The day medical history was rewritten

Nearly forty years ago, in the middle of the night at a Cape Town hospital, South African surgeon Christiaan Barnard rewrote medical history when he carried out the first-ever heart transplant.

The operation captivated the imagination of the world, catapulting Barnard and South Africa on to the world stage and leading to hundreds of similar operations around the globe.

Dene Friedman, who was in the theatre during the groundbreaking operation, assisting with the running of the heart-lung machine, remembers the surgery “as if it were yesterday”.

“Nobody took a photograph, nobody did anything ... We didn’t think of the publicity side of it,” she said.

Barnard had not even told the hospital that he would be attempting the operation, giving little thought to the reaction his techniques would generate.

“Professor Barnard told them in the early hours of the next morning. He just gave a phone call,” remembers Friedman.

“We just thought that we were doing something worthwhile for the patient,” she said of Louis Washkansky, a 53-year-old diabetic with incurable heart disease who had suffered three heart attacks.

Barnard had already practised the basic surgical technique for the transplant—that was pioneered by other surgeons on animals—in the laboratory.
He only needed one donor to put this knowledge into practice.

On the night of the December 2 1967, a 25-year-old woman was fatally injured in a car accident.

Her blood type matched that of Washkansky’s and her father agreed that her heart could be donated for the surgery.

“We entered the theatre in the middle of the night and left at 8 am the next morning,” said Friedman.

“It was very impressive, exciting and scary. As it had never been done before, we weren’t sure about the effects in a human patient.”

The 30-strong medical team looked on in rapture as the transplanted heart gave its first few beats, making medical history.

However, Washkansky died 18 days later after developing double pneumonia as a result of the immuno-suppressive drugs he was taking.

“It was terrible. When Washkansky died, I was totally disappointed,” said Friedman, who has since gone into private practice.

Barnard subsequently became the target of much criticism for rushing into the operation when so little was still known about immuno-suppression.

However, the naysayers did not prevent the operation from making history, and opening the way to about 100 heart transplant attempts in the following year.

“On Saturday, I was a surgeon in South Africa, very little known. On Monday, I was world renowned,” Barnard recalled later.

His bright smile, good looks and charm also contributed to Barnard’s fame, and the son of a poor Afrikaner preacher was often seen at the side of actresses like Gina Lollobrigida and Sophia Loren.

He married three times, the last time in 1988 to 18-year-old model Karin Setzkorn, whom he also subsequently divorced.

“Professor Barnard was very dynamic ... a very exciting person to work for, very challenging,” remembers Friedman, who worked with him until Barnard’s retirement in 1983 due to problems with rheumatoid arthritis.

Until then Barnard continued transplanting hearts, and pioneering other techniques such as “piggyback” transplanting, putting a second heart into a patient while leaving the first in place.

He also became the first to carry out a heart-lung transplant.

Not one to conform, Barnard admitted he had often practised passive euthanasia and regularly clashed with South Africa’s government over apartheid issues.

“He never thought that he would captivate the imagination of the public and the whole world. He didn’t think so at all,” said his former colleague.

Barnard died in 2001 while on holiday in Cyprus, at the age of 78, from an asthma attack.—AFP

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