'We can proceed quietly'
Former news chief recalls the media hoopla that surrounded Shumway's historic 1968 surgery
Reporters from all over the world gathered to hear from Norman Shumway (left) and Donald Harrison after the first successful U.S. heart transplant in 1968. Some journalists tried to climb the walls of the hospital to peek into the operating room.
Thirty-eight years ago, Stanford University Medical Center became the focus of world attention after Norman Shumway, MD, performed the first adult heart transplant in the United States. Spyros Andreopoulos, director emeritus of the medical school’s Office of Communication & Public Affairs, offers his reminiscences of the historic event. This updated account is based on an article he wrote for Campus Report in 1988.
By SPYROS ANDREOPOULOS
For two weeks, between Jan. 6 and 22, 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 long vigil began on 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 were in progress. I was on vacation; she was in charge.
Fifteen minutes later, Jane was at Stanford Hospital while her husband manned the phones of the news bureau, calling my home every two minutes. Earlier in the week I had talked to Dr. Norman Shumway who said no transplant was being planned. While I was 60 miles away enjoying the fresh air, beauty and solitude of Point Reyes National Seashore, the unexpected happened: a heart donor had become available at Stanford Hospital and the surgeons prepared for the historic operation.
Quickly, Jane alerted the staff. Two classrooms adjacent to the news bureau were converted into a pressroom, and additional help was assembled, Bob Beyers, director of the University News Service; Harry Press, and photographers Jose Mercado and Chuck Painter. And I, just a hectic few days after dealing with the press in announcing the synthesis of biologically active DNA by Nobel Laureate Arthur Kornberg and his associates, found my brief vacation at a sudden end.
We had established a plan of action a few months earlier, when it became apparent that Dr. Shumway, after years of research in dogs, was ready to go ahead with the first human trial. Our purpose was to assist the news media—both print and electronic—in getting prompt and accurate accounts to the public, to protect the patient and his relatives from unnecessary intrusions on their privacy, to make certain that the presence of the press did not disrupt normal hospital functions and to educate the public about contributions it could make in terms of donating organs for transplants.
When Dr. Christiaan Barnard had performed the first human heart transplant in South Africa a month earlier, Dr. 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 the South African event, and he naturally wanted to avoid it. He said to me, “We don’t need to worry about the press now. 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 who was at a wedding reception also attended by members of the transplant team. He determined that a hospital emergency call received at the reception presaged the surgery that followed.
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, Dr. Shumway and cardiologist Donald C. Harrison talked to reporters.
At the press conference, Dr. 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 still unresolved problems of immunologic rejection. He continued, “We have reached first base perhaps, but the work is just beginning.”
While professional ethics prevented him from discussing details, Dr. 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 Dr. Shumway’s only scheduled appearance with the exception of a brief statement he made several days later after the heart transplant 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 has been 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 Dr. Shumway’s view, tended to raise public hopes too early. It was also an attitude that was later to be admired by reporters.
In the ensuing two weeks, we issued at least one news bulletin each day about the patient’s condition. Phone calls were coming in continually. Calls were being received from Tokyo, Argentina, London, Paris and South Africa. One South African reporter tried to reach Dr. Shumway directly by identifying himself as “Dr. Barnard.”
One legitimate call from Dr. Barnard actually did come in, and the tables were turned when it was relayed to Dr. Shumway through a reporter—CBS anchorman Walter Cronkite. Barnard had tried to phone Dr. Shumway but couldn’t get through. In desperation, Barnard called Cronkite at CBS News in New York and asked him if he could relay the message to Shumway concerning immunosuppressants. Cronkite obliged by calling me, and Shumway and Barnard talked.
The news bureau was now open round-the-clock, with all five of us sneaking home whenever possible to grab a few minutes of sleep. Because of the patient’s many ups and downs, reporters were afraid they might miss some new development. They camped outside the office during the night, some in sleeping bags, others on the floor. Our workload got heavier and other Stanford news writers were called in—Jeff Littleboy and Bob Lamar as well as support people to handle the phones. But the bulletins kept rolling—up to four in one day as the patient’s condition changed. The phones kept ringing.
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. Jane Duff and I faced that problem each time we had something legitimate to report.
In back of them were phalanxes of photographers and cameramen with their floodlights. 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.” And we would have to repeat the same for those reporters who came late.
One day I had to leave early for another meeting. A crew from an overseas TV service had missed the press conference. The reporter wanted to interview me right away. I said I’d be happy to see him later. The reporter knew that I was Greek by birth and that my mother had called from Athens to say she had watched me on Greek TV. The reporter repeated his plea. When he saw he was not succeeding, he paused, looked at me sadly and said, “Okay, if you don’t want to do it for me, do for your mother.” I couldn’t refuse.
On the serious side, I believe the press generally did a fine job in covering the operation. The reports of our first heart transplant were restrained and accurate. The press was kept abreast of events as they occurred, and it was even possible to satisfy most reporters’ individual requests. One correspondent from Los Angeles, then relatively unknown, covering the transplant for NBC News was Tom Brokaw. Because his experience in covering medicine was limited, I would meet with him every morning to explain things. A year later after the network transferred him to New York, he wrote me a touching letter to thank me for helping to launch his career with NBC.
Locally, the news coverage was limited to the suburban newspapers and the San Jose Mercury. By an unhappy coincidence, the San Francisco Chronicle and San Francisco Examiner were shut down by a printers’ strike. Chronicle reporter David Perlman, who is widely regarded as the dean of the nation’s science writers, did not cover Stanford’s first heart transplant for his paper, but for the Washington Post.
And so it went. Today with a record of more than 1,000 heart transplants, the largest number in the world and vastly improved survival rates, the program Dr. Shumway started at Stanford remains the undisputed leader in the world. As for us, 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.
Stanford Medicine integrates research, medical education and health care at its three institutions - Stanford University School of Medicine, Stanford Health Care (formerly Stanford Hospital & Clinics), and Lucile Packard Children's Hospital Stanford. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu.