Almost 50 years have passed since this seminal moment in medical history—but it's a tale that's worth retelling...

“At precisely 5.52am on Sunday December 3, 1967, a 24-year-old heart starts beating in a 54-year-old chest, while an old, sick heart lies discarded, dead for all time” read the headlines. 

 

The surgeon

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Dr Christiaan Barnard. Image via Alchetron

Christiaan Barnard, a tall, handsome South African surgeon, performed the world-famous operation. He had an impressive record in surgery, having performed Africa’s first human kidney transplant and first open-heart operation.

He lived during a time of transplant frenzy: the world’s first kidney transplant having taken place in 1950; the first lung transplant in 1963; and the Soviet scientist Vladimir Demikhov was even attempting dog head transplants...

Barnard took a pragmatic view of transplant, saying, “It is infinitely better to transplant a heart than to bury it to be devoured by worms.”

Learn how heartbeats were discovered here.

 

The recipient

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Louis Washkanksy. Image via DFiles

Heart transplantation is a last resort, when all other attempts to reinvigorate the failing heart have been attempted. The recipient of the first heart transplant, Louis Washkansky, was indeed desperate, heart failure having rendered him “a bloated and breathless wreck of a man, with days to live”.

Barnard likened the plight of the heart transplant patient to that of a man being chased by a lion into a river filled with crocodiles: the operation was as risky as swimming in crocodile-infested waters, but you would do it if faced with otherwise certain death (being eaten by a lion— or death from severe heart failure).

Today, those waiting to receive a heart face the dilemma of needing to be sick enough to need a new heart (desperate enough to enter the river), yet well enough to undergo the operation (strong enough to swim). Washkansky himself, having taken the risk, survived only 18 days after the operation.

Thankfully, modern heart transplants are a lot safer, with an average survival time of 13 years. In 2012, former vice president Dick Cheney received a new heart at the age of 71, and daily relishes this “gift of life”.

Learn more about heart surgery here.

 

The donor

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Denise Darvall. Image via South African History Online

“Where there’s death, there’s hope”—at least in the world of transplantation, for the surgery depends on another’s tragedy. For Louis Washkansky, the donor was Denise Darvall, a bank worker knocked down by a car as she left a bakery. Her mother was also killed; her father a hero for consenting to Denise’s donation in his moment of double tragedy.

 

The forgotten heroes

It’s true that “the winner takes it all” and that “first never follows”, and Barnard is rightly remembered as a hero. Other surgeons in the United States nearly pipped him to the post, however, and were instrumental in Barnard’s learning and in refining the surgery.

Other real heroes were the tiny babies, born without a brain, and gifted as potential donors by their brave parents, in early failed transplants. Such legacies have been a source of moral debate; baby Teddy Houlston inspired the nation.

The most resonant words of all belong to the wife of Clive Haupt (Barnard’s second donor) who said, “I am glad that my husband’s coloured heart could save the life of a white man. I am also glad because it has changed the whole idea of apartheid. Now everyone can see that all of us—white, black or brown—have the same heart”.

Did ever history record such an inspirational chapter?

 

Helen Cowan completed a PhD in cardiac pharmacology at Oxford in 2002. She is a qualified nurse and has written for the British Journal of Cardiac Nursing, and worked as a columnist in the Nursing TimesRead more from Helen here.

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