This Day in World History
December 3, 1967
Barnard performs first heart transplant
For five hours, the thirty-person surgical team worked in an operating room in Cape Town, South Africa. The head surgeon, Dr. Christiaan Barnard, was leading the team into uncharted territory, transplanting the heart of a young woman killed in a car accident into the chest of 55-year-old Louis Washkansky. As the operation neared to a close, Barnard used electrodes to stimulate the heart. It began pumping, and the team knew they had succeeded. The operation was not the first organ transplant—kidney transplants had been performed for more than ten years. In transplanting the heart, though, Barnard pushed medicine into a new phase.
“On Saturday,” Barnard remembered later, “I was a surgeon in South Africa, very little known. On Monday I was world-renowned.” The recipient, 55-year-old Louis Washkansky, lived only eighteen days after the surgery before dying of pneumonia. Nevertheless, Barnard had revolutionized cardiac care. The surgeon improved his heart transplant techniques over the years such that some patients lived for several years after surgery. He also experimented with new techniques, including using artificial heart valves and using hearts from monkeys as a stopgap measure for some patients.
Along with his medical breakthroughs, Barnard challenged social conventions. His second heart transplant roused controversy in his native land because the recipient was white and the donor was “coloured”—the term under South Africa’s apartheid system for a person of mixed white and black ancestry. Over the years, Barnard became more outspoken about the rights of black South Africans, putting his reputation behind the end of apartheid. He also became somewhat controversial for his obvious enjoyment of his celebrity status and for, late in life, trying to find ways to reverse aging.
Barnard will be most remembered, though, as a bold surgeon looking to expand the boundaries of medicine.
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Rom Harre is Emeritus Professor of Philosophy at Linacre College, Oxford, and Adjunct Professor of Philosophy at Georgetown University, Washington, DC. In his book, Pavlov’s Dogs and Schrodinger’s Cat: Scenes from the Living Laboratory, we get an enlightening look at the use of plants and animals–including humans–in scientific experiments. In the excerpt below we see how dogs were essential to figuring out heart transplants.
By coincidence, two men, one living in the seventeenth century and one in the twentieth, who both used dogs as models and whose work led to major breakthroughs in medicine bore the same name. The first Richard Lower used dogs to perfect blood transfusion techniques, while the second Richard Lower used the same species of animals to perfect heart transplantation methods.
History, as presented in the media and so in popular belief, credits the beginning of heart transplantation techniques to Christiaan Barnard. Digging a little deeper we come across the most successful practitioner of this art, Norman Shumway. However, using dogs as experimental apparatus – as pilot plants- to perfect the surgical techniques required to carry out transplant operations on human beings. Christiaan Barnard did forty-eight trial transplants with dogs before he undertook such an operation with a human being. He acknowledges that what he uses ‘was a technique built on that developed by Shumway and Lower, who had experimented on more than 300 dogs… With their findings joined to mind there was little point in continuing to further sacrifice of animals.’
Richard Lower studied at the Medical School at Cornell but moved for his residency period to the University of Washington in the northwest of the United States. One autobiographic snippet suggests that the American northwest suited his love of the outdoors. Finding things not to his liking there he moved south to Stanford were he could qualify more quickly. Working in very primitive conditions in the training section of the hospital he eventually met up with Norman Shumway and forged a remarkable partnership with him.
Norman Shumway (1923-2006) studied medicine at Vanderbilt University, moving on to a doctorate at the University of Minnesota in 1956. He was appointed as a surgery instructor at Stanford University in 1958, where he remained for the rest of his career. He seems to have been a somewhat paradoxical character. Reticent and wary of publicity, yet he was famous for his witty and jocular conversation, particularly during the course of long and demanding surgical procedures. The persistence with which he pursued his goal of successful himan heart transplantation suggests a dogged streak.
Lower began his experimental programme as an assistant to Shumway working on the techniques for open heart surgery, including the possibility of cooling a living heart so as to stop its beating. Under this condition surgical repair would be greatly facilitated. The heart could then be warmed up and restarted with a fibrillator. Perhaps the heart could be removed completely from the patient’s body for delicate surgical work and replaced when the repair was done. This is the procedure known as ‘auto-transplantation’.
Dogs were already in regular use at Stanford University Medical School for training surgeons. …Lower and Shumway continued their use of dogs as experimental apparatus, pilot plants for the ultimate transfer of the techniques to the human case. Despite his skill in surgery Lower was unable to achieve successful autotransplantation. The reason was simple
