Divine Influences in Medicine:
Cardiac Surgery: Historical Perspective and Contemporary Personal Witness

Divine influences in health and disease have been observed over the history of man. Though sometimes disputed by pure scientists and medical practitioners, intervention by divine sources has been documented in religious and secular literature. The premise presented in this manuscript is that God can and does influence health, disease, and the healing process as well as those who practice the healing art of medicine. The foundational basis for this argument is laid out in the historical perspective, with particular reference to the healing experiences of the ancient covenant peoples of the Bible and the Book of Mormon and the observational and practical foundation of modern medicine as practiced by the Greeks. The focus is then shifted specifically to the heart and circulatory system allowing contemporary personal observations and witness related to the premise. My own experience as a cardiac surgeon and man of faith reaffirms that God frequently intervenes at critical moments through divine revelation—or in other words, clear insight as communicated by the Spirit of God—to scientists and practitioners of medicine.

Healing among Ancient Covenant Peoples

At the beginning of recorded biblical history there was little mention of disease. The first several chapters of the book of Genesis do not refer to sickness, and the inhabitants of the earth lived for many years. According to Genesis 5, Adam lived over 900 years; Methuselah an estimated 969, fathering children at age 782; and Noah 500 years. Plague is first mentioned in Abraham’s time as recorded in Genesis 12:17^: “And the LORD plagued Pharaoh and his house with great plagues because of Sarai Abram’s wife,” meaning the incident in which the Pharoah took Sarai into his own house. During Moses’ time, plagues were inflicted on the Egyptians because of Pharaoh’s persistence in refusing to let the Israelites go. Thus, early in the Old Testament, the concept of disease being divinely inflicted as punishment for disobedient behavior was established. As a monotheistic society, the Israelite nation looked to the Lord as the source of all goodness and health and attributed sickness to breaking their covenants with him.[1]

Strict codes of behavior and hygiene under the mosaic law as detailed in the scriptures (Numbers and Deuteronomy) were to be obeyed. Much has been made of the presumed medical basis of food prohibitions and hygiene practice in the Hebrew traditions, but these laws were primarily followed for religious reasons.[2] Obedience to the law was expected to bring forth blessings, presumably better health as a gift from God. Adherence to rigid rituals of bathing, selection and preparation of foods, concepts of sanitation, and the theory of isolation practiced for leprosy were unique to the Israelite nation.[3] These rituals were defined, refined, and made more detailed, complicated, and restrictive over time by Hebrew priests.

Use of medications for treatment of disease was apparently very limited during Old Testament times. Jeremiah, however, mentions use of a resinous gum (“balm of Gilead”): “Is there no balm in Gilead; is there no physician there? (Jer. 8: 22).” This is likely due to individual reliance on divine intervention from the LORD by obedience to His commandments and following as a culture the established health rituals. David summed it up in Psalm 103: 2-3, referring to the benefits offered by reliance on the LORD: “Bless the LORD, O my soul, and forget not all his benefits: Who forgiveth all thine iniquities; who healeth all thy diseases.”

In Book of Mormon times, the people in ancient America, who lived under the mosaic law, treated “fevers, which at some seasons of the year were very frequent in the land.” with natural remedies “because of the excellent qualities of the many plants and roots, which God had prepared to remove the cause of diseases, to which men were subject by the nature of the climate—” (Alma 46:40).

In the New Testament, despite the presence of an existing medical profession (see Luke 8:43), Jesus Christ miraculously cured all manner of physical illnesses including fever, leprosy, gynecologic bleeding, skeletal deformity (withered hand), dropsy (edema-fluid retention), deafness, blindness, and paralysis. Assuming that being possessed by demons or a “lunatick” (Matt. 17:15) refers to mental health disease or perhaps epilepsy, Jesus drove demons or devils, even multiple demons out of nine individuals.[4] Jesus raised three people from the dead. When he healed a blind man, he refuted the prevailing Jewish notion that physical maladies are caused by sin. “And as Jesus passed by, he saw a man which was blind from his birth. And his disciples asked him, saying, Master, who did sin, this man, or his parents, that he was born blind? Jesus answered, Neither hath this man sinned, nor his parents: but that the works of God should be made manifest in him” (John 9:1-7).

Jesus Christ commissioned the Twelve Apostles during his ministry and gave them the power to heal. Following the Savior’s death and resurrection, the Apostles continued to perform healing miracles: “There came also a multitude out of the cities round about unto Jerusalem, bringing sick folks, and them which were vexed with unclean spirits: and they were healed every one” (Acts 5:16).

Following his crucifixion, the resurrected Christ showed himself to the people of Nephi, in the land Bountiful, and healed their sick: “All the multitude with one accord, did go forth with their lame, and with their blind, and with their dumb and with all them that were afflicted with any manner; and he did heal them every one as they were brought forth unto him” (3 Nephi 17:7-9, emphasis added).

Greek Medicine: Observation and the Rational Approach

Meanwhile, a different approach to health and healing was developing among the Greeks. Before Hippocrates, who lived in the Greek golden era, Greek healing was tied closely to divine intervention by pagan Gods. Many temples of healing in honor of Asclepius, the Greek deity of medicine, were built between the 6^th and 3^rd centuries B.C. throughout what was later the Roman Empire.[5] Religious cures were mingled with practical treatments. Priests of the cult of Asclepius administered care that was largely homeopathic, or diet based, though some plant-derived drugs were used. Therapeutic bathing, diet, exercise, and massage were employed, as were prayer and symbolism, indicating a strong reliance on divine intervention in medicine. Particularly interesting treatment occurred during “incubatio” sleep in a designated area, wherein the priests of Asclepius cult administered therapy to patients during the night and wakened them from spontaneous or drug-induced sleep. They employed dream therapy, prayer, sacrifice, symbolism, and even non-venomous snakes to excite the imagination. All this began to change when Hippocrates appeared on the healing scene.

Hippocrates lived on the island of Cos in Greece during the period 460-375 B.C.[6] A man of high intellect, he was considered the foundation of Greek medicine. He began to establish a rational attitude toward medicine, based upon careful observation of the patient, free from pagan religious or superstitious explanations. The rational attitudes expressed in the collected writings of Hippocrates represent a great advance in medical thinking, but required centuries of gradual development. Hippocrates` work formed a foundation on which truth could be laid. Asclepius temples dedicated to the worship of pagan Gods, however, continued to flourish during his period and for centuries thereafter.

During the centuries following the ministry of the Savior and His Apostles, healing in the Greek culture and medicine evolved further. If Hippocrates is the foundation for Greek medicine, Galen must be considered the apex of Greek medicine.[7] Galen lived from 129-203 A.D. He was educated in Pergamon, site of the famed Asclepius healing temple, and later in Alexandria. Galen established experimental physiology as a discipline. He regarded anatomy as the foundation of medical knowledge. He was an excellent pharmacist, formulating medicines derived from plant and animal ingredients. He was also a prolific writer with over 300 titles attributed to him, which achieved wide circulation during his lifetime. By 500 A.D. his works dominated medical thinking. Medical and church authorities considered his work based on divine inspiration and therefore infallible. He was dubbed Divinus Galenus (Galen the Divine). His authority, theory, and dogma were unchallenged for 1,500 years.

Unfortunately, Galen`s concept of the function of the heart and circulation were not correct. Galen understood that the valves of the heart controlled direction of blood flow and that the heart generated pulsatile force, filling during relaxation and ejecting blood during contraction. However, he thought incorrectly that that the heart and circulation to and from it was an ebb and flow, with the heart functioning like a bellows system. According to his theory, mixing of the arterial and venous circulation occurred across minute pores in the ventricular septum of the heart. His explanation of circulation prevented proper understanding for centuries in part because of the idea that it was sinful to challenge divinely inspired knowledge.

In many respects, it is remarkable how much the ancients knew about the human body, its physiology in health, and the symptoms and signs resulting from disease. Medical treatment of disease during those times, though empirical and based mostly on pharmacologically active extracts of plants, was not without effectiveness. It remained for those who followed, however, to design scientific experiments that more completely defined the function of the various organ-systems in order to establish the basis for specific treatment modalities.

Transition to the Modern Period

While the practice of medicine in the Middle Ages is beyond the purview of this brief survey, it should be observed that the vast intellectual awakening of Europe in the period from about 1450 to 1550, sometimes called the Renaissance, had its counterpart in medicine. In addition to the deep respect evinced in medieval Europe for medical knowledge and practice of the Greeks, in common with developments in other fields of learning, many additional Greek medical texts were made available for general use, including the complete works of Galen in 1525. The wide dissemination of knowledge was made possible after 1450 with the invention of the printing press. As questions arose, some inquirers began to replace total reliance on the medical knowledge of the Greeks with careful observation and methodical study.[8] A new age, not only in literature and art, but also in science and in medicine, had begun.

