Werner Forssmannthe ForgeESTP

On a sunny afternoon in the early summer of 1929, in a small hospital in Eberswalde, near Berlin, Werner Forssmann, 24, strapped a nurse to an operating table. Then he numbed his own arm.

He was a junior surgeon with an idea his chief had already refused. Slide a thin tube into a vein at the elbow and keep pushing, up the arm and into the heart. If it worked, doctors could reach inside a living heart without opening the chest. His chief told him to try it on animals.

He did not want to wait, and reckless was not quite the word for him. He had studied a drawing of the same procedure done on a horse, and he had practiced for weeks on cadavers. What he lacked was permission.

The theater nurse, Gerda Ditzen, held the keys to the supplies, and she had agreed to let him try it on her. He told her she had to be strapped down in case she fainted. Once she was, he pretended to work on her arm and did it to his own instead. He cut down to the vein, slid in a rubber catheter made for the bladder, and pushed it up toward his shoulder.

Then he unbuckled her and asked her to call the X-ray department. She was angry, and she had every right to be. She made the call anyway.

They went down to the X-ray room with the tube still in his arm. By his own account a colleague burst in to stop him, and he fended him off with a few kicks. Then, watching the shadow on the screen in a mirror, he pushed the tube on into his chest.

The X-ray plate shows the tip lying in the right side of his heart. A man had threaded a tube from his elbow into his own heart, watched it arrive, and was alive to argue about the details.

This is the part of the Forge pattern people miss. The act looked impulsive, but it was planned in detail, rehearsed on the dead, and done in the one hour when nobody would stop him. The impulsive part was doing it alone.

He wrote it up fast, with the X-ray as proof. His paper on probing the right heart appeared in a German medical weekly on 5 November 1929. He was 25.

By then he had moved to the Charité in Berlin, under Ferdinand Sauerbruch, the most famous surgeon in Germany. Sauerbruch saw the paper and dismissed him for going ahead without approval.

He left heart work for urology, the specialty his borrowed catheter had been made for. In 1932 he joined the Nazi Party, a choice that darkens everything after it. He served as an army doctor, was taken prisoner, and by 1950 was a urologist in the small town of Bad Kreuznach.

His idea had not waited for him. In other hands the heart catheter became an everyday tool of medicine, and in 1956, aged 52, the small-town urologist shared the Nobel Prize.

Forges are often right early and alone. He saw it in one afternoon. The world took twenty-seven years to agree.