Posted by Steve Lettau on Mar 19, 2020

Editor's Note: This is the fifth annual appearance of What It’s Like, a proven favorite with readers inside and outside Rotary. - The Rotarian

Dean Rohrs - Rotary Club of Langley Central, British Columbia; past RI vice president

In December 1967, I was completing my nurse’s training at Groote Schuur Hospital in Cape Town, South Africa. At that time, Christiaan Barnard was leading a team that hoped to perform the first successful human heart transplant at that hospital. There was a race between teams, because it was such a huge medical achievement. I was on “backup rotation” one night when I was called into the OR. It was just a coincidence that I happened to be on duty.

You have to understand, with a surgery like that, the room is crowded with people: the surgeons, their assistants, the anesthetists, the folks operating the heart-lung machine that keeps the patient alive. My job was just to do whatever needed to be done. I counted the cotton swabs used during the surgery, to make sure none were left in the patient. I fetched water. The surgeons would lean toward me and say, “Please mop my brow,” because they were perspiring.

In the moment, you understand that you’re doing something most unusual, but you’re so involved with the process that you’re just making sure you’re watching and filling in wherever you can. I knew the man receiving the heart and his family; he had been on the ward for a long time and he was clearly dying. He would have been gone in 24 or 48 hours. And here was this young woman who had been in a car accident and donated her heart.

Because of the surgical draping and the number of people leaning over the patient, I had no sightline into the chest cavity. But I did see everything that went in and came out. I saw the needles the surgeons were using to sew tissue together and tie off the bleeders. I saw the suctioning and the cauterization. And I saw the new heart itself go in. It was very different back then in how they did harvesting, and far more dramatic. They had to carry the new heart from one surgical theater to the other. I saw it being brought into the OR and lifted into the patient. Of course there was drama, because you are putting something into somebody’s chest that could give life but came from somebody who gave life. When I saw the new heart itself, I don’t remember thinking anything other than, “Oh my God, that’s somebody’s heart.”

Our surgery wasn’t the first attempted heart transplant. There had been one earlier, but the patient didn’t survive the procedure. Our patient survived for 18 days and was able to talk to his family. It wasn’t his heart that gave out; he died of pneumonia, partly because the immunosuppressant drugs weren’t as effective back then. Still, because our patient survived, that surgery became international news. Nobody on that team could have anticipated how big the reaction would be. It was instantly a world-famous event.

I was only 25 when it all happened — that’s 50 years ago now, good grief! Sometimes I feel a little embarrassed when people make a big deal out of it, because I was so peripheral. But that surgery did shape the course of medical history. And I have to give Professor Barnard credit. He was not always an easy man to work with, but it took a lot of courage to do what he did, because many people said back then that you can’t touch the heart. It was culturally and religiously unacceptable. That surgery changed the way people thought about the heart, and it changed the way we treat heart disease to this day.

As told to Steve Almond