A Surgeon with Heart

Shumway s talent and technique made transplants possible.

May/June 2006

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A Surgeon with Heart

Charles Painter/News Service

Outside Stanford Hospital, on a sunny January day in 1968, the world had come to watch. More than 50 journalists—a number that burgeoned two days later to around 150—gathered near the east wing, and some photographers climbed the walls of the building hoping to get a shot of what was happening.

Inside, surgeon Norman E. Shumway was making history—taking a donor heart and putting it inside 54-year-old steel worker Mike Kasperak. It was the first successful heart transplant in the United States, and although the heart beat for only 14 days, it advanced a medical procedure that since has saved tens of thousands of lives. In the United States alone, more than 2,000 patients go home each year with transplanted hearts.

Shumway, professor of cardiothoracic surgery emeritus, died February 10 at his home in Palo Alto of complications from cancer. He observed his 83rd birthday the previous day.

Shumway was born in Kalamazoo, Mich. When he enrolled at the University of Michigan in 1941, he planned to become a lawyer, but he was drafted into the Army in 1943. After completing six months of training in Texas, Shumway was given a medical aptitude test. The final question asked: “If you were to pass this test would you prefer a career in medicine or dentistry?” He marked the box after “medicine” and set course to be a doctor.

He went on to Baylor University and then medical school at Vanderbilt University. He did his residency at the University of Minnesota, where he developed an interest in cardiac surgery while participating in early efforts to help children born with malformed hearts.

After a brief stint practicing in Santa Barbara, Calif., Shumway came to Stanford in 1958. Early on he worked to perfect a technique for cooling the heart so surgeons had ample time to do repairs. (Cooling lowers the metabolic rate and preserves the heart tissue, allowing doctors to restart the organ after surgery.)

As his methods improved, Shumway began testing them with animal subjects. In 1959, he collaborated with Richard Lower, then a surgical resident, to give a dog a transplanted heart. The mongrel lived eight days. Eventually the survival rate of his animals increased to 70 percent.

Late in 1967, Shumway announced that he was ready to do a human transplant. But on December 3 of that year, a little-known South African surgeon, Christiaan Barnard, beat him to it, transplanting a human heart in 55-year-old Louis Washkansky in Cape Town. The press went wild, and Barnard became an instant household name. Even though Barnard had used protocols designed by Shumway and Lower, Shumway didn’t complain that the South African had stolen the spotlight. He preferred to keep the transplant program quiet until he and his colleagues could document successes in medical journals. He hoped the hubbub surrounding Barnard’s accomplishment might deflect attention from his first transplant operation.

No such luck. On January 6, 1968, a San Jose newspaper reporter attending a wedding on campus happened to pick up the phone when some nurses from the surgical team, who were also guests at the wedding, were called back for the transplant. Shumway’s operation, coming only a month after Barnard’s, became a sensation as well.

Around the country, cardiac centers rushed to duplicate the operation, but patients continued to die relatively quickly after surgery because their bodies rejected the unfamiliar organs. By 1970, most hospitals were observing a moratorium on transplants.

Shumway pushed on and worked to develop the techniques that would make long-term survival possible. Originally, heart transplant surgeons could identify organ rejection only by noting abnormalities in an EKG, but by then it was usually too late. To get an earlier indicator, Shumway’s team performed heart biopsies using a tiny catheter, eliminating the need for strong immunosuppressant drugs in many cases. Shumway also pioneered the use of cyclosporine, an anti-rejection drug that reduced chances of infection. In 1981, these advances helped make possible the world’s first successful human heart-lung transplant, which Shumway performed with Stanford colleague Bruce Reitz, ’66.

“When all those around him said it could never happen, his vision, his determination, his unrelenting commitment and pioneer spirit saved thousands of lives,” Senate Majority Leader Bill Frist, who studied under Shumway as a fellow at Stanford, said in a statement after his mentor’s death. “He was not only a great surgeon, but a great teacher as well.”

Indeed, one of Shumway’s greatest accomplishments was training the next generation of surgeons. He often handed over the operating theater to students, and was known for saying, “I might not be the best surgeon in the world, but I certainly must be the best first assistant.”

In 1993, more than 600 people attended a birthday dinner honoring Shumway. At one point in the evening those surgeons who had been trained by “the Boss” were asked to come forward. Hundreds of physicians stood and moved to the front. One was his daughter Sara, also a heart surgeon. In addition to Sara, Shumway is survived by his former wife, Mary Lou; daughters Lisa and Amy; a son, Michael; and two grandchildren.

Beyond his celebrated achievements, Shumway is remembered as a gentle man with a kind bedside manner. A memorial website is filled with notes from patients, many of them “blue babies” born with heart defects, who went on to live normal lives because of Shumway’s repairs.

Susan Craze of Redwood City is one of those who will always be grateful for Shumway’s gifts. She and her husband lost three of their five children to heart disease before the surviving two were saved by transplants in the early 1980s. Her daughter, Elizabeth, was 2 years old when she received her new heart, the youngest transplant patient ever at that time. “Without him, we wouldn’t have had any children,” Craze says.

Despite his reputation as a miracle worker, Shumway was humble, say his co-workers. Recalling her first day on the job 40 years ago, Cele Quaintance noted that Shumway parked himself at her station all night to help the rookie nurse monitor four pediatric heart patients. He “brought in a lawn chair and stayed there with me until morning. I had no clue who he was, and I did not care because he clearly cared about those kids and about me,” she wrote on the memorial website.

Others remember his quick wit, even in the operating room. His aphorisms are legend: “All you need to know to perform open heart surgery is that water runs downhill and seeks its own level”; “air rises”; and “all bleeding stops sometime.”

Golf was his favorite pastime. One former colleague, Ronald Dorfman, an emeritus professor of pathology, remembered that Shumway operated on him in 1988 to replace a faulty heart valve. “Some months later, when I was back playing golf,” Dorfman recalls, “I outdrove him on one hole. He threatened to open me up and undo the valve!” Shumway continued to carry his own bag on the Stanford Golf Course into his 80s.

“He was,” says Bruce Reitz, “the most incredible individual I’ve ever been fortunate enough to come into contact with. He had unique gifts and a tremendous personality.”

Craze agrees. After her children’s surgeries, she made it a habit to collect copies of a 1971 issue of Life magazine with a cover story titled: “The Tragic Record of Heart Transplants.” Her two surviving children—now 24 and 39 years old—attest otherwise.

CHRISTINE FOSTER is a Stanford contributing writer living in Mountain View.

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