Articles & Essays

Jack has written more than 500 articles and essays for The Atlantic, Scientific American Mind, Wired, American Heritage, The History Channel Magazine, The Washington Post Magazine, Minnesota Monthly, and many other publications.

Read his articles and essays here.

Jack El-Hai's Books
  • The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness
    The Lobotomist: A Maverick Medical Genius and His Tragic Quest to Rid the World of Mental Illness
  • Non-Stop: A Turbulent History of Northwest Airlines
    Non-Stop: A Turbulent History of Northwest Airlines
  • Lost Minnesota: Stories of Vanished Places
    Lost Minnesota: Stories of Vanished Places
  • The Nazi and the Psychiatrist: Hermann Göring, Dr. Douglas M. Kelley, and a Fatal Meeting of Minds at the End of WWII
    The Nazi and the Psychiatrist: Hermann Göring, Dr. Douglas M. Kelley, and a Fatal Meeting of Minds at the End of WWII
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Resuscitation for the Masses: How the Invention of CPR Shifted the Line between Life and Death

In 1960, the Journal of the American Medical Association published a manuscript credited with saving more lives than any other medical article of the previous hundred years.CPR training using a life-saving mannequin

Modestly titled “Closed-Chest Cardiac Massage,” it described a simple method of keeping alive people in cardiac arrest. “Anyone, anywhere, can now initiate cardiac resuscitative procedures,” the manuscript’s authors wrote. “All that is needed are two hands.”

By pairing their new technique of closed-chest heart massage with mouth-to-mouth artificial respiration, W.B. Kouwenhoven, James Jude, and G. Guy Knickerbocker braided together two separate threads of resuscitative medicine that had been under investigation for years. During the closing decades of the nineteenth century, researchers had tried closed-chest heart compression on animals and humans, but the technique did not gain a clinical foothold.

Meanwhile, surgeons reported success with open-chest heart massage — seizing the heart and squeezing it to restore circulation — as early as 1901. Physicians coupled this emergency technique with electrical defibrillation by the mid-twentieth century.

Artificial respiration boasts an even longer history. William Tossach described a mouth-to-mouth method in 1744, but the later discovery of elevated levels of carbon dioxide in exhaled air gave rise to a fear of using it in resuscitation. For more than a century, efforts to mechanically compress the chest to restore breathing were common. James Elam at last confirmed in 1954 that mouth-transmitted air could safely maintain respiration.

Four years later, Kouwenhoven and Knickerbocker were studying closed-chest defibrillation when they noticed that the heavy electrodes they were using on a dog compressed the chest and caused an increase in arterial blood pressure. They wondered whether rhythmically applying pressure to the chest could maintain blood circulation.

Working with Jude, they soon discovered that using two hands to press down the sternum compressed the still or fibrillating heart and forced blood out from it. Repeated once or more per second, the process could keep blood circulating in the victim until defibrillation equipment was available or the patient could be transported to a hospital.

It was a seemingly miraculous transformation of the boundary between life and death.

In a 1960 presentation at the Maryland Medical Society, the JAMA authors and James Elam declared that closed-chest heart massage and mouth-to-mouth ventilation “cannot be considered any longer as separate units, but as parts of a whole and complete approach to resuscitation.” This merging created cardio-pulmonary resuscitation (CPR) as we know it today.

In a half century, CPR has revolutionized resuscitative medicine and spread around the world. Millions of Americans receive CPR training every year, often making bystanders the first defense against sudden cardiac arrest.

* * *

Please note: I have previously written about the history of CPR for Proto magazine.


An Interview with a Stage Hypnotist

Last month, I posted the first in a series of short essays adapted from an article on hypnotists and hypnotism that I wrote for (but was never published in) Harper's magazine several years ago. What follows is the second part of the series, which focuses on my meeting with a working stage hypnotist.

I met Frank Pruden, who uses the name “Frankie Z” as a stage hypnotist, in a St. Paul, Minn., restaurant that was empty except for us. He had staked out a corner booth in the deepest recess of the establishment, and he seemed to regard all the empty seats as a challenge to fill the place with his big voice. I could see how he could send his speech to the far reaches of the high school gyms, outdoor amphitheaters, wedding halls, and fairground grandstands in which he performs. An antique advertising card showing a stage hypnotist at work

Pruden, a goateed man with receding hair, had been working a dozen years as a DJ-for-hire when one of his phobias caught up with him. Several years ago, a group of friends planned a trip to Las Vegas and asked him to come along. “You all fly. I’ll drive,” he told them. He had served as an aerial photographer in the Marine Corps, sometimes leaning out of aircraft to take pictures, but he later developed a fear of flying. “It was a control thing,” he said. “In a plane, I’d freeze up and my heart would go boom-boom.” 

