Fifty years ago, 1968 was termed “The year of heart transplants.” It was a fascinating, thrilling, inspirational yet, in many senses, tragic year. On the occasion of the 50th anniversary of that year, I reread Thomas Thomson’s best seller Hearts: Of Surgeons and Transplants, Miracles and Disasters Along the Cardiac Frontier. It was published in 1971, the year I began medical school at Baylor College of Medicine in Houston.¹ Despite being swamped with the torturing deluge of Dr. Michael E. DeBakey’s new 3-year curriculum, I found time to read that gonzo journalistic effort. It had a profound impact on me because we were still living the dream and fallout of that 1968 heart transplant and mechanical circulatory assist device (MCAD) epoch in 1971—indeed, the first such epoch. Several years later, after completing a residency and fellowship and joining Baylor as faculty, Dr. DeBakey asked me to be on the team that would restart those programs. Heart transplants were again being performed at St. Luke’s/Texas Heart Institute, cyclosporine would soon be available, and the drama of Barney Clark’s 112 days with a total artificial heart was playing out. As a young pup on the faculty, it was an extraordinary honor, and I have been enmeshed in that world ever since. What I experienced was profound: medicine at its best (and sometimes worst); learning the meaning of true love and gifting as I dealt with brain death, organ donation, and retrieval; and the suffering of families of the near-dead and dying patients with advanced heart failure. They all became my heroes, and they still are.

A prized possession of mine is a framed collage that we made to celebrate the “second epoch of cardiac transplantation.” It was February 21, 1994, the tenth anniversary of restarting The Methodist Hospital’s heart transplant program. In the center of the collage is a dramatic picture taken in the operating room as our surgeons lifted a recently arrested and amputated donor heart from the chest cavity. Three hands are in the picture, two of the retrieval surgeon and one of the assistant. They were captured in the photo lifting the heart up high, and it is a beautiful site—a perfect heart that soon would rest in the thorax of a fortunate death-defying recipient. The picture always reminds me of a priest lifting high the Eucharist at a Catholic Mass, because for me, heart transplantation has always been a sacred event. To the right of this image are columns of initials of 310 heart transplant patients who had rested within that second epoch. To the left is a poem I penned in 1985 out of frustration with the wait for an organ donation. The subject was a favored patient of mine. A profound dilemma of heart transplantation is the wait we still face (although MCADs are now making great strides to reach Dr. DeBakey’s vison of cardiac replacement machines). The autographs of Michael E. DeBakey, George P. Noon, Antonio M. Gotto, Jr., Hartwell H. Whisennhand, H. David Short III, and me are in the margins, though so many more teammates and teams-of-teams made heart transplantation possible and successful enough to continue to this day. Every time this procedure is performed we witness a miracle, and it reminds us of the extraordinary profession to which we are privileged to belong.

James B. Young, M.D.

Chief Academic Officer, Cleveland Clinic
Professor of Medicine and Vice-Dean for Cleveland Clinic Academic Affairs
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Section Editor, Poet’s Pen, Methodist DeBakey Cardiovascular Journal

1. Thompson T. HEARTS: of surgeons and transplants, miracles and disasters along the cardiac frontier. New York: McCall Publishing; 1971. 304 p.

   

The Wait