On the operating table under a bright light and surrounded by a jungle of glittering equipment is a sixty-year-old man being covered with special green drapes that leave a long, rectangular opening squarely over the middle of his chest and another opening over his left leg.
Dr. Russell M. Nelson joins seven other members of the surgical team in the room: the senior resident in surgery; a surgical nurse; an anesthesiologist; a heart-lung machine specialist; a computer specialist; and two other nurses, one of whom is in charge of the operating room. I stand slightly apart from them, an observer, scrubbed and wearing sanitized clothing.
Having taken their positions, they begin their work with an alacrity that is somewhat chilling to a newcomer. The senior resident, in one deft stroke, makes a foot-long incision the length of the sternum, following quickly with a cauterizing tool that seals off the numerous small vessels that have begun to bleed into the wound.
Meanwhile, Dr. Nelson is making an incision in the left leg to locate a vein that will be removed. This is to be a quadruple coronary arterial bypass operation—in other words, surgery to bypass obstructions in four arteries that feed the patient’s heart muscle. The vein being taken from the thigh will be used for the bypass grafts. There is a snipping of scissors and more cauterizing. I make an unscheduled exit to the hallway for a breath of fresh air and a reassessment of my determination to continue with this assignment.
Then comes the whirring sound of an electric saw. Reentering the room, I am stationed at the head of the operating table, where in full view before me I see that the patient’s sternum has been sawed through longitudinally and an ingenious retractor has been placed in the cleft. Several cranks on a short lever spread the retractor apart—and there, between the patient’s spread ribs, is his beating heart.
Soft music is playing quietly over the intercom. The surgeons’ eyes reveal no amazement, no sense of drama—only deliberate concentration. My weak-in-the-knees feeling soon leaves, and the procedure takes on a magnetic fascination.
An incision is carefully made into the aorta and one of the chambers of the heart, which continues to beat. Long sutures are prepared. Tubes coming from the heart-lung machine—the “pump”—are inserted into the incisions, and at a given signal the heart-lung machine whirrs into action. Now the dark venous blood entering the heart is intercepted and routed through the heart-lung machine, which oxygenates it and returns it—now a brighter red—to the arterial system leading to the patient’s body. At length the heartbeat slows to a stop and the intricate repairs begin.
The surgeons now wear glasses with powerful magnifiers built into the lenses. Using a very small scalpel, they begin to carefully probe the layer of fat around the heart to locate the arteries in question, which are scarcely distinguishable from the surrounding fatty tissue. They find one, and after a glance at an X-ray illuminated on the wall, the surgeon makes a small slit. Then a small catheter is inserted into the slit and pushed carefully up the artery until it suddenly comes to a stop against an obstruction. After a light tap on the catheter, which I can almost feel in my own fingertips, the surgeon says, “That’s it. There’s just a very narrow opening for blood to pass through.”
A section of the pencil-size vein that will serve as the graft is carefully measured and trimmed to the correct length. Then, with the utmost care and an amazing display of teamwork, the two surgeons begin to sew the graft onto the slit in the artery. The tiny, curved needle passes from hand to hand; the hairlike thread is drawn snug; the knots are tied.
After more than an hour of painstaking labor, four grafts have been connected to the aorta. Suddenly the blood pressure drops, much to everyone’s surprise. Making the diagnosis immediately, Dr. Nelson points to a clamp that should have been left on one of the many tubes at this critical point in the procedure. It is quickly replaced—a small mistake, but one that could have been costly.
“I still love you,” he says to the team member responsible for the oversight. There is a nod of appreciation. Then Dr. Nelson adds with a wry tone, “Sometimes I love you more than other times …”
And there are smiling eyes all around. He is clearly the one in control of this operation. He keeps the atmosphere light enough so that all the team members remain relaxed. But there is also an unspoken demand for constant concentration.
“This is how an emergency has to be handled,” says the anesthesiologist quietly aside. “The surgeon in charge—whoever he is—has got to stay cool. He has to stay calm and think, ‘Let’s find out what has to be done, and then do it.’”
Dr. Nelson later comments: “It’s a matter of extreme self-discipline. Your natural reaction is, ‘Take me out, coach! I want to go home.’ But of course you can’t. A life is totally dependent on the whole surgical team. So you’ve got to stay just as calm and relaxed and sharp as you ever were.”
He recalls his days as an intern when he saw instances of undisciplined conduct in the operating room. Once when he was helping amputate a gangrenous leg, the surgeon became so excited that as he was cutting through tissue loaded with deadly organisms, he slipped and jabbed the knife through Dr. Nelson’s arm.
