February 1, 2024 • 34 mins
We discover a museum in a hospital singularly devoted to one historic event from its operating theaters: the world's first human heart-to-heart transplant.
The surgeon and his team didn't know if it would work, but were fueled by the determination to achieve what seemed impossible. Listen on to hear how it played out.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Cindy (00:00):
This is a, somebody who obtained his PhD in two years
instead of six.
Len (00:05):
that implanted an extra head onto a dog.
And everybody thought this is,is gonna walk out of here I
think he should have gotten theNobel price, but he never did
Kate (00:28):
Usually the museums we visit are based on a niche
subject, person or location.
But today's museum is dedicatedto something much more specific,
one singular medicalbreakthrough.
Welcome to the heart of CapeTown Museum.
Situated within the very wing ofGroote Schuur Hospital where the
her world's first hearttransplant took place in 1967.
(00:51):
The exact operation rooms usedare on display and staged as
they were during the operationwith Silicon figurines.
We hop on a tour with guide Lenand speak to Cindy about the
operation itself, what led toit, and most importantly about
the visionary surgeon behind itall, dr.
Christian Barnard.
The heart of Cape Town Museum isa testament to human ingenuity,
(01:14):
resilience, and the relentlesspursuit of medical progress.
so I'm here at the heart of CapeTown Museum with Cindy.
Cindy, how are you today?
Cindy (01:26):
I'm fine, thank you.
Kate (01:27):
How did the heart of Cape Town Museum come to be?
Cindy (01:30):
The museum came to be after It became a famous story
after the first successfulhuman-to-human heart transplant
done by Professor Barnard in1967.
So because the story became sobig the hospital started the own
museum.
And then in 2007, our curator,Henry Yuba came on board and he
(01:52):
did further restoration to bringit back to its original form.
So when you go through ourmuseum today, the equipment that
you're seeing in theater is theoriginal equipment that was
booked to their theater thenight of the operation.
Kate (02:05):
So What are the challenges in running this museum?
Cindy (02:08):
I think the awareness is a big problem for us because if
I just take for example, southAfricans, there's not a lot of
South Africans that actuallyknow about us.
So majority of our, our visitorsare from overseas, so it's being
well advertised for tourism herein South Africa, but our South
Africans aren't aware of themuseum here.
Kate (02:30):
Are they not taught about this in school?
Cindy (02:32):
They are taught about it in school, but those are grade
sixes and sevens.
What we actually find is thekiddies are bringing their
parents here, which I think isgreat.
So, you know, and, when you getto speak to their parents,
they're like, wow, you know,like I know about the story, but
I didn't know about the museum.
Kate (02:48):
What's the most popular part of the museum?
Cindy (02:50):
The theaters.
Kate (02:52):
And what's the most asked question?
Cindy (02:55):
The most asked question.
Is the dog real?
So one of the first rooms thatyou enter into when you head up
to theater is the animal lab.
So they have what looks like areal dog on the table, and it's
having a heart transplant andall the equipment is there.
So it looks very, very real
Kate (03:17):
What effect did Covid have on the museum?
Cindy (03:20):
So Covid had a big effect in the sense that we actually
had to close the museum.
So we were closed for the entireduration of Covid.
We only opened in May this year.
Kate (03:30):
Wow.
That's a lot of lost revenue andlost visitors.
Cindy (03:33):
Lost revenue, lost visitors.
And the reason for that wasbecause Groote Schuur Hospital
is actually a designated covidhospital.
And because most of our visitorsare tourists, you know, you're
running a high risk.
Problem there.
Kate (03:46):
Cindy, why do you like working at the heart of Cape
Town Museum?
Cindy (03:50):
I'll tell you, I originally come from hr, that's
my degree, I was an HR clerk andwhen Covid was done, and the
curator approached me and hesaid to me, look, he's got this
museum and he needs somebody toopen it up.
It's been closed for two years.
And I said to him, well, take methrough the museum.
Let me, let me see, let mevisit.
And he brought me here and hetold me the story.
(04:12):
He's so passionate about it thatI fell in love with the story
and that's why I'm here.
I never in my life got to meetChris Barnard.
I'm very jealous because mycolleague did but I can imagine
that he was a great, great guy.
Kate (04:25):
Why should people come to the heart of Cape Town Museum?
Cindy (04:28):
Because of the beautiful story once you've been on a
tour, you'll understand what I'msaying.
We've got people from all overthe world that come here to
visit us.
From cardiac thoracic surgeons,all the way down to people who
just want to know what the bigdeal is about.
And all of them leave here withsaying, this was actually the
highlight of the holiday.
So that is the impact that thestory has.
Kate (04:51):
I can tell you it was definitely one of the highlights
of my holiday as well.
The way the museum is structuredallows you to get a real sense
of Chris Barnard's character.
Cindy (05:00):
What I do know is Professor Chris Barnard was a
dynamic man.
He was a, he was a driven man.
This is a, somebody who obtainedhis PhD in two years instead of
six.
So nobody's ever been able to doit since him, you know, so if
that doesn't give you anindication of what type of drive
this man had how, however, withthat said, One of the things
(05:21):
that he did say in one of hisinterviews is this is what made
him famous, the first successfulhuman to human heart transplant.
But what he actually wanted tobe remembered for in his life or
his legacy, was the work he didon children.
Kate (05:36):
So now we go on a guided tour of the museum with Len.
He'll explain the details of thesurgery and then take us through
what led up to it and show usthe operating rooms.
Len (05:47):
My name is Len by the way, and I'm gonna take you through
the process of the very firstheart to heart.
Ha human to human not heart,human to human heart transplant
that had occurred in thishospital by professor Christiaan
Bernard.
Now also the donor at that stagewas Denise Darvall, and Mr.
Louis Washkansky was therecipient.
(06:07):
Now, Louis Washkansky wasseverely ill at that stage.
He had two prior heart attacksalready.
He also had an aneurysm on theheart and his kidneys and liver
didn't function properly purelybecause of the fact that his
heart didn't function properly.
Christiaan Bernard 45 years ofage at that stage.
Denise Darvall, 25.
Mr.
Louis Washkansky 53.
Now at one point, also inChris's book, if you ever read
(06:30):
One Life very interesting book,you will read that he was
actually concerned that he mightnot have a donor in time to save
Mr.
Washkansky's life.
So Mr.
Washkansky was at the end of hislife, he basically had no chance
of surviving for much longerthan a few weeks.
Okay, so on the Saturday of the2nd of December of 1967, Denise
and her mum was walking acrossthe road, to actually buy a
(06:52):
caramel cake.
And as they came out of the cakeshop, a drunken driver came and
knocked them both over.
Now Denise was flung about 40feet, and she knocked her head
against a stationary vehicle.
Her mom, Myrtle died instantlyat the scene of the accident.
So Denise was brought to thisroom.
This was the old emergency roomof the Groote Schuur hospital
(07:13):
that you're standing in now.
So she was brought to this roomand she was treated here for the
injuries, but very soon theyrealized that she's not gonna
survive.
And then Dr.
Bozman went out to Mr.
Darvall who was sitting outside.
He was sitting outside,obviously waiting for good news
on his daughter because he'salready lost his wife.
Now, Dr.
Bosman had to go outside andsay, sorry, but she's not gonna
(07:34):
survive.
Can we use the organs fortransplant purposes?
And Mr.
Darvall took about four minutesand he said, you know, the way
that I know my daughter, shewould rather let someone else
live if she can't live at all.
So that is how they gotpermission to, to gain the
organs for transplantationpurposes.
The other very important thingthat we must realize is that
(07:56):
there was a difference betweenthe law in South Africa and the
law outside South Africa.
In South Africa, it stated thattwo doctors can declare you
dead.
But there was no criteriaattached.
Didn't say this had to happen orthat had to happen.
Two doctors can declare youdead.
So if you bump your turn, theydecide you're dead.
You're dead And in the rest ofthe world it actually stated
(08:17):
that your heart must stopbeating before they can declare
you dead.
And that is primarily the reasonwhy it happened here.
Because once your heart stopbeating inside your chest
cavity, basically clottingstarts taking place and the
heart starts dying, then youcan't harvest a good heart
anymore.
So that is primarily the mainreason why the operation
(08:38):
happened in South Africa,because of that gap that Chris
Baarnard saw with regards tobrain dead.
