29/11/2025
https://www.facebook.com/share/17q8s4ndYR/
Louis Washkansky knew he was dying.
At 53 years old, the South African grocer lay in a hospital bed at Groote Schuur Hospital in Cape Town, his heart barely functioning. Diabetes. Three heart attacks. Coronary artery disease so severe that only about 10% of his heart still worked. His legs were swollen with fluid, drained by needles, infected where the punctures had been made.
In October, he'd slipped into a diabetic coma. When he woke, when his wife Ann whispered "How are you doing?" through the pain and the swelling, Louis had managed a smile. "I'm on top of the world," he'd whispered back.
But they both knew the truth. Every known treatment had been exhausted. His kidneys were failing. His liver was failing. Doctors gave him weeks, maybe days.
Then Dr. Christiaan Barnard offered him an impossible choice.
A heart transplant. From another human being. Something that had never successfully been done in the history of medicine.
Barnard had trained at the University of Cape Town and spent time in America learning from Norman Shumway at Stanford, where the first successful animal heart transplant had been performed in a dog in 1958. He'd practiced the technique on forty-eight dogs in his laboratory. He'd studied immunology in Virginia. He'd watched other surgeons get close but never quite dare.
In January 1964, James Hardy in Mississippi had transplanted a chimpanzee heart into a dying man. The patient, Boyd Rush, died after 90 minutes without regaining consciousness.
By 1967, multiple surgical teams around the world stood on the edge of attempting a human-to-human transplant. Norman Shumway at Stanford. Adrian Kantrowitz at Maimonides Medical Center in New York. All waiting for the right moment, the right patient, the right donor.
Barnard decided he would not wait any longer.
He told Louis and Ann Washkansky that the operation had an 80% chance of success—a claim ethicists would later criticize as wildly misleading given that this had literally never been done before. But Barnard believed in direct honesty about the alternative.
"For a dying man it is not a difficult decision," Barnard would later write, "because he knows he is at the end. If a lion chases you to the bank of a river filled with crocodiles, you will leap into the water, convinced you have a chance to swim to the other side."
Louis didn't hesitate. "I'd back any horse that could win," he said.
The surgical team prepared. They took swabs from Louis's skin, nose, mouth, throat, re**um to identify every bacterium living on and in his body so they could target antibiotics precisely after surgery. They washed him repeatedly with antiseptic. They waited for a donor.
On the afternoon of Saturday, December 2, 1967, a car struck two women crossing a busy street in Cape Town.
Denise Darvall, 25 years old, and her mother had been hit by a drunk driver. Her mother died at the scene. Denise was rushed to Groote Schuur Hospital with massive head trauma.
Peter Rose-Innis, the senior neurosurgeon, examined her. Skull X-rays showed two serious fractures. When ice water was poured into her ear—a test for brain function—she showed no sign of pain. No electrical activity registered in her brain. She was brain dead, kept alive only by a respirator and blood transfusions that maintained her heartbeat.
Doctors Coert Venter and Bertie Bosman approached Denise's father, Edward Darvall, who had just lost his wife and was now losing his daughter. They asked for permission to use her heart—to save another person's life.
Edward Darvall knew his daughter had loved helping others. Through his grief, he said yes.
Christiaan Barnard went home that afternoon and dozed while listening to music. When he woke, he decided to modify the surgical technique he'd learned from Shumway. Instead of cutting straight across the back of the atrial chambers, he would cut two small holes for the blood vessels—a refinement that might preserve the heart's structure better.
In South Africa at that time, the law stated simply that a patient was considered dead when declared dead by a physician. But Barnard didn't want to remove a beating heart. At his brother Marius's urging, he injected potassium into Denise Darvall's heart to stop it, rendering her technically dead by whole-body standards before removal.
In the early morning hours of Sunday, December 3, 1967, both patients were wheeled into operating theaters at Groote Schuur Hospital.
Christiaan Barnard led a team of thirty people—surgeons, anesthetists, nurses, technicians—in an operation that would change medical history. His younger brother Marius assisted.
For six hours they worked.
They opened Louis Washkansky's chest. They connected him to a heart-lung machine. They removed his diseased heart, leaving portions of the atria—the upper chambers—in place. They prepared Denise Darvall's healthy heart, cooled with oxygenated blood to protect it from damage.
Then came the moment of truth. The careful suturing of blood vessels. The connection of the donor heart to what remained of Louis's original cardiac structure. The delicate work of making sure every vessel aligned, every connection held.
When everything was ready, Barnard gently applied electrical stimulation.
The donor heart began to beat.
For the first time in human history, a person lived with another person's heart pumping blood through their veins.
At 6:00 AM, Ann Washkansky received a phone call. The operation was a huge success.
When Louis woke, his first words were: "I'm still alive."
The world erupted.
Newspapers around the globe ran the story on front pages. Journalists and film crews flooded into Cape Town. Christiaan Barnard—charismatic, photogenic, articulate—became an instant international celebrity. One commentator called it "another frontier crossed—a frontier no less important and far more immediate than the stars." Newsweek heralded "an era as significant as the age of the atom."