“I didn’t like that too well,” he says in obvious understatement. “I resolved then and there that I would discipline my body to be subject to the dominion of my spirit.”
Four hours have now elapsed, and things are just about wrapped up. The heart-lung machine has been disengaged and the heart gently shocked into activity with electrodes; the grafts, now fairly bulging with a new blood supply for the heart muscle, have been checked for leaks. The heart is doing well on its own, and the patient is stable. Thoughts now turn to the patient’s worried family, and one of the nurses reaches for a telephone: “We’re off the pump, we’ve done four grafts, and Dr. Nelson will be down in about 45 minutes.”
Open-heart operations like this one are done more than 100,000 times each year in the United States. In his more than thirty years as a pioneer in the field, he has seen the technology associated with open-heart surgery, and the expertise of surgeons, advance to the point where less than two in one-hundred patients fail to leave the hospital.
His own medical education began in 1942 during his second year at the University of Utah, and since that time he has developed a summary view of medicine that is remarkably simple: “As a physician analyzes a patient’s problem,” he says, “one crucial question needs an answer: Is the patient’s condition one that will improve with the passage of time, or will it become worse? For example, a fractured rib will heal with only minimal care; but a deteriorating heart valve cannot heal, and with time will only worsen. The doctor’s function is to convert the process from one that will not heal to one that will heal with the passage of time.”
In carrying out that function, he says, a physician or surgeon must realize that he has no healing power in himself to dispense. He can only depend on the divinely endowed and timelessly dependable healing powers of the human body. He quotes from the Doctrine and Covenants: “There is a law, irrevocably decreed in heaven before the foundations of this world, upon which all blessings are predicated—
“And when we obtain any blessing from God, it is by obedience to that law upon which it is predicated.” (D&C 130:20–21.)
“In other words,” he continues, “whenever a blessing is received, it’s because a law has been obeyed. And that means it will always work—not just most of the time, not just some of the time, but every single time without exception. That takes the pressure off an individual who is willing to study the laws that govern the physical body and be obedient to them. Otherwise we’d be crazy to take these patients down to death and back every day.”
It was while he was studying medicine at the University of Utah that he met his wife-to-be. He had been recruited for a role in a play, and when he arrived at the theater for the first rehearsal, he heard the soprano voice of a dark-haired young woman on the stage. He stopped suddenly and asked the director, “Who is that beautiful girl singing up there?”
“That’s Dantzel White. She’s the one you’ll be performing with,” was the reply.
He vividly remembers the feeling that came over him. “I thought she was the most beautiful girl I had ever seen and sensed that she was the one I would marry,” he said. Dantzel felt the same way. When she went home to Perry, Utah, she announced to her parents that she had met the man she wanted to marry. Three years later they were married in the Salt Lake Temple.
Having entered the university’s medical school in 1944, Russell completed the four-year course in three years, with continuing encouragement from his wife and his parents, Edna and Marion C. Nelson. Then followed an internship at the University of Minnesota Hospitals where, in addition to the normal surgical training, he began a program leading to the Ph.D. degree. He also became part of a team that received a five-year research grant to develop a machine that would take over the functions of a patient’s heart and lungs while the heart was being surgically repaired. The challenges were enormous, but after nearly three years of labor it was ready for use. In 1951 it was used for the first time in an open-heart operation on a human being.
After a two-year interruption for medical service in the U.S. Army during the Korean War and another year of service at the Massachusetts General Hospital in Boston, he returned to the University of Minnesota and completed his Ph.D. degree in 1954. With this long period of advanced surgical training behind them, he and Dantzel returned to Salt Lake City with their family, which now included four daughters—Marsha, Wendy, Gloria, and Brenda—with a fifth, Sylvia, soon to arrive. As an assistant professor of surgery at the University of Utah College of Medicine, he continued in research, teaching, and surgery.
Those first days of open-heart surgery were, in his words, “like sailing an uncharted sea,” with moments of euphoria but with despair as well, when surgery was unable to save a life. Brother Nelson describes one such instance early in his career: “In 1957, Brother and Sister H. brought their third child to me for repair of congenital heart disease. Their first child had died from congenital heart disease before the advent of cardiac surgery, and their second also died after an unsuccessful open-heart operation that I performed. I operated on the third child, but she died later that night.
