Netcare Exhibition credits Exhibition overview & acknowledgments Memorial

Entrance Lobby With special thanks to Richard Friedland for his passionate Threshold sculpture by Marco Cianfanelli and meticulous dedication in bringing this exhibition to Portrait of Professor Christiaan Barnard fruition and with gratitude to the late Jeremy Rose, A brief biography of Professor Barnard whose expert curatorial involvement provided the elegant Floor 9 conceptual seed from which this exhibition grew. A selection of South African doctors’ contributions to medicine Professor Barnard’s contribution to medicine A brief history of intesive care medicine Exhibition Content & photographs

Floor 10 Concept: Beaufort West Museum Marco Cianfanelli of Museum The first successful human heart transplant Jeremy Rose Dr Jose de Nobrega Dr Des Fernandes Professor Barnard’s contribution to the development of the Project Management Dr Otto Thanning prosthetic aortic valve replacement Jocelyn Rhodes Dr Heinz Mödler The future of Curation & research Dene Friedman Juliet White Karin Berman Floor 11 Co-curation & design Sister Georgina de Klerk Professor Barnard’s contribution to paediatrics Natalie Edwards Olga Sokoloff Professor Barnard’s awards and gifts from patients Writing Interviews Physician’s Oath / Nurse’s Pledge of Service Angus Douglas Dr Jose de Nobrega Proof reading Celeste McCann Floor 12 Glenn O’Hearne, Peter Warrener, Dene Friedman Robert Sobukwe’s time at Hospital Richard Friedland Dr Willie Koen Tribute to and his laboratory team Exhibition & graphic design Dr Otto Thanning Dr Des Fernandes The Heterotopc or “piggyback” heart transplant technique Carina Comrie Michael Tymbios Deirdre Barnard Visser Sister Tollie Lampbrecht Floor 14 Technical design Dr Susan Vosloo A glance at the monumental decade of the 1960s Nico van Loggerenberg Dr Cecil Moss Professor Barnard regarding the transplant Exhibit fabrication Sister Georgina de Klerk Russell Jones at Scanshop Helen Simmons & Gary Klugman Cabinet Curation Floor 15 Portrait of Professor Roger van Wyk at Educentric Two of ’s most famous icons Christiaan Barnard Life Magazine celebrates the first heart transplant Cabinets Simon Croft Exhibition Photographs of the first successful heart transplant patient Artist: Marco Cianfanelli ’s ECG the moment his new heart began to beat Threshold artwork Technical design Artist: The studio of Marco Cianfanelli Guide Floor 16 Marco Cianfanelli Fabrication Professor Barnard remembered by those who knew him Technical design Russell Jones at Scanshop Barnard’s personal struggle with arthritis The studio of Marco Cianfanelli Barnard’s first autobiography “One Life” and review of the book. CNC cutting Rayno von Schlicht at Rind Routing Carpentry Nils Korupp at Joynt Design Lighting Design Pamboukian Lighting Design Netcare 3 Christiaan Barnard December Memorial Hospital 1967

Professor Christiaan Barnard achieved international fame On 3 at for expanding the boundaries of medicine. Barnard was not in Cape Town, a young surgeon by the name of only committed to furthering medical science, he was also Dr Christiaan Barnard and his team performed the deeply committed to patient care. In this exhibition Netcare world’s first human heart transplant. Once the news honours Barnard the man, and pays tribute to the principles reached the world the barefoot boy from Beaufort West he stood for: science in service of humanity, and patient care had become a superstar surgeon. in service of the individual. This exhibition is also for all the unsung champions of the healthcare profession. Those who dedicate their lives to these principles; serving the health and wellbeing of the individual to make our world a better place. “My moment of truth – the moment when the The Netcare Christiaan Barnard Hospital was opened on 3 December 2016, the 49th anniversary enormity of it all really hit of the world’s first human heart transplant. me – was just after I had taken out Washkansky’s heart. I looked down and saw this empty space… the realisation that there was a man lying in front of me without a heart but still alive was, I think, the most

Louis Washkansky wheeled to the Radiotherapy Unit for awe-inspiring moment of all.” cobalt treatment to prevent rejection after his heart transplant. © Photograph courtesy of Georgina de Klerk Professor Christiaan Barnard Quoted by Peter Hawthorne in “The Transplanted Heart”

1 2 Portrait of Professor Threshold Christiaan Barnard

Christiaan Barnard Memorial Hospital Conceived as a work that sits between exhibit content and Foreshore, Cape Town, 2016 artwork, this composite portrait speaks of the complexity

18 mm birch plywood of Professor Christiaan Barnard’s character, expressed 3 mm mild steel hangers and support structure through the artifacts of his personal and professional height 2,4 m relationships. The installation is composed of a collection width 10,2 m depth 8 m of portrait artworks of Barnard, given to him by patients, in a show of gratitude for his work and care. When Marco Cianfanelli began to imagine a means of creating a portrait

At the moment on the 3rd December 1967, that Louis Along the sculptures’ opposite axis, in contrast to its of this complex subject, he considered that Barnard might Washkansky’s heart was removed, Professor Christiaan undulating forms, are the linear slices of vacant space, that best be described by those whose lives were profoundly Barnard stared, for the first time, into an empty living express both the enduring skeletal structure of the rib cage, influenced by his work. The Beaufort West Museum housed human chest cavity. In later accounts of the event he as well as the amplified unfolding of the crucial moments this collection of artworks dedicated to Barnard, and the recalls that “at that moment the full impact of what I was between one heart’s removal, and the other’s insertion. decision was made to include their voices in this tribute. doing hit me”. That open chest cavity came to represent In this regard, the sculpture is both form and space, Each portrait depicts Barnard as he was seen through the potential, hope, faith and perseverance. It was this notion representing the transitional moment between states of eyes of a patient, while the fragmented photograph depicts that inspired Marco Cianfanelli’s suspended sculpture existence. The threshold contains a space in which the linear the many facets of his personality. Threshold. flow of time is suspended in a moment of veiled potential. About the Artist The sculpture is an archway, the threshold where the Rippling out from the immersed forms of the heart, are the arrangement of 75 linear plywood profiles represents the waves of its final heartbeat. The organ’s last burst of life, as Marco Cianfanelli was born in Johannesburg in 1970 and incremental expansion of the moment in time where the chillingly recorded in Louis Washkansky’s electrocardiogram, graduated with a distinction in Fine Art from the University of impossible suddenly and dramatically becomes possible. fell to flat inactivity while the surgeons prepared to insert the the Witwatersrand. He has won numerous awards, including Modelled on the form of a human heart, each of the profiles donor heart. In that moment, devoid of any heart activity, the the ABSA L’Atelier and Ampersand Fellowship. Cianfanelli is individually describe the subtle organic complexities of the patient’s life was sustained and monitored by machines. renowned for his bold public art pieces and large sculptural cardiac chambers. Collectively, the profiles resolve into The gentle ripples in the plywood structure suggest the works. He was a member of the design team for Freedom an archway that suggest an anatomical form, or an interior waning of one source of energy, and simultaneously, the Park, South Africa’s national monument to freedom, and his biological chasm. latent potential of another. fragmented portrait sculpture, Release, forms the centrepiece of the Capture Site in KwaZulu-Natal. Cianfanelli’s large-scale public works can be seen in South Africa, the Middle East and the United States. His artworks can be found in public and private collections across the world, including at the Museum of Modern Art in New York City, and at the Smithsonian National Museum of African Art.

www.marcocianfanelli.com

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Christiaan Barnard’s Contribution 09 to Medicine

He introduced the principles of specialist postoperative care to Groote Schuur Hospital, and developed South Africa’s first intensive care unit (ICU), established in 1958. Theatre complex Surgical Intensive Care Unit Paediatric Professor Christiaan Barnard demonstrated extraordinary levels of care and concern for his patients, sacrificing much Intensive Care Unit of his own time to be with them. After surgery he would spend hours watching over his patients, particularly if they were children. He set a standard of postoperative care that Exhibition Overview even his younger registrars and doctors found hard to keep pace with. This level of care undoubtedly contributed to the A selection of SA’s doctors’ contributions to medicine recovery of his patients. Professor Barnard’s contribution to medicine A brief history of intensive care medicine On the rare occasions when he himself was sick, his doctors would complain that he would often defy their orders to stay in bed so that he could check on his own patients.

“To me it was just one more new operation in the long list of procedures made possible by the development of the heart-lung machine.”

First heart transplant recipient, Louis Washkansky, referred to Barnard as “The man with the golden hands”. © Gallo

10 11 CBMH The first Floor 10 successful human heart transplant “…We have a man in the hospital here, and we can save his life if you give us permission to use your 10 daughter’s heart…” Cath labs Cardiac Care Unit On a Saturday afternoon, 2 December 1967, , her brother Keith and her parents stopped in Main Medical Intensive Care Unit Road in Salt River, Cape Town, to buy cake for a friend. Medical ward Denise’s father, Edward, and Keith waited in the car while Doctor’s consulting rooms the two women walked to the bakery across the road from the car. On their way back to the car a drunk driver, who had ignored a red traffic light, crashed into the women, killing Denise’s mother instantly and leaving Denise Exhibition Overview seriously injured.

