Nothing to Lose and Everything to Gain

In December 1967, fifty-three-year-old Louis Washkansky, a South African businessman, was dying. He had diabetes, chronic heart, kidney, and liver disease. By 1965, he had had three heart attacks and only about one third of his failing heart continued to function. All his heart doctors and tests confirmed he was dying. His doctors recommended he see the cardiac surgeon, Dr. Christiaan Neethling Barnard. Washkansky had nothing to lose and everything to gain. 

Image is an anatomical drawing of a red human heart with blue pulmonary arteries. Washkansky had nothing to lose and everything to gain. 

A New Procedure

Dr. Barnard told Washkansky and his wife about an experimental procedure. He proposed Washkansky become the world’s first human heart transplant recipient. For the procedure, Dr. Barnard would need the heart of a donor who died from disease or injuries that left the heart intact. The doctor would surgically replace Washkansy’s heart with the donor’s heart.

The doctor told Washkansky and his wife that the procedure had an 80% chance of success. Washkansky’s wife feared her husband would absorb the donor’s personality. She believed, as many, did that one’s soul rested in one’s heart.But Washkansky wanted to take his only chance. On November 10, 1967, the Chief of Surgery identified Washkansky as a potential heart transplant candidate.

The Preparation

Dr. Barnard’s team prepared Washkansky for the surgery. They swabbed his skin, nose, mouth, throat, and rectum to determine which bacteria lived on and in his body so he could be on the proper antibiotics. They washed him frequently with a disinfectant called Phisohex (hexachlorophene). And waited for a donor.

A Possible Donor

In late November, a young black man had a catastrophic head injury. Though the Chief of Surgery strongly recommended they avoid using a “colored” donor, the family was asked for permission for him to be a heart donor. Unfortunately, his heart was damaged and wasn’t suitable. Washkansky feared his chances of getting a new heart were slim.

December 3, 1967

A drunk driver plowed into twenty-five-year-old Denise Davail and her mother when they were crossing the street. Davail’s mother died at the scene. Davail had devastating head injuries. A neurosurgeon determined she was brain dead. A blood transfusion and respirator kept her heart beating. Doctors approached her father, who had been at the scene, and told him that there was a man in the hospital who was gravely ill. They told him it would be a “great kindness” if he allowed them to transplant her heart into this man. After a few minutes of contemplation, he told the doctors that if they couldn’t save his daughter, they should try to save that man.

Photograph of a surgical suite with six wax figures in green surgical gowns, what head wraps and masks--a recreation of Dr. Bernard and his team in the operating room

The Surgery

At one in the morning, they took Washkansky and Davail to surgery. Dr. Barnard, his brother, Dr. Marius Barnard, and a team of thirty surgeons, anaesthetists, nurses and technicians implanted Davail’s heart into Washkansky’s body. Only the two Dr. Barnards had ever attempted a heart transplant before. And although the Barnard brothers had performed many transplants before, their only patients had been dogs. (Read more about Dr. Christiaan Barnard and his techniques.)

Surgical Success

Washkansky survived the surgery. He woke and spoke with his wife. 

On the fifth postoperative day, Dr. Barnard suspected Washkansky’s symptoms were signs of his body rejecting the donor heart. The doctors bombarded Washkansky with immunosuppressant drugs to prevent rejection of the donor heart. Unfortunately, this reduced Washkansky’s resistance to other illnesses. He came down with pneumonia. On the eighteenth postoperative day, Washkansky died.

Legacy

Image of Dr. Christiaan Barnard shortly after the surgery during a press conference. he is in a suit with a curtain behind him

Today, doctors across the world perform more than 5,000 heart transplants each year. Eighty-seven percent survive the first year. The average life expectancy after a heart transplant is a little more than nine years. All because a dying man took a chance on a doctor and a new surgery. He had nothing to lose and everything to gain. 

Image Credits

Top:Image by Open Clipart-Vectors from Pixabay

Middle Photo: by TheSokks – Own work, CC BY-SA 4.0, from Wikimedia Commons

Last Photo: by Ron Kroon / Anefo, CC0, via Wikimedia Commons

2 comments

  1. I think this also points out that limited success, or even what could be seen as a failure, can be the first step to success. What brave doctors and patient and family!

    1. Very good point, Lisa. There are many steps to success that we often see as failure. Brave, yes. And scared and hopeful and a whole mix of other emotions we probably can’t imagine. They paved the way for others.

Leave a comment

Your email address will not be published.

%d bloggers like this: