree And then in yoshi and gonguli were the two first indian female practitioners of western medicine And hildegard of bingen was germany's first female physician And it's notable to comment that many of the women from europe Although barred continued to practice surgery and medicine And in some instances they were educated at the Women's medical college in philadelphia to attain their education and training And then in 1474 da vinci Rendered a famous painting of hands in art And it's possibly the lost Art of the lady of lichtenstein We're not sure and the most elegant the most exquisite drawing of the hands in the history of art and and to the peak of human skill and If you look at history and its Importance of women The quote states the ideal Surgeon should have the eye of an eagle the heart of a lion and the hands of a woman And that's from a 15th century english proverb and I certainly Don't associate dr. Cooley with Anything He was more talented than Practically just about anybody i ever worked with his hands and To many of the surgeons in our industry are god's gift to humanity and i believe that whole heartedly The birth of our profession And the fall of the first domino took place around 1813 to 1953 The french revolution is illustrated here in the art form with unfortunately the Decapitation of uh louis the 16th at the beginning of the french revolution in 1793 It's speculated that le galois was uh in School at the time and could see the courtyards where these executions took place and drew many thoughtful conclusions related to if you could Possibly develop artificial circulation and support the human body He was the first to propose such a Concept and idea and by 1828 james k Showed that contractility of muscle Could be restored by Perfusing with blood and yet you you have to note here. They're talking Surringe kind of like embalming syringes so to speak That were utilized for small quantity perfusion laboratory experiments The door hinges to pivotal moments in our history uh could be stated That beginning in 1858 to 1885 we saw the precursors and the Origins of isolated limb perfusion x vivo perfusion bubble and film oxygenators and brown sequad as you can see Use limbs of guillotine prisoners to conduct his studies and we had a kind of brutal beginning But thank god morals and ethics changed and were not uh In that state any longer and uh biologic oxygenators emerged this is where clarence waltin lelly high developed his concept of Cross circulation in 1890 the first Cross circulation experiment was performed by fritter it and uh, he joined the carotid arteries of two dogs So lelly high kind of thought the heart lung machine was too complicated when he witnessed clarence denise's introduction in 1951 Which uh resulted in a very disastrous situation mustard applied the use of Biologic oxygenators and you'll see that in a moment So I put this slide in this morning thinking it might be advisable to call attention to people There is sensitive content about to uh be revealed And yet it is medical research. It's uh ethical to try and implement new technology on our human subjects Having first step time in the laboratory. I run these two videos concurrently You get the pleasure of hearing music from 1947 Out of holland and dr. Youngblood and i'm going to abbreviate these because uh the presentations Are about four minutes and I don't want to consume that much But both of these systems used the dale schuster pump, which was a diaphragm pump and it Utilized as you can see the compressibility of a diaphragm and contain glass cases and uh in much in william mustard's case You see the uh rhesus monkey longs They cost only 40 dollars And so he felt like that was Something that he could Develop and evolve if you see the female perfusionist. I don't have her name but operating the uh system there and The lungs had to be changed every 10 minutes because after such a period of time they would Become exhausted and uh no longer functional But if you look at uh the progression through the netherland film in 1952 He had his third machine, which was supposedly smaller and then later on you see A dog that had been operated on and this is 1952 Uh and this is two days after the operation. So I think uh, that's incredible. I don't think I would uh recover that quickly, but I hope you enjoy the very birth of our profession in the form of these videos From 1855 to 1928 you see the development of a necessary component the peristaltic heart lung pump that uh ultimately prevailed in the uh beginning of our technology and the contributions of michael de backey Were uh many but this one may have been his most monumental the birth of rapid infusion systems, which Gavin utilized this technology to apply his uh Heart lung machine and develop it the del shuster pump proved to be Too small to support larger children and certainly adults de backey Used the system for transfusion in 1934 Terabinsky in moscow just to illustrate from europe to russia to america all around the globe people were trying to respond to the need for repair of congenital heart defects and then Ultimately in the mid 1960s