Chris Barnard's first heart transplant – the night he stared into an empty chest
September is Heart Awareness Month in South Africa and this year will mark 50 years since the first human-to-human heart transplant, performed at Groote Schuur Hospital on 3 December 1967.
The Heart of Cape Town Museum opened its doors on 3 December 2007, 40 years after the first heart transplant.
To celebrate, we decided to visit the Heart of Cape Town Museum located in the very theatre where this intricate procedure was performed by Dr Christiaan Barnard, and where all the research started. If you are fresh out of ideas on what to see and do in Cape Town and have a keen interest in history and medicine, it is worth paying a visit.
On arrival, Christine Heydenrych, who used to be a pathology technician during those years, welcomes you and takes you into the adjacent room. "It was in this room that the events towards the first human-to-human heart transplant started," Christine says. The tour starts in what used to be the casualties ward, where 25-year-old Denise Darvall would succumb to her injuries sustained in a fatal motor car accident in Main Road, to become the first donor.
The building where the surgery took place
The events leading up to the first heart transplant
It was a marriage of coincidences coupled with years of research that lead to this significant day in medical history. Denise and her family were crossing Main Road, close to Groote Schuur Hospital, where 54-year old Louis Washkansky was being treated in the Cardiac Clinic.
As Denise and her mother Myrtle were crossing the street, an inebriated driver knocked them over. Myrtle died on the scene, while Denise suffered severe head injuries and was taken in an ambulance to Groote Schuur, just a couple of kilometres away.
At the same time, Louis Washkansky was a regular in-patient in the hospital. He suffered from diabetes and an incurable heart disease. Earlier that year in November, Prof Val Schrire, a founder of the Cardiac Clinic and a cardiologist at the time, put Washkansky forward as a possible recipient.
Shortly after Denise’s accident, Ann Washkansky, wife of Louis Washkansky, drove past the accident scene, not knowing that Denise would become her husband's donor.
Denise was admitted to casualties, where medical staff tried to resuscitate her. Her healthy, young heart was still beating, but was pumping blood into an empty shell – she was brain dead and there was nothing that the doctors could do.
A flurry of phone calls and decisions followed – Dr Barnard had to inform his staff that they might have a suitable donor, and that the first human-to-human heart transplant could happen that very night.
"Dr Barnard didn't think of this operation as something extraordinary," says Christine. "For him, it was another patient needing help."
What constitutes death?
The ethical and religious aspects surrounding brain death at the time proved a problem, since the absence of a beating heart was always seen as the sign of death and the whole body had to be lifeless in order for the person to be declared dead.
However, in South Africa at that time, when two doctors declared a person brain dead, it was legal for organs to be donated.
Denise’s father, remembering how kind and giving his daughter was throughout her life, gave his permission for Denise to become the very first heart donor. Her kidneys were also donated and sent to Karl Bremer Hospital, where they were given to a young boy.
Tour down memory lane
The tour proceeded through a vast number of media archives, documents and photos, coupled with tales about Dr Barnard's colourful character as a doctor and his lifetime achievements. The unsung heroes of this transplant are also commemorated during the tour. You get to see a representation of the laboratory where the research was done, with specific mention of Hamilton Naki, the laboratory assistant, recognised for his surgical skills in the animal lab, as well as his ability to teach these skills to the medical students, without any medical experience.
A replica of the bedroom of Denise Darvall is a poignant reminder of the her great gift.
A reconstruction of 25-year old Denise Darvall's bedroom
The surgery that made history
The procedure took place in Theatres A and B, where the museum is located today. These theatres have been transformed to reflect the events of the night.
Denise Darvall and Louis Washkansky were both wheeled to the theatres at 00:45 that Sunday morning. At 06:13, Washkansky’s new heart started beating in his chest. Although he only lived for 18 days after the procedure, the transplant was a success. Dr Barnard arrived at the hospital as an ordinary cardiothoracic surgeon and left as an international celebrity.
A representation of the surgery that night
The theatre where the procedure took place was reconstructed and silicone figures portray what happened on 3 December. In a television interview showed during the tour, Dr Christiaan Barnard describes how he experienced the point of no return while staring into Washkansky's open chest – the first time he ever saw a live human with an empty chest cavity. In the interview, a significantly older Dr Barnard then pauses, holding back the tears. The King of Hearts was only human after all.
A silicone statue of Dr Christiaan Barnard at his desk
Denise's healthy heart was transferred to Louis's chest. In that moment, as the surgical staff waited for that heart to start beating, they were breathless. But then, the heart took on signs of life. Even the clock on the wall is set to 05:58, the exact moment when Denise’s heart started beating in Louis Washkansky’s chest, and an emotional Dr Barnard saying to his surgical staff: “Dit gaan werk!” (It’s going to work!)
Special tribute is paid to Louis Washkansky and his family – the intensive care unit was remodelled and a silicone figure of Washkansky shows him enjoying the cowboy novels he loved so much in his hospital bed.
A replica of Louis Washkansky days after the transplant.
The attention to detail, the knowledge and enthusiasm of Christine and the fascinating history of a medical breakthrough is impressive.
Some of the highlights of the museum include:
- A life-size reconstruction of the operating room on the day of the procedure, with original equipment and silicone mannequins, each resembling a member of the original team.
- A realistic reconstruction of Dr Christiaan Barnard’s office, with a silicone version of the man himself sitting behind his original desk.
- An auditorium where visitors can watch a documentary on the events.
- A display of the actual donor and recipient hearts. (When viewing these, you can clearly see how damaged Washkansky's heart was before the transplant.)
What I took home from my visit
As a 10-year old, I was fascinated by the story of Dr Christiaan Barnard. Little did I know how this visit to the Heart of Cape Town Museum would touch me years later. I never considered organ donation. The idea scared me. I was ignorant, squeamish and not open to organ donation.
It wasn't until I stood in Denise's "room", where a picture of her younger brother at her grave promptly made me burst into tears, that I would give organ donation a second thought.
"Ek hoop jy skryf lekker," (I hope you enjoy writing), Christine says to me as she walks me towards the exit, unaware of the spectrum of emotions welling up in my chest.
Driving back home on Main Road, past the very spot where the accident took place that would put in motion the events leading up to the first heart transplant, I felt eerie, cold, strange. Denise's story remained in my mind the entire weekend. She didn't just add a couple more days to Louis Washkansky's life, she was a cog in the machine of what was to follow – all the patients on the brink of death, getting a new lease on life.
I'm contemplating signing up as an organ donor now. Life in South Africa is precarious. We never know what might happen. I might die young with a healthy heart that may just what someone else needs. I urge you also to consider organ donation.
The Heart of Cape Town Museum is situated at Entrance 3 of the original hospital building. The Museum is open from Monday to Sunday, 09:00 to 17:00. Tours take place at 09:00, 11:00, 13:00 and 15:00 and can be pre-booked. Visit www.heartofcapetown.co.za, call 021 404 1967 or email firstname.lastname@example.org for more information.
To sign up as an organ donor, visit https://www.odf.org.za/donor-registration
Image credits: Wikimedia Commons and Marelize Wilke