From Utena to Maine
Bernard Lown was born Boruch Lac on June 7, 1921, in Utena, Lithuania, to Nison and Bela Lac, née Grossbard. His family was Jewish, and one of his grandfathers was a rabbi. In 1935, when he was fourteen and as the threat to Europe’s Jews grew, the family emigrated to the United States and settled in Maine, where his father ran a shoe factory in Pittsfield. Bernard spent his teenage years in Lewiston and graduated from Lewiston High School in 1938.
Years later he credited a Lewiston doctor, Max Hirshler, with inspiring him to pursue medicine. He studied zoology at the University of Maine, graduating in 1942, and earned his medical degree from Johns Hopkins University School of Medicine in 1945. He trained at Yale-New Haven Hospital, at Montefiore in the Bronx and at the Peter Bent Brigham Hospital in Boston, now Brigham and Women’s Hospital, where his mentor was the renowned cardiologist Samuel A. Levine. In 1946 he married his cousin Louise, also from Lewiston; they were married for 73 years, until her death in 2019, and had three children, Anne, Fredric and Naomi.
Getting heart patients out of bed
Lown’s first contributions challenged accepted practice. As a resident at Montefiore he showed how the body’s potassium levels determine whether the heart drug digitalis is safe, at a time when digitalis poisoning was a major cause of death among patients with heart failure. His work helped doctors move away from long-acting forms of the drug and drew attention to the potassium losses caused by diuretics.
Working with Levine, he also questioned the standard treatment for heart attacks, which kept patients flat in bed for six weeks or more. Prolonged bed rest caused dangerous blood clots in the lungs, and death rates after a heart attack were then around 35 percent. Lown and Levine’s “chair treatment”, which got patients sitting up much sooner, met fierce resistance from other doctors, but it reduced deaths sharply in the patients they treated and was rapidly adopted. Hospital stays after a heart attack fell from weeks to days.
The defibrillator
Lown’s greatest medical achievement grew out of his conviction that sudden cardiac death, when the heart’s rhythm collapses into the chaotic quivering called ventricular fibrillation, was reversible. In the 1950s doctors had begun to shock such hearts with alternating current taken straight from a wall socket. In 1959 Lown showed that alternating current could injure the heart and could itself be lethal. Working at the Harvard School of Public Health with Barouh Berkovits, an engineer at the American Optical Company, he set out to find a method that was both safe and effective.
After a year of intense experiments, in 1961 Lown and his colleagues showed that a particular direct-current waveform, which became known as the Lown waveform, could reliably stop ventricular fibrillation and restore a normal heartbeat without damaging the heart or surrounding muscle. In 1962 the surgeon Donald Effler used the new DC defibrillator at the Cleveland Clinic, and he credited it with making modern cardiac surgery possible, including the coronary bypass operations first performed there later in the decade. Lown also discovered that timing a shock to avoid a brief vulnerable moment in the heartbeat could safely correct other fast, disordered rhythms, a technique he named cardioversion.
Not every idea he pursued worked at once. In the late 1950s, hoping to see the fatty plaques that block coronary arteries, he took up the new technology of fibre optics through his friend the physicist Elias Snitzer, who introduced him to Michael Polanyi, a physicist at the American Optical Company. The optics of the day were not good enough to image the plaques, but the work showed that fibre optics could measure oxygen in the blood and the heart’s output. With some irony, when he submitted two abstracts to the World Cardiology Conference in 1964, the one on fibre optics was accepted and the one on the defibrillator and cardioversion was rejected.
Saving lives in the coronary care unit
Lown’s work changed how hospitals care for heart attack patients. Because the hours and days after a heart attack are when patients are most likely to die suddenly, he helped promote the coronary care unit, a specialised ward where patients are continuously monitored and where a defibrillator and trained staff are always ready. In 1964 he introduced the use of lidocaine, until then used mainly by dentists as a local anaesthetic, to control dangerous rhythms of the heart’s lower chambers.
Direct-current defibrillation became the foundation of modern resuscitation. The Lown–Berkovits waveform remained the standard until the late 1980s and 1990s, when improved biphasic waveforms began to replace it, but the paddles in every emergency department, the defibrillators carried by paramedics, the automated external defibrillators now mounted in airports, schools and stadiums, and the defibrillators implanted inside patients’ chests all descend from the safe direct-current shock that Lown pioneered. He also studied how psychological stress and lack of sleep can trigger dangerous heart rhythms, helping to establish the link between the mind and sudden cardiac death.