“My grief was beyond expression. When I went home, I told the story to Dantzel and said, ‘I’m through. I’ll never do another heart operation as long as I live!’ I wept most of the night. All I could think of were the faces of those two parents, and I could still see those pathetic children in my mind, blue-lipped and with clubbed fingers, yet with smiles of confidence and hope. I determined that my inadequacies would never be inflicted on another human family.
“When morning came, Dantzel finally said, ‘Isn’t it better to keep trying than to quit now and require others to go through the same grief of learning what you already know?’
“I listened to her counsel. I returned to the laboratory to work a little harder, learn a little more, and strive further.”
Twenty-five years later, he has still not become hardened to the suffering of his patients. “Nowadays doctors have a very high rate of success in these operations,” he says, “but we can’t save everyone—that would be impossible. Sometimes all we can do is offer comfort. We don’t ever want to destroy hope. The doctor’s job is to cure sometimes, to relieve suffering frequently, but always to comfort.”
In 1959 he left the University of Utah and went into private practice. There he was, thirty-five years old and with a family of six children, in training all those years after medical school, going deeper and deeper into debt in order to properly train himself.
His lack of concern for money is reflected in a humorous incident that occurred when he was called, in 1964, to be president of the Bonneville Stake. Elders Spencer W. Kimball and LeGrand Richards were assigned the task of choosing a new stake president, and in an interview Elder Kimball showed him a figure written on a piece of paper and asked him if that was all the tithing he had paid in the previous year. Glancing at the paper, Brother Nelson said, “Yes, it’s an honest tithing.”
“Well, I thought you were a little more prosperous than this figure might indicate,” said Elder Kimball.
“I don’t know how much I paid,” he said. “All I can say is, it’s a full tithing.”
But great was his embarrassment when he went home and consulted his records. As it happened, that was the year they had moved from one ward to another within the stake. Consequently, the figure Elder Kimball had showed him was the amount he had paid for the one month they had lived in their new ward; Elder Kimball didn’t have record of the tithing he had paid during the previous eleven months of the year!
Nevertheless, he was called to the demanding work of a stake president. Prior to his setting apart, Brother Nelson had mentioned that one of the serious challenges facing him as a surgeon was the difficulty of aortic valve replacement. In the blessing, Elder Kimball promised him that the quality of his work as a surgeon would increase so that he would have the time to serve as stake president without jeopardizing his patients. Elder Kimball himself was to benefit later from this blessing, for in 1972 the open-heart operation that Dr. Nelson performed on him included aortic valve replacement.
In 1965, Dr. Nelson was presented with an extraordinary opportunity to assume the position of professor of surgery and chairman of the Division of Thoracic and Cardiovascular Surgery at another major university. Included in the offer was a generous salary and an arrangement to pay fully for the college education of all his children when the time came.
The Nelsons were overwhelmed by this offer and were inclined to accept. But before making a decision that affected not only their family but also his service as stake president, he sought the counsel of President David O. McKay.
After hearing the details of the situation, President McKay closed his eyes, leaned back in his chair, and pondered the matter for some time. Then he said, “Brother Nelson, it doesn’t feel good to me. I don’t think you should go to Chicago.”
“That was it,” says Dr. Nelson. “We declined their gracious offer with many thanks. And here we stayed.”
In June 1971, Dr. Nelson received a phone call from President N. Eldon Tanner asking if he could come to his office. He went at once and found that President Harold B. Lee was also there. (President Joseph Fielding Smith was not well that day.) President Lee and President Tanner indicated that they would like him to serve as head of the Sunday School organization of the Church, if it wouldn’t take him away from his work as a surgeon.
When he had recovered from the shock, Dr. Nelson responded by saying that he would accept any call from the Lord even if he had to leave his medical practice. But they insisted that they wanted him to accept the calling only if he could continue his work as a surgeon as well. Thus he entered upon more than eight years of service as general president of the Sunday School.
That summer of 1971 he attended an area conference in Manchester, England. It was there that Elder Kimball first spoke to him of difficulties with his heart. Subsequent tests showed a deteriorating aortic valve and a dangerous obstruction in one of his arteries. As Dr. Nelson explained it, “The risks of an aortic valve replacement alone in a man aged seventy-seven are high. The risks of a coronary graft operation alone in a man of that age are high. To combine them would compound enormously the risk of either one alone.” Surgery was therefore very risky; but on the other hand, the chances for spontaneous recovery without surgery were considered nil.
A special meeting with the First Presidency was called. A weary Elder Kimball, faced with these seemingly insurmountable problems, said, “I’m an old man and ready to die. It is well for a younger man to come to the Quorum and do the work I can no longer do.”
Then President Lee rose and in a firm voice declared, “Spencer, you have been called! You are not to die! You are to do everything that you need to do to care for yourself and continue to live.”
Elder Kimball said, “Then I will have the operation performed.”
At that point Dr. Nelson’s heart sank, for the weight of responsibility then seemed to pass to his shoulders. However, on the eve of the operation, he received a blessing under the hands of President Lee and President Tanner to the effect that the operation would be performed without error and that he need not fear.
The operation was performed on 12 April 1972. It was flawless—thousands of intricate manipulations performed without error, according to the blessing he had received. Even more special to Dr. Nelson was an overpowering feeling that came upon him at the conclusion of the operation: “The Spirit told me that I had just operated on a man who would become president of the Church,” he said.
On another occasion, he and Dantzel were combining five days of surgical meetings with a welcome vacation in Colorado Springs, Colorado. During the third night, however, he was troubled by an uneasy feeling that would not go away, so he awakened Dantzel and said, “Let’s pack and go home.”
Within minutes they were on their way to the airport. With no reservations, they nevertheless got seats on the next flight from Denver and arrived in Salt Lake City an hour later. From the airport he called his secretary and said, “Who’s looking for me?”
“How did you know?” was the surprised reply. “You’re needed at the hospital for Elder Paul H. Dunn.”
Elder Dunn had experienced symptoms of a heart attack during the night, and an arteriogram indicated almost complete obstruction of the coronary arteries. President Kimball arrived and gave Elder Dunn a blessing while the operating room was hurriedly prepared.
Just as Dr. Nelson began operating, the heart attack came. Emergency procedures stabilized the circulation, and the surgery was successfully performed. Elder Dunn recovered and was able to resume his heavy responsibilities.
Since his release from the general presidency of the Sunday School in October 1979, Brother Nelson has served as a Regional Representative. He has a demanding surgical schedule, often with two open-heart operations a day; he’s actively involved in professional associations and community affairs; and he still has children at home.
With such heavy demands on his time, how does he manage to have a rewarding family life with only twenty-four hours in each day? Before giving Dr. Nelson a blessing on the eve of President Kimball’s surgery, President Harold B. Lee asked Dantzel how it felt to be the wife of a man who was so busy in his profession and in his Church calling. She simply replied, “When he’s home, he’s home!”
The relationship between the Nelsons and their children has had a particular quality that speaks of eternal ties. Brother Nelson marvels at the close natural affinity for the children that he has observed in Dantzel over the years. He tells, for example, of the birth of their seventh daughter:
“After Laurie was born, Dantzel and I were waiting for the nurse to bring our newborn daughter to us. Dantzel had been under anesthetic during the delivery and had not yet seen the new baby.
“Suddenly she said, ‘I hear our baby crying.’
“‘You’re kidding,’ I said. ‘You haven’t even seen her yet.’
“But she insisted, ‘That’s our baby. I know her voice.’
“So I left the room and walked down the corridor to the large cart that conveyed all the babies from the nursery to their mothers. There was only one baby crying. They all looked alike to me, so I checked the identification tag and found that the one crying was labeled ‘Baby Girl Nelson, Room 571.’ That was an inspiration to me. Dantzel knew her child’s voice even before she had ever heard it. It reminded me of the Savior’s statement that ‘my sheep know my voice.’”
Another such experience occurred in connection with the birth of their son, Russell, Jr. One night in 1957, Dantzel awakened him to tell him of a very special experience: “It was more than just a dream,” she said. “I saw a little baby boy. He had a round face and lots of hair; he looked just like you! I had a wonderful visit with him.”
Brother Nelson didn’t pay a great deal of attention to this announcement at the time, even though their sixth child was on its way. Over the next seventeen years as that daughter (Emily) and three others (Laurie, Rosalie, and Marjorie) arrived, she told him from time to time, “I saw him again. He’s such a sweet and special little boy.”
Then in 1972 he traveled to Sun Valley, Idaho, to speak at a medical convention. In the middle of the night, he was awakened with a very real experience in which he learned that the child his wife was then expecting was to be a son, the one who had been appearing to Dantzel over the years.
When the child arrived—a hefty twelve-pound boy—and the nurse brought the baby to Dantzel for the first time, she exclaimed, “He’s the one! He’s the one I’ve seen and known for all these years!”