William Harvey Defines the Circulatory System

Galen’s theory of the circulation lasted until 1628 A.D. when the landmark contribution of William Harvey of De Motu Cordis (Movement of the Heart) was published.[9] This 72-page book published in the Latin language demonstrated the circulation in animals based on carefully designed experiments and observations. Harvey was stimulated by simple observation of the valves of veins located superficially in the forearm of man. Simple experiments demonstrated that blood flows toward the heart in veins rather than toward the extremities as taught by Galen. Because of valves in the heart, blood could only flow in one direction and because both ventricles contracted and expanded together, there was no pressure difference between them sufficient to drive blood through the septum. Harvey reasoned, therefore, the heart was a pump, not a bellows. From his experiments on the circulation Harvey concluded: I began to think whether there might not be a movement, as it were, in a circle.”

Harvey’s work appears to have been divinely influenced.[10] The title page of De Motu Cordis reveals an engraving of a heraldic angel with right hand resting on a column. The column is wrapped with a banderole inscribed aiterno deo commenda, “commit to eternal God” and below, the Benedictine motto: Ora et labora, “Pray and work.” Harvey had a strong religious background through his education in England. King’s School, Canterbury, where he studied, which required daily prayer morning and evening in the classroom. He began each day at the University of Cambridge with compulsory prayer in chapel. During Harvey’s visit to Padua, Italy, as a medical student, he would have certainly been attracted to the cathedral of Santa Giustina with a chapel reputed to contain bones of St. Luke, the evangelist-physician referred to in Col. 4:14 as “Luke, the beloved physician.” At Padua, the Benedictines of the cathedral taught “their theology of salvation as therapeutic, as the restoration of a broken human nature to its created divine image by the healing of Christ the physician.”[11]

In his last will and testament, Harvey committed his soul “to Him who gave it and to my blessed Lord and Saviour Christ Jesus” and was considered by a contemporary a “pious good Man.”[12] In 1616, at the age of 37, he prefixed his first lecture on human anatomy, with the words, “And to none can these attributes be referred save to the Almighty, first cause of all things. . . the Creator and Father of all that is in heaven and earth, on whom all things depend for their being, and at whose will and pleasure all things are and were engendered.”[13] While neither trying to debunk the learning of the ancients nor to establish a reputation as a prominent figure in the unfolding Scientific Revolution, he was inspired by the quest of “final causes” and sought merely to know the truth and the purpose of the circulation of the blood in the context of the order of the cosmos.[14]

By the hard work of many dissections and experiments and his own detailed observations, very likely accompanied by a routine of daily prayer, William Harvey’s mind appears to have been opened to inspiration of truth and understanding --or in other words, divine revelation--of the human circulatory system not previously known.

Divine Influence in Contemporary Cardiac Surgery

Once the principles of the circulation were understood, three more centuries were required before these principles were widely accepted, the morphology of various disease states of the heart and circulatory system were defined, and technology developed sufficiently to allow correction of maladies of the heart and blood vessels. Divine influence has been observed during the rapid unfolding of the entire field of cardiac surgery during a 80-year period by the cumulative effort of countless physicians and a few great ones. Common threads in the great advances in cardiac surgery from my own perspective as a cardiac surgeon and a man of faith appear to be: (1) study of known precepts; (2) intent and intense thought; (3) careful planning involving writing and illustration; (4) opening the mind to divine inspiration.[15]

As we understand that the natural powers of healing are stronger than any medicine or operation that can be applied, we can begin to recognize that the task of a physician or surgeon is to assist those natural processes. All progress in medicine begins with understanding basic physical and biological scientific truths and known clinical methods of treatment. Careful, unbiased, objective, and intellectually honest observation leads to correct diagnosis of the problem and understanding of the morphology. As we focus complete attention and the powers of mental concentration on the problem that confronts us, the mind is open to invite divine inspiration to solve the problem. At times the solution, which comes through revelation from God, is a departure from the established method and a completely new, innovative approach. Thus, medical knowledge is advanced as new understanding is applied. Skeptics and unbelievers attribute such new insight to their own capability and personal brilliance or genius, while those who believe in divine intervention recognize this phenomenon as a gift of the Spirit.

Elder Russell M. Nelson

While Elder Russell M. Nelson, of the Quorum of the Twelve Apostles, is well known among the Latter-day Saints for his prominence as a cardiac surgeon, who received divine inspiration in the advancement of his field, less well known is the fact that he was part of the team of surgeons that developed the heart-lung machine, first used in successful cardiac surgery in 1954.[16] This was a foundational breakthrough in the progress of heart surgery as it allowed the surgeon to stop the heart during surgical repair and then to start it up again.