So he got in two neurosurgeons,he got her declared brain dead,
and then they immediatelystarted putting her on a support
system so that she can surviveuntil they could harvest a good
heart from her.
So immediately they kept thecirculation going, everything so
(08:59):
that they can harvest a perfectheart from her.
Right.
Let's go to this list here.
Kate (09:03):
Introducing the Transplant Dream team.
With 15 members and twopatients, not everyone operated,
but they all played a vitalrole.
Len (09:11):
Half of the team were on standby and the other half was
basically off.
So Chris alternated that so thatthere's always a fresh team to
actually do the operation.
So remember as from September,Mr.
Washkansky was in bed already inthe hospital severely ill, and
three weeks prior to theoperation, he was moved to Chris
Baarnard's section awaitingtransplant.
(09:33):
Okay?
Now you'll also see anothergentleman there, certain Dr.
Em Baarnard.
He was Marius Baarnard, Chris'sbrother.
And he was also involved in thevery first heart transplant.
And I'll tell you about that alittle bit later.
This gentleman, professor VelvaSchrire he was the head of
cardiology at that stage, and hebasically identified Mr.
Washkansky as a possiblerecipient.
(09:54):
then also very interesting thingthat Very few people know is
that on the 22nd of November ofthat year, they actually had a
donor with matching tissue typeas well as matching blood type.
And the operation actually couldhave happened on the 22nd of
November already, but why didn'tit?
Because of a law that we had inSouth Africa called apartheid.
(10:16):
And the reason why they decidednot to do the operations is
purely because Chris and VelvaSchrire agreed that with the
first operation, they will notuse a person of color.
Cause they don't want to be seenas experimenting on people of
color, which is actually a noblecause, but one was also remember
that basically they lost aperfectly good heart at that
(10:36):
stage that they could havetransplanted.
Kate (10:39):
Len also points out the anesthetist that we're working
on that day.
Len (10:42):
Yeah, the gentleman on that board there, professor j Ozinski
very interesting character thatalso called him Ozzy.
His name was Joseph, and he wasthe senior aneasthetist on the
day.
Now, a lot of doctors that comepast here say it's quite amazing
that he actually survived theanesthetics, especially if you
take it the way that it was donein those days, as well as the
fact that Mr.
Washkansky was severely ill.
(11:04):
And then one must also sayOzinsky was very, very dedicated
to this whole process.
The last night of Mr.
Washkansky's life, he actuallyhand ventilated him the whole
night to see if he couldactually save his life.
So he was very dedicated, verycommitted doctor, but Chris tend
to attract those people to him.
They said Chris had a a natureof asking you to do something
(11:26):
and you know that he's actuallygonna abuse you, but you said
yes before because you felt sohonored and privileged that he
actually asked you to dosomething.
Kate (11:34):
Interestingly, Len drops at the assistant anesthetist,
Cecil Moss, had some seriouslyimpressive moonlighting gigs.
Not only was he the Springbokcaptain while working there, but
he also served as theanesthetist for Nelson Mandela's
surgery on Robin Island back in1979.
And if that wasn't enough, heeven went on to coach the
(11:55):
Sprinboks for seven years in the1980s.
Len (11:57):
now a lot of people want to know, why would you anesthetize
someone that's brain dead?
The reason for that is purelybecause they are involuntary
twitching that takes place aswell as out of respect for the
patient.
You're not gonna operate onsomeone without anesthetics,
right?
Okay, two things about ChristianBaarnard, very important little
things is.
Firstly, he loved the fame whenhe came, became famous- and
(12:20):
remember that happened within aweek after the operation- he
just loved every minute.
He sucked it up like a sponge.
And the second thing that hesucked up like a sponge was
ladies, okay.
He loved the ladies as well,wherever in the world.
So any case, he loved the fame.
This is at a film premier thathe attended, he was the first
person ever where two Popesasked him for an audience.
(12:41):
He didn't have to ask for anaudience with a Pope, which is
quite amazing.
Kate (12:44):
There's a picture of Chris with Sophia Lauren, princess
Diana, and crowded with fansbegging for autographs.
Len (12:51):
And then as I said, Chris loved the fame.
Wherever he could get hispicture taken, he would do that.
And this is at the worldtransplant games in Manchester.
Kate (13:00):
Okay, hold up folks.
We have got to take a moment todive into something truly
remarkable.
The World transplant games.
Picture this, it's like theOlympic games, but exclusively
for organ transplant recipients.
And guess what?
Donor families and living donorscan join in on the action and
compete in certain events.
The next games are in Italy inMarch, 2024.
Len (13:23):
Then a very interesting little thing is that Chris
always said that the best workthat he did, or the most
interesting work was his workwith children.
And there's a very importantthing that very few people know,
but it's written in his book.
One Life, he did research onintestinal atresia on infants.
And what intestinal atresia isbasically it's a, a constriction
(13:44):
of the blood flow to theintestines of the baby.
And babies are born like thatand they normally don't live
very long after that.
And they used to lose abouteight out of every 10 children.
Now what happened is he'sdecided to do some research on
this.
So he took dogs that weresupposed to have puppies and he
would take the one puppy outwith the umbilical cord still
connected, and he would simulatethe problem that he experienced
(14:06):
in infants.
Then he would implant the puppyback into the mum and wait for
the mum to give birth.
And then he perfectly had thesame problem as with children
with intestinal atresia.
And then he would rectify thatproblem and experiment on that.
Now, that research of hisreduced the death rate from
eight out of every 10 to two outof every 10, and that method was
(14:29):
also applied worldwide.
So that's one of the things thathe didn't really get credit for.
As a matter of fact, I think heshould have gotten the Nobel
price, but he never did.
Right.
Kate (14:38):
After Chris's work on intestinal artresia, he got a
bursary to study in Minnesota.
He did research with otherdoctors towards the first heart
transplant and was gifted aheart lung machine to take back
to South Africa to further hisresearch.
Len (14:53):
So then he started doing heart transplants on dogs and he
did 48 heart transplants ondogs.
And guess how many weresuccessful?
None.
Right.
The first successful hearttransplant that Chris did was on
Mr.
Washkansky.
Then just as a matter ofinterest, he was also the very
first person to, in thishospital on the continent of
(15:13):
Africa, do a kidney transplant.
And that he did two months priorto the first heart transplant,
he used the complete team thathe used in the heart transplant
to do the kidney transplant.
And he always boasted that hehad a hundred percent success
rate with kidney transplants,but he only did the one and that
patient lived for 20 years.
(15:33):
So that wasn't too bad.
Kate (15:35):
He was also the first person on the continent of
Africa to do open heart surgery.
It was on a little girl calledJoan Pick.
Len (15:45):
He was also the very first person to actually do open heart
surgery on the continent ofAfrica on a little girl called
Joan Pick.
She was a daughter of one of theworkers with him, and she had a
problem with the heart valve andhe actually fixed that heart
valve as well.
And then he was the very firstperson This sounds crazy, but
this, this is really a crazystory.
There was a certain Dr.
(16:06):
Demikov in Russia that implantedan extra head onto a dog.
And when Chris Baarnard heardthis, he thought, oh, well I can
also do it.
And he did it here as well.
So on the day when Yani Lowe wasthe head of surgery at that
stage, heard about this,.
he actually ran down to the labto see this lot and there was
this dog with one body, twoheads, and they were both
licking up water from a bucket.
Kate (16:28):
Yes, I know.
Wow.
A lot to take in here.
Okay, so first off, they foundthe dogs at the pound that were
going to be euthanized anyway,the 1960s were a very bad time
to be a stray dog in Cape town.
Secondly, yes, medical ethics,that branch was still emerging.
Animal transplant experimentsbegan in the early 19 hundreds.
(16:50):
In 1905 French, Dr.
Christian Cabrol performed atransplant of a dog's heart onto
the neck of another dog.
Three years later, American Dr.
Charles Guthrie grafted a secondhead onto a dog well before Dr.
Demikov's similar surgery in1954.
Notably, the dog involved in Dr.
Demikov's experiment managed tosurvive for 29 days following
(17:13):
the surgery.
Len (17:14):
Anybody know how a heart lung machine works?