transition into the adult population, but this is a 1934 experiment in moscow And you see a female assistant is working with uh terabinsky in that setting This slide is uh the early oxygenators. I just created a menagerie here You see the game changer in the helical coil By richard the wall on the upper left and then coolly coffee pot in the center and uh The big oxygenator on the right upper Photograph is the brompton membrane, which actually was uh the system utilized in the very first successful ECMO procedure in 1971 on an adult and then Aki scenic on the lower left his roller disc oxygenator viking bjork's roller disc oxygenator in the center, which was the precursor and uh conceptual idea that K and cross used to develop their disc oxygenator on the lower right so Trailblazers were many among uh the women in medicine Nonland larger than padmabati and uh winger from uh atlanta Both were uh very prominent in uh inserting women into the fold in cardiology Padmabati was the first woman cardiologist in india and in 1953 developed the first cardiac clinic And cardiac catheterization lab and uh winger Was so prominent. She's still uh professor emeritus at emory university in the department of cardiology Mara logan is another prominent figure in 1943. She was first african-american woman to perform open heart surgery They stayed in uh their historical accounts that it was the not such operation in the world I cannot in all the historical uh research that I have attempted on her Uh reveal to you what the procedure was there were many options that I looked at But everyone canceled out so one day maybe I can find that out And you can't talk about women in cardiology and cardiac surgery without Certainly the mention of helen tassig helen tassig proposed the idea of uh developing a shunt which became known as the Blaylock tassig Thomas shunt And for treatment of blue baby syndrome in children with cyanotic congenital anomalies and you see some of the Awards that she was presented in uh life as she deservedly Uh Very prominently deserved Recorded history states Mary Gibbon Or Maley as her friends and family referred to her on May the 6th 1953 conducted the first successful use of the heart lung machine. She's the undisputed first lady of perfusion and the first perfusion is and uh, I had the pleasure of Developing a dvd And dr. Gibbon states in this dvd the last lecture he gave at our institution In 1972 three months before his death He stated that Mary was a very expert perfusion operator This the picture you see in the center is a reenactment that took place one month after this procedure He would not allow a Camera in his operating room, but uh, dr. Dobel one of his surgery residents took a photograph It's not the highest quality, but it's the only photograph of that historic day And he stated at the 50th anniversary That uh had Gibbon known he took that picture. He would have been Tossed out of the residency program and on the right you see leroi ferries and charlie reed presenting married with honorary membership in the newly founded Society uh, uh the american society of extra corral circulation and uh, if you look at all these ladies beginning with maldabbit in the 1930s who published a monumental atlas on congenital heart defects, but all of these women here made Enormous contributions and you see some of the topics on the right there To the field of cardiology and cardiac surgery and they continue to do so today Nina star brownwald is a figure that many of you may not be aware of She was the first at the age of 32 years On march the 11th 1960 perform the first mitral valve replacement in a human And she went on to pioneer tissue culture techniques and refined pacemakers, so this lady was a very monumental figure in our past Jane somerville is a cardiologist from the united kingdom and who participated by managing the first heart transplant in the uk she's photographed here with uh Donald ross who conducted the procedure and went on to develop homograph they already Valve replacement as all of us know She was very prominent in working with him She's pictured here in the center kind of the black checkered dress so The door is open an urgent need of rises And that being cardiovascular profuseness the surgeons had many problems and complications with Surgery residents running the heart lung machine because they were more interested in the surgery procedure itself at not necessarily the Do diligent monitoring required for The heart lung machine and the related technology and you see the first simulation here in paris france at a conference in 1951 young blood is demonstrating his system at that meeting and You can't overlook the beginnings in america of cardiac surgery dating in 1902 luther hill who sutured a stab wound in a kitchen inside a small shack with the use of borrowed lanterns for light and lexus correll who in 1908 by direct means of transfusion you see the photographic image on the bottom right He connected a five-day-old child to the father for Blood transfusion and remembered this is before blood typing and cross matching was conducted Fortunately, he was