This time, however, Pruden realized he really wanted to travel to Las Vegas with everyone else. He tracked down a hypnotist and not only received treatment that erased his anxiety over flying, but he also signed on for training as a hypnotherapist. He soon studied stage hypnotism, as well. Right away, he began performing before audiences. 

I shook my head, but I knew that I had been going under.

He thus fell into an old tradition of entertainment. Public demonstrations of hypnotism have drawn crowds in Europe and North America for more than 200 years. For much of the twentieth century, stage hypnotists offered the only exposure the public had to hypnotic techniques, and the performers developed most effective and innovative methods of induction. Some stage hypnotists spent years on the road. They typically treated audiences to demonstrations of somnambulism, lethargy, and catalepsy; brought audiences, through suggestion, to hysterical laughter; and showed how people could play musical instruments and sing while under hypnosis.

I asked Pruden to demonstrate the method of induction he uses. “I made up my own,” he said. “I ask them to take deep breaths, to let go of their thoughts, to lose the stress and tension from their bodies. I tell them to relax their muscles from their head to their feet and to go to a special place that only they know. They can float and feel relaxed on their own personal cloud.” Abruptly Pruden stopped and stared at me. “You’re not going under, are you?”

I shook my head, but I knew that I had been going under. I’m one of a minority, estimated at 20 percent of the population, who easily succumb to hypnosis. (All told, 90 percent of people can be hypnotized, which excludes those with major psychoses, mental disabilities, and other cognitive disorders.) Throughout Pruden’s patter, I felt a familiar detachment build within me, a sensation that I was suspended in the restaurant rather than sitting there. I watched Pruden’s lips move, heard his voice, and took in his words with great attention. Everything else receded to the background. The feeling was no different from when I am comfortable and relaxed while daydreaming, reading an engaging book, or spellbound in a movie theater. I have seen it in my children when time flies for them while they’re having fun at a birthday party. 


The Case of the Boxing Kangaroo

I'll be posting sparingly over the next week or two, but I wanted to let you know about a contributing gig I now have with the wonderful history blog Wonders and Marvels. (I covered Wonders and Marvels last month here when I wrote about four top history blogs.)

My first post for Wonders and Marvels is about the tragic death of Peter the Great, a famed boxing kangaroo. I learned about Peter's demise by chance when researching the history of the Minneapolis Auditorium for my book Lost Minnesota: Stories of Vanished Places. The tale stuck in my memory, and I've now finally disgorged it.

(I don't think the video above shows Peter, but you get the idea.)

I hope you like my Wonders and Marvels post. More stories of history and the history of medicine here soon.


Savants in the News

Last month I wrote a post on my experiences with Max Weisberg, a mentally disabled savant who put his numerical talents to work as a sports bookmaker. I’ve long been interested in people like Max with an extraordinary mental gift amid deficits or disabilities.Kim Peek, the autistic savant who inspired the movie Rain Man. (Courtesy of Darold Treffert/Wisconsin Medical Society)

Commonly called savants (sometimes with the obsolete and inaccurate prefix idiot), those people often draw attention and make news. If your interests are like mine, you may find these recent stories of savants to be thought provoking and fascinating.

• In an account written for the Wisconsin Medical Society, Derek Amato explains how he became “Rain Man Beethoven” following a swimming pool diving accident in which he suffered a severe concussion. In addition to memory and hearing problems, the accident left him with newfound musical aptitude. Darold A. Treffert, M.D., a psychiatrist who has extensively studied savants, wrote that Amato’s experience astonished him and remains the only known case of an injury resulting in sudden musical savant syndrome.

• A new book by Thomas Fabricius, Autism and the Savant Hypothesis, examines the relationship between savant behaviors and autism.

• In a blog post for Slate, Katy Waldman looks at a recent study that finds autism running in the families of many child prodigies. People with savant abilities are not necessarily child prodigies, or visa versa, but Waldman explains that “the line between savant and prodigy seems slightly blurrier when viewed through the lens of this investigation, led by Ohio State Mansfield professor Joanne Ruthsatz and concert violinist Jourdan Urbach.”

• From New Zealand comes the story of teenager Julian McLaren, who is autistic and has perfect pitch as well as a strong musical memory. "He has such huge talents and strength," his music teacher says. "Some things it will take me five or six years to teach to an average student, Julian can pick up in about five seconds."

• Wired magazine’s Tanya Lewis wrote a story about the efforts of neuroscientist Allan Snyder of the University of Sydney to develop electrical brain stimulation that allows anyone to tap unused, savant-like abilities.