So what the heart lung machinedoes is it basically takes over
the function of the heart andthe lungs while the heart and
the lungs don't work duringheart transplant or open heart
surgery, where they actually hadto stop the heart.
So it circulates the bloodthrough the body, but it not
only circulates it, it takes outthe deoxygenates, oxygenated
(17:34):
blood, oxygenates it, and thenreturns it to the body and
circulates it through the body.
In the old days prior to theheart lung machine, what they
used to do is they used to takethe parent of the child, which
they were going to operate on,and they would link the two,
onto one another with two pipescoming into the arteries and the
veins in the leg.
And then they would, with alittle pump, circulate the blood
(17:56):
from the mother to the child.
So the mother's lung did the jobof getting oxygen in and then it
would circulate it back throughthe child and back to the mum.
But the problem with that isthat they very soon realized
that they've got a 200% chanceof losing both patients.
And that is when the heart lungmachine was discovered.
It was absolutely brilliantbecause now they didn't have to
(18:17):
use a human to do thecirculation.
Kate (18:19):
Len also told us a story of when Chris was in the US and
he was presented with a patientwith liver problems.
The patient's liver couldn'trecover quick enough, so the
doctor was replacing a pint ofblood every day for the patient.
When Chris saw this, he thoughtof a better plan.
He took a baboon and putoxygenated saline solution into
(18:40):
the baboon while taking out allof its blood.
When there was no blood left, hereplaced it with human blood.
Len (18:46):
And the next morning the baboon was sitting there eating
bananas and peaches andwhatever.
So he did some amazing, crazystuff.
They, they were just soexperimental at that stage.
It was just unreal.
And the kind of things that hedid, I mean, just another
example, what happened is Chrishad no ways of reducing the body
temperature of the person oranimal that he operated on,
(19:06):
specifically animals.
And what he used to do, he usedto go down to the chemist of the
university and he used to drawsome condoms there.
And he then he would implant itin the stomach of the dog, and
then he would circulate coldwater through there to reduce
the temperature of the body ofthe dog.
So they did amazing things andcrazy things Sometimes.
Kate (19:25):
Now, of course, Chris had a whole team of people to
support him in his research andsurgery.
We're showing a video of onevery special assistant to Chris,
Hamilton Naki.
Hamilton Naki was born in a poorblack family in the Eastern Cape
of South Africa.
With limited opportunities, heleft school at 14 and started
working as a gardener in CapeTown.
(19:47):
He was then hired as an animallab assistant where he
progressed from cleaning cagesto performing anesthesia.
When he joined Chris Barnard,his remarkable skill and
dexterity at animal anesthesiawas noticed.
He was appointed as PrincipalSurgical Assistant.
Which was quite extraordinary atthe time, given the divisive
apartheid laws.
(20:08):
These are Chris words from thevideo.
Hamilton had a lot of skill.
As far as the technical side,uh, was concerned, he probably
had more skill than I had,because I was not really a very
good technician.
And what's more important isthat he was proud.
He was, he had tremendous pridein, uh, the quality of his
performance.
(20:29):
Hamilton went on to even teach students and assisted
transplant surgeon Dr.
Rosemary Hickman until hisretirement in 1991.
He was awarded an honorarymaster's degree from the
University of Cape Town in 2003,two years before his death.
So many people with tremendouspotential, uh, has never had the
(20:50):
opportunity to develop thatpotential.
I would say the agreement tosuccess is firstly a certain
amount of ability, and thesecond one is opportunity.
Uh, and many, there are many,many people who are probably as
skilled as Hamilton, as giftedas Hamilton, that has never had
the opportunity to explore whatGod gave them.
Now we enter the theatre rooms which are set up to look
(21:11):
exactly like they did on the dayof the operation.
There's two separate theatreswith a small sterilisation room,
serving as a central connectionbetween them.
Len (21:21):
You are actually in the real theater where the Denise
Devall organs were taken out onthe morning of the 3rd of
December.
This is also National HeritageSite in South Africa.
This operating theater as wellas the operating theater on the
other side where theimplantation occurred.
The person that prepared a Misavalve for the removal of the
heart was Marius Barnaard hisbrother.
(21:42):
So he was, here, he opened upthe chest cavity and waited for
Chris to finish on that side andcome and remove the heart.
The operations started aroundabout one o'clock that morning.
They gave them anesthetics.
That took about 20 minutes, andabout 20 past they started
opening up the chest cavities.
I must just state that in DeniseDarvall's heart, they did not
remove while it was beating.
(22:03):
They waited for the heart tostop before they removed the
heart.
They switched off the machines.
It took about, say, 10 to 15minutes before the heart
stopped, and then they removedthe heart.
So yeah, as I said, Mariusopened the chest cavity they
carried it.
As a matter of fact, Chriscounted his steps as he walked
next door with a heart in abucket like this.
Cause what they do is they putanti clotting agent in the heart
(22:26):
while it's still in the body.
Then they remove the heart, putit in ice, cold ringers,
lactate, and they would carry itnext door and also they reduce
the body temperature, I tell youthat already..
Kate (22:36):
We move into the other theater, through the
sterilization room, the theaterwith the recipient in it.
Len (22:41):
Just one thing that I must say, you, the, the only two
people that knew about hearttransplants in this operating
theater was Chris Baarnard andMarius.
None of the other staff.
The other staff was purelynormal surgery staff, so they
were the only people that knewhow to do a heart transplant.
Let's start back at the history.
What happened here.
(23:01):
So at around about threeo'clock, Chris actually managed
to remove the heart on that sideand he carried it the 31 steps
to this side.
And the nurse that held thebucket there said she was so
scared to drop that because sheknew Chris would kill her.
There was no dose about it.
It was just kill her.
Any case they immediately put iton the heart lung machine so
that they can oxygenate theheart, and then they started the
(23:23):
implantation part.
And they implanted the heart andaround two minutes to six was
the critical time when they hadto see whether this heart was
actually going to beat.
And as you know, Chris didn'thave a lot of success with dogs,
so he was also just as concernedas anybody whether this is
actually gonna work or not.
And he took these two pedals,these are the goodies that they
(23:44):
used to shock the heart with.
He put it against the heart andas he shocked it, the heart
started beating immediately.
So that was quite an incrediblemoment.
You can just imagine the reliefamongst this people and the
excitement when this happened.
As a matter of fact, that ladythat's are still alive today,
Dinny said to me, we were allsmiling and congratulating each
(24:04):
other.
And also Chris, as a matter offact, experience the
tremendously.
It must have been the mostexciting moment for everybody in
this hall that morning.
The only hiccup that they hadthat whole night was when Chris
had to put one pipe from thefrom the heartlung machine into
the femoral artery.
As he put it in immediately, hesaid, listen, we've got a
blockage.
Clam down, I'm gonna move it tothe aorta.
(24:27):
And as they clammed down, theynever switched off the heart
lung machine and the next momentthere was blood all over the
floor.
So then they had to clean up theblood.
They also had to get the bubblesout of the machine before they
could carry on with theoperation.
That only took them two minutes,but it must have felt like two
hours, if not four.
Kate (24:43):
Len points our attention to a blackboard on the far wall,
which has a list of surgicaltools and tally marks against
each one.
Len (24:51):
Another interesting thing is also the figures that you see
on the board there, which is afive and a scratch out, another
five scratch out, everythingthat goes into the chest must
come out again.
So if you put in five of these,you must count them and scratch
them out once you've taken themout so that everybody knows
everything is out Then the otherinteresting thing is, of course,
the cloths that you see hanginghere in those days, they also
(25:13):
use cloths to actually suck upthe blood from the chest cavity,
and then they would take thesecloths and they would actually
weigh it there to see what theblood loss of the patient was.
Nowadays, they don't do thatanymore.
They just do a thumb suck andsay, well, it probably lost
about so much, and it just plugin the, the blood into the, into
the person.
So that's when the operationbasically was a success.
(25:35):
When the heart started beating,then I still had to close him up
and remove him to the recoveryroom.
Kate (25:41):
We enter the recovery room with Hyperrealistic silicon
figurines set up in the hospitalroom.
There's Louis Kinski waving fromthe bed with a book in his lap,
and Dr.
Barnard attending to him inScrubs.
Len (25:53):
Unfortunately we couldn't use wax because it's too hot in
South Africa.