the correct blood type and correll went on After this procedure, which was the first in the world to be the honorary guest at her 21st birthday party But yet the station wagon is what i want to emphasize here or okay and frederick cross Utilized the station wagon on A date in 1956 when they scheduled two procedures using their disc oxygenator one Was utilized at a hospital In the morning they purposely scheduled a procedure at the second hospital At another location so that if things went bad on the first one which it did Then they could get to the second one and begin that procedure without news traveling That fast in this period and fortunately the second procedure went great And dr. Killie told the story of he and arthur bell in 1956 loading up his station wagon driving over to bentob hospital and Taking care of the patient And as he stated in this story in the account and i think it's 100 000 open hearts where he expressed this story arthur bell almost fell out of the back of the Station wagon in attempt to keep it from crashing out onto the road notice the women in perfusion history and You're going to see the prominent row that they played Here's a 1957 photograph in Venezuela where dr. Cooley is Pictured here with maria paris Uh, they conducted an asd closure on a 14-year-old girl And you see the cleveland clinic in the lower right in this same period when they launched their cardiac surgery program Robert gross who needs no introduction by me to his contributions Most of you will know that that he worked with marie dresser who is pictured on the left here for 30 years That's his scrub nurse And his perfusionist was gene luke. I don't have a photograph of her, but yet He transitioned from extra cardiac surgery to intra cardiac treating children at bolstin children's hospital Dwight harkin Utilized the disc oxygenator his perfusionist pictured on the right in this photograph was scottie fosberg Dwight harkin could be very abrupt as stated by some surgeons in the operating room In one day a fateful day. He got upset about something. He tossed a surgical instrument Behind his back and hit the disc oxygenator Breaking the glass Fortunately, it was in the earliest period of the procedure and they could clamp off and Scotty had to run over across town to get another disc oxygenator Bring it back set it up in primate and then they can conclude the procedure Here's the 1960s photograph Uh, I title a bottle of bud, please This is a reminder Of my introduction into cardiac surgery when the blood was supplied in glass containers Eventually they supplied them in uh Plastic uh containers as you know today, but this is a female perfusionist operating the disc oxygenator And I don't have the name the terry might know And here again is another picture in the 1960s of texas heart issue and the disposable plastic sheet oxygenators The travenal bag in the uh model 6lf and 2lf and then the rig bag over on the left I had the privilege of running all three in my training at texas heart chris clay Found the travenal 2lf and the rig bag in the pump storage room and asked me would I be Willing to run them. I said absolutely as long as she was present And she was and she coached me very well because we had had no training on those two oxygenator We did train on the 6lf in the adults Donate Friedman is pictured here in the very first heart transplant that took place by christian bernard in South africa in 1967 She highly anticipated the call that she received on that day at 10 p.m. And then very uh prominently described the worldwide frenzy that ensued as you can imagine In poland in 1980 you see uh dr yorosi And she's running the heart lung machine At her institution Um, I don't know what the procedure was but yet it was the first in poland women taking the lead as you can see With the mal rose heart lung machine on the left and the perspex oxygenator a female perfusionist operating the system And it became traditional to place a rose on that heart lung machine in his procedures and then at the Center photograph you see in new york in rochester The pump is surrounded by nothing but women operating the disk oxygenator and on the right as well as well At the national institute of health And then you see dr. Helms were Surrounded by three women I don't know if they're in the laboratory here in this photograph or in the operating room at Cincinnati children's hospital, but he was among the first to Utilize the heart lung machine to treat congenital heart defects And everyone at texas heart knows the legend and history of mary martin I had the privilege of meeting her once or twice And uh, she's pictured here Operating the coolly coffee pot Which terry crane Can certainly tell you more technologically about than I can because I never saw it in action Other than on a video that he Supplied me and here you see the progression of the oxygenators which richard de wall Developed from the left the gang changing oxygenator the de wall helical coal revolutionized the introduction of the possibilities of a bubble oxygenator and cardiac surgery and then The change to the travenoff sheet bag And then