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MIRACLE IN SOUTH AFRICA: A Historical Review of U.S. Magazines' Coverage of the
First Heart Transplant
Raymond N. Ankney
University of North Carolina at Chapel Hill
Address correspondence to: Raymond N. Ankney, 501 Highway 54 Bypass, Apt. 5A,
Carrboro, NC 27510. Telephone number: (919) 929-4184. Email address:
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MIRACLE IN SOUTH AFRICA: A Historical Review of U.S. Magazines' Coverage of the
First Heart Transplant
ABSTRACT
Magazine coverage of the first human heart transplant, which was performed in
South Africa in December 1967 by Christiaan Barnard, was reviewed. Magazines
showed a pro-American slant in their coverage by asserting that luck played a
large part in Barnard performing the operation. They also downplayed Barnard's
accomplishment by saying he received surgical training in the United States.
However, few stories mentioned that Barnard's patients were living much longer
than those of American surgeons.
Miracle in South Africa
Denise Darvall was in a coma at Groote Schuur Hospital in Cape Town, South
Africa, on December 3, 1967. A recent automobile accident irreparably damaged
her brain. A mechanical respirator was the only thing keeping Darvall alive.
Doctors knew that within hours she would die. However, Darvall's undamaged,
young heart continued to pump furiously.1
In a nearby room, Louis Washkansky, another patient, was also dying. Two heart
attacks left the Lithuanian immigrant bedridden. His massively enlarged heart
beat irregularly. It could not circulate enough blood to feed his body tissues,
which were slowly dying from food and oxygen deprivation.2
Heart surgeon Christiaan Neethling Barnard went to talk to Ed Darvall,
Denise's father, about an unprecedented request: the gift of his daughter's
heart to Washkansky.3 "'We have done our best, and there is nothing more that
can be done to help your daughter. There is no hope for her. You can do us and
humanity a great favor if you will let us transplant your daughter's heart.'
Said Darvall: 'If there's no hope for her, then try to save this man's life.'"
He signed the consent form that gave the South African doctors the go-ahead to
attempt the world's first human-to-human heart transplantation.4
Marais M. Malan, a South African editor, wrote a book titled Heart Transplant.
He noted that the operation made Barnard a hero in the United States media. When
Washkansky died 18 days after the operation, the media emphasized that it was
from pneumonia, not from a heart-related problem.5 Peter Hawthorne, a South
African journalist who covered the transplant, published a book titled The
Transplanted Heart. He also found that the media provided positive coverage of
Barnard.6 Life magazine, for example, placed a color picture of Washkansky in
his hospital bed on the cover, superseding the originally planned picture of
Audrey Hepburn, according to Hawthorne.7
Christiaan Barnard, the transplant surgeon, and his editorial collaborator,
Curtis Bill Pepper, offered a different perspective of the coverage in a book
titled One Life. The operation, they said, caused a media frenzy that was
unparalleled in South African history.8 In a second book titled South Africa:
Sharp Dissection, Barnard said reporters stopped at nothing to obtain
sensationalized, misleading stories. He never defined what he meant by
sensationalized, misleading stories but said that the press "must be prepared to
report events and news accurately without creating, with the sole purpose of
selling its wares, issues that concentrate on the sensational."9
Little has been written about magazine coverage of the first heart
transplant.10 For example, Malan and Hawthorne provided in-depth information
about the key players in the event and described the events that took place in
detail. However, their books were not intended to review magazines' coverage of
the transplant. They were historical accounts of a medical accomplishment.
Barnard made the media's aggressive coverage of the heart transplant a focus in
his books,11 but his criticisms of the coverage were generally not supported
with the details necessary to determine which reporters were involved. Instead,
the reader is to accept his interpretation of the events.12
The goals of this paper were to see if Barnard's assertions applied to
American magazines via a historical review of articles listed in the Readers'
Guide to Periodical Literature and the books published about the event as well
as analyzing how the magazines covered the transplant. No one has ever tried to
pull together information from these disparate sources to determine how
magazines covered the transplant.
The hypothesis was that magazines published dramatic stories about the
transplant, but they downplayed Barnard's accomplishment through a pro-American
slant in the coverage.
The first human-to-human heart transplant had all the elements of a great
story: "drama, sentiment, pathos, uncertainty, novelty, heroism, and colourful
main characters."13 In particular, magazines emphasized the drama of the
operation, the sentiment of Ed Darvall losing his daughter, the pathos of Denise
Darvall dying so violently, the uncertainty of Washkansky's future, the novelty
of the operation, the heroism of Washkansky for undergoing the procedure, and
the strength of Barnard's character.
Malan called it a "could not miss story" and noted that an American magazine
reportedly offered $500,000 for exclusive pictures of the transplantation.
However, none were taken. Malan also noted:
Every word he [Washkansky] uttered, every boiled egg he ate was
recorded faithfully by nurses and doctors and reported to the
news-hungry
public through the press. The heart transplant became the only topic
of
conversation, both in South Africa and abroad, where banner headlines
and
pictures of Mr. Washkansky, Miss Darvall and Prof. Barnard carried the
story
to every corner of the globe.14
The headlines and cutlines from the early coverage in magazines supported
Malan's point. Time's headline on December 15, 1967, read: "The Ultimate
Operation."15 The cutline under a picture of Washkansky after the operation
added: "In its way, equal to Mount Everest."16 Under a picture of Barnard, Time
wrote: "Not the kind of man anyone had to drive."17 Newsweek's headline on
December 18, 1967, stated: "The Heart: Miracle in Cape Town."18
In addition, Science News asserted that "the drama of human heart transplants
has grasped the public's interest."19 Look called it a "dramatic" attempt to
improve the treatment of heart disease.20 Time called the event "the Cape Town
drama." In some ways, its coverage seemed more like a dramatic novel than a news
story. For example, Time said the "drama" began when Washkansky was admitted to
the hospital with progressive heart failure. "Washkansky was dying, and knew
it," it said.21 Darvall, in comparison, was the victim, Time said. Her
misfortune gave a dying man a chance of survival. The article said:
Denise Ann Darvall, 25, had no thought of death when she set out
with her father and mother to visit friends for Saturday-afternoon
tea. In
Cape Town's Observatory district, Edward Darvall stopped the car. His
wife
and daughter started across the street to a bakery to buy a cake when
both
were struck by a speeding car. Mrs. Darvall was killed instantly.