As a matter of fact, within thefirst few days, there was a
dramatic increase in his generalcondition.
The legs, the swelling in thelegs came down.
He was actually sitting upspeaking to the nurses, making
jokes with him.
And he was a very lovablecharacter.
But in those first few days, hewas actually progressing
(26:13):
extremely well.
And everybody thought this is,is gonna walk out of here Even
he was eating normally.
Everything went extremely well.
And then at one point he startedcomplaining about abdominal
pain, chest pain, and shoulderpain.
And now remember, Chris had ateam of specialists sitting
twice a day to, to discuss hisprogress and see what they're
(26:35):
gonna do for the next period.
And at that point, the onlyconclusion that they could come
to was that it was rejection.
So they started givinganti-rejection medication for a
few days, and then when theytook another x-ray, they
actually saw a spot on the lung,lung, and then they realized
that it was actually pneumoniaand it wasn't rejection.
(26:57):
At that point, the immune systemis reduced because of the
anti-rejection medication.
And then he couldn't fight thepneumonia.
And that is the reason why hedied in 18 days time.
After that, that same morningthat he passed away, that
actually did the autopsy on him.
The the heart operation was inperfect Nick.
There was nothing wrong withthat.
(27:18):
As a matter of fact, the sadthing is there were no signs of
rejection.
But unfortunately, that is howit happened.
And I think also what Chris didat that point, because of the
fact that it was the very firstoperation and they didn't know
what to expect, when the problemset in, he immediately believed,
and I think he pushed thatanti-rejection medication to
(27:38):
actually try and pull himthrough, which was unfortunately
the wrong decision.
And Chris regretted that for avery long time in his life.
So it was a very, very sad thingfor him as well.
Kate (27:48):
And that, my friends, Is the incredible tale of the
world's inaugural human heart toheart transplant.
It unfolded with an air ofsecrecy, with only the hospital
staff knowing at the time.
Yet, when the procedure wasfinished and the veil was
lifted, the entire globe wascaptivated by the news, sparking
media requests and fan mail fromfar and wide.
Len (28:10):
So these are basically all letters of congratulations,
letters from admirers and peoplejust appreciated what he did.
But there was a lot of peoplethat gave him negative criticism
as well.
If you looked in that box you'remost welcome to come and read
it.
Kate (28:24):
For example, one s Pascal wrote to Chris the simple
message"it is my profoundconviction that you are unmoral,
a bunch of ghouls all of you."Another letter read:"memo to the
great heartless transplanter.
Well done Messer abouter."
Len (28:40):
some had wanted him arrested immediately.
Some said they were a lot ofbutchers in Cape Town, so there
was a lot of people that wereactually negative towards the
operation as well.
But eventually, I mean, allpeople now know that her heart
transplant is basically a relieffor someone that's got serious
heart conditions.
This one letter that I want tofocus on, and that's of a little
girl called Cheryl.
(29:01):
That wrote a letter to Chris andsaid, listen, I please want to
do a heart transplant betweentwo birds.
Will you please tell me how it'sdone?
And and Chris wrote back to herand said, listen, I can't tell
you how it's done, but come andhave a look and I'll show you
how it's done.
Let's turn around.
I'm gonna go down that wallquickly.
This is just the first sixpatients.
Now, as I said, Dr.
(29:22):
Fuller Blyk, the one on thatside and Peter Smith are sitting
here together.
Philip Blyk survived for 18months, and Peter Smith survived
for 20 months.
So you take from 18 days, 18months, 20 months.
Then we, unfortunately get tothis gentleman.
Yeah, William Killops.
He didn't survive for too long.
He had acute rejection of theheart.
(29:44):
Severe rejection of the heart.
And he only survived for twomonths and a few days, two
months and nine days as a matterof fact.
So he wasn't a very goodpatient.
He, he really struggled to, forhis body to, to, to get used to
this new heart.
And then this lady came along,amazing Lady of Dorothy Fisher,
first lady of color thatactually received a heart.
(30:05):
And she called Chris daddy.
And because she called Chrisdaddy, she could basically get
away with anything.
She didn't always drink hermedication.
She didn't always come for adoctor's visits, but she lived
for 13 years.
So if you take it now, we areready from 18 days, we are onto
13 years.
And then this gentleman camealong and decided, okay, I'm the
(30:27):
sixth patient, I'm gonna showyou how it's done.
And he left for 23 years.
So Albert, he recovered well,and as I said, he left for 23
years.
As a matter of fact, he didn'tdie of anything of his heart.
He died of a diabetes induceddrug.
So completely different.
Dorothy died of rejectioneventually, kilos, as I said,
severe rejection.
(30:48):
Philip Blyk died of rejection.
Pie Smith died of cancer.
Kate (30:52):
So out of the initial six heart transplant patients, sadly
five died from tissue rejection.
Tissue rejection occurs when theimmune system mistakenly attacks
the transplanted organ ortissue.
Anti-rejection medication isused to suppress the immune
response, allowing the body togradually adapt to the
transplant without resistance.
(31:13):
it's a delicate balance that'sthat they strive to achieve in
the realm of transplantation.
Len (31:18):
So it all depends on how your body adapts to this new
organ.
But I must also say that theanti-rejection medication
improved in 1980 dramatically.
And that helps a lot of peoplenow.
So it doesn't really reduce yourimmune system that much
nowadays.
So let's go to the sad ending ofChris.
On the 1st of September of 2001,he was in Papos in Cyprus on
(31:39):
holiday there, also went to sellsome olive oil there because he
was at that stage, farming closeto Beaufort West.
And he also tried to exportolive oil.
And the evening he went down tothe swimming pool to have a
quick swim cause he believed ithelped for his arthritis.
And as he got out of the pool,he had a massive asthma attack
and he passed away of asthma atthe age of 79.
(32:02):
Interestingly enough, this ishis own words, and I'm gonna
tell you exactly what he saidabout himself, I'm a guy who
loves people.
I love the female sex, and Ilike to enjoy life.
And that's Chris Baarnard in anutshell.
That is just Chris.
And if you read his books, it'sjust amazing.
By the way, he re, he wroteabout 36 books in his lifetime
as well, so he was quite a bitof a writer as well.
Kate (32:22):
Chris's legacy is profound and far reaching.
There's a whole corridor in themuseum that celebrates a hundred
heart transplants at GrooteSchuur hospital alone between
1985 and 2003.
His work instilled hope incountless patients and propelled
advancements in cardiac surgery,sparked global awareness of the
(32:42):
field and ignited healthydiscussions on medical ethics.
His dedication, vision, anddetermination have left a mark
and inspired future generationsof medical professionals to push
the boundaries of what ispossible in the pursuit of
improving and saving lives,including.
His dedication, vision, anddetermination have left a mark
(33:05):
and inspired generations ofmedical professionals to keep
pushing the boundaries of whatis possible in the pursuit of
improving and saving lives,including.
Len (33:15):
And I hope to at one point be able to transport pig hearts
into humans.
As we stand here today, on ayearly basis, there's a million
people waiting for new heartsand only five to 6,000
operations are getting donepurely because of the lack of
donors.
Kate (33:38):
On that note, I'll leave you with three pieces of advice.
On that note, I'll leave youwith three pieces of advice.
One, register to be an organdonor.
Two, visit the heart of CapeTown Museum and three, never
lose sight of your goals.
Don't forget to check out ourInstagram this week where we
have photos of the museumdisplays, including the actual
hearts of the first donors andrecipients, the theater rooms,
(34:01):
fan mail, hate mail, and lots ofnewspaper clippings.
Thanks for listening to Roadshowand Tell.
If you enjoyed this deep diveinto a specialty museum, make
sure you subscribe so you don'tmiss an episode.
We're a new podcast.
So if you wanna help support us,please share it with a friend
(34:22):
and leave a rating and review.
If you are involved with or knowof a regional or specialty
museum that should be featured,please get in touch at
roadshowandtell@gmail.com.
I'm your host, Kate.
Roadshow and Tell was edited andproduced on the lands of the
Gadigal people.
(34:42):
I acknowledge the TraditionalCustodians of the various lands
on which you may be listeningfrom, and the lands that the
museums featured in this podcastreside on.
I also acknowledge anyAboriginal or Torres Strait
Islander people listening tothis podcast.
