Alexis Carrel - Biography

The embroiderer Nobel laureate
Something as female as embroidery was of great importance to Alexis Carrel's rise to fame in the masculine environment of surgeons. He was the eldest son of Alexis Carrel-Billiard, a textile manufacturer, and his wife, Anne-Marie Ricard, both from bourgeois Roman Catholic Families.

Carrel made his first acquaintance with the life saving dextrousness when he was four years old, when his father died. To supplement her income, his mother undertook embroidering to support her three children. Alexis was very impressed by her skill with the tiny needles employed. Alexis was sent to a Jesuit day school and college near his home in Lyon. As a schoolboy he showed an interest in biology by dissecting birds. Encouraged by an uncle, he conducted experiments in chemistry.

After taking his baccalaureat he entered medicine at the University of Lyon in 1890. When the French President Mare-François-Sadi Carnot (born 1837) was assassinated by an Italian anarchist in Lyons on June 24, 1894, he was already specialising in surgery, and he was advised that the surgeons could not repair the president's portal vein which had been severed by the assassins knife. Such wounds could not at that time be successfully repaired.


A student of embroidery
From that time on Carrel became interested in techniques of suturing blood vessels and went to one of the finest emboriderists in Lyons, Madame Leroidier, to learn to use the tiny needles and thread which they employed. He developed an extraordinary skill in using the finest needels and practiced sewing with a needle and thread on paper until he was able to make stitches that would not show on either side. He used these skills in experiments on animals with vessel anastomosis, and devised a method of turning back the ends of cut vessels like cuffs, so that he could unite them end-to-end without exposing the circulating blood to any other tissue than the smooth lining of the vessel. By this device and by coating his instruments, needles and thread with parafin jelly, he avoided blood clotting that might obstruct flow through the sutured artery or vein. He avoided bacterial infection by a most exacting aseptic technique.

Carrel was attached to hospitals at Lyon from 1893 to 1900, from 1896 as an interne, except for a year as surgeon in the French army's Chasseurs Alpins. In 1900 he was conferred doctor of medicine at the University of Lyon.

His talent for anatomy and operative surgery became apparent when in 1898 he was attached to the laboratory of the celebrated anatomist Jean-Léo Testut (1849-1925) at the faculty in Lyon. He was prosector under Testut until 1902. That year he began publishing his results on suturing of blood vessels, but despite his undoubted clinical skills he was not popular with members of his faculty. This was enhanced by his often espousing myztical views.


A surgeon healer?
In 1903 Carrel took a pilgrimage to Lourdes and was impressed by the recovery of a young woman with tuberculous peritonitis. He strongly suggested a controlled study of the healings of Lourdes. This made him more unpopular with the faculty and he realized that he would not achieve any clinical advancement if he remained in Lyons. His brilliant achievement did not spare him from difficulties, brought on partly by his critical attitude toward what he considered the antiquated traditions and political athmosphere of the Lyon medical faculty. Finding a university career blocked by local opposition, he left Lyon and after a year of advanced medical studied in Paris, decided to migrate to Canada and left France "to forget medicine and raise cattle".


A new career in North America
When he arrived in Canada in 1904, Carrel met with two physicians who encouraged him to continue his medical career in North America, and he gave a paper at the French Language Congress in Montreal in 1904 which greatly impressed the chairman of physiology at the University of Chicago. He was offered a teaching position in Chicago and accepted, and arrived there in September 1904. In Chicago he worked in the physiological institute of George Neil Stewart (1860-1930). Here he commenced his experimental work on vessel surgery and soon had authored publications on anastomosis of blood vessels and transplantation of a kidney. In 1905 he transplanted a puppy's kidney to the carotid and jugular of an adult dog and watched the kidney function for several hours. In 1908 he was able to present a dog that had lived for 17 months with a transplanted kidney.

Carrel and his seven years younger collaborator, Charles Claude Guthrie, performed a number of surgical heterografts and homografts with kidneys and thyroids and commenced the study of rejection problems. A major part of the work that became the foundation for Carrel's receiving the Nobel Prize was performed jointly by Carrel and Guthrie during two 3-month periods in 1905 and 1906 at the Hull Laboratory at the University of Chicago, resulting in the publication of 21 jointly written papers.

Carrel's growing reputation for surgical skill, bold experimentation, and technical originality rapidly gained the attention of a number of leading scientists of that time, in particular the neurosurgeon Harvey Williams Cushing (1869-1939), the surgeon William Stewart Halstead (1852-1922) from Johns Hopkins and the pathologist/bacteriologist Simon Flexner (1863-1946), who was the director of the recently established Rockefeller Institute. Both Johns Hopkins and Rockefeller offered him positions and he chose the Rockefeller, which signalled the commencement of a long and happy association. This choice was probably largely due to Simon Flexner, a brilliant Jew from Louisville, Kentucky, who had little formal education, but understood the importance of so orthodox a mind as Carrel's to a faculty interested in making quantum leaps in medical research.


French-American transplants becomes Nobel laureate
Carrel was with the Rockefeller Institute of Medical Research, New York City, from 1906 to 1939, a full member from 1912. Here he resumed his surgical experimentation. Subsequent progress in surgery of the heart and blood vessels and in transplantations of organs has rested upon the foundation he laid down cetween 1904 and 1908. In 1910, he demonstrated that blood vessels could be kept in cold storage for long periods of time before transplanting them (Journal of the American Medical Association, Chicago, 1908; 51: 1662), and he was the first to cultivate tumour tissue in vitro. In this he had seized upon the work of Ross Granvlle Harrison (1870-1959) of Yale University, who announced in 1908 the cultivation of frogs cells in vitro.

On January 17, 1912, he removed a minute piece of heart muscle from an unhatched chicken embryo and placed it in fresh nutrient medium in a stopperd Pyrex flask of his design. He transferred the tissue every forty-eight hours, during which time it doubled in size and had to be trimmed before being moved to its new flask. Twenty years later, longer than the lifetime of a chicken itself, the tissue was still growing. Every January seventeenth, the doctors and nurses at the Rockefeller Institute would celebrate with Carrel, singing "Happy Birthday" to the chicken tissue.Joes

The replacement of diseased organs with sound ones and the restoration of amputated limbs had long been prevented because the suregon did not have a reliable technique for re-establishing circulation in the transplanted or restored part without the danger of hemorrhage or thrombosis. It was Carrel who perfected the anasotmosis of blood vessels in 1902 and, in doing so, provided the method which would revolutionize vascular surgery and make it possible to transplant organs and restore amputated limbs.

In 1912 Alexis Carrel won the Nobel Prize for physiology or medicine "in recognition of his work on vascular suture and the transplantation of blood-vessels and organs." He was the first person from North America to win this prize.