Harvard University, Cambridge, MA, USA.
Columbia University, New York, NY, USA.
Soc Stud Sci. 2018 Aug;48(4):507-539. doi: 10.1177/0306312718794034.
In 1962, surgeons at two hospitals in Bombay used heart-lung machines to perform open-heart surgery. The devices that made this work possible had been developed in Minneapolis in 1955 and commercialized by 1957. However, restrictions on currency exchange and foreign imports made it difficult for surgeons in India to acquire this new technology. The two surgeons, Kersi Dastur and PK Sen, pursued different strategies to acquire the ideas, equipment, and tacit knowledge needed to make open-heart surgery work. While Dastur tapped Parsi networks that linked him to local manufacturing expertise, Sen took advantage of opportunities offered by the Rockefeller Foundation to access international training and medical device companies. Each experienced steep learning curves as they pursued the know-how needed to use the machines successfully in dogs and then patients. The establishment of open-heart surgery in India required the investment of substantial labor and resources. Specific local, national, and transnational interests motivated the efforts. Heart-lung machines, for instance, took on new meanings amid the nationalist politics of independent India: Even as surgeons sought imported machines, they and their allies assigned considerable value to 'indigenous' innovation. The confluence of the many interests that made Sen and Dastur's work possible facilitated the uneasy co-existence of conflicting judgments about the success or failure of this medical innovation.
1962 年，孟买的两家医院的外科医生使用心肺机进行心脏直视手术。这项技术的实现得益于 1955 年在明尼阿波利斯开发的设备，并于 1957 年实现商业化。然而，货币兑换和外国进口的限制使得印度的外科医生难以获得这项新技术。两位外科医生 Kersi Dastur 和 PK Sen 采取了不同的策略来获取进行心脏直视手术所需的理念、设备和隐性知识。虽然 Dastur 利用与当地制造专业知识联系起来的帕西网络，但 Sen 则利用洛克菲勒基金会提供的机会，与国际培训和医疗器械公司建立联系。在他们成功地在狗和病人身上使用机器的过程中，他们都经历了陡峭的学习曲线。印度心脏直视手术的建立需要投入大量的劳动和资源。特定的地方、国家和跨国利益推动了这一努力。心肺机在独立的印度的民族主义政治中具有了新的含义：即使外科医生寻求进口机器，他们及其盟友也赋予了“本土”创新相当大的价值。使 Sen 和 Dastur 的工作成为可能的众多利益的融合，促进了对这项医学创新的成败存在冲突判断的艰难共存。