I pay my respects to elderspast, present, and emerging, and
celebrate the diversity ofAboriginal peoples and their
(35:05):
ongoing cultures and connectionsto the lands and waters of
Australia.
This is a, somebody who obtained his PhD in two years
instead of six.
Len (00:05):
that implanted an extra head onto a dog.
And everybody thought this is,is gonna walk out of here I
think he should have gotten theNobel price, but he never did
Kate (00:28):
Usually the museums we visit are based on a niche
subject, person or location.
But today's museum is dedicatedto something much more specific,
one singular medicalbreakthrough.
Welcome to the heart of CapeTown Museum.
Situated within the very wing ofGroote Schuur Hospital where the
her world's first hearttransplant took place in 1967.
(00:51):
The exact operation rooms usedare on display and staged as
they were during the operationwith Silicon figurines.
We hop on a tour with guide Lenand speak to Cindy about the
operation itself, what led toit, and most importantly about
the visionary surgeon behind itall, dr.
Christian Barnard.
The heart of Cape Town Museum isa testament to human ingenuity,
(01:14):
resilience, and the relentlesspursuit of medical progress.
so I'm here at the heart of CapeTown Museum with Cindy.
Cindy, how are you today?
Cindy (01:26):
I'm fine, thank you.
Kate (01:27):
How did the heart of Cape Town Museum come to be?
Cindy (01:30):
The museum came to be after It became a famous story
after the first successfulhuman-to-human heart transplant
done by Professor Barnard in1967.
So because the story became sobig the hospital started the own
museum.
And then in 2007, our curator,Henry Yuba came on board and he
(01:52):
did further restoration to bringit back to its original form.
So when you go through ourmuseum today, the equipment that
you're seeing in theater is theoriginal equipment that was
booked to their theater thenight of the operation.
Kate (02:05):
So What are the challenges in running this museum?
Cindy (02:08):
I think the awareness is a big problem for us because if
I just take for example, southAfricans, there's not a lot of
South Africans that actuallyknow about us.
So majority of our, our visitorsare from overseas, so it's being
well advertised for tourism herein South Africa, but our South
Africans aren't aware of themuseum here.
Kate (02:30):
Are they not taught about this in school?
Cindy (02:32):
They are taught about it in school, but those are grade
sixes and sevens.
What we actually find is thekiddies are bringing their
parents here, which I think isgreat.
So, you know, and, when you getto speak to their parents,
they're like, wow, you know,like I know about the story, but
I didn't know about the museum.
Kate (02:48):
What's the most popular part of the museum?
Cindy (02:50):
The theaters.
Kate (02:52):
And what's the most asked question?
Cindy (02:55):
The most asked question.
Is the dog real?
So one of the first rooms thatyou enter into when you head up
to theater is the animal lab.
So they have what looks like areal dog on the table, and it's
having a heart transplant andall the equipment is there.
So it looks very, very real
Kate (03:17):
What effect did Covid have on the museum?
Cindy (03:20):
So Covid had a big effect in the sense that we actually
had to close the museum.
So we were closed for the entireduration of Covid.
We only opened in May this year.
Kate (03:30):
Wow.
That's a lot of lost revenue andlost visitors.
Cindy (03:33):
Lost revenue, lost visitors.
And the reason for that wasbecause Groote Schuur Hospital
is actually a designated covidhospital.
And because most of our visitorsare tourists, you know, you're
running a high risk.
Problem there.
Kate (03:46):
Cindy, why do you like working at the heart of Cape
Town Museum?
Cindy (03:50):
I'll tell you, I originally come from hr, that's
my degree, I was an HR clerk andwhen Covid was done, and the
curator approached me and hesaid to me, look, he's got this
museum and he needs somebody toopen it up.
It's been closed for two years.
And I said to him, well, take methrough the museum.
Let me, let me see, let mevisit.
And he brought me here and hetold me the story.
(04:12):
He's so passionate about it thatI fell in love with the story
and that's why I'm here.
I never in my life got to meetChris Barnard.
I'm very jealous because mycolleague did but I can imagine
that he was a great, great guy.
Kate (04:25):
Why should people come to the heart of Cape Town Museum?
Cindy (04:28):
Because of the beautiful story once you've been on a
tour, you'll understand what I'msaying.
We've got people from all overthe world that come here to
visit us.
From cardiac thoracic surgeons,all the way down to people who
just want to know what the bigdeal is about.
And all of them leave here withsaying, this was actually the
highlight of the holiday.
So that is the impact that thestory has.
Kate (04:51):
I can tell you it was definitely one of the highlights
of my holiday as well.
The way the museum is structuredallows you to get a real sense
of Chris Barnard's character.
Cindy (05:00):
What I do know is Professor Chris Barnard was a
dynamic man.
He was a, he was a driven man.
This is a, somebody who obtainedhis PhD in two years instead of
six.
So nobody's ever been able to doit since him, you know, so if
that doesn't give you anindication of what type of drive
this man had how, however, withthat said, One of the things
(05:21):
that he did say in one of hisinterviews is this is what made
him famous, the first successfulhuman to human heart transplant.
But what he actually wanted tobe remembered for in his life or
his legacy, was the work he didon children.
Kate (05:36):
So now we go on a guided tour of the museum with Len.
He'll explain the details of thesurgery and then take us through
what led up to it and show usthe operating rooms.
Len (05:47):
My name is Len by the way, and I'm gonna take you through
the process of the very firstheart to heart.
Ha human to human not heart,human to human heart transplant
that had occurred in thishospital by professor Christiaan
Bernard.
Now also the donor at that stagewas Denise Darvall, and Mr.
Louis Washkansky was therecipient.
(06:07):
Now, Louis Washkansky wasseverely ill at that stage.
He had two prior heart attacksalready.
He also had an aneurysm on theheart and his kidneys and liver
didn't function properly purelybecause of the fact that his
heart didn't function properly.
Christiaan Bernard 45 years ofage at that stage.
Denise Darvall, 25.
Mr.
Louis Washkansky 53.
Now at one point, also inChris's book, if you ever read
(06:30):
One Life very interesting book,you will read that he was
actually concerned that he mightnot have a donor in time to save
Mr.
Washkansky's life.
So Mr.
Washkansky was at the end of hislife, he basically had no chance
of surviving for much longerthan a few weeks.
Okay, so on the Saturday of the2nd of December of 1967, Denise
and her mum was walking acrossthe road, to actually buy a
(06:52):
caramel cake.
And as they came out of the cakeshop, a drunken driver came and
knocked them both over.
Now Denise was flung about 40feet, and she knocked her head
against a stationary vehicle.
Her mom, Myrtle died instantlyat the scene of the accident.
So Denise was brought to thisroom.
This was the old emergency roomof the Groote Schuur hospital
(07:13):
that you're standing in now.
So she was brought to this roomand she was treated here for the
injuries, but very soon theyrealized that she's not gonna
survive.
And then Dr.
Bozman went out to Mr.
Darvall who was sitting outside.
He was sitting outside,obviously waiting for good news
on his daughter because he'salready lost his wife.
Now, Dr.
Bosman had to go outside andsay, sorry, but she's not gonna
(07:34):
survive.
Can we use the organs fortransplant purposes?
And Mr.
Darvall took about four minutesand he said, you know, the way
that I know my daughter, shewould rather let someone else
live if she can't live at all.
So that is how they gotpermission to, to gain the
organs for transplantationpurposes.
The other very important thingthat we must realize is that
(07:56):
there was a difference betweenthe law in South Africa and the
law outside South Africa.
In South Africa, it stated thattwo doctors can declare you
dead.
But there was no criteriaattached.
Didn't say this had to happen orthat had to happen.
Two doctors can declare youdead.
So if you bump your turn, theydecide you're dead.
You're dead And in the rest ofthe world it actually stated
(08:17):
that your heart must stopbeating before they can declare
you dead.
And that is primarily the reasonwhy it happened here.
Because once your heart stopbeating inside your chest
cavity, basically clottingstarts taking place and the
heart starts dying, then youcan't harvest a good heart
anymore.
So that is primarily the mainreason why the operation
(08:38):
happened in South Africa,because of that gap that Chris
Baarnard saw with regards tobrain dead.
So he got in two neurosurgeons,he got her declared brain dead,
and then they immediatelystarted putting her on a support
system so that she can surviveuntil they could harvest a good
heart from her.
