The troopers gave Fay Brisk the news first, and she telephoned over to Montefiore that night. The switchboard operators told her no one was working in the animal quarters to answer her questions. Years later, Brisk would claim to have heard the jangling of dog tags at the other end of the line when she finally got through the next morning. Yes, someone at the hospital told her, the two Dalmatians did come in the previous week, but no, the older one was no longer there. On Friday, while Julia Lakavage was talking to the state troopers in Ulster County, her dog Pepper was splayed out on an operating table in a large building on Gun Hill Road in the Bronx. Medical researchers had tried to implant her with an experimental cardiac pacemaker, but the procedure went awry, and she died. The dog's body had already been cremated.
A hospital spokesman explained later that the order had gone out for six male Dalmatians, to be paid for by weight. The dealer had brought in two females instead.
Pepper's journey in the summer of 1965 helped start a national media sensation and a broad panic over the theft of pets for biomedical research. Her death on an operating table in the Bronx would help animal welfare advocates break a long-standing stalemate in Congress and push through the most significant animal-protection bill in American history. At the same time, she became a martyr to the cardiology revolution at a crucial moment in its development. Pepper also represents a turning point in science, from an earlier age when animals for experiment would be plucked from the road or the river, to a new era of standardized, mass-produced organisms that can be shipped right to the laboratory door. In a five-part seriesto be published over the course of this week, Slate will explore her legacy.
Man Cuts Dog
Here's one way to give a dog heart block: Anesthetize it, flip it over, and make an incision along the midline of its chest. Crack open the sternum and pull apart the bone and muscle. It's best to use a dog of medium size, with short hair and a long torso—like a Dalmatian. You won't be able to accomplish very much while the dog's heart is full of blood, so tie off the venae cavae with a tourniquet to block the flow into the right atrium. Remember to move quickly, as the dog can endure only a few minutes in this predicament. (You can buy some extra time by presoaking the animal in a basin of ice water.) Disrupt the heart's conduction mechanism by sewing a single, black silk suture between the tricuspid valve—which separates the right atrium from the right ventricle—and the coronary sinus. Now untie the tourniquet to restore the flow of blood, and you're done. If all goes well, the dog will have lost the ability to pace its own heart.
Every year, 200,000 Americans, and more than 500,000 people worldwide, receive a permanent cardiac pacemaker as a treatment for heart block, bradycardia, or another heart-rhythm disorder. The ubiquity of the pacemaker has a lot to do with the elegance of the procedure now used to implant it: The whole operation takes just an hour or two, it can be performed under local anesthetic, and patients are sent home the next morning. The safe and simple technique—in which doctors make a small incision near the collarbone, open a vein, and slide the pacing leads directly into the heart—was invented more than 50 years ago by Seymour Furman, a young resident at Montefiore Hospital who was spending his afternoons in the dog lab.
Early versions of the pacemaker were crude devices that attached to the external surface of the heart or the front of the patient's chest. A Boston physician named Paul Zoll installed one of the first modern devices in 1952. He wired up a pair of hypodermic needles and plunged them directly into a patient's skin. The pulse generator was a large, external box plugged into the wall. In 1957, an open-heart surgeon at the University of Minnesota started attaching the pacemaker leads directly to the cardiac muscle. This allowed the device to work at a much lower voltage—jolts from the earlier machine had sometimes blistered the patients' skin—but the electrodes were unstable, and it took major surgery to implant them.
Seymour Furman's great insight was to combine the new field of cardiac pacing with a medical procedure that had only recently become mainstream, cardiac catheterization, in which a thin tube is inserted into a blood vessel and advanced into the heart for diagnostic testing. The cardiac catheter had earned its inventers a Nobel Prize in 1956, and one of its early practitioners—Doris Escher—was Furman's mentor at Montefiore. With her guidance, he hoped to pass an electrode through the venous system to the right atrium, where he could pace the heart with more stability and less current than ever before. This would also eliminate the need for chest-cracking, open-heart surgery.
In the fall of 1957, Furman set to figuring out the details of his new procedure in the dog lab. The canine anatomy turned out to be perfect for the experiment: The dog's external jugular vein was large and easily accessible, and provided the catheter with a straight shot into the right ventricle. But before Furman could test the dogs with his new catheter leads, he'd have to open their hearts and induce an artificial block. That procedure proved to be dangerous: Of the 16 dogs assigned to Furman, only four survived.
Bill Miller arrived with his truck at Montefiore Hospital on Thursday, July 1. He'd spent several days carting two goats and 18 dogs across Pennsylvania and New Jersey, and had already sold most of the live cargo to medical centers in Manhattan. He unloaded the remaining animals that afternoon in the Bronx and set off for home.