• The Telegraph of London reported on Paul Frampton, a University of North Carolina physicist described by his ex-wife as a savant, who “specializes in the secrets of time and space.” Reporter Philip Sherwell notes that Frampton currently occupies space in a prison cell in Argentina after his arrest for allegedly smuggling cocaine into the country. Frampton claims to be innocent, the victim of a scheme to lure him to South America for a romantic tryst with a woman who supposedly held the title of “Miss Bikini World.”


Did Abraham Lincoln Have Ataxia?

Recent research suggests that the U.S. President may have suffered from this mysterious neurological disease. 

For nearly twenty years, people who have a kinship to Abraham Lincoln have been gathering for reunions in Indiana, Iowa, and Kentucky – and medical researchers have been there along with them.The last known photo taken of Abraham Lincoln before his death.

The researchers, led by Laura Ranum, Ph.D., formerly of the University of Minnesota and now with the University of Florida, came not to hear stories of the Great Emancipator or to share potato salad and coffee, but to collect DNA samples and to learn more about the Lincoln family’s medical history. The 299 vials of blood they have carried back to Minnesota contain vital clues to the mystery of spinocerebellar ataxia, a devastating neurological condition that affects about 150,000 Americans. 

What is ataxia?

People with ataxia suffer from a deterioration of the cerebellum, brain stem, and spinal cord ― regions of the nervous system that govern muscle control. Ataxic patients are loosely defined as anyone with clumsiness and a lack of coordination from cerebellar degeneration. 

In many people, a genetic flaw causes the elaborately structured cells of the cerebellum to die off. The disease proceeds gradually, eventually robbing its victims of the ability to walk, hold objects, move their eyes, speak, and perform common activities of daily life. If patients lose control of the muscles for swallowing, they can develop pneumonia or even choke to death.

Unraveling the mystery

 Ranum began her Lincoln family gene hunt in 1992 when she received a phone call from an Ohio physician who described a patient with familial ataxia. When she called the patient, her mother, and several cousins afflicted with the disease, she learned that all were related to President Lincoln. Some even referred to the ataxia in the family as “Lincoln’s disease.” 

When a newspaper reporter in Louisville wrote a story about “Lincoln’s disease,” another offshoot of the family contacted Ranum. This time, the relative was descended from President Lincoln’s aunt Mary. The identification of this second branch of the family means that one of President Lincoln’s paternal grandparents must also have had the disease and passed it on to one or more children. In 1994 Ranum's team mapped the gene to the eleventh chromosome. 

Although the trips to Lincoln family reunions spanned more than a decade, the hardest part of the gene hunt was yet to come. Ranum and her lab colleagues studied the DNA contained in the blood vials collected from Lincoln’s extended family. The search for this gene was particularly difficult because it fell near a region of chromosome 11, called a centromere, that tends to stick together.

Everyone wondered whether the President himself either had ataxia or would have developed it later in life.

In 2005 the group finally found what they had long been seeking: the specific mutation responsible for the Lincoln family’s ataxia. “Any family member with the gene will develop ataxia if they live long enough,” Ranum says. “And their children have a 50 percent chance of getting it, too.” Because both Lincoln’s aunt and uncle on his father’s side carried the ataxia mutation, one of the President’s paternal grandparents had to carry it as well. That means that Lincoln had a 25 percent chance of carrying the mutation himself. 

Eventually the researchers demonstrated that the mutation, an accident of chemistry, affects the function of another protein called a glutamate transporter that normally regulates how much stimulation the brain’s neurons receive. Failure to control this stimulation leads to damaged neurons; in fact, it is what likely causes the death of the cerebellum cells. With the loss of enough of these cells, patients lose control of the movements of their legs, arms, and eyes. 

Inevitably, everyone wondered whether the President himself either had ataxia or would have developed it later in life. Medical historians have long speculated that President Lincoln’s tall stature may have resulted from Marfan syndrome, a disorder of the body’s connective tissue. Ranum says that family history and historical accounts of Lincoln’s gait make it much more likely that the President suffered from ataxia. Finding the mutation in his family allows researchers to conclusively test whether Lincoln had the responsible gene. 

Lincoln’s last direct descendant, Robert Todd Lincoln Beckwith, died in 1985 along with genetic evidence that might have shed light on the question. But Lincoln’s own DNA remains possibly available in tissue samples and on items splattered with blood after his 1865 assassination. 

Although some believe the question is irrelevant to the scientific study of ataxia, Ranum and her colleagues disagree. If Abraham Lincoln were found to have carried the mutation, it would help increase awareness of this devastating disorder. 

[Note: This post is adapted from articles I have previously written about Lincoln and ataxia for the Minnesota Medical Foundation. Last month in this blog I wrote about the strange fate of Lincoln's funeral car.]

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