I was 15 years old when Christiaan Barnard performed the first heart transplant. I still have the Life magazine cover. My dad was a cardiologist, so the drama carried out in the public's imagination was reinforced by my respect for the practice of medicine and discovery. My ultimate choice of going into surgery and then into heart surgery and then heart transplantation I trace back to that single operation.
This procedure reversed what had been inevitable death from heart disease, restoring the opportunity of new life. It demonstrated the ability of an individual working with a team to revolutionize health care. The interesting thing is that it was the relatively inexperienced Barnard who made history in the new field. He beat to the punch—and undercut—more systematic and more disciplined scientists and surgeons of the time. Dr. Norman Shumway of Stanford University (who was my mentor) had patiently and with great rigor made a decade of systematic research by writing papers, teaching others and working through the challenges of the procedure. Barnard, who watched some of these procedures being carried out when he trained in the U.S., went back to South Africa and—with very little background and at the age of 45—seized the moment and performed this transplant. His patient died 18 days later, for Barnard was racing ahead of medicine's understanding of tissue rejection. But the pioneering spirit of that operation captured me at the time.
Frist is majority leader of the U.S. Senate
1967: The first human-to-human heart transplant is performed. The operation is a success, but the patient dies after complications set in.
South African surgeon Christiaan Barnard, who prepared for this day by performing a number of experimental heart transplants involving dogs, led a 30-member surgical team in implanting the heart of a young woman into 53-year-old Louis Washkansky, a Cape Town grocer suffering from diabetes and incurable heart disease.
Washkansky received the heart of Denise Darvall, a 25-year-old bank clerk who was left brain-dead following an automobile accident the day before. She was removed from life support, and her father gave permission for her heart to be given to Washkansky.
The transplant, performed at Cape Town's Groote Schuur Hospital, was a success. Washkansky's body did not reject the heart, due in large part to the immunosuppressive drugs he received. But those drugs also weakened his immune system, and he contracted double pneumonia, which killed him 18 days after the transplant.
Barnard, who became an international celebrity (and reveled in it) as a result of the transplant, soldiered on. Over the next several years he performed additional heart transplants, with the survival times for his patients gradually improving. One patient, Dorothy Fisher, survived for 24 years after receiving a new heart in 1969.
Other surgeons, however, weren't as bullish on transplant surgery, because of the high risk of organ rejection by the recipient. It wasn't until cyclosporine came into widespread use in the early 1980s that an effective means of reducing that risk was found. After that, organ-transplant surgery took off.
Barnard, meanwhile, became more interested in anti-aging research, and his reputation took a hit when he lent his name to Glycel, an anti-aging skin cream that in the end did nothing at all to slow the process. Barnard died in 2001.
"On Saturday, I was a surgeon in South Africa, very little known. On Monday, I was world renowned." That's how Dr. Christiaan Barnard recalled events in December of 1967, when he became the first surgeon to perform a heart transplant on a human being.
Barnard was the son of a rather poor Afrikaner preacher and his wife, and grew up in Beaufort West, a town on South Africa's semi-arid Great Karroo plateau. He studied medicine at the University of Cape Town and at the University of Minnesota. In Minneapolis he began helping researchers who were working on a heart-lung machine, and soon switched his specialty from general surgery to cardiology and cardiothoracic (heart-lung) surgery.
By 1967, Barnard was senior cardiothoracic surgeon at the Groote Schuur Hospital in Cape Town, where he had introduced open heart surgery and other pioneering surgical procedures. He had spent many years experimenting with heart transplantation, mostly with dogs. The first successful kidney transplant had been done in 1954, opening this exciting surgical frontier. Barnard had a patient, 55-year-old Louis Washkansky, who had diabetes and incurable heart disease. Washkansky could either wait for certain death or risk transplant surgery with an 80 percent chance of surviving. He chose the surgery. As Barnard later wrote, "For a dying man it is not a difficult decision because he knows he is at the end. If a lion chases you to the bank of a river filled with crocodiles, you will leap into the water convinced you have a chance to swim to the other side. But you would never accept such odds if there were no lion."
Early in December of 1967, Denise Darvall, a woman in her mid-20s, was fatally injured in an automobile accident. She had had the same blood type as Washkansky. She died shortly after arriving at the hospital, but her heart was still healthy. In a five-hour operation on December 3, Barnard successfully replaced Washkansky's diseased heart with the healthy heart. He knew it was a surgical success when he first applied electrodes and it resumed beating. Washkansky lived for only 18 days more, dying of double pneumonia as a result of his suppressed immune system. It was a milestone, however, in a new field of life-extending surgery.
Barnard was celebrated around the world for his daring accomplishment. Handsome and only 45 years old at the time, he graced the covers of magazines, toured the world, and became quite a popular figure. He enjoyed his fame, but it strained his marriage of 21 years. His first wife was a nurse who had helped support him while he developed his career as a surgeon. They were divorced in 1969, and Barnard married his second wife the following year. This marriage, too, ended after 12 years. He married for a third time. He had five children, spanning 32 years, but one of his sons died at age 31.
Barnard had been bothered by rheumatoid arthritis since he was young, and advancing stiffness in his hands forced his retirement from surgery in 1983. He took up writing, however, and wrote a cardiology text, a (sometimes sensational) autobiography, and several novels, including a thriller about organ transplants. He lives on a 32,000 acre sheep farm and game preserve in the Karroo region where he grew up, where he reintroduced wildebeest and springbok. He has just two regrets in his long and eventful career. First, he endorsed an "anti-ageing" skin cream in 1986, which turned out to be of dubious effectiveness and was withdrawn from the U.S. market in 1987. Although his endorsement made him a great deal of money, it tarnished his medical reputation. His only other regret was not fighting harder against South Africa's policy of apartheid. "I opposed it whenever I could," he said. "But I didn't stick my neck out."