9:15 In the next room, the heart-lung machine is ready. Developed by Michael DeBakey for his pioneering heart transplant surgeries in the 1960s, it is a series of foolproof-simple pumps, and a simple artificial lung that adds oxygen to the blood. 
Using Smith's own blood vessels for the grafts eliminates the chance of rejection (defined) that plague transplants from outside the body.
From above Smith's head, the anesthesiologist can see the heart beating, seemingly innocent of the turmoil it is about to undergo. For the first time in more than six decades, this heart is going to lie still.
8:50 The anesthesiologist gives a guided tour of the maze of pipes, tubes, valves, wires and bags in the anesthesiologist's domain near the patient's head. From a plethora of sensors, several video monitors show the body's core temperature, the blood temperature, the blood pressure on the arterial (defined) and venous (defined) sides, the pulse, the heart's electrical signals (on an electrocardiograph), the blood's level of oxygenation, the amount of carbon dioxide in exhaled air, pressure in the patient's airway, and a few other factors I've doubtless forgotten.
It's a complicated picture, to say the least, but she's shut off the alarms, for fear "they would drive us crazy." With so many possible indicators to keep track of, what does she look for? "A pulse that's inconsistent with good blood pressure and perfusion" (defined).
9:13 The supervising anesthesiologist mentions that the first heart surgery of the modern era occurred in 1895 in Germany, when Wilhelm Justice sewed up the left ventricle of a man who had been stabbed in the heart. The patient survived.
9:15 In the next room, the heart-lung machine is ready. Developed by Michael DeBakey for his pioneering heart transplant surgeries in the 1960s, it is a series of foolproof-simple pumps, and a simple artificial lung that adds oxygen to the blood.
© University of Wisconsin-Madison Medical School, Edward Joseph, photographer.
To demonstrate exactly how foolproof, the machine's minder points to the small cranks that are clamped next to each pump. If the electricity goes out, manual cranking can keep Smith alive. Not that an outage is likely: The hospital is independently connected to two electric utilities, and if they both go out, a backup generator is standing by.
But Smith's life will depend on this machine just as much as it will on the skill of this surgical team.
By now, the plumbing project is slipping into high gear.
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