The Shumway legacy: When the whole world was watching Stanford Hospital
BY SPYROS ANDREOPOULOS
Spyros Andreopoulos, director emeritus of the medical school's Office of Communication & Public Affairs, recalls the media hoopla that surrounded Shumway's historic 1968 heart transplant.
For two weeks in January 1968, my staff and I spent virtually our entire existence as the conduits between the first adult heart transplant in the United States and the world.
The vigil began on a Saturday afternoon when Jane Duff, then-assistant director of the medical center news bureau, received a call at home that preparations for a heart transplant had begun. I was on vacation; she was in charge. Earlier in the week I had talked to Norman Shumway, MD, PhD, who said no transplant was being planned. While I was away at Point Reyes National Seashore, the unexpected happened: A heart donor had become available. Quickly, Jane alerted the staff. Two classrooms adjacent to the news bureau were converted into a pressroom. Additional help was assembled. My brief vacation had ended.
We had established a plan of action a few months earlier, when it became apparent that Shumway, after years of research in dogs, was ready to proceed with the first human trial. Our purpose was to assist the media with prompt, accurate information, to protect the patient from unnecessary intrusions on his privacy, to ensure that the press did not disrupt hospital functions and to educate the public about donating organs.
When Christiaan Barnard, MD, had performed the first human heart transplant in South Africa a month earlier, Shumway, I recall, had sighed with relief. He was aware of the press accounts of "the circus atmosphere with Marx Brothers overtones" that had accompanied that event, and he naturally wanted to avoid it. "We don't need to worry about the press now," he said. "We can proceed quietly and say nothing until we report our first 10 cases in the surgical journals."
Yet, when the transplant was done on Jan. 6, 1968, the tip actually came from a reporter from the San Jose Mercury News who was at a wedding reception with members of the transplant team. When they received an emergency call from the hospital, he deduced that the transplant operation was imminent.
By the time I arrived at Stanford that night, the operation was in progress. About 50 reporters had gathered outside the news bureau and a brief statement about the heart transplant was issued immediately. A bulletin on the patient's condition was given the next morning. That afternoon Shumway and cardiologist Donald C. Harrison, MD, talked to reporters.
At the news conference, Shumway was careful not to raise false hopes. He emphasized that too little was known about heart transplants in humans to promise an appreciable extension on the patient's life. There were unresolved problems of immunologic rejection. "We have reached first base perhaps, but the work is just beginning," he said.
While professional ethics prevented him from discussing details, Shumway extended his remarks to an aspect of transplantation he felt was of public interest. Heart transplants had necessitated a complete review of the medical, technical, social and legal problems and opportunities that face the nation. He said the medical profession needed guidelines from society to operate in this promising, yet exceedingly delicate, area of surgical practice. One of these was the concept of "brain death." A clear definition was essential for the procurement of donor hearts.
This was Shumway's only scheduled appearance with the exception of a brief statement he made several days later after the patient died. He declined numerous requests for special interviews and invitations to appear on "Face the Nation," "Meet the Press" and the "Today Show." A hallmark of Shumway was his avoidance of publicity, both of the personal kind that had raised some flack for other heart surgeons and of the general kind that, in Shumway's view, tended to raise public hopes too early. It was an attitude that was later to be admired by reporters.
The news bureau was now open round-the-clock. Because of the patient's many ups and downs, reporters were afraid they might miss a new development. They camped outside the office during the night, some in sleeping bags, others on the floor.
By the third day there were more than 150 reporters from all over the world covering the event. I have no problem dealing with reporters on a one-to-one basis, but having to face so many of them before dozens of microphones and TV cameras was an ordeal. For several minutes, we would read the news bulletins and answer questions—all kind of questions. "What did we mean by prothrombin time? "Give us a simple term for platelets." "Explain the function of the spleen."
The press generally did a fine job in covering the operation. The reports were restrained and accurate.
Today with a record of more than 1,000 heart transplants, the largest number in the world and vastly improved survival rates, the program Shumway started at Stanford remains the undisputed leader in the world. As for me, the first heart transplant highlighted the impossibility of withholding information about a historic operation until the facts of the cases were first reported in the scientific journals.
