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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 firstname.lastname@example.org 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 For personal use. Only reproduce with permission from The Lancet Publishing Group.