So immediately they kept thecirculation going, everything so
(08:59):
that they can harvest a perfectheart from her.
Right.
Let's go to this list here.
Kate (09:03):
Introducing the Transplant Dream team.
With 15 members and twopatients, not everyone operated,
but they all played a vitalrole.
Len (09:11):
Half of the team were on standby and the other half was
basically off.
So Chris alternated that so thatthere's always a fresh team to
actually do the operation.
So remember as from September,Mr.
Washkansky was in bed already inthe hospital severely ill, and
three weeks prior to theoperation, he was moved to Chris
Baarnard's section awaitingtransplant.
(09:33):
Okay?
Now you'll also see anothergentleman there, certain Dr.
Em Baarnard.
He was Marius Baarnard, Chris'sbrother.
And he was also involved in thevery first heart transplant.
And I'll tell you about that alittle bit later.
This gentleman, professor VelvaSchrire he was the head of
cardiology at that stage, and hebasically identified Mr.
Washkansky as a possiblerecipient.
(09:54):
then also very interesting thingthat Very few people know is
that on the 22nd of November ofthat year, they actually had a
donor with matching tissue typeas well as matching blood type.
And the operation actually couldhave happened on the 22nd of
November already, but why didn'tit?
Because of a law that we had inSouth Africa called apartheid.
(10:16):
And the reason why they decidednot to do the operations is
purely because Chris and VelvaSchrire agreed that with the
first operation, they will notuse a person of color.
Cause they don't want to be seenas experimenting on people of
color, which is actually a noblecause, but one was also remember
that basically they lost aperfectly good heart at that
(10:36):
stage that they could havetransplanted.
Kate (10:39):
Len also points out the anesthetist that we're working
on that day.
Len (10:42):
Yeah, the gentleman on that board there, professor j Ozinski
very interesting character thatalso called him Ozzy.
His name was Joseph, and he wasthe senior aneasthetist on the
day.
Now, a lot of doctors that comepast here say it's quite amazing
that he actually survived theanesthetics, especially if you
take it the way that it was donein those days, as well as the
fact that Mr.
Washkansky was severely ill.
(11:04):
And then one must also sayOzinsky was very, very dedicated
to this whole process.
The last night of Mr.
Washkansky's life, he actuallyhand ventilated him the whole
night to see if he couldactually save his life.
So he was very dedicated, verycommitted doctor, but Chris tend
to attract those people to him.
They said Chris had a a natureof asking you to do something
(11:26):
and you know that he's actuallygonna abuse you, but you said
yes before because you felt sohonored and privileged that he
actually asked you to dosomething.
Kate (11:34):
Interestingly, Len drops at the assistant anesthetist,
Cecil Moss, had some seriouslyimpressive moonlighting gigs.
Not only was he the Springbokcaptain while working there, but
he also served as theanesthetist for Nelson Mandela's
surgery on Robin Island back in1979.
And if that wasn't enough, heeven went on to coach the
(11:55):
Sprinboks for seven years in the1980s.
Len (11:57):
now a lot of people want to know, why would you anesthetize
someone that's brain dead?
The reason for that is purelybecause they are involuntary
twitching that takes place aswell as out of respect for the
patient.
You're not gonna operate onsomeone without anesthetics,
right?
Okay, two things about ChristianBaarnard, very important little
things is.
Firstly, he loved the fame whenhe came, became famous- and
(12:20):
remember that happened within aweek after the operation- he
just loved every minute.
He sucked it up like a sponge.
And the second thing that hesucked up like a sponge was
ladies, okay.
He loved the ladies as well,wherever in the world.
So any case, he loved the fame.
This is at a film premier thathe attended, he was the first
person ever where two Popesasked him for an audience.
(12:41):
He didn't have to ask for anaudience with a Pope, which is
quite amazing.
Kate (12:44):
There's a picture of Chris with Sophia Lauren, princess
Diana, and crowded with fansbegging for autographs.
Len (12:51):
And then as I said, Chris loved the fame.
Wherever he could get hispicture taken, he would do that.
And this is at the worldtransplant games in Manchester.
Kate (13:00):
Okay, hold up folks.
We have got to take a moment todive into something truly
remarkable.
The World transplant games.
Picture this, it's like theOlympic games, but exclusively
for organ transplant recipients.
And guess what?
Donor families and living donorscan join in on the action and
compete in certain events.
The next games are in Italy inMarch, 2024.
Len (13:23):
Then a very interesting little thing is that Chris
always said that the best workthat he did, or the most
interesting work was his workwith children.
And there's a very importantthing that very few people know,
but it's written in his book.
One Life, he did research onintestinal atresia on infants.
And what intestinal atresia isbasically it's a, a constriction
(13:44):
of the blood flow to theintestines of the baby.
And babies are born like thatand they normally don't live
very long after that.
And they used to lose abouteight out of every 10 children.
Now what happened is he'sdecided to do some research on
this.
So he took dogs that weresupposed to have puppies and he
would take the one puppy outwith the umbilical cord still
connected, and he would simulatethe problem that he experienced
(14:06):
in infants.
Then he would implant the puppyback into the mum and wait for
the mum to give birth.
And then he perfectly had thesame problem as with children
with intestinal atresia.
And then he would rectify thatproblem and experiment on that.
Now, that research of hisreduced the death rate from
eight out of every 10 to two outof every 10, and that method was
(14:29):
also applied worldwide.
So that's one of the things thathe didn't really get credit for.
As a matter of fact, I think heshould have gotten the Nobel
price, but he never did.
Right.
Kate (14:38):
After Chris's work on intestinal artresia, he got a
bursary to study in Minnesota.
He did research with otherdoctors towards the first heart
transplant and was gifted aheart lung machine to take back
to South Africa to further hisresearch.
Len (14:53):
So then he started doing heart transplants on dogs and he
did 48 heart transplants ondogs.
And guess how many weresuccessful?
None.
Right.
The first successful hearttransplant that Chris did was on
Mr.
Washkansky.
Then just as a matter ofinterest, he was also the very
first person to, in thishospital on the continent of
(15:13):
Africa, do a kidney transplant.
And that he did two months priorto the first heart transplant,
he used the complete team thathe used in the heart transplant
to do the kidney transplant.
And he always boasted that hehad a hundred percent success
rate with kidney transplants,but he only did the one and that
patient lived for 20 years.
(15:33):
So that wasn't too bad.
Kate (15:35):
He was also the first person on the continent of
Africa to do open heart surgery.
It was on a little girl calledJoan Pick.
Len (15:45):
He was also the very first person to actually do open heart
surgery on the continent ofAfrica on a little girl called
Joan Pick.
She was a daughter of one of theworkers with him, and she had a
problem with the heart valve andhe actually fixed that heart
valve as well.
And then he was the very firstperson This sounds crazy, but
this, this is really a crazystory.
There was a certain Dr.
(16:06):
Demikov in Russia that implantedan extra head onto a dog.
And when Chris Baarnard heardthis, he thought, oh, well I can
also do it.
And he did it here as well.
So on the day when Yani Lowe wasthe head of surgery at that
stage, heard about this,.
he actually ran down to the labto see this lot and there was
this dog with one body, twoheads, and they were both
licking up water from a bucket.
Kate (16:28):
Yes, I know.
Wow.
A lot to take in here.
Okay, so first off, they foundthe dogs at the pound that were
going to be euthanized anyway,the 1960s were a very bad time
to be a stray dog in Cape town.
Secondly, yes, medical ethics,that branch was still emerging.
Animal transplant experimentsbegan in the early 19 hundreds.
(16:50):
In 1905 French, Dr.
Christian Cabrol performed atransplant of a dog's heart onto
the neck of another dog.
Three years later, American Dr.
Charles Guthrie grafted a secondhead onto a dog well before Dr.
Demikov's similar surgery in1954.
Notably, the dog involved in Dr.
Demikov's experiment managed tosurvive for 29 days following
(17:13):
the surgery.
Len (17:14):
Anybody know how a heart lung machine works?
So what the heart lung machinedoes is it basically takes over
the function of the heart andthe lungs while the heart and
the lungs don't work duringheart transplant or open heart
surgery, where they actually hadto stop the heart.