Denise was
barely alive, but only barely, on arrival at Groote Schuur Hospital.
Her head
and brain were almost completely destroyed.22
Time's article continued to build on the drama as Barnard asked Washkansky
whether he wanted to undergo the first human-to-human heart transplantation. The
operation could allow him to live a long, relatively normal life, but there was
a 20 percent chance he would die in the operating room. Barnard gave Washkansky
two days to think about the operation. Two minutes later, Time said, Washkansky
agreed to undergo the operation.23
Barnard then became the focus of the drama. The South African doctor worked
tediously in the operating room to remove Washkansky's heart and to replace it
with Darvall's heart. The new heart, Time said, had to be attached to
Washkansky's blood vessels, including the left auricle, the right auricle, the
aorta, the pulmonary artery, and the pulmonary veins. Any mistake in attaching
the heart would have killed Washkansky.24
The 30-member transplant team worked nonstop for four hours to give Washkansky
a new heart. Barnard then reached the critical point in the operation: Would the
heart, which had not been beating since Darvall died, start circulating the
blood? If not, Washkansky was also dead. The first heart transplant would have
ended in disaster. Barnard shocked the heart with electrodes, hoping that it
would regain a rapid beat. It did. At 5:52 a.m. on a Sunday morning, Barnard
yelled, "Christ, it's going to work!"25
Washkansky regained consciousness an hour later. After four days, Washkansky
waved at photographers, joshed with doctors, and walked a quarter mile to
receive radiation treatment, which was used because its immunosuppressive
effects made it less likely he would reject the transplant. Washkansky even
conducted a radio interview.26
Life's coverage also emphasized the drama of the story. However, its approach
differed from Time's emphasis on the patients. In contrast, Life directed its
coverage almost entirely on Barnard and the difficulties the surgical team
faced. The article described how Barnard heroically overcame a series of
obstacles. For example, the first obstacle for the surgical team, Life said, was
to decide when Darvall was dead so it could remove her heart. The article
explained:
If she were not, their actions would constitute murder, no matter
how remote her chance of living or how slight her hold on life. Thus
the
South African doctors waited until every sign of life in the
25-year-old was
goneDnot only in her heart but in her lungs and brain as well. Only
then did
they begin the complex task of transferring the heart of one human
being into
the body of another.27
Life's coverage then focused on the drama that occurred during the second
obstacle: the team operating on Darvall to keep her heart alive so it could be
transplanted to Washkansky. Because her heart had stopped pumping, the surgeons
quickly needed to insert a tube to provide the heart with life-sustaining oxygen
and nutrients. Any slight delay would have allowed the heart to deteriorate,
making it unsuitable for transplantation. "Operating at top speed, the first
team of doctors opened the donor's chest and inserted a tube into the right side
of the heart, where bloodDbluish from lack of oxygenDenters and is pumped to the
lungs to be oxygenated."28
The surgeons soon faced the third obstacle. They had to remove both hearts.
The surgeons removed Darvall's heart first because if a surgical accident
occurred, they could stop the procedure before Washkansky's heart had been
excised. The surgeons carefully clamped Darvall's major arteries and began to
extract her heart. Washkansky's heart was removed in a similar way, although a
piece of his heart was left as a foundation for the new heart.29
The fourth obstacle, Life said, was the "monumental task" of connecting
Darvall's heart to Washkansky's blood vessels. "The remaining section of the
rear wall of the old heart and the corresponding opening in the new one were
stitched together, then the arteries and veins," the article said. "To test the
stitches, blood was pumped from the body into the new heart." The stitches held.
The surgical team shocked the heart, and it started beating. The operation, Life
concluded, was "a triumph of modern surgery."30
Newsweek's December 18, 1967, article titled "The Heart: Miracle in Cape Town"
covered the science fiction angle of the transplantation. In fact, Newsweek's
lead quoted Washkansky as saying, "I am a new Frankenstein."31 The article
added:
The gallows humor of the remark was appropriate: the sturdy,
170-pound Washkansky had been to the edge of deathDindeed over the
lineDand
had been brought back to life by perhaps the most remarkable bit of
surgical
virtuosity in the history of medicine. . . . All last week, the heart
of the
25-year-old Anglican bank clerk pumped the life's blood of a
55-year-old
Jewish grocer. Lurid fiction had become scientific fact and the
distinctions
between life and death had become blurred and rearranged.32
The magazine also maintained that the operation marked a new era in medicine,
the transplantation age, where many people would live to be 100 years old and
doctors would play God. However, Newsweek questioned whether there would be
negative consequences of this era. Would doctors hasten a patient's death to
transplant his or her organs? How would you know if the patient was really dead?
