HEARTBEAT: Dr Christiaan Barnard performed the first heart transplant on a patient named Louis Washkansky. On May 29th this year a man called Hamilton Naki died. What is the connection?
Well, in heart transplantation, one team retrieves the donor heart; a second team implants it into the recipient. On this momentous occasion Dr Barnard led the implanting team and made his way into the history books. Hamilton Naki was the man who removed and prepared the donor heart from a young woman, Denise Darvall, who had been the victim of a road traffic accident.
This was in Groote Schuur Hospital, Cape Town, South Africa. This was an infringement of the law. Hamilton was black, Denise was white and this was the era of apartheid. Hamilton Naki had no degrees or diplomas. When his face appeared inadvertently in some of the celebratory post-operative team photographs, the hospital explained that he was a cleaner or a gardener.
This highly gifted gentle man had left school at 14 because his family could no longer afford to keep him there. He made his way to Cape Town and found a job as a gardener at the University of Cape Town Medical School. Needless to say, the faculty and the students were all white. A serendipitous meeting with the head of the animal research laboratory led to his employment there.
His merits quickly became apparent, and in this busy laboratory which dealt extensively with transplant operations - kidneys, livers, hearts - he became a technical expert. He trained young surgeons in these difficult techniques, particularly in the field of liver transplantation. Christiaan Barnard, before his death, acknowledged that Hamilton was probably a better technical surgeon than he was himself. This was high praise indeed from a surgeon noted for his skill and dexterity.
He worked at the medical school until 1991 and retired on a small pension. In retirement he used his medical connections to raise funds for a mobile clinic in the Eastern Cape. Selflessly thinking of others, he could only afford for one of his own children to complete high school.
Recognition of his work came only with the new South Africa, created largely by another great and selfless man, Nelson Mandela. Their lives demonstrate to us yet again, the triumph of true humanity over hate, intolerance and bigotry. I had never heard of Hamilton Naki at the time of our first heart transplant in Dublin. Barnard, of course, everybody knew. Given my vocation this is a belated, but heartfelt tribute to a great man and a great surgeon.
I am about to be released from writing for a couple of weeks during which time I am sure that all the ills of the health service will be resolved. Then I can resume my passage through a medical life, where as I recollect I am becalmed in my surgical internship. Apropos that, I have just received a call from an old friend and patient Noel Meagan, a nephew of Sister Claude, who was responsible for paying us, all those years ago. Noel recalled visiting his aunt in this spic and span hospital and being fed cream cakes and lemonade.
This aspect of cleanliness and tidiness was genuinely a feature of Dublin hospitals at this time and even given that the population of the city has more than doubled over the intervening period, something else has altered drastically for the worse.
A further anecdote about Sister Claude; the Mother General of the Mercy Order used to visit the institutions of the order on a regular basis, partly on inspection and partly to discuss any problems with the Sisters.
On a visit to the Mater, Sister Claude complained that Sr Rosarii, who looked after us doctors, was spending too much money in so doing. Sr Rosarii, our mother hen, acknowledged her failing and that possibly we should not get grapefruit every morning. She requested, however, one favour from the Mother General. "Certainly," said the MG relieved that Sister R had taken the little reprimand so well. "Would you tell the doctors yourself, Mother?" We continued to receive our grapefruit.
Nowadays reading about shortfalls of €20 million to €30 million, either the price of grapefruit has risen astronomically, or there are more serious matters involved.
I wrote recently about MRSA and the serious threat posed. Recent articles in the New England Journal of Medicine deal with outbreaks of such infections in the community rather than in the hospital setting. It is, as stated, a very serious contemporary problem and just now we can't prevent it. Ill-advised and opportunistic legal action shows scant understanding of this serious problem.
Daisy, Countess of Fingall in her autobiography, 70 years young, describes the young ladies in Merrion Square, watching anxiously from behind the curtains as the equerries from Dublin Castle rode out to deliver the invitations to balls and levees and the terrible sense of disappointment if the summons did not come. I thought of this when I did not receive an invitation to the tent at the Galway Races. I suppose this is the modern day equivalent, although lacking, dare I say it, the style.
Perhaps something I wrote annoyed somebody. If so. Good.
Maurice Neligan is a cardiac surgeon