So it circulates the bloodthrough the body, but it not
only circulates it, it takes outthe deoxygenates, oxygenated
(17:34):
blood, oxygenates it, and thenreturns it to the body and
circulates it through the body.
In the old days prior to theheart lung machine, what they
used to do is they used to takethe parent of the child, which
they were going to operate on,and they would link the two,
onto one another with two pipescoming into the arteries and the
veins in the leg.
And then they would, with alittle pump, circulate the blood
(17:56):
from the mother to the child.
So the mother's lung did the jobof getting oxygen in and then it
would circulate it back throughthe child and back to the mum.
But the problem with that isthat they very soon realized
that they've got a 200% chanceof losing both patients.
And that is when the heart lungmachine was discovered.
It was absolutely brilliantbecause now they didn't have to
(18:17):
use a human to do thecirculation.
Kate (18:19):
Len also told us a story of when Chris was in the US and
he was presented with a patientwith liver problems.
The patient's liver couldn'trecover quick enough, so the
doctor was replacing a pint ofblood every day for the patient.
When Chris saw this, he thoughtof a better plan.
He took a baboon and putoxygenated saline solution into
(18:40):
the baboon while taking out allof its blood.
When there was no blood left, hereplaced it with human blood.
Len (18:46):
And the next morning the baboon was sitting there eating
bananas and peaches andwhatever.
So he did some amazing, crazystuff.
They, they were just soexperimental at that stage.
It was just unreal.
And the kind of things that hedid, I mean, just another
example, what happened is Chrishad no ways of reducing the body
temperature of the person oranimal that he operated on,
(19:06):
specifically animals.
And what he used to do, he usedto go down to the chemist of the
university and he used to drawsome condoms there.
And he then he would implant itin the stomach of the dog, and
then he would circulate coldwater through there to reduce
the temperature of the body ofthe dog.
So they did amazing things andcrazy things Sometimes.
Kate (19:25):
Now, of course, Chris had a whole team of people to
support him in his research andsurgery.
We're showing a video of onevery special assistant to Chris,
Hamilton Naki.
Hamilton Naki was born in a poorblack family in the Eastern Cape
of South Africa.
With limited opportunities, heleft school at 14 and started
working as a gardener in CapeTown.
(19:47):
He was then hired as an animallab assistant where he
progressed from cleaning cagesto performing anesthesia.
When he joined Chris Barnard,his remarkable skill and
dexterity at animal anesthesiawas noticed.
He was appointed as PrincipalSurgical Assistant.
Which was quite extraordinary atthe time, given the divisive
apartheid laws.
(20:08):
These are Chris words from thevideo.
Hamilton had a lot of skill.
As far as the technical side,uh, was concerned, he probably
had more skill than I had,because I was not really a very
good technician.
And what's more important isthat he was proud.
He was, he had tremendous pridein, uh, the quality of his
performance.
(20:29):
Hamilton went on to even teach students and assisted
transplant surgeon Dr.
Rosemary Hickman until hisretirement in 1991.
He was awarded an honorarymaster's degree from the
University of Cape Town in 2003,two years before his death.
So many people with tremendouspotential, uh, has never had the
(20:50):
opportunity to develop thatpotential.
I would say the agreement tosuccess is firstly a certain
amount of ability, and thesecond one is opportunity.
Uh, and many, there are many,many people who are probably as
skilled as Hamilton, as giftedas Hamilton, that has never had
the opportunity to explore whatGod gave them.
Now we enter the theatre rooms which are set up to look
(21:11):
exactly like they did on the dayof the operation.
There's two separate theatreswith a small sterilisation room,
serving as a central connectionbetween them.
Len (21:21):
You are actually in the real theater where the Denise
Devall organs were taken out onthe morning of the 3rd of
December.
This is also National HeritageSite in South Africa.
This operating theater as wellas the operating theater on the
other side where theimplantation occurred.
The person that prepared a Misavalve for the removal of the
heart was Marius Barnaard hisbrother.
(21:42):
So he was, here, he opened upthe chest cavity and waited for
Chris to finish on that side andcome and remove the heart.
The operations started aroundabout one o'clock that morning.
They gave them anesthetics.
That took about 20 minutes, andabout 20 past they started
opening up the chest cavities.
I must just state that in DeniseDarvall's heart, they did not
remove while it was beating.
(22:03):
They waited for the heart tostop before they removed the
heart.
They switched off the machines.
It took about, say, 10 to 15minutes before the heart
stopped, and then they removedthe heart.
So yeah, as I said, Mariusopened the chest cavity they
carried it.
As a matter of fact, Chriscounted his steps as he walked
next door with a heart in abucket like this.
Cause what they do is they putanti clotting agent in the heart
(22:26):
while it's still in the body.
Then they remove the heart, putit in ice, cold ringers,
lactate, and they would carry itnext door and also they reduce
the body temperature, I tell youthat already..
Kate (22:36):
We move into the other theater, through the
sterilization room, the theaterwith the recipient in it.
Len (22:41):
Just one thing that I must say, you, the, the only two
people that knew about hearttransplants in this operating
theater was Chris Baarnard andMarius.
None of the other staff.
The other staff was purelynormal surgery staff, so they
were the only people that knewhow to do a heart transplant.
Let's start back at the history.
What happened here.
(23:01):
So at around about threeo'clock, Chris actually managed
to remove the heart on that sideand he carried it the 31 steps
to this side.
And the nurse that held thebucket there said she was so
scared to drop that because sheknew Chris would kill her.
There was no dose about it.
It was just kill her.
Any case they immediately put iton the heart lung machine so
that they can oxygenate theheart, and then they started the
(23:23):
implantation part.
And they implanted the heart andaround two minutes to six was
the critical time when they hadto see whether this heart was
actually going to beat.
And as you know, Chris didn'thave a lot of success with dogs,
so he was also just as concernedas anybody whether this is
actually gonna work or not.
And he took these two pedals,these are the goodies that they
(23:44):
used to shock the heart with.
He put it against the heart andas he shocked it, the heart
started beating immediately.
So that was quite an incrediblemoment.
You can just imagine the reliefamongst this people and the
excitement when this happened.
As a matter of fact, that ladythat's are still alive today,
Dinny said to me, we were allsmiling and congratulating each
(24:04):
other.
And also Chris, as a matter offact, experience the
tremendously.
It must have been the mostexciting moment for everybody in
this hall that morning.
The only hiccup that they hadthat whole night was when Chris
had to put one pipe from thefrom the heartlung machine into
the femoral artery.
As he put it in immediately, hesaid, listen, we've got a
blockage.
Clam down, I'm gonna move it tothe aorta.
(24:27):
And as they clammed down, theynever switched off the heart
lung machine and the next momentthere was blood all over the
floor.
So then they had to clean up theblood.
They also had to get the bubblesout of the machine before they
could carry on with theoperation.
That only took them two minutes,but it must have felt like two
hours, if not four.
Kate (24:43):
Len points our attention to a blackboard on the far wall,
which has a list of surgicaltools and tally marks against
each one.
Len (24:51):
Another interesting thing is also the figures that you see
on the board there, which is afive and a scratch out, another
five scratch out, everythingthat goes into the chest must
come out again.
So if you put in five of these,you must count them and scratch
them out once you've taken themout so that everybody knows
everything is out Then the otherinteresting thing is, of course,
the cloths that you see hanginghere in those days, they also
(25:13):
use cloths to actually suck upthe blood from the chest cavity,
and then they would take thesecloths and they would actually
weigh it there to see what theblood loss of the patient was.
Nowadays, they don't do thatanymore.
They just do a thumb suck andsay, well, it probably lost
about so much, and it just plugin the, the blood into the, into
the person.
So that's when the operationbasically was a success.
(25:35):
When the heart started beating,then I still had to close him up
and remove him to the recoveryroom.
Kate (25:41):
We enter the recovery room with Hyperrealistic silicon
figurines set up in the hospitalroom.
There's Louis Kinski waving fromthe bed with a book in his lap,
and Dr.
Barnard attending to him inScrubs.
Len (25:53):
Unfortunately we couldn't use wax because it's too hot in
South Africa.
As a matter of fact, within thefirst few days, there was a
dramatic increase in his generalcondition.
The legs, the swelling in thelegs came down.
He was actually sitting upspeaking to the nurses, making
jokes with him.