Who would decide? A computer? The government?33 Newsweek's coverage quoted an
anonymous public health official in Washington saying: "I have a horrible vision
of ghouls hovering over an accident victim with long knives unsheathed, waiting
to take out his organs as soon as he is pronounced dead."34
U.S. News & World Report offered only 10 paragraphs of coverage to the first
human-to-human heart transplantation. However, the magazine's coverage was also
highly positive, as demonstrated by the headline "A History-making Operation."
U.S. News & World Report, like Life, emphasized the lifesaving work of Barnard's
30-person team.35 Science News added: "Simply connecting up as complicated a
piece of plumbing as the human heart is a prodigious mechanical feat."36 It also
credited Barnard for his "pioneering efforts" and "historic" operation.37
Magazines maintained their interest in Washkansky as he began his
rehabilitation. They even published the most trivial details about his recovery.
"The 55-year-old grocer dined on steak and eggs, asked for a glass of beer (and
was turned down), enjoyed the sunshine on a balcony outside his room at Cape
Town's Groote Schuur Hospital, and made plans for a homecoming party before
Christmas."38 Newsweek added that Washkansky had recovered enough to yell at the
media. "What am I," he growled at a photographer, "a freak?"39
The magazines also provided extensive coverage when his condition deteriorated
13 days after the operation. Doctors discovered a dramatic rise in his white
blood cell count. A chest X-ray revealed a shadow in the lungs, the classic sign
of pneumonia.40 The article noted the hospital's quick response:
Hurriedly breaking off a television interview, Dr. Christian
Barnard, the 44-year-old surgeon who had headed the transplant team,
rushed
through the hospital to Washkansky's bedside. He identified the
attacking
organism as pneumococcal pneumonia, the most common form of the lung
ailment,
and said both lungs were affected. Twenty million units of penicillin
were
administered immediately in intravenous doses. Barnard was clearly
worried.41
Time noted that although the hospital listed his condition as satisfactory,
the pneumonia could be fatal in a diabetic patient with a heart transplant.42
Finally, Time43 and Newsweek44 offered in-depth reporting on Washkansky's
death from double pneumonia the following week. Overall, there were two
important themes in the magazine stories about his death.
First, they emphasized that it was not Barnard's fault that the patient died.
Time said: "The underlying cause of the process that ended in death was clouded
and likely to become the subject of medical dispute, but one thing was clear: it
was not the failure of the transplanted heart. To the last, that organ
functioned with a surprisingly strong and regular beat."45 Newsweek added:
"Pathologists found evidence of pneumonia in both lungs, but no signs that the
heart was being rejected. Indeed, the new heart functioned until death."46
The second theme was the promiseDbut sad endingDresulting from the first
human-to-human heart transplant. Newsweek, for example, pointed out that
information gained from the operation would help future patients. "And though he
[Washkansky] died late last week, the dramatic operation remained a surgical
landmark against which all future transplant surgery will be measured."
Moreover, Newsweek's article quoted an anonymous member of the surgical team as
saying, "We climbed Everest. Next time, we will know how to get down."47
Science News also emphasized that the transplant was "a success" and "a great
step forward." Washkansky's immune system had not rejected the heart, and the
transplant had improved his quality of life. "Until the last five minutes of
Washkansky's life, the young heart of Denise Darval, replacing his own,
continued to beat strongly. His improved circulation had improved other body
functions and lessened the swelling in his legs and liver, which had resulted
from the poor pumping of his own failing heart."48
On the other hand, Time reminded its readers of the plight of Ed Darvall, the
father of the first heart donor. "After Washkansky died, the man who had made
the transplant possible was despondent. Said Edward Darvall: 'There was at least
part of my daughter alive, and now it's all gone. I feel empty.'"49
Despite the generally positive coverage about the first heart transplant,
magazines downplayed Barnard's accomplishment through a pro-American slant in
their coverage in four ways. First, they asserted that luck played a large part
in the team performing the first operation. Time said:
For weeks and months and even years, surgical teams at more than 20
medical centers around the world have been standing ready to make the
first
transplant of a heart from one human being to another. What they have
been
waiting for is the simultaneous arrival of two patients with
compatible blood
typesDone doomed to die of some disease that has not involved his
heart and a
second doomed to die of irreversible heart disease.50
Time added that an American surgeon, Doctor James D. Hardy at the University
of Mississippi Medical Center, could have performed the operation years before
Barnard. On three occasions, it said, Hardy had patients dying of brain injuries
who could have donated hearts, but there were no recipients. Furthermore, Hardy
twice had patients with advanced heart disease but no donors. In fact, Hardy
transplanted a chimpanzee's heart into one of the dying patients three years
before Barnard's operation. But the small ape's heart could not support the
circulation and failed within two hours.51
Science News also emphasized how Hardy's misfortune prevented him from
performing the first human heart transplant. It said:
But Dr. Hardy was beset by the problems of timing the recipient's
crisis with death of a suitable donor. . . . Time and fate cooperated
a bit
in Cape Town. Grocer Washkansky lay a month in Groote Schuur Hospital
with no
chance that his badly fibrosed heart would allow him to survive. His
only
hope was transplantation. Finally a young women, Denise Darvall, was
brought
in mortally injured after being hit by a car.52
Newsweek53 and Science News54 also noted that other American surgeons had been
prepared to perform the procedure, including Doctors David Blumenstock of the
Mary Imogene Bassett Hospital in Cooperstown, New York, William Likoff of the
Philadelphia's Hahnemann Medical College and Hospital, Richard Lower of the
Medical College of Virginia, and Adrian Kantrowitz of the Maimonides Hospital in
Brooklyn, New York.
