Orvan Hess

							                                                                                                                                          OBITUARY



             Obituary




                                                         Orvan Hess
                                                         Obstetrician and gynaecologist who developed the fetal heart monitor; first to use penicillin
                                                         in USA; faculty member at Yale University School of Medicine; advisor to a US President.
Jim Fiora




                                                         Born June 18, 1906, in Bayoba, Pennsylvania, USA; died after a brief illness
                                                         aged 96 years on Sept 5, 2002.

                                                   rvan Walter Hess was, in the words

                                         O
                                                                                                    Although less well-known, Hess made other
                                                   of one prominent colleague, an “enthu-        important and wide-ranging contributions to
                                                   siastic and energetic” obstetrician,          medical science. His first paper, in 1936,
                                         gynaecologist, and World War II surgeon                 described the use of cat gut in the perineum.
                                         who pioneered fetal-heart-rate monitoring               He also published works on vascular injuries of
                                         and was the first to use penicillin in the USA, in      the extremities in casualties of war.
                                         a patient with scarlet fever.                              Hess, who grew up in a farming community,
                                            Hess is perhaps best known for his work,             graduated from Lafayette College, Easton,
                                         which he started as a young faculty member at           PA, in 1927 and received his medical degree
                                         Yale in the late 1930s, on ways to monitor the          from the University of Buffalo, New York, in
                                         fetal heart rate. Although a colleague, Edward          1931. He went on to serve his internship in
                                         Hon, is often regarded as the father of the             orthopaedics and surgery at the Children’s
                                         technique, Hon only became interested in such           Hospital of Buffalo, followed by a year in
                                         research some 10 years after Hess, according to         surgery, gynaecology, and obstetrics at Yale-
                                         a letter from Hon found by Joshua Copel,                New Haven Hospital, and a residency in
                                         professor of obstetrics and gynaecology and             obstetrics and gynaecology that he completed
                                         head of maternal-fetal medicine at Yale. Hess           in 1937.
                                         and Hon’s work resulted in a 1957 paper in                 Apart from his service during World War II in
                                         Science in which they described the first               the 91st Evacuation Hospital of the US Army,
                                         equipment to record the fetal heart rate—               where he served under General George S Patton
                                         more than 6 feet tall and 2 feet wide. The work         in North Africa, Sicily, and Normandy, Hess
                                         continued after that, as the team, along with           worked at Yale in research and on the wards
                                         Wasil Kitvenko, head of Yale’s electronics              delivering children for his entire career. He
                                         laboratory, refined the device. Today, of course,       retired from Yale’s faculty in 1975, but remained
                                         such equipment is much smaller and its use has          “a visible member of the staff”, according to
                                         substantially reduced the number of stillbirths—        Copel. In 1979, he received an American
                                         although, somewhat predictably, it is also argued       Medical Association scientific achievement
                                         that the fetal heart monitor has increased the          award. Hess, who was certified by the American
                                         number of unnecessary caesarian sections.               Board of Obstetrics and Gynecology and by the
                                            The story of Hess’ use of penicillin in 1942         American College of Surgeons, also served as
                                         is one of serendipity and courage. When a               president of the Connecticut State Medical
                                         patient, Anne Miller, developed scarlet fever and       Society and on many state and national
                                         streptococcal septicaemia, Hess went to speak to        policy-making committees, including President
                                         Miller’s internist, John Bumstead, finding him          Lyndon B Johnson’s White House Conference
                                         asleep in the library. Hess happened on an article      on Medicare.
                                         in Reader’s Digest on the use of soil bacteria to          Hess is survived by two daughters, five
                                         kill streptococcus in animals. According to a           grandchildren, and five great-grandchildren. His
                                         1988 article in the Chicago Tribune Magazine,           wife died in 1998.
                                         Hess and Bumstead convinced government                     Charles Lockwood, now the chairman of
                                         officials to give them some 5·5 g of penicillin—        obstetrics and gynaecology at Yale, said he
                                         about half the available supply of the drug in          received a note from Hess just this August
                                         the USA. At that time, penicillin had only been         congratulating him on his appointment. “He
            Ivan Oransky                 tried, unsuccessfully, in one patient in the UK.        signed his note with a crisp, clear signature”,
            e-mail:                      They administered it to Miller, whose fever broke       Lockwood recalls, “I suspect he retained his
            ivan-oransky@erols.com       within 24 h and who lived to the age of 90 years.       enthusiasm to the end”.


            THE LANCET • Vol 360 • October 12, 2002 • www.thelancet.com                                                                        1179




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