the bitly temp trawl on the right and black and white The color photograph is the fourth and last oxygenator that I know of that he developed Which was the bitly tan oxygenator which many in the audience will Recall from their past and the can of defoaming a spray I never had to use it, but we always had it available in case the oxygenator started foaming Here's a lady that many of you may not know Betty Stevens she worked with albert star at the university of oregon in portland developing the star edwards heart valve along with Lowell edwards edwards last census today She would Be in the operating room dr. Star would uh size the annulus of The valve that they're going to replace and then she would sell the sewing ring on to that Artificial annulus or implantation. She's pictured here. She was a perfusionist and very adept at perfusion She's pictured here seated beside carmen gianca musi who was a past president of the american academy You can't go to houston and not talk about madeline massingale Bell she was very prominent in the development of our societies and prominent in establishing ethics morals and guidelines in our Very early days. She's pictured here with calvin scott who was also a perfusionist and very A wonderful man who I had the privilege to know and meet He was a past president also john callahan is pictured here uh in 56 Conducting the first surgical Uh cardiac procedure in alberta surrounded by nothing but women And here's michael debakie in the same sense You see on the left a female perfusionist operating the heart lung machine and disc oxygenator And then on the right you see mary martin with her hands gesturing a lot of anticipation I think that's when they did the first ventricular assist device implantation in 1964 At texas heart you see the uh Happy happy happy statement texas heart is one of the happiest places i know They have graduated in history 900 graduates 330 332 of which to my count Were women about 37 percent and I just love The photograph of charlie and dine clark here looking at their book that we all Utilized in our Education Chris clay on the right gave the eulogy At the academy meeting for dine clark and then you see on the lower right with bud frazier three prominent people that Are very significant to us and In the final uh photograph that i revealed to you We applaud the american academy. They had three Charter members dine clark patty gash and teleira hill who Uh Along with all these other women you see photograph there. This is in 1984 at the fourth academy meeting and uh I think that this is a sign that We are open and freely willing to Be receptive to women In our profession and then the career conditions today from a trail blaze by these wonderful women Notice the american board survey associating 78.9 percent of the board certified profusals responded, which is a wonderful Sampling and yet you see the disparity that emerges In age from approximately around age 30 to 39 to 50 to 59 uh greater separation in The male-female ratio and of course that's to this sampling side but It's revealing to us In many ways and we can't take our eye off the ball the need for women In perfusion and you see more of the same here by gender The percentages of women through uh 16 to 20 and then greater than 25 years and the separation that occurs and I don't know if that's due to Establishing and family getting married maybe Having children and things like this, but there's a lot of reasons why this can take place This this slide kind of disturbed me 90 perfusion students graduating Had the or three percent of the sampling pool felt they had a Negative experience in their education. I just uh can't imagine that And it's very important something that we need to call our attention to but yet that's for program directors and the training uh programs to address I certainly couldn't but I think we need to be alarmed by that And then years anticipated before retiring as you see to no surprise The male female separation from uh one to 40 years is Very significant and prominent and then something I don't understand or cannot explain as the looming Contrast of compensation and financial uh remuneration to female perfusions I have no earthly idea why there would be a Uh separation in this regard and that needs to be addressed. I know in my Hiring experiences. This was never the case so With all of this said I want to say thank you to Kathy Kibler Deb Adams and uh any other figure that Played a role in inviting me to present today And then uh, I do so in memory of a great man salga riscio He's pictured here with and that's at the last academy meeting he attended Three months later. I got the horrible news Of his death and uh, I hope ann is doing well Uh, I also mentioned In honor of terry crane who we all love to Be present on our cases back in the early 80s When uh terry would come over and Lecture us and sit with us on cases and impart His vast knowledge and he's pictured here with his lovely wife marilyn and on the lower right dr. Cooley His grandson and uh jessica. We love all of you and uh, you're just our texas heart family Thank you very much