Doctors against nuclear war
Lown believed that doctors’ duty to prevent death extended to the greatest threat of all. In 1961 he gathered physicians from Boston’s teaching hospitals to found Physicians for Social Responsibility, whose 1962 articles in the New England Journal of Medicine described the medical consequences of a hydrogen bomb attack on Boston. In 1980, as Cold War tensions rose again, he joined with the Soviet cardiologist Yevgeny Chazov, a friend from joint research on sudden cardiac death, and other physicians to found International Physicians for the Prevention of Nuclear War, known as IPPNW.
During the Vietnam War Lown was also a leading member of the Committee of Responsibility, which arranged for badly burned and injured Vietnamese children to be brought to the United States and treated free of charge in American hospitals. He led a delegation to Washington to win government support, and in 1967 the Pentagon began flying the children to the United States for care.
The organisation brought doctors from both sides of the Iron Curtain together to spread authoritative information about what nuclear war would do. In 1982 three Soviet and three American physicians, including Lown and Chazov, discussed the consequences of nuclear war on Soviet national television before an audience estimated at 100 million. By 1985 IPPNW represented about 135,000 physicians in some 60 countries, and that year it was awarded the Nobel Peace Prize, which Lown and Chazov accepted together in Oslo. The award was criticised in the West because Chazov held senior positions in the Soviet medical establishment, but Lown argued that dialogue between doctors of the two blocs was itself the point.
Medicine for the whole world
Lown also worked to share medical knowledge with poorer countries. In 1988 he founded SatelLife, which used low-orbit satellites to deliver medical literature to health workers in the developing world, and in 1997 ProCor, an internet network that helped health workers in low-income countries learn about preventing heart disease. The Bernard Lown Scholars in Cardiovascular Health programme at the Harvard T.H. Chan School of Public Health, set up in 2008, trains health professionals from Africa, Asia and Latin America.
He was a passionate critic of what he saw as the commercialisation and over-treatment of American medicine. His book The Lost Art of Healing, published in 1996, argued that doctors had come to rely too much on technology and too little on listening to patients. In 2012 his research foundation became the Lown Institute, which studies and campaigns against unnecessary and unequal care.
A Jewish immigrant’s journey
Lown’s life traced a familiar path for Jewish families from Lithuania: a rabbi’s grandson in a small town, an emigrant at fourteen who escaped the destruction that would overtake Lithuanian Jewry a few years later, and a young man who rose through American public schools and universities to the top of his profession. In later life Lithuania honoured him with the Cross of Commander of the Order of the Lithuanian Grand Duke Gediminas.
He described the physicians of the world as having a special moral authority because their work is to preserve life. He once said that he had concluded that doctors were the cultural vanguard of civilisation. His sense that healers must speak out against mass death, shaped in part by the history of his people, ran through both his medicine and his activism.
Later years and legacy
Lown retired from the Harvard School of Public Health in 2000 as professor of cardiology emeritus, but remained active in writing and advocacy, publishing a memoir of his peace work, Prescription for Survival, in 2008. That same year the State of Maine renamed the bridge between Lewiston and Auburn the Bernard Lown Peace Bridge. The University of Maine’s Alumni Humanitarian Award is named for him, and he received honorary degrees from universities around the world.
Bernard Lown died at his home in Chestnut Hill, Massachusetts, on February 16, 2021, at the age of 99. Every year, people whose hearts stop are brought back to life by defibrillators built on the principle he proved, and patients after heart attacks survive in coronary care units shaped by his work. Few doctors have done more to prevent sudden death, whether from a failing heart or from the weapons he spent decades trying to abolish.
Sources & further reading
Bernard Lown, Wikipedia · Bernard Lown, UMaine grad and Nobel Peace Prize winner, dies at 99, Bangor Daily News · The Nobel Peace Prize 1985, NobelPrize.org · Bernard Lown, Acceptance Speech, NobelPrize.org · Bernard Lown, Wikiquote · Researched from the sources above and checked against them. Spotted an error? Tell us.
A life of tikkun olam. This is part of tikkun olam, the Jewish idea of repairing the world, and every one of us can add to it.