The second way in which magazines downplayed Barnard's accomplishment was by
saying American physicians had pioneered the procedure.55 For example, Science
News said that American surgeons had known the mechanics of performing the heart
transplant for at least 10 years. "But doctors in the United States have not
been willing to take the chance."56 In addition, Newsweek said:
The ground-breaking experimentation that led to last week's
operation was performed in 1960 by Dr. Norman E. Shumway of Stanford
Medical
Center in Palo Alto, Calif. . . . Just three weeks ago, the graying
44-year-old Shumway predicted: 'We are on the verge of clinical
application.'
Since he had developed the 'atrial stump' technique of attachment,
many
surgeons expected that he would be the first to use it in a human
being.57
Business Week added: "Not only Barnard was ready to try the revolutionary
operation. Earlier, Dr. Norman E. Shumway of Stanford University Medical School
had said he was only waiting for a patient; the technology and the technique
were perfected. . . ."58 In contrast, Science News argued that Lower of the
Medical College of Virginia deserved to be the pioneering surgeon in human heart
transplantation. He had "been ready for months to perform a heart transplant. So
far he has lacked the right combination of donor and recipient."59
In addition, Saturday Review asserted that Barnard had done nothing to develop
the procedure. It noted that he had never published any papers about heart
transplant research. Moreover, he never performed heart transplants on
experimental animals in the United States.60
Finally, an article in Saturday Review compared the work of Shumway and
Barnard. "Dr. Barnard transplanted Mr. Washkansky's heart without ever having
published a scientific paper on his experimental procedures. Dr. Shumway
described his prior research with animals in numerous papers spread over a
decade."61
The third way in which magazines downplayed Barnard's accomplishment was by
saying he received surgical training in the United States. Saturday Review noted
that Barnard, who was already licensed as a physician in South Africa, went to
the University of Minnesota for postgraduate study.62 Newsweek and Time said
that Barnard attended the University of Minnesota in the mid-1950s, about ten
years before he performed the transplant, for his Master of Science and Ph.D.
degrees in surgery.63
Business Week even maintained the basic research and experimental surgery
training that Barnard received at the University of Minnesota allowed him to
perform the transplant. It pointed out: "From the public's viewpoint, it may
have seemed that the state of the art in heart surgery had taken a sudden leap
forward over night. But actually the Cape Town operation can be traced to a long
series of developments in surgical science over the last 15 yearsDmany of them
in the U.S., and many of them at the University of Minnesota."64
Time agreed that Barnard would not have performed the operation without his
American surgical training. It added: "In fact, he [Barnard] has learned more
from former colleagues in the U.S. and from keeping up with their research."65
In addition, several magazines suggested that Barnard could not have performed
the procedure without a visit to the research laboratory of Richard Lower of the
Medical College of Virginia. For example, Business Week asserted that Lower
taught Barnard the "history-making" technology during a visit to the United
States in 1964.66 "Dr. Barnard worked at the Medical College of Virginia for
three and a half months last winter. Dr. Lower says the South African surgeon
studied techniques of transplant surgery and the management of transplant cases
post-operatively."67
Finally, the fourth way in which magazines downplayed Barnard's accomplishment
was by emphasizing that it was performed in a country with segregated racial
policies. South Africa's apartheid policy was opposed by most of the world.
Thus, it was viewed as a renegade nation, and many stories questioned how a
medical miracle could occur there.
I often wonder whether there would have been so much controversy
and so many issues raised about the morality and legality of heart
transplantation had the first operation been performed in the United
States
or Britain. The feeling seems to be that nothing good can come from
South
Africa, and that if something from South Africa appears to be good on
the
surface, then there must be an ulterior motive.68
The issue of South Africa's racial policies surfaced in the December 15, 1967,
issue of Time and the December 18, 1967, issue of Newsweek,69 when a 10-year-old
colored boy, Jonathan Van Wyk, received a kidney from Denise Darvall. However,
the team deflected the criticism by noting that black South Africans were
benefiting from the transplantation program. Marius Barnard, a member of the
transplant team and Christiaan's brother, was quoted in Newsweek as saying:
"What I am most thrilled about as a South African is that we could use the heart
of an Anglican girl to put into the body of a Jewish gentleman and a kidney into
a colored child."70
However, South Africa's racial policies became the focus of magazine coverage
after Barnard's second heart transplant. The second heart transplant recipient
was a 58-year-old white man, Philip Blaiberg. The donor was a 24-year-old
colored man, Clive Haupt.71 "In South Africa, more than surgery was involved in
the transplant. In this country, laws against racial mixing are very strict, yet
Dr. Blaiberg, a white man, was given the heart of a 'colored'Dpartly
NegroDdonor."72 The Saturday Evening Post added: "Dr. Barnard fully acknowledged
that when he provided one of his patients with the heart of a mulatto who could
not have eaten in the same restaurant, lived in the same building, or even
occupied the same hospital ward as the white man whose life he saved."73
Hawthorne added that the doctors were forced to answer pointed questions about
South Africa's racial policies, which few of them supported.74 In addition,
Malan said that almost all publications stressed the fact that a coloured man's
heart had been given to a white man.75
Time also emphasized the race angle of the story. "Dr. Barnard asked Blaiberg
whether he would object to receiving a Colored man's heart. No, replied the
desperate patientDwho, like Washkansky, happened to be Jewish."76 Newsweek's
version differed slightly. "In the meantime, Blaiberg was asked if he would
accept a heart from a colored man. 'Yes,' he whispered."77
Ebony, a magazine primarily targeted at blacks, offered some of the best
coverage of this point. It credited Barnard for his marvelous heart
transplantation but did not blame him for South Africa's racial policies.78
Furthermore, it said:
If Dr. Blaiberg completely recovers and again walks the streets of
Cape Town, a most ironic situation will ensue. Clive Haupt's heart
will ride
in the uncrowded train coaches marked 'For Whites Only' instead of in
the
crowded ones reserved for blacks. It will pump extra hard to circulate
the
blood needed for a game of tennis where the only blacks are those who
might
pull heavy rollers to smooth the courts. It will enter fine
restaurants,
attend theaters and concerts and live in a decent home instead of in
the
tough slums where Haupt grew up. Haupt's heart will go literally to
hundreds
of places where Haupt himself, could not go because his skin was a
little
darker than that of Blaiberg.79
In conclusion, the first goal of this paper was to see if Barnard's assertions
about sensationalized media coverage of heart transplantation applied to
American magazines. He never defined what he meant by sensationalized,
misleading stories, but said that the press "must be prepared to report events
and news accurately without creating, with the sole purpose of selling its
wares, issues that concentrate on the sensational."80
Overall, the magazine stories appeared to be balanced, factually accurate, yet
dramatic. Thus, it seemed unlikely that Barnard's comments were directed at
American magazines. In fact, most of the evidence suggested that Barnard was
referring to the South African and British press. A South African newspaper, for
example, criticized Groote Schuur Hospital for not paying the funeral expenses
for a heart donor. Barnard felt this newspaper's coverage was sensationalistic
and inappropriate. In addition, during a lecture by Barnard at Cambridge
University, a British newspaper provided prominent coverage to his quip about
doing some serious drinking. He felt that the reporter was acting maliciously by
printing the quote. However, these cases were unusual because Barnard generally
did not provide the details necessary to determine which reporters were involved
in the contentious coverage.81
The second goal of the paper was to analyze how the magazines covered the
first human heart transplant. As the hypothesis suggested, magazines emphasized
the drama of the first transplant. Science News proclaimed that "the drama of
human heart transplants has grasped the public's interest."82 Look called it a
"dramatic" attempt to improve the treatment of heart disease.83 Time called the
event "the Cape Town drama."84
However, the magazines showed a noticeable pro-American slant in their
coverage in four ways. First, they asserted that luck played a large part in
Barnard's team performing the first operation. Second, they said American
physicians, not Barnard, had pioneered the procedure. Third, magazines
downplayed Barnard's accomplishment by saying he received surgical and
transplant training in the United States. Finally, the stories denigrated
Barnard by saying the transplant should not have been performed in South Africa,
a country whose segregated racial policies were opposed by most of the world.
Saturday Evening Post, for example, headlined its editorial on the transplant:
"Frankenstein in South Africa."85 Saturday Review called the operation an
unethical "experiment" and "optimistic ballyhoo."86 The article also asserted
that Barnard had done nothing to develop the procedure. It noted that he had
never published any papers about heart transplant research. Moreover, he never
performed heart transplants on experimental animals in the United States.87
However, this criticism about Barnard not performing heart transplants on
experimental animals in the United States was extremely misleading. Barnard's
team completed 50 heart transplants in dogs in South Africa over the previous
three years.88 Furthermore, the magazines failed to mention that Barnard's
patients were surviving much better than the patients of American surgeons.
Shumway's first three patients lived 15, 3, and 46 days, compared with 18, 593,
and 621 for Barnard.89 Philip Blaiberg, Barnard's second patient, did so well
that he went swimming in the surf, drove his car through Cape Town traffic, and
wrote his autobiography, "Looking at My Heart."90
Time was one of the few magazines to credit Barnard for his patients doing
well. For example, it wrote an in-depth article on how American surgeons
traveled to Cape Town in July 1968 to learn from the South African surgeon. Time
quoted Brooklyn surgeon Adrian Kantrowitz as saying: "Chris Barnard has been
doing it better than all of usDthat's why we are here."91
These findings were the most revealing part of the research. The heart
transplant was the medical equivalent of the Sputnik launch: It shocked the
American public. Few could believe that this pioneering procedure had been
performed in South Africa. Thus, the magazines had to explain why "the world's
first heart transplant was performed without fanfare by little-known surgeons in
an obscure hospital in Cape Town."92 Malan may have summed it up best when he
said:
In a country like the United States, where scientific research has
almost become a way of life, enormous sums of money are available and
the
best brains of the western world are concentrated, it is easy to think
big.
So enormous is the bulk of research programe in the United States, in
which
medicine and space research play the major roles, that hardly a day
passes
without the announcement of some important discovery. Little wonder
then that
everyone expected that the first heart transplant operation would be
performed in that country. . . . Certainly no one expected that an
obscure
team in a country with limited research facilities and less research
funds
was anywhere near a surgical achievement which the medical giants of
the
world were still considering with something approaching awe.93
ENDNOTES
1Marais M. Malan, Heart Transplant (Johannesburg, South Africa:
Voortrekkerpers Ltd., 1968), 15.
2Malan, Heart Transplant, 18.
3Groote Schuur Hospital had been prepared to perform a heart transplant on
Washkansky for one month. Thus, when a member of the transplant team went off
duty, the hospital required that he or she leave a telephone number with the
sister in charge in case a potential donor was found. (Malan, Heart Transplant,
18-9).
4"The Ultimate Operation," Time, 15 December 1967, 64.
5Malan, Heart Transplant, 89.
6Peter Hawthorne, The Transplanted Heart (Johannesburg, South Africa: Hugh
Keartland Publishers, 1968), 112.
7Hawthorne, The Transplanted Heart, 113.