And he was a very lovablecharacter.
But in those first few days, hewas actually progressing
(26:13):
extremely well.
And everybody thought this is,is gonna walk out of here Even
he was eating normally.
Everything went extremely well.
And then at one point he startedcomplaining about abdominal
pain, chest pain, and shoulderpain.
And now remember, Chris had ateam of specialists sitting
twice a day to, to discuss hisprogress and see what they're
(26:35):
gonna do for the next period.
And at that point, the onlyconclusion that they could come
to was that it was rejection.
So they started givinganti-rejection medication for a
few days, and then when theytook another x-ray, they
actually saw a spot on the lung,lung, and then they realized
that it was actually pneumoniaand it wasn't rejection.
(26:57):
At that point, the immune systemis reduced because of the
anti-rejection medication.
And then he couldn't fight thepneumonia.
And that is the reason why hedied in 18 days time.
After that, that same morningthat he passed away, that
actually did the autopsy on him.
The the heart operation was inperfect Nick.
There was nothing wrong withthat.
(27:18):
As a matter of fact, the sadthing is there were no signs of
rejection.
But unfortunately, that is howit happened.
And I think also what Chris didat that point, because of the
fact that it was the very firstoperation and they didn't know
what to expect, when the problemset in, he immediately believed,
and I think he pushed thatanti-rejection medication to
(27:38):
actually try and pull himthrough, which was unfortunately
the wrong decision.
And Chris regretted that for avery long time in his life.
So it was a very, very sad thingfor him as well.
Kate (27:48):
And that, my friends, Is the incredible tale of the
world's inaugural human heart toheart transplant.
It unfolded with an air ofsecrecy, with only the hospital
staff knowing at the time.
Yet, when the procedure wasfinished and the veil was
lifted, the entire globe wascaptivated by the news, sparking
media requests and fan mail fromfar and wide.
Len (28:10):
So these are basically all letters of congratulations,
letters from admirers and peoplejust appreciated what he did.
But there was a lot of peoplethat gave him negative criticism
as well.
If you looked in that box you'remost welcome to come and read
it.
Kate (28:24):
For example, one s Pascal wrote to Chris the simple
message"it is my profoundconviction that you are unmoral,
a bunch of ghouls all of you."Another letter read:"memo to the
great heartless transplanter.
Well done Messer abouter."
Len (28:40):
some had wanted him arrested immediately.
Some said they were a lot ofbutchers in Cape Town, so there
was a lot of people that wereactually negative towards the
operation as well.
But eventually, I mean, allpeople now know that her heart
transplant is basically a relieffor someone that's got serious
heart conditions.
This one letter that I want tofocus on, and that's of a little
girl called Cheryl.
(29:01):
That wrote a letter to Chris andsaid, listen, I please want to
do a heart transplant betweentwo birds.
Will you please tell me how it'sdone?
And and Chris wrote back to herand said, listen, I can't tell
you how it's done, but come andhave a look and I'll show you
how it's done.
Let's turn around.
I'm gonna go down that wallquickly.
This is just the first sixpatients.
Now, as I said, Dr.
(29:22):
Fuller Blyk, the one on thatside and Peter Smith are sitting
here together.
Philip Blyk survived for 18months, and Peter Smith survived
for 20 months.
So you take from 18 days, 18months, 20 months.
Then we, unfortunately get tothis gentleman.
Yeah, William Killops.
He didn't survive for too long.
He had acute rejection of theheart.
(29:44):
Severe rejection of the heart.
And he only survived for twomonths and a few days, two
months and nine days as a matterof fact.
So he wasn't a very goodpatient.
He, he really struggled to, forhis body to, to, to get used to
this new heart.
And then this lady came along,amazing Lady of Dorothy Fisher,
first lady of color thatactually received a heart.
(30:05):
And she called Chris daddy.
And because she called Chrisdaddy, she could basically get
away with anything.
She didn't always drink hermedication.
She didn't always come for adoctor's visits, but she lived
for 13 years.
So if you take it now, we areready from 18 days, we are onto
13 years.
And then this gentleman camealong and decided, okay, I'm the
(30:27):
sixth patient, I'm gonna showyou how it's done.
And he left for 23 years.
So Albert, he recovered well,and as I said, he left for 23
years.
As a matter of fact, he didn'tdie of anything of his heart.
He died of a diabetes induceddrug.
So completely different.
Dorothy died of rejectioneventually, kilos, as I said,
severe rejection.
(30:48):
Philip Blyk died of rejection.
Pie Smith died of cancer.
Kate (30:52):
So out of the initial six heart transplant patients, sadly
five died from tissue rejection.
Tissue rejection occurs when theimmune system mistakenly attacks
the transplanted organ ortissue.
Anti-rejection medication isused to suppress the immune
response, allowing the body togradually adapt to the
transplant without resistance.
(31:13):
it's a delicate balance that'sthat they strive to achieve in
the realm of transplantation.
Len (31:18):
So it all depends on how your body adapts to this new
organ.
But I must also say that theanti-rejection medication
improved in 1980 dramatically.
And that helps a lot of peoplenow.
So it doesn't really reduce yourimmune system that much
nowadays.
So let's go to the sad ending ofChris.
On the 1st of September of 2001,he was in Papos in Cyprus on
(31:39):
holiday there, also went to sellsome olive oil there because he
was at that stage, farming closeto Beaufort West.
And he also tried to exportolive oil.
And the evening he went down tothe swimming pool to have a
quick swim cause he believed ithelped for his arthritis.
And as he got out of the pool,he had a massive asthma attack
and he passed away of asthma atthe age of 79.
(32:02):
Interestingly enough, this ishis own words, and I'm gonna
tell you exactly what he saidabout himself, I'm a guy who
loves people.
I love the female sex, and Ilike to enjoy life.
And that's Chris Baarnard in anutshell.
That is just Chris.
And if you read his books, it'sjust amazing.
By the way, he re, he wroteabout 36 books in his lifetime
as well, so he was quite a bitof a writer as well.
Kate (32:22):
Chris's legacy is profound and far reaching.
There's a whole corridor in themuseum that celebrates a hundred
heart transplants at GrooteSchuur hospital alone between
1985 and 2003.
His work instilled hope incountless patients and propelled
advancements in cardiac surgery,sparked global awareness of the
(32:42):
field and ignited healthydiscussions on medical ethics.
His dedication, vision, anddetermination have left a mark
and inspired future generationsof medical professionals to push
the boundaries of what ispossible in the pursuit of
improving and saving lives,including.
His dedication, vision, anddetermination have left a mark
(33:05):
and inspired generations ofmedical professionals to keep
pushing the boundaries of whatis possible in the pursuit of
improving and saving lives,including.
Len (33:15):
And I hope to at one point be able to transport pig hearts
into humans.
As we stand here today, on ayearly basis, there's a million
people waiting for new heartsand only five to 6,000
operations are getting donepurely because of the lack of
donors.
Kate (33:38):
On that note, I'll leave you with three pieces of advice.
On that note, I'll leave youwith three pieces of advice.
One, register to be an organdonor.
Two, visit the heart of CapeTown Museum and three, never
lose sight of your goals.
Don't forget to check out ourInstagram this week where we
have photos of the museumdisplays, including the actual
hearts of the first donors andrecipients, the theater rooms,
(34:01):
fan mail, hate mail, and lots ofnewspaper clippings.
Thanks for listening to Roadshowand Tell.
If you enjoyed this deep diveinto a specialty museum, make
sure you subscribe so you don'tmiss an episode.
We're a new podcast.
So if you wanna help support us,please share it with a friend
(34:22):
and leave a rating and review.
If you are involved with or knowof a regional or specialty
museum that should be featured,please get in touch at
roadshowandtell@gmail.com.
I'm your host, Kate.
Roadshow and Tell was edited andproduced on the lands of the
Gadigal people.
(34:42):
I acknowledge the TraditionalCustodians of the various lands
on which you may be listeningfrom, and the lands that the
museums featured in this podcastreside on.
I also acknowledge anyAboriginal or Torres Strait
Islander people listening tothis podcast.
I pay my respects to elderspast, present, and emerging, and
celebrate the diversity ofAboriginal peoples and their
(35:05):
ongoing cultures and connectionsto the lands and waters of
Australia.
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