Elder Nelson has used personal experiences with divine intervention as teaching parables. He relates a personal experience of divine intervention “during the early pioneering days of surgery of the heart.”[17] He tells of a man with two faulty heart valves. At that time one valve could be helped surgically, the other could not. Thus, an operation was not advised. The man pleaded with great faith and prayer for help. Responding to the man’s great faith and trust, Dr. Nelson agreed to try to help him by operation. Dr. Nelson stated: “I prayed over and over again, but still did not know what to do for his leaking tricuspid valve.” Even as the operation commenced, he did not know what he would do. During the operation, “while examining this valve, a message was distinctly impressed upon my mind: Reduce the circumference of the ring. Then a picture came vividly to my mind showing how stitches could be placed …to accomplish the desired objective.” The repair was completed as diagramed in his mind. The operation was successful and restored functional life for many years. The “miracle” was “an answer to prayer.”

I had been in Birmingham, Alabama, for a meeting and had observed Dr. John W. Kirklin replace the aortic valve using continuous stitches of suture material. Prior to this, I and most other surgeons had been using individual stitches to attach the valve. The stitches were all placed before the artificial valve was lowered into position in the aorta, using only three strands of suture material. The loops of suture were pulled up sequentially using a small hook instrument to approximate the aortic tissues to the artificial valve. I was impressed by the simplicity, even and smooth approximation of the tissues to the valve, quality of distribution of the tension on the suture, and the reduction of knots (there were only three knots). I used this technique in my patients subsequently and was pleased with it.

Elder Russell M. Nelson has been a professional colleague, partner in practice, mentor, and friend to me for many years. While visiting with Dr. Nelson at a medical meeting, I extolled the benefits of using continuous suture technique to replace the valve. He seemed interested. It wasn’t long after that meeting that he told me that he had been using the continuous suture technique and had learned a better way to do it. He said: “The Spirit gave me the technique during an operation. It was a gift from God.” He went on to describe method in detail, which had to do with the method of tightening the suture loops as the valve was lowered into position. Pulling up the suture loops was always a bit of a nuisance because of tangling, overlap, the inherent resistance of the tissues and the sewing cuff of the artificial valve to the sliding through of the suture, the need for a hook to sort the loops and tighten them, and the risk of the hook fraying or breaking the suture. Dr. Nelson had been given the inspiration that a length of soft silk string could be placed around a loop of the primary suture and used as a “pulley” to tighten the suture as the valve was lowered into position. The pulley was then removed and the rest of the suture tightened easily without resistance from the tissues. It all sounded very logical to me. I tried the revised technique exactly as he had described to me and found it to work perfectly. This formed the basis for a standardized technique that could be performed exactly the same in every case of aortic valve replacement providing reproducible, and predictable excellent result. We published this technique in a scientific journal for the benefit of fellow surgeons and their patients.[18] I did not deviate from this technique during the subsequent 20 plus years of practice, knowing the source of this gift of knowledge.

Personal Experiences

I had sufficient personal experiences during 35 years of practice of cardiovascular surgery to know that I did not work alone. I have had my mind guided in decisions made in the operating room and my hands directed to perform technical maneuvers that were beyond my ability.[19] During the first year of my practice in 1972 I operated on a five year old child with a localized narrowing of the aorta just above the aortic valve (supravalvular aortic stenosis).[20] I performed the operation that was standard for the condition at that time. This consisted of insertion of a fabric gusset at one side of the aorta to widen out the aorta across the narrow point. I performed the operation according to established technique. Unfortunately, the obstruction was not relieved, and a second operation was required a few months later. During the second operation, as I carefully examined the tissues involved in the process, it was impressed upon my mind that I should divide the narrow area at two points and for a more symmetric repair of the defect. The details of the operation unfolded with remarkable clarity and a fabric patch with two limbs was inserted to restore the proper anatomic relations of the deformed aorta. A new solution to the problem of supravalvular aortic stenosis had been found. Subsequent patients with similar abnormalities were treated with the new procedure. It was reported in written form in the medical literature and the operation is now widely employed in the practice of cardiac surgery.