8Christiaan Barnard and Curtis Bill Pepper, One Life, (Toronto: The Macmillan
Company, 1970), 330.
9Chris Barnard, South Africa: Sharp Dissection (New York: Books in Focus,
Inc., 1977), 81, 102.
10The literature review and search of computerized databases failed to
identify any medical or science journalism textbooks that focused on how
reporters covered the transplant.
11"Literally within hours of the last suture being tied, the routine of Groote
Schuur Hospital and the lives of all concerned with the operation were disrupted
by an influx of press, television and radio men that was unprecedented in the
history of South Africa. They came from every major news network in the Western
world, bringing with them all the sophisticated technology of contemporary mass
communication. Groote Schuur was totally unprepared for this influx, and for
several days something close to chaos prevailed. In fact, it became necessary to
seek police intervention to secure the welfare of the recipient and the personal
privacy of many of the medical and nursing staff" (Barnard, South Africa: Sharp
Dissection, 81).
12"We had blocked off the ward in an effort to keep them out, but throughout
that day and all that followed they were to infiltrate in every way
possibleDmasquerading as doctors and orderlies and even climbing trees outside
the hospital window" (Barnard and Pepper, One Life, 330); Barnard, South Africa:
Sharp Dissection, 81.
13Malan, Heart Transplant, 40.
14Malan, Heart Transplant, 46-7, 122-3.
15"The Ultimate Operation," Time, 64.
16"The Ultimate Operation," Time, 64.
17"The Ultimate Operation," Time, 71.
18"The Heart: Miracle in Cape Town," Newsweek, 18 December 1967, 86.
19"Kidneys lead the field." Science News, 2 March 1968, 214.
20"Heart Transplants are not Enough." Look, 16 April 1968, 92.
21"The Ultimate Operation," Time, 64.
22"The Ultimate Operation," Time, 64.
23"The Ultimate Operation," Time, 64.
24"The Ultimate Operation," Time, 64.
25"The Ultimate Operation," Time, 65; Malan, Heart Transplant, 14.
26"The Ultimate Operation," Time, 65.
27"'It was a nice beat, you know'," Life, 15 December 1967, 27.
28"'It was a nice beat, you know'," Life, 27.
29"'It was a nice beat, you know'," Life, 27.
30"'It was a nice beat, you know'," Life, 27.
31"The Heart: Miracle in Cape Town," Newsweek, 86.
32The anonymous public health official was never identified ("The Heart:
Miracle in Cape Town," Newsweek, 86).
33"The Heart: Miracle in Cape Town," Newsweek, 86.
34"When are you really dead?" Newsweek, 18 December 1967, 87.
35"A History-making Operation." U.S. News & World Report, 18 December 1967,
63.
36"A Spate of Heart Transplants." Science News, 20 January 1968, 59.
37"A plea for a transplant moratorium." Science News, 16 March 1968, 256.
38"Watching and Learning." Newsweek, 22 December 1967, 36.
39"Watching and Learning." Newsweek, 41.
40"Watching and Learning." Newsweek, 41.
41The magazine used a different spelling for Barnard's first name ("Watching
and Learning," Newsweek, 41).
42"Progress, Then a Setback." Time, 22 December 1967, 41.
43"End & Beginning." Time, 29 December 1967, 32.
44"'We Climbed Everest.'" Newsweek, 1 January 1968, 52.
45The anonymous member of the surgical team was never identified ("End &
Beginning," Time, 32).
46"'We Climbed Everest.'" Newsweek, 52.
47"'We Climbed Everest.'" Newsweek, 52.
48The story's author seems to have misspelled Darvall's name. All other
magazine articles and books spelled it "Darvall" not "Darval." ("Balancing the
Drug Dosage," Science News, 6 January 1968, 7).
49Edward Darvall made this comment even though one of his daughter's kidneys
was functioning well for 10-year-old Jonathan Van Wyk ("End & Beginning," Time,
32).
50"The Ultimate Operation," Time, 64.
51"The Ultimate Operation," Time, 71.
52The article contained a typographical mistake. It should have been "woman"
and not "women." ("A Spate of Heart Transplants," Science News, 60).
53"The Heart: Miracle in Cape Town," Newsweek, 89.
54"First human hearts transplanted," Science News, 16 December 1967, 581.
55"Transplanting the Heart." Saturday Review, 6 January 1968, 98; Malan, Heart
Transplant, 127.
56"First human hearts transplanted," Science News, 581.
57"The Heart: Miracle in Cape Town," Newsweek, 89.
58The atrial stump technique involved leaving part of Washkansky's heart to
make it easier to attach the donor heart. ("Fertile seedbed of transplant
surgery." Business Week, 6 January 1968, 98.)
59 It is more likely that other surgeons did not want to perform the first
transplant because of the publicity and the difficult ethical issues. If luck
played such a large role in Barnard performing the transplantDbecause the donor
and recipient happened to die at the same timeDwhy did two American teams
perform transplants within weeks of the operation. One team performed two
transplants within the following month. ("A Spate of Heart Transplants." Science
News, 59.)
60"Transplanting the Heart." Saturday Review, 98.
61"A Realistic Look at Heart Transplants." Saturday Review, 3 February 1968,
53.
62"A Realistic Look at Heart Transplants." Saturday Review, 54.
63"The Heart: Miracle in Cape Town," Newsweek, 87; "The Ultimate Operation,"
Time, 72; "Fascinations & Lessons," Time, 19 January 1968, 50; "Were Transplants
Premature?" Time, 15 March 1968, 66.
64"Fertile seedbed of transplant surgery." Business Week, 98, 100.
