On Dec. 3, 1967, a medical milestone was made in Cape Town, South Africa. A 54-year-old grocer, Louis Washkansky, received a heart transplanted from a young woman who died in a fatal accident while crossing the street. A medical team of 30 under the direction of Dr. Christiaan Barnard, assisted by his right-hand man and brother Marius, performed the nine-hour operation. Washkansky survived the operation and lived for 18 days before succumbing to pneumonia.
Norman Edward Shumway M.D., Ph.D., Stanford University Frances and Charles Field Professor of Cardiovascular Surgery, Emeritus, was born February 9, 1923, in Kalamazoo, Michigan. His father ran a creamery. Shumway was quiet, witty, irreverent and intuitive about people and about what would and would not work. Despite his fame as the father of heart transplantation, he shunned publicity.
"What he did, more than anyone else, was make heart surgery safe." —O.H. Frazier, M.D. (Denton Cooley protégé)
Denton Cooley, one of the greatest heart surgeons of the 20th century, was a third-generation Houstonian. He was born in 1920 in comfortable economic circumstances. His father was a successful dentist; his maternal grandfather, a physician. As a young scholar and athlete, Cooley showed great promise. As a youth, he was inspired by his parents and a family friend who also was his mother’s obstetrician, Dr. E.W. Bertner, who later founded the Texas Medical Center.
When professor Stephen Westaby, a heart surgeon at John Radcliffe Hospital, Oxford, England, decided to go to the United States to refine his surgical skills, he was advised, “Go to Kirklin. There you will learn discipline.”
In the second half of the 20th century, a group of surgeons advanced the work of early pioneers in cardiothoracic surgery who had first introduced surgical procedures to relieve heart disease. Two of these men were from institutions in America’s heartland: Dr. John Kirklin worked at the Mayo Clinic in Rochester, Minnesota, while at nearby University of Minnesota in Minneapolis; and Dr. Clarence Walton “Walt” Lillehei pioneered open heart surgery.
Perhaps no one person embodies the advancements in the surgical treatment of cardiovascular diseases during the 20th century more than Dr. Michael Ellis DeBakey. As a world-renowned scientist, innovator, medical educator, administrator, author, medical statesman and humanitarian, his name has become synonymous with firsts in surgery, biomedical innovations and the establishment of several educational and medical institutions.
A 1965 NBC documentary, "Who Shall Live?", narrated by Edwin Newman, created a stir. The documentary portrayed the highly controversial decision-making process that occurred during the early days of dialysis when only a few patients could be treated, and even then at great cost. The documentary showed faceless black silhouettes of the anonymous committee of community members against a stark white background as they deliberated over cases and selected which patients would receive dialysis treatment. Their decision meant life or death for the end-stage renal disease patients they were reviewing. The committee's authority was final and irrevocable. Ultimately, the serious ethical dilemma of a committee's choosing who would and wouldn't receive medical treatment to extend their lives set in motion a transformation of the healthcare system in this country.
Topics: Hospital Administration
The first hemodialysis machines at the University of Washington weighed about 1,000 pounds. They were bulky and could only treat one patient at a time. Using them cost about $10,000 annually.
During the early days of dialysis, in the 1960s, only a few patients could be treated, and even then at great cost. This was unacceptable to W.J. Kolff, the inventor of the first artificial kidney.
As head of the Department of Artificial Organs at the Cleveland Clinic, Kolff wanted to make dialysis so reasonable that anyone could afford it. In his biography, Inventor for Life, The Story of W.J. Kolff, Father of Artificial Organs, Herman Broers relates how Kolff went in search of a way to allow kidney patients to dialyze at home to relieve the pressure of limited beds in dialysis centers. In 1966, Kolff and his team arrived at a solution.
Before 1960, end-stage kidney disease was always fatal. According to a University of Washington research study: “Use of the artificial kidney—or kidney dialysis—to cleanse the blood of toxic products meant that an artery and a vein were damaged every time the patient was hooked up to the machine. A patient could receive perhaps five to seven treatments before doctors would literally run out of places to connect the machine to the patient and the patient would ultimately succumb to the disease.”