South African Medical Pioneers — Dr. Chris Barnard
It’s probably safe to assume that most people consider Doctor Chris Barnard performing of the world’s first successful heart transplant the highlight of South Africa’s contribution to international medicine.
That’s not entirely true, but it certainly did focus on the quality of medical science on the tip of Africa.
Christiaan Neethling Barnard was born in Beaufort West in the then Cape Province on the 8 November 1922.
After completing his schooling at the Beaufort West High School in 1940, he applied to study medicine at the University of Cape Town Medical School, obtaining his MB ChB in 1945.
Barnard did his internship and residency at the Groote Schuur Hospital in Cape Town, after which he worked as a General Practitioner in the nearby town of Ceres.
In 1951, he returned to Cape Town, to complete his master degree, which he did successfully, receiving Master of Medicine from University of Cape Town in 1953.
In that same year, Barnard obtained a Doctorate in Medicine (MD) from UCT for his dissertation entitled, “The Treatment of Tuberculosis Meningitis.”
At this point, Barnard was not showing any particular interest in the discipline in which he would later become world famous. He did groundbreaking research into the life-threatening birth defect, intestinal atresia. His research and surgical interventions, successfully provided a cure for the medical condition, saving numerous children, and which was later adopted by surgeons in Britain and the USA.
Fortunately, at this point, fate stepped in.
Groote Schuur’s Head of Medicine John Brock was contacted by Chief of Surgery Owen Wangensteen from the University of Minnesota in Minneapolis in the United States, if he could recommend a promising South African doctor for a post in the United States, and Brock recommended Chris Barnard. Barnard left for the USA in December 1955, to begin a two-year scholarship under Wangensteen.
Barnard’s sojourn in the United States was to change both Barnard’s life and the history of cardiac surgery forever. Although Wangensteen initially expected Barnard to continue his work on intestines, Barnard seized the opportunity to absorb the latest information and techniques from American colleagues, who were pioneering many of the techniques that Barnard would later introduce into South Africa, and use in his own ground-breaking surgery.
He gained more and more experience in the areas of cardiac surgery, including assisting in operations and operating the heart-lung machine, and he was eventually allowed by Wangensteen to transfer to the cardiac department.
In 1958, Barnard received a Master of Science in Surgery for a thesis titled “The Aortic Valve — Problems in the fabrication and testing of a prosthetic valve”. In that same year, Barnard was also awarded his Ph.D. for his dissertation, “The Aetiology of Congenital Intestinal Atresia.”
Barnard was later to describe the 2 years which he spent in the USA as “the most fascinating time in my life!”
When Barnard returned to South Africa in 1958, he was appointed as head of the Department of Experimental Surgery at Groote Schuur, and was also appointed Director of Surgery Research at UCT.
In a move that would have been highly usual for the time, considering that the South African authorities were openly hostile to the Communist regime in the USSR, in 1960 Barnard travelled to the Moscow, to meet with Vladimir Demikhov, at the time one of the world’s foremost organ transplant experts, to learn as much as he possibly could.
Barnard’s career was still on an upward trajectory.
In 1961, he Barnard was appointed a head of the Division of Cardiothorasic Surgery at the teaching hospitals of the University of Cape Town, and shortly afterward, in 1962, he was appointed as Associate Professor in the Department of Surgery at UCT. Barnard’s younger brother Marius, had also qualified as a doctor and he now joined Barnard, eventually becoming his right-hand man in the department of Cardiac Surgery.
Cometh the hour, cometh the man!
Louis Washkansky, a 54 year-old grocer suffering from diabetes and incurable heart disease was in a critical condition in Groote Schuur hospital, and Barnard had had decided that should a donor be found he would attempt a heart transplant.
On December 2nd, 1967, a young woman by the name of Denise Darvall was tragically injured in a collision with a car while crossing the street in Cape Town. She has sustained two serious fractures to her skull and showed no signs of brain activity. Her father was approached and agreed to the request for his daughter’s heart to be used in the world’s first heart transplant attempt.
In the early hours of the morning, on 3rd December 1967, Chris Barnard, with his brother Marius and a team of 30 medical assistants, the historic procedure was performed for the first time, in an operation lasting approximately 5 hours.
Before the actual operation proceeded, Denise’s heart was injected with potassium to stop it beating, and the operation proceeded.
In that historical moment, the names of Chris Barnard, Denise Darvall and Louis Washkansky were forever linked.
Washkansky lived for 18 days before succumbing to pneumonia, due to the immuno-suppressive drugs he was receiving.
The individuals involved, as well as Groote Schuur Hospital itself, received worldwide publicity. Chris Barnard became a super-star!
Barnard’s second transplant attempt took place on January 2nd, 1968. The recipient was Phillip Blaiberg, who survived for 19 months. This second procedure created a considerable controversy, mainly in the African-American press, due to the fact that the donor, 24 year-old Clive Haupt, was a black male.
This controversy was not tempered in the least by the fact that Barnard was an outspoken critic of the South African government’s Apartheid policies.
Following Barnard’s breakthrough, almost 100 transplants were performed worldwide in 1968. However, only a third of these patients survived longer than 3 months. As a result, most medical centres stopped performing heart transplants.
To put these statistics into perspective, in the 7-year period from the historic first heart transplant in December 1967 and November 1974, 10 heart transplants were performed at Groote Schuur Hospital in Cape Town.
Of these 10 patients, 4 lived longer than 18 months, one recipient lived for over 13 years, and another, Dirk van Zyl, who received a heart transplant in 1971, was the longest-lived recipient, surviving for 23 years.
Barnard continued to innovate, and pioneered the concept of the “piggy-back” (heterotropic) heart, where the original damaged heart is retained, alongside the transplanted heart, with the 2 hearts operating in tandem, the first of which transplants he performed in 1974.
Not only was Barnard a brilliant surgeon, but he made many additional contributions to the treatment of cardiac diseases, such as the Tetralogy of Fallot and Ebstein’s anomaly.
In 1972, He was promoted to Professor of Surgical Science in the Department of Surgery at the University of Cape Town in 1972, and in 1981, he became a founding member of the World Cultural Council. Among his numerous awards received over the years, he was named Professor Emeritus in 1984.
Christiaan Barnard, the young Afrikaans boy from Beaufort West, in the Western Cape is probably also the only South African who has ever been granted an audience with the Pope (Pope Paul VI in January 1968)
On that same visit to Rome, he allegedly had a brief romantic fling with Italian film star Gina Lollobrigida.
Barnard retired as Head of the Cardiothoracic Surgery at Groote Schuur Hospital in 1983 after developing severe rheumatoid arthritis which ended his surgical career.
He then spent 2 years as the Scientist-in-Residence at Oklahoma Transplantation Institute in the United States.
Christiaan Neethling Barnard died on September 2nd., 2001 while on holiday in Cyprus, from a severe asthma attack. He was 78 years old.
Many believe that he would have deservedly won the Nobel Prize in Physiology or Medicine, had he not been a white South African living in Apartheid-era South Africa.
Interesting facts:
Chris Barnard appeared on the cover of Time, Life and Newsweek magazines.