65"The Ultimate Operation," Time, 72.
66"Fertile seedbed of transplant surgery." Business Week, 98.
67"A Spate of Heart Transplants." Science News, 59.
68Barnard opposed apartheid and insisted that all transplantation patients
receive the same care from the same nurses and the same doctors in the same
operating rooms. However, black patients were cared for in separate wards.
(Barnard, South Africa: Sharp Dissection, 46, 97; Hawthorne, The Transplanted
Heart, 84).
69The term "colored" or "coloured" was used in South Africa to identify
someone of mixed racial origin ("The Ultimate Operation," Time, 66; "The Heart:
Miracle in Cape Town," Newsweek, 88).
70"The Heart: Miracle in Cape Town," Newsweek, 88.
71"Cape Town's Second." Time, 12 January 1968, 38; Malan, Heart Transplant,
113.
72"New Heart For OldDAnother 'Transplant.'" U.S. News & World Report, 15
January 1968, 12; Hawthorne, The Transplanted Heart, 181.
73"Frankenstein in South Africa." Saturday Evening Post, 10 February 1968, 72.
74Hawthorne, The Transplanted Heart, 185.
75Malan, Heart Transplant, 40.
76"Cape Town's Second." Time, 38.
77"Surgery and Show Biz." Newsweek, 15 January 1968, 49.
78"The Telltale Heart." Ebony, March 1968, 118.
79"The Telltale Heart." Ebony, 118.
80Barnard, South Africa: Sharp Dissection, 102.
81The magazine stories did not contain any quotes from Barnard criticizing the
coverage. In fact, he leveled most of his criticisms of the press in a 1977 book
titled South Africa: Sharp Dissection. It seemed likely that much of Barnard's
criticism was directed at the South African and British press. Barnard said he
was very disturbed by the local press's coverage of his first double transplant,
where he left the diseased heart in place and transplanted a second heart into
another section of the chest. "It was briefly mentioned in our local press, but
the aspect that received much greater publicity was the fact that we used the
heart of a 13-year-old Coloured girl and that the hospital authorities refused
to provide the money to cover the cost of her burial. This was written up in
great detail: the plight of the family and the alleged lack of sympathy on the
part of hospital authorities and the doctors" (Barnard, South Africa: Sharp
Dissection, 84-85). In addition, Barnard criticized the British press for its
coverage of his lecture at Cambridge University. "As it happened, it was my
birthday, November 8, and they had discovered this, for when I got off the train
they said they knew it was my birthday and they would like to invite me to have
a drink with them before the lecture. I accepted but first attended a short
press conference where I answered several questions, discussed heart
transplantation and posed for press photographs. At the conclusion I turned to
the students and said jocularly, 'Come on, now, let's get down to some serious
drinking!' In the local press the next morning there was nothing whatsoever
about my discussion on heart transplantation. The only reference to my visit was
that after arriving in Cambridge and completing the formalities, Professor
Barnard turned to the students and said, 'Let's get down to some serious
drinking'" (Barnard, South Africa: Sharp Dissection, 88).
82"Kidneys lead the field." Science News, 214.
83"Heart Transplants are not Enough." Look, 92.
84"The Ultimate Operation," Time, 64.
85"Frankenstein in South Africa." Saturday Evening Post, 72.
86"A Realistic Look at Heart Transplants." Saturday Review, 54.
87"Transplanting the Heart." Saturday Review, 98.
88"The Heart: Miracle in Cape Town," Newsweek, 87.
89C. N. Barnard, "The first heart transplant D background and circumstances,"
South African Medical Journal 85 (September 1995) : 924.
90"Heartening." Newsweek, 25 November 1968.
91"Summit for the Heart." Time, 26 July 1968.
92"Surgery and Show Biz." Newsweek, 49.
93Malan, Heart Transplant, 71, 73.
ANNOTATED BIBLIOGRAPHY
"A History-making Operation." U.S. News & World Report, 18 December 1967, 63.
This article addressed the first heart transplant from the view of the
surgical
team. However, it offered little new information about the event.
"A plea for a transplant moratorium." Science News, 16 March 1968, 256.
The article provided useful information on the controversy in the medical
community
after most of the early heart transplant patients died. In fact, many
physicians
supported a moratorium on heart transplants until more research on tissue
rejection was
completed.
"A Realistic Look at Heart Transplants." Saturday Review, 3 February 1968, 53-8.
The author offered a critical review of the transplant after the first
patient's
death. He opposed Barnard performing the first procedure and questioned his
transplant
expertise.
"A Spate of Heart Transplants." Science News, 20 January 1968, 59-60.
The article provided useful information on the heart transplantation race
that
ensued after Barnard's procedure. Surgical groups throughout the world were
performing
the procedure; however, some lacked extensive training.
"Balancing the Drug Dosage." Science News, 6 January 1968, 7-8.
The article described the difficulty that surgeons would have in preventing
patients
from rejecting heart transplants. Moreover, it noted that if too many
anti-rejection
drugs were provided, the patient could die of an infection.
Barnard, Chris. South Africa: Sharp Dissection. New York, NY: Books in Focus,
Inc, 1977.
This book provided a good overview of the events surrounding the first
heart
transplant. The author also went in-depth about his views on the negative
role the media
play in society. However, he gave few details to substantiate his claims
about unethical m
edia behavior, such as the reporter involved and the publication he or she
worked for.
Barnard, Christiaan and Curtis Bill Pepper. One Life. Toronto: The Macmillan
Company,
1970.
The authors provided an excellent review of Barnard's life. They also
offered
in-depth coverage of the first transplant. However, the book gave little
new information
on the media coverage of the event.