Of his experience as a husband and father, Brother Nelson says that the greatest satisfaction any of us can have is to know that we’re doing what the Lord wants us to do. In that connection, he learned an interesting lesson when, on a rafting trip in the Grand Canyon, he and his daughter Gloria were thrown from the raft as it plunged over a large rapid.
“It was a terrifying experience,” he reflects, “but it taught me to ‘cling to the iron rod.’ As we went over that rapid, I tried to cling to my daughter, fearful for her survival. But as we took more difficult rapids later, I learned to hang on to the ropes tightly and have my daughter hang on to me. The same principle applies in gospel living. If a man will cling to the word of God and be obedient so that his family can rely on him, the whole family will be safe.”
Of his marriage to Dantzel, Brother Nelson says, “It’s clearly the single most important thing I have ever done. She has given me companionship, ten beautiful children, and all those wonderful intangible things a wife gives to a husband to help him strive for fulfillment and selflessness.”
He also describes her willingness to stick by him during the lean years when he was in medical training. He recalls that one night as they were walking down a street in Boston, they pressed their noses against the window pane in a furniture store and Dantzel wistfully asked, “Do you think we’ll ever be able to afford a table and a lamp?” But they got by. “The children didn’t seem to know that it wasn’t normal to sleep in sleeping bags on army cots,” he says.
Their one luxury at that time was a used piano, so that they might have music in their home—a special love of theirs. Dantzel’s particular musical talent is singing. Previous to their marriage, she had won a scholarship to the Juilliard School of Music—an opportunity she exchanged for the privilege of marriage and children. Since 1967, however, she has been a member of the Tabernacle choir. And Russell, after rebelling at the strictures of piano practice as a lad, resumed musical study in college and now plays the piano and organ. In fact, Dantzel reports that he once said he thought he would take up organ playing seriously because in the next world there will be no need for heart surgeons!
Meanwhile, in this world, he is still busy. At age fifty-seven, he has received a multitude of awards for distinguished service, both in the medical profession and in public service. He has had the honor of serving as a director of the American Board of Thoracic Surgeons; he has been president of the Utah Heart Association and the Utah State Medical Association—and the list goes on. But the one interest that overrides all other concerns is his determination to be obedient to the Lord in furthering the work of the kingdom of God.
“The Lord has a tremendous work yet to accomplish in the Church,” he insists. “He’s going to need every faithful soul; there won’t be one prepared, qualified Latter-day Saint who won’t have all the responsibility to shoulder that he or she can bear.
“There are so many wonderful people in countries that are not yet open to the gospel. I remember a Regional Representatives Seminar back in September 1978, in which President Kimball gave a wonderful talk on missionary work in various parts of the world, especially China. He told all of us there that nothing is too hard for the Lord, but that we must do our part—to pray for the people of China, to start learning Mandarin, and to extend our own talents in whatever specialty we might have to the Chinese people. So I started praying that way, and Dantzel and I began to study Mandarin.
“One day I was in Boston for scientific meetings, and I started my day out with a prayer like that in my hotel room. Then during one of the meetings I got restless for some reason, so I moved from the front of the hall and took a seat toward the rear. When an intermission was announced, I found myself sitting next to a Chinese fellow. I thought back on my prayer that morning, and so I introduced myself. He replied in beautiful English that he was Professor Wu of the Chinese Academy of Medical Sciences in Peking. We struck up a conversation, and before the day was over I had invited him to come to Salt Lake City to give a lecture. He did, and he liked what he saw; and after he returned, I received an invitation to come to the Peoples Republic of China as a visiting professor of surgery. We went, and we’ll be going again in the future.
“Then last August the dean of their medical school, the head of the department of surgery, and two of their top heart surgeons came here and stayed with us a month. They were able to meet President Kimball and several other General Authorities. We write to them frequently now, and one of their young men will be here as one of our trainees for two years beginning in 1983.”
Obedience to a request from the president of the Church to pray for a people or to study a language is only one facet of Russell M. Nelson’s obedience to the maxim “Follow the prophet.” He is baffled when he hears people ask questions like, “Is it really the will of the Lord that we do everything that President Kimball says?”
“The Lord said, ‘Whether by mine own voice or by the voice of my servants, it is the same,’” he reminds us. “My experience is that once you stop putting question marks behind the prophet’s statements and put exclamation points instead, and do it, the blessings just pour.
“I never ask myself, ‘When does the prophet speak as a prophet and when does he not?’ My interest has been, ‘How can I be more like him?’”