Blades of Light
How a purloined research device, an ounce of bravery, and a physician with a death grip brought about a brilliant medical enlightenment.
When a medical laser changes or saves a life, a handful of curious New York ophthalmologists and an audacious scientist are the ones to thank. Back when the laser was an exhilarating new technology—physicist Theodore Maiman created the first working laser at Hughes Research Laboratories in Malibu, Calif., in 1960—a group of doctors based at New York’s Bellevue Hospital sought to test the effects of a laser beam on a living eye. Being ophthalmologists, they feared that a direct hit could be disastrous. But the only way to know for sure was to try it.
In a loan that was not strictly aboveboard, the doctors “borrowed” the laser from the downtown Manhattan office of Technical Research Group (TRG), a defense private research firm. It was the first working example TRG had made, and they had set it aside to tackle the creation of different types of lasers. TRG physicist Gordon Gould, the man credited with hitting upon the principles that made lasers possible and invented its identifying acronym, had learned of the physicians’ request and chose to help, even though he was then fighting a tedious and ultimately fruitless battle with the U.S. government for a security clearance. (In his younger days, Gould had been associated with a Marxist study group. Unsurprisingly, this did not play well in the McCarthy era and Gould never did receive his clearance.) Many in his position would have flatly refused the doctors, not wanting to do anything that could possibly jeopardize the case, but Gould went ahead. He and another sympathetic TRG employee who had a security clearance snuck the two-piece laser out of its storage in a classified part of the building and spirited it away to Bellevue.
The doctors had already chosen a rabbit for their test subject, but were not sure how to protect their own eyes during the experiment. The very novelty of the laser stumped the highly educated medical experts, who settled on the dubious strategy of simply shutting their eyes when the time came. The role of Milton Zaret, MD, left him vulnerable: As the designated rabbit wrangler, he had to keep one eye open to ensure the test subject was correctly positioned.
When the deed was done, Dr. Zaret let go of the rabbit and found it distressingly limp. Fears that the laser was to blame melted away when he realized he had inadvertently squeezed it to death. The doctors then examined the deceased’s target eye and saw that the laser had indeed burned a hole in its retina, but not its vitreous humor or its surface structures. The truth dawned as bright and searing as the beam itself: The laser could serve as a scalpel made of light. Within months, ophthalmologists at what is now New York–Presbyterian Hospital performed the first laser surgery on a human being.
In its early days, the laser was described as “a solution looking for a problem.” It has since solved an impressive number of problems in its 55 years of existence, including many that had no solution before it came along. Not only was ophthalmology transformed by the laser, but so was dermatology, the specialty practiced by Leon Goldman, MD, the founding president of the American Society for Laser Medicine and Surgery (ASLMS). “These technologies were most rapidly adopted where you just plain could not do anything before,” says Raymond Lanzafame, MD, MBA, a general surgeon and continuing medical education director for the ASLMS. “An example from ophthalmology is the detached retina. There was not much you could do in 1960. But after 1960, there was much that you could do.”
(Continues on next page...)