Louis Washkansky's recovery was followed hourly by media worldwide. He regained full consciousness. He talked easily with his wife. His new heart pumped strongly, clearing the fluid that had accumulated in his legs. For almost two weeks, his progress was excellent.
Then his condition began to deteriorate.
Infiltrates appeared in his lungs on X-rays. The surgical team faced an agonizing diagnostic dilemma: was this rejection—the heart failing—or infection? They elected to treat for rejection, intensifying the immunosuppressive drugs that prevented Louis's body from attacking the foreign heart.
It was a fatal error.
Louis had developed bilateral pneumonia. The enhanced immunosuppression, meant to save the heart, left him defenseless against the infection spreading through his lungs.
On December 21, 1967—eighteen days after the transplant—Louis Washkansky died of pneumonia and septicemia.
But his heart had functioned perfectly until the very end.
The death didn't stop Barnard. If anything, it focused him. He'd learned crucial lessons about the balance between preventing rejection and maintaining the immune system's ability to fight infection.
On January 2, 1968—less than two weeks after Washkansky's death—Barnard performed his second heart transplant. The patient was Philip Blaiberg. The donor was Clive Haupt, a 24-year-old Black man who had suffered a stroke.
Philip Blaiberg returned home from the hospital. He lived an active life for 593 days—nineteen months—before his body finally rejected the transplanted heart.
The success sparked a wave of transplants worldwide. Within weeks, Adrian Kantrowitz performed a transplant on an infant (who survived only two hours). Norman Shumway performed his first human transplant on January 6. By 1971, Denton Cooley and Michael DeBakey in Texas had performed over thirty transplants combined.
But the early results were devastating. Of the first 170 transplants performed worldwide, the outcomes were grim. Fifty patients died from rejection. Thirty from infections. Others from various complications. Only a third of patients lived longer than three months.
Many medical centers abandoned the procedure. By the early 1970s, only Shumway's team at Stanford continued attempting transplants regularly, slowly refining techniques and learning from every failure.
Barnard persisted. Between December 1967 and November 1974, he performed ten heart transplants at Groote Schuur Hospital. Four patients lived longer than 18 months. Two became long-term survivors.
Dorothy Fischer, his fifth patient, lived for over thirteen years. Dirk van Zyl, who received a transplant in 1971, survived for over twenty-three years—the longest-lived of Barnard's patients.
Barnard also introduced heterotopic heart transplantation—a procedure where the donor heart is placed alongside the recipient's original heart, acting as an auxiliary pump. In that early era before sophisticated immunosuppression, this approach had advantages for patients whose bodies were struggling with rejection.
The breakthrough that would transform transplant survival came in the early 1980s with cyclosporine—an immunosuppressive drug that inhibited T-cell activation more selectively than previous medications. It dramatically reduced acute rejection episodes while allowing patients to maintain better resistance to infection.
One-year survival rates, which had been below 30% in the late 1960s and 1970s, suddenly jumped to over 80%. By the 2020s, refined immunosuppressive regimens and surgical techniques have pushed survival rates even higher.
Today, heart transplantation is a relatively routine procedure performed at centers worldwide. Hundreds of thousands of lives have been saved. Patients can live decades with their transplanted hearts, maintaining active, productive lives.
Christiaan Barnard never won the Nobel Prize. He later speculated it was because he was a white South African during the apartheid era—though the real reason was likely that he'd built on decades of research by others, particularly Shumway's work.
He was married and divorced three times. In his later years, complicated by ill health and loneliness, he struggled. He died suddenly on September 2, 2001, at age 78, while on vacation in Cyprus.
But his legacy endures not in awards or accolades. It endures in every person who lives because a failing heart was replaced with a healthy one. In every family that got more years with someone they love. In the normalization of an idea that once seemed impossible—that the heart, traditionally seen as the very seat of life and identity, could be removed and replaced.
What Barnard did on that December night in 1967 required technical skill learned from years of training and practice. But it required something more: the courage to be first. To face unprecedented risk. To proceed when others hesitated.
Louis Washkansky knew he was dying. He chose to leap into unknown waters rather than wait for the lion to catch him.
Denise Darvall's family, in their moment of deepest grief, chose to give life through death.
Christiaan Barnard chose to dare.
For eighteen days in December 1967, a grocer in Cape Town lived with another woman's heart beating in his chest. It shouldn't have been possible. For all of human history, it hadn't been possible.
But that didn't make it impossible.
That distinction—between what has never been done and what cannot be done—is where medical progress lives. In the courage to attempt what seems impossible. In the willingness to fail publicly. In the determination to learn from every setback.
The first heart transplant patient died. But the procedure succeeded. The knowledge gained from Louis Washkansky's eighteen days saved Philip Blaiberg for nineteen months. The lessons from both saved Dorothy Fischer for thirteen years. And the cumulative wisdom from all those early pioneers now saves hundreds of thousands.
A human heart stopped beating in Cape Town in 1967.
For the first time in history, another heart was ready to replace it.
And the world changed.