A man with a complex abnormality of the heart, present since birth (corrected transposition), was evaluated for cardiac transplantation. The heart had deteriorated under the burden created by the defect. He had nearly reached the end of life and the only option for prolonging his life was cardiac transplantation. In addition to the failing heart, the position of the heart in the body was reversed (situs inversus).[21] Operation to transplant the heart had not been accomplished in such a patient. The problem was how to match the normal position of the transplanted heart to one in which everything was reversed. All diagnostic material was studied in detail. A plan was formulated including simple drawings of how the operation could be accomplished. Some weeks passed while waiting for a suitable donor. During this period there was a nagging feeling that the plan was not right. When the donor was finally identified in a distant city, I rethought the problem intently while the donor heart was obtained. A completely new plan was impressed upon my mind. The new plan was accompanied by feeling of confidence that it would work. The complex operation unfolded with remarkable ease and was completely successful. We rebuilt the venous channels routing them from the abnormal locations to the left side of the body to the normal right side locations. The patient did well after operation and lived for many years without obstruction to the venous channels that we had created.

A woman presented with attacks of extreme shortness of breath.[22] Diagnostic imaging revealed a tumor involving nearly all of the left side filling chamber of the heart (left atrium) and the veins which brought blood from the lungs to the heart (pulmonary veins). The cause of difficulty breathing was due to high back pressure in the pulmonary veins due to obstruction of blood flow by the tumor. Further growth of the tumor would have ended her life most uncomfortably. Tumors in the left atrium are very difficult to remove because of limited access at operation. It had been reported that such tumors could be removed by first removing the heart to gain exposure to the tumor. After removing the tumor, the heart was reattached in its natural position in the patient (autotransplantation). Removing a tumor of this extent, involving nearly all of the left atrium and one-half of the right lung, as was the situation in this patient, had never been accomplished.

After studying the diagnostic images of the problem, I was confident that an operation could be done to rid the patient of the tumor. The problem would be reconstruction of the left atrium after the tumor was removed. This would require rebuilding the left atrial reservoir capacity. I thought this could be done using “patches” of the heart sac (pericardial sac). We proceeded with the operation. The patient was placed on the heart-lung machine to sustain her. The heart was arrested and removed from in front of the tumor leaving a rim of the left atrium for later reattachment. The heart was placed in a basin of ice-cold saline solution for preservation. Removal of the tumor required detachment of the left atrium from the veins draining the left lung and the lower one-half of the right lung. Nearly all of the left atrium containing the tumor and the obstructed upper one-half of the right lung were removed “en bloc.” How to reconstruct the left atrium and reconnect the pulmonary veins starkly confronted us.

As I examined the remaining tissues carefully and thought intently about what options were available, it was impressed clearly upon my mind to simply reattach the stumps of the veins directly to the heart sac. Rather than using patches of the heart sac, it could be left in its natural position (in situ). The heart sac remaining had been in contact with the outside of the left atrium and was therefore the exact size and shape to reconstruct what had been removed. This was an entirely new solution to a difficult problem that had not been known previously. Reattachment of the pulmonary veins was accomplished in short order working from the inside of the heart sac. It was then possible to bring the patient’s own heart out of the cold storage bath and attach the remnant of the left atrium to a rim of the heart sac that was created during the suturing process. A patch of pericardium was required for part of the reconstruction where the heart sac had been attached to the tumor and therefore removed. The other great vessels were then reattached. When blood was allowed to flow into the autotransplanted heart, it resumed its normal function promptly.

Conclusion

Personal experiences such as those described have been dramatic and unmistakable examples of divine intervention in real life surgical situations. Such messages of truth and enlightenment have been defined as revelation, inspiration, unique insight, or if visually explicit, a vision. Though somewhat different in manifestation, all are related and each message is a gift from God. The General Epistle of James 1:17-18 describes this well: “Every good gift and every perfect gift is from above, and cometh down from the Father of lights, with whom is no variableness… of his own will begat he us with the word of truth…”¹⁸ God will give these good gifts of truth and knowledge to the man/woman whose mind is prepared to receive the gift regardless of nationality, culture, or religious persuasion.

Each time a new insight has been revealed to my mind by the Spirit of God, it has been accompanied by a quiet reassurance that proceeding according to revelation would be successful. Such insight also been accompanied by an enhanced physical ability and dexterity to perform the technical maneuvers required to accomplish the task. These experiences have been gratefully received and appropriately credited to the blessings of the Spirit. An egotistical surgeon could easily credit his own genius, but I know otherwise. These experiences are divinely influenced and part of God’s gifts of truth and knowledge to man. These gifts presented to many other health professionals have resulted in advancing the science of the healing profession to its present state on knowledge.