Barnard, C. N. "The first heart transplant D background and circumstances,"
South African
Medical Journal 85 (September 1995) : 924-6.
The author provided in-depth information about the circumstances leading to
the
first human heart transplant. He also noted that the patients of the South
African
transplant team survived much better than the patients of an American team.
"Cape Town's Second." Time, 12 January 1968, 38-9.
The article offered an in-depth description of the events surrounding the
second
heart transplant. It also gave the reader a good understanding of how the
operation was
performed.
"End & Beginning." Time, 29 December 1967, 32.
The article offered a detailed description of the patient's death from
double
pneumonia and what the transplant team had learned from the operation. It
complemented
the magazine's earlier coverage.
"Fascinations & Lessons." Time, 19 January 1968, 50-1.
The article examined the outcomes of the early heart transplant patients
and
questioned whether surgeons had rushed to perform the procedure without the
necessary
experience.
"Fertile seedbed of transplant surgery." Business Week, 6 January 1968, 98-100.
The author reviewed Barnard's training in the United States and concluded
that this
experience was crucial to him performing the first heart transplant.
"First human hearts transplanted." Science News, 16 December 1967, 581.
The article emphasized the likelihood of Washkansky's body rejecting the
transplant.
It also addressed the technical issue of Washkansky receiving a smaller
female heart.
"Frankenstein in South Africa." Saturday Evening Post, 10 February 1968, 72.
The editorial drew a comparison between Barnard's accomplishment and that
of Doctor
Frankenstein. It also pointed out that technological advances can occur in
repressive
countries.
Hawthorne, P. The Transplanted Heart. Johannesburg, South Africa: Hugh Keartland
Publishers, 1968.
The author found that the U.S. media provided highly positive coverage of
Barnard.
It also gave the reader a good understanding of how the operation was
performed. In
addition, he described the events that took place in detail. However, his
book was not in
tended to review U.S. magazines' coverage of the transplant.
"Heartening." Newsweek, 25 November 1968, 125-6.
The article provided an in-depth look at human heart transplantation. It
maintained
that the procedure was still experimental, although some patients had had
dramatic
recoveries.
"Heart Transplants are not Enough." Look, 16 April 1968, 92.
The article provided a critical look at human heart transplantation. It
maintained
that heart transplants offer little hope to most patients with advanced
heart disease.
"'It was a nice beat, you know.'" Life, 15 December 1967, 27.
This article gave a detailed report on the first heart transplant from the
perspective of the surgical team. It also described the technical features
of the
operation.
"Kidneys lead the field." Science News, 2 March 1968, 214.
The article provided useful information on the state of heart, liver,
spleen, lung,
pituitary, and adrenal gland transplants. It noted that kidney
transplantation probably
has advanced more than other fields.
Malan, M. Heart Transplant. Johannesburg, South Africa: Voortrekkerpers Ltd.,
1968.
The author provided an in-depth review of the key players in the first
heart
transplant: Barnard, Darvall, and Washkansky. In addition, he described the
events that
took place in detail. However, his book was not intended to review U.S.
magazines'
coverage of the transplant. Thus, there was only limited information about
this angle.
"New Heart For OldDAnother 'Transplant.'" U.S. News & World Report, 15 January
1968, 12.
The article provided a useful description of Barnard's second heart
transplant. It
also addressed race relations in South Africa, which became a topic of
discussion when
the donor was black and the recipient was white.
"Progress, Then a Setback." Time, 22 December 1967, 41.
This article was a follow-up to Time's earlier coverage. It provided good
information on the patient's fight with double pneumonia.
"Summit for the Heart." Time, 26 July 1968, 49-50.
This article described how American surgeons traveled to South Africa in
July 1968
to learn heart transplantation techniques from Chris Barnard. The reason
that the
surgeons went there was because Barnard's patients were surviving much
longer than the
patients of American surgeons.
"Surgery and Show Biz." Newsweek, 15 January 1968, 49.
The article noted that Barnard had become a media celebrity. It also
offered insight
into the second heart transplant where the donor was black and the
recipient was white.
"The Heart: Miracle in Cape Town." Newsweek, 18 December 1967, 86-90.
This article gave a detailed report on the first heart transplant. It also
described
the technical features of the operation as well as the ethical-religious
issues.
"The Telltale Heart." Ebony, March 1968, 118-9.
The article addressed the irony that black South Africans were good enough
to serve
as organ donors but not good enough to eat in the same restaurants as
whites.
"The Ultimate Operation." Time, 15 December 1967, 64-71.
This article also provided an in-depth report on the first heart
transplant. It
addressed how the surgeons performed the operation and noted that the
procedure was
developed in the United States.
"Transplanting the Heart." Saturday Review, 6 January 1968, 98-101.
The author offered a provocative look at the first transplant and asked two
tough
questions. Should the procedure have been done? Should Barnard have been
the one to do it?
"Watching and Learning." Newsweek, 22 December 1967, 36.
This article was a follow-up to Newsweek's earlier coverage. It provided
good
information on the patient's fight with double pneumonia.
"'We Climbed Everest.'" Newsweek, 1 January 1968, 52.
The article offered a detailed description of the patient's death from
double
pneumonia and what the transplant team had learned from the operation.
"Were Transplants Premature?" Time, 15 March 1968, 66.
The article questioned whether surgeons had rushed to perform the procedure
without
the necessary experience.
"When are you really dead?" Newsweek, 18 December 1967, 87.
This article addressed the ethical and legal issues involved in
transplantation. It
noted that there was some controversy in defining death.