Robert J. Siegel, MD
University of California, Los Angeles and Cedars-Sinai, United States (Spring 2016)
Waking from a deep sleep or a dream can trigger a memory with an ethereal quality. This is especially true when the memory is more than 50 years old. I grew up in a home where nocturnal parties were frequent. These gatherings were attended by actors and artists, and were associated with robust conversation, laughter, music, heavy consumption of alcohol and rooms made opaque by cigarette smoke. One evening past midnight, I awoke to tip-toe down our spiral staircase and eavesdrop on the partygoers. From the dark shadows at the entrance to the living room, I witnessed the enthusiastic, inebriated celebrants. One mustached man with a deep voice raised his glass and said to a smiling and equally inebriated celebrant, “I challenge you to shatter this wine glass with your voice!” I looked at my mother, an actress, whose face showed both astonishment and concern—was this the start of a fight? Or if he did “shatter the glass,” what would happen to all the other glasses in the room? My father, a doctor to many of the inebriants, was clearly enjoying himself and was unperturbed by any potential consequences of the challenge. What happened next would have a far-reaching effect on my life, becoming the seed for my future medical research that would result in a treatment for blockages in blood vessels.
The smiling man, a husky individual with a cherubic face, responded to the challenge with a laugh; the room became silent and still; the hi-fi was shut off and all the festivities halted. The man then put the glass on the mantle of the fireplace, faced it, and standing about a foot away proceeded to sing a singular tone which became progressively louder and more intensive. The glass began to vibrate, slightly wobbled, and then shattered! The partygoers cheered in jubilation and I scurried back to my room before I could be detected. My heart was pounding from utter amazement of this feat. I later learned that the singer was a Swedish opera star named Jussi Björling.
Also in the mid-1950s in Sweden, Drs. Inge Edler1 and Carl Hertz began to explore the use of ultrasound as a diagnostic tool as well and to evaluate its biologic effects on tissues. Their pioneering work led to the ultrasound identification of the mitral valve. The mitral valve was identified by Vesalius as the valve that separates the left atrium from the left ventricle. Vesalius penned very accurate descriptions of the valve, and because it resembled the shape of a bishop’s mitre, or headpiece, he named it the mitral valve in his book, De Humani Corporis Fabrica (On the Fabric of the Human) published in 1543. The landmark work by Edler and Hertz four centuries later evolved into the development of modern day ultrasound, currently the major diagnostic modality used to evaluate cardiac anatomy. The recent development of 3Dimensional echo has resulted in anatomic images of the heart and allows for real-time assessment of cardiac structure and function.
In the year that Björling was at my parent’s house, he also sang at Carnegie Hall. Though a heavy drinker, he was not professionally impaired by his alcohol intake. He was one of the greatest tenors of the century with a photographic memory for music. In 1960, he suffered a heart attack before a performance at Covent Garden and nonetheless insisted on performing. Sadly he died within the year of heart failure.
The woman who brought Mr. Bjorling to my parent’s party was a Swedish actress, Signe Hasso. She became a close family friend and for me was always a source of encouragement. She believed that “every living thing vibrates and has its own wavelength.” She advocated strongly for me to become a doctor, became my confidant for my dreams of medicine, and my patient after I became a cardiologist. I cared for her until her death.
Witnessing the power of sound that night in the mid-1950s set me on a mission of discovery. I explored the power of sound and successfully applied it to open blocked arteries in hearts and legs of humans.2 Moreover, just as Bjorling could break the glass at a distance, we have been able to apply sonic energy at a distance external to the body to dissolve blood clots in animal studies and in patients, and improve blood flow in patients with heart attacks.
- Edler, I. The diagnostic use of ultrasound in heart disease, Acta Med. Scand. 1955;308:32.
- Siegel, R. J. and H. Luo. Ultrasound Thrombolysis. Ultrasonics 48:312-320, 2008.
ROBERT J. SIEGEL, MD, was a Senior Staff Fellow in Cardiac Pathology at the National Institutes of Health. He is internationally recognized as an expert in the field of cardiovascular ultrasound. His research interests include valvular heart disease, therapeutic applications of ultrasound energy, 2D and 3D transesophageal echocardiography for the guidance and monitoring of percutaneous procedures such as mitral valve repair and aortic valve replacement. He is on the editorial board of several cardiovascular journals, has edited three textbooks on ultrasound-related topics, and has authored over 300 scientific papers related to cardiovascular medicine.