The heart of innovation

On February 14, the Innovation Acceleration Program will celebrate Children’s Hospital Boston’s rich history of innovation at the hospital’s first Innovation Day. Of all the groundbreaking discoveries and procedures that have taken place within Children’s walls, few have had the impact of the surgery performed by Robert Gross, MD, one summer’s day in 1938.

“If you look at the history of cardiac surgery,” says Children’s Associate Anesthesiologist-in-Chief Mark Rockoff, MD, who also chairs the hospital’s Archives Program, “it essentially all started with Dr. Gross.”

Gross’s patient, 7-year-old Lorraine Sweeney, from Brighton, Mass., came to him with a diagnosis of patent ductus arteriosus, a congenital heart defect consisting of a persistent abnormal opening between the pulmonary artery and the aorta. In 1938, it was generally a death sentence—one that would likely end with Sweeney dying of congestive heart failure before adulthood. Accepted practice dictated that surgery was not a survivable option. Gross, the chief surgical resident at Children’s at the time, disagreed.

After two years of successful animal experiments, Gross was certain that the defect could be corrected in a human being “without undue danger.” He lobbied for the opportunity to test his theory, despite skepticism from his peers, and direct opposition from William Ladd, MD, Children’s surgeon-in-chief, and Gross’s superior.

Undaunted, Gross waited until Ladd boarded a ship bound for Europe. Then, with the blessing of Sweeney’s mother, he put his career on the line and performed a revolutionary surgery—tying off Sweeney’s patent ductus arteriosus, allowing normal flow of blood through her heart. “Dr. Gross told me that if I had died, he would never have worked again,” Sweeney recalls. “He would have ended up back on his family’s chicken farm.”

Lorraine Sweeney in 1938, with a doll given to her by Dr. Gross

Instead, Lorraine Sweeney became the first person in the world to survive surgery to correct a congenital heart defect. By the following day, she was sitting up in a chair, and by the third day after surgery, she was up and walking around. Legend has it that Ladd first learned that history had been made at his hospital from a newspaper he picked up on his vacation. Upon his return to Boston, Ladd immediately fired Gross, but under pressure from other physicians and hospital leadership, he eventually relented. Upon receiving the call asking him to return to Children’s, Gross—who was by then building a barn on his farm in Framingham—told Ladd he’d be back when the barn was finished.

Gross went on to succeed Ladd, serving as Children’s surgeon-in-chief from 1945 to 1967, and cardiovascular surgeon-in-chief from 1967 until 1972. Gross continued to see Sweeney as his patient until she was 14, but with her health remaining excellent, and no signs of further trouble with her heart, she drifted out of contact with her Children’s physicians. After she married in 1949, and became pregnant, Sweeney (now Lorraine Sweeney Nicoli), came back into contact with Gross by way of her obstetrician, who had concerns about possible complications resulting from her heart defect. Gross assured the doctor that both Sweeney and her heart were perfectly healthy.

Gross and Sweeney continued to cross paths over the years, most significantly in 1963, at a celebration of the surgery’s 25th anniversary, when they reunited in the operating room where they made history. In 1972, Gross retired from practice and moved to Burlington, Vermont. He passed away in 1988, just two months after the 50th anniversary of the operation that paved the way for modern cardiac surgery.

“If you look at the history of cardiac surgery, it essentially all started with Dr. Gross.”

Sweeney, who, according to the conventional medical wisdom of 1938, should never have made it to adulthood, is now a great-grand- mother. She returned to Children’s twice last year—once to join Rockoff and W. Hardy Hendren, MD, chief emeritus (and Gross’s successor) in recording her story for Children’s Hospital’s Archives Program, and again in September to participate in the dedication of the Children’s Hospital History Wall, in which she and Gross share a significant role.

Rockoff believes that Gross’s pioneering work embodies the ultimate goal of all Children’s clinicians: To find new ways to take care of children, so they can live long, productive lives. “It’s an amazing tale of chutzpah,” he says—a description that can be applied to so many Children’s innovators through the years. “When you tell them that something can’t be done, it just makes them want to prove you wrong.”