Revelation has been given by God continuously throughout the history of medicine, “precept upon precept; line upon line, line upon line; here a little, and there a little” (Isa. 28:10). Thus, by divine influence the practice of medicine has gradually progressed from magic, cult worship, and medicines derived from bark and berries to technologically assisted diagnosis and evidence-based treatment plans supported by a pharmacopeia of chemically compounded drugs and well defined, proven surgical procedures all based upon scientific truth. Every revelation from God has had historic consequences on the practice of medicine which has been influenced by countless small advances, which in aggregate, has resulted in a continuous flow of scientific knowledge. The history of the world has thus moved forward in a positive direction, to the blessing of all of Heavenly Father’s children. What seems self-evident today, however, may in the future appear primitive as God continues to reveal light and knowledge to man providing treatment based on genetic and molecular biologic determinants of disease.

Endnotes

[1] On the Web. Mason WA. The monotheistic concept and the evolution of medical thought. Phylon 12:255-263, Clark Atlanta University. http://jstor.org/stable/271640

[2]. Lyons AS, Petrucelli RJ II. Medicine, An Illustrated History. Harry N. Abrams, Inc. New York, p. 71.

[3] On the Web. Mason WA. The monotheistic concept and the evolution of medical thought. Phylon 12:255-263, Clark Atlanta University. http://jstor.org/stable/271640

[4] On the Web: Miracles attributed to Jesus. Wikipedia. http://en.wikipedia.org/wiki/Miracles_attributed_to_Jesus

[5] Doty DB. Discovery in medicine: from ancient Greeks to the present. Jour Collegium Aesculapium, Fall 2006 pp. 42-49.

[6] Doty DB. Discovery in medicine: from ancient Greeks to the present. Jour Collegium Aesculapium, Fall 2006 pp. 42-49.

[7] Doty DB. Discovery in medicine: from ancient Greeks to the present. Jour Collegium Aesculapium, Fall 2006 pp. 42-49.

[8] On the Renaissance in medicine, see Roy Porter, The Greatest Benefit to Mankind: A Medical History of Humanity ( New York: W.W. Norton & Company, 1990 [C1997]), 168-200. Porter’s account is considered by many to be the best one volume history of medicine.

[9] Harvey W. Exercitatio Anatomica De Motu Cordis Et Sanguinis In Animalibus. Fasimile of the Francofurti Edition 1628. The Classics of Cardiology Library, Birmingham 1985.

[10] On the Web: Boyle MO. William Harvey’s Anatomy Book and Literary Culture. Med Hist 52(1):73-91 2008 http://www.pubmedcentral.nih.gov

[11] On the Web: Boyle MO. William Harvey’s Anatomy Book and Literary Culture. Med Hist 52(1):73-91 2008 http://www.pubmedcentral.nih.gov

[12] Keynes, Sir Geoffrey, Harvey Through John Aubrey’s Eyes ([London]: The Royal College of Physicians and Surgeons,1958), pp. 6-7.

[13] Power, Darcy, William Harvey (London: Masters of Medicine, 1897), 52-55.

[14] Pagel, Walter, William Harvey’s Biological Ideas (Basel and New York: S Karger, 1967), pp. 22-26.

[15] Doty DB. Cardiac surgery and the creative process. Annual of Cardiac Surgery 6^th Ed. Current Science Ltd. London UK and Philadelphia PA USA 1993, pp. 89-94

[16] On the Web: Russell M. Nelson, Wikipedia. http://en.wikipedia.org/wiki/Russell_M._Nelson

[17] On the Web: Nelson RM. Sweet Power of Prayer. Ensign 33 (May) 2003 http://www.lds.org/

[18] Doty DB, Nelson RM. Aortic valve replacement: continuous-suture technique. Jour Cardiac Surg 1986; 1:379-382.

[19]Doty DB. Discovery in medicine: from ancient Greeks to the present. Jour Collegium Aesculapium, Fall 2006 pp. 42-49.

15 Doty DB, Polansky DB, Jenson CB. Supravalvular aortic stenosis: repair by extended aortoplasty. Jour Thorac Cardiovasc Surg 1977; 74:362-371

¹⁶ Doty DB, Renlund DG, Caputo GR, Burton NA, Jones KW. Cardiac transplantation in situs inversus. Jour Thorac Cardiovasc Surg 1990; 99:493-499.

[22] Doty DB, Doty JR, Reid BB, Anderson JL. Left atrial sarcoma: resection and repair by cardiac autotransplant and in situ pericardial patch. Ann Thorac Surg 2006; 82:1514-1517.

¹⁸ The Holy Bible, King James Version. James 1:17-18.