Ian C. Ellul

The Maltese Cardiac Society Conference 2014 was held on the 17-18th October where it attracted a record participation of around 500 attendees. Indeed, locally we have made significant advances in this field, which are usually more aptly attributed to larger countries. One such technology is the Transcatheter Aortic Valve Implantation (TAVI). This minimally invasive surgical procedure replaces the heart valve without actually removing the damaged one. Locally, a transfemoral approach is used to carry out this procedure. In essence, it means that there is no need to open the chest to insert the new valve and the patient can return home after a couple of days.  

At this stage I would like to take you back to December of 1967, when the first human heart transplant was carried out. This was carried out by a South African cardiac surgeon, Christiaan Barnard, utilizing the techniques developed and perfected by Norman Shumway and Richard Lower. He performed the transplant at the Cape Town’s Groote Schuur Hospital. All the medical team was caucasian, with the exception of Hamilton Naki who was Barnard’s black assistant.  Although Naki never received a formal medical education, he was recognised for his surgical skills and for being able to teach such skills to medical students and physicians alike. In fact,Barnard specifically wanted him on his team during this first transplant procedure.

Nothing exceptional, you might say. However, in order to appreciate its significance, one must understand that in Africa, at that time, there was apartheid. Black people were not allowed to operate on caucasians or even enter operating theatres during such interventions. These, among the plethora of other restrictions, of course. In fact, the exceptionality of Naki’s contribution has also been captured on the silver screen through Hidden Heart, a documentary released in 2008.

Notwithstanding the restrictions imposed through apartheid, on 2 January 1968, Barnard performed a second operation by transplanting the heart of a young black man, Clive Haupt, who had died the previous day from stroke into a 58-year-old Caucasian dentist named Philip Blaiberg. Blaiberg survived the operation, and survived for 19 months (the first heart transplant patient died 18 days after the operation). At this stage, I question whether these historical anecdotes, by their very nature, are reminiscent of the paradoxicality of human nature.