The Heart of the Matter

Tuesday, February 21, 2006

B y the time they filed in for the operation, they already had been briefed by the heart surgeon. Dr. Edward LeFrak had even given the group a chance to question him about the long and complicated procedures he does to help save lives.

"Do you have to stand the whole time?" wondered 14-year-old Claire Trueman.

"People ask that all the time," LeFrak said with a smile. "They say, 'Don't you have to pee? Don't you have to eat?' You're so focused, you don't think about it."

John Athy, who is 13, wanted to know: "Do you have any rituals before you operate on somebody?"

Breakfast, LeFrak replied, which usually includes nonfat yogurt, granola cereal, tomato juice and tea.

"I have to be at my max, so to speak," he explained.

"Do you ever get nauseous and stuff?" asked Cat McKinstry, 14.

The doctor confessed. The first time he watched surgery, long before entering medical school, he took one look and fainted. "We don't want anybody to hit the floor today," he said.

And no one did, though the bird's-eye view the eighth-graders had as LeFrak got started shortly after 9 a.m. did provide some stomach-challenging moments.

The 15 students from St. Mark School in Vienna were among the latest visitors to the observation dome at Inova Fairfax Hospital. It's a very cool place, a room with seats positioned around a huge, clear bubble. Through that bubble you can look into one of the operating rooms, practically right over the operating table. If you want to see even more of what's happening, video screens show close-ups of where the lead surgeon is focused -- in sharp detail and color.

About 3,000 students a year take this unusual field trip to Inova's heart institute. The hospital doesn't expect the visitors to become doctors because of this experience, but it does hope they leave smarter about their own bodies and health. What they're eating now can contribute to heart disease later in life -- especially foods such as potato chips and doughnuts, the St. Mark girls and boys learned.

LeFrak's patient that morning was an elderly woman with a heart artery that over time had become clogged by fatty deposits. Arteries are the pipelines that transport oxygen-rich blood through the body, so this was a critical problem.

But there was a ready solution. The operating team would take a section of vein from the woman's left leg and use it to bypass, or go around, the blocked artery. Because veins carry blood back to the heart, they can take this kind of duty. LeFrak would use silk thread as thin as a human hair and sew the vein into place during the operation, which took about five hours.

The classmates watched as the doctor cut carefully through the protective, fluid-filled sac that surrounds the beating heart. With long blue drapes covering much of the patient, "it's hard to grasp that they're actually working on a real human body," said Meghan Smith, 14.

"It's a little scary," she said, "but fascinating."

-- Susan Levine

© 2006 The Washington Post Company