The first successful human heart transplant Denise was transported to Groote Schuur Hospital, only Professor Barnard’s contribution to the development a few kilometres away from the accident. She was placed Recipient: Louis Washkansky 1913 – 1967 of the prosthetic aortic valve replacement in a ward near Louis Washkansky, a 53-year-old diabetic © Heart of Cape Town Museum The future of heart transplantation who was suffering from incurable congestive . Coincidentally, Washkansky’s wife, Ann, who had just been to visit him, drove past the scene of the accident where the two women still lay. 05:52 am

Later that day at Groote Schuur Hospital, Edward Darvall was approached by two doctors who notified him that 3 december 1967 Denise was on a life support machine and that there was nothing more they could do for her. One of the doctors, Dr Bertie Bosman, said, “We can’t save your daughter – her injuries are too bad. But I tell you, we have a man in Louise Darval’s transplanted heart the hospital here, and we can save his life if you give us begins to beat in Louis Washkansky’s chest permission to use your daughter’s heart and her kidney.” Donor: Denise Darvall 1942 – 1967 © Heart of Cape Town Museum

14 15 CBMH The world Floor 11 opens its arms to Dr. Christiaan 11 Barnard

Maternity After successfully completing the first human heart transplant in December 1967, Christiaan Barnard became one of the Labour & Neonatal wards most famous people in the world. Soon after the operation, NNICU he graced the covers of Time, Newsweek and Life; he had tea Surgical wards with the President of the United States of America, Lyndon Johnson, and was nominated for a Nobel Prize in Physiology or Medicine. It was the most publicised medical event ever. It was also a far cry from his humble beginnings as the son of a poor Exhibition Overview missionary in the small Karoo town of Beaufort West.

Professor Barnard’s contribution to paediatric medicine He danced with Princess Grace of Monaco, befriended Professor Barnard’s awards and gifts from patients Sophia Loren and had a medallion presented to him during Physician’s Oath & Nurse’s Pledge of Service an audience with Pope Paul VI. While Barnard revelled in his newfound celebrity status, the tributes and honours started to pour in: several honorary fellowships from the USA, six honorary degrees from across the world, numerous honorary memberships, medals and certificates. He was given the Freedom of the City in ten different countries, as well as honorary citizenships of the USA, France, , Greece, Brazil

and Canada. Barnard swarmed by adoring fans in Italy. 538 © Image courtesy of Karin Berman In 1998, he established the Christiaan Barnard Foundation in Vienna, Austria. Its two objectives were the provision of heart operations and medical assistance projects for children and the total awards, accolades, delivery of awareness campaigns for cardiovascular diseases. memberships, honours and recognitions presented to christiaan barnard to date.

18 19 CBMH Hamilton Naki collaborates with The Professor Christiaan Barnard Floor 12 in the research laboratory. Hamilton Naki © Heart of Cape Town Museum 12 story Surgical wards At the age of 18, Hamilton Naki travelled from the rural area began testing it on dogs; all the while honing and refining of to Cape Town in an effort to find some form of the cardiac surgical skills and techniques he had been Paediatric wards employment to enable him to provide financial support for exposed to in America. It was the unlikely circumstances of IVF clinic his family. He managed to secure employment working as a working together in the laboratory, which fostered a close Doctor’s consulting rooms gardener on the grounds of the . relationship between Barnard and Naki.

Naki’s unlikely transition from gardener to master research In the early days, Naki performed the role of anaesthetist, surgeon is in some part thanks to a remarkable German and he was captured ‘on record’ providing guidance to Exhibition Overview by the name of Robert Goetz. Goetz fled Nazi Germany Professor Arthur Bull, an esteemed anaesthesiologist, on in 1936; after spending time in Switzerland and Scotland how to anaesthetise a dog. On witnessing the proficiency Robert Sobukwe’s time at Groote Schuur Hospital he found a position at the UCT medical school in 1938. In of Naki at work, visiting academics were amazed to hear Tribute to Hamilton Naki and his laboratory team 1944, after re-qualifying as a doctor, Goetz was promoted that he had not received formal training and was not qualified The Heterotopc or “piggyback” heart transplant technique to Associate Professor of Surgical Research. at all.

Goetz invited Naki to work in the surgical research Barnard taught Naki the correct anatomical names of laboratory. At first Naki was essentially a general assistant, the various structures in the body, and developed a handling and managing the animals before they were strong admiration for the self-taught research surgeon. It anaesthetised. But Goetz recognised his potential and soon struck Barnard that apartheid made it virtually impossible the young man from Ngcingane learnt how to anaesthetise for someone like Naki to get the sort of recognition he animals, set up intravenous drips, and suture surgical deserved. As Barnard later said, “If Hamilton had had the incisions. In 1955 the laboratory team, which included opportunity to study, he would probably have become a Naki, performed a heart transplant on a dog. Goetz and his brilliant surgeon.” wife, a cardiovascular physician, were ardently opposed to apartheid and in 1957 left South Africa for America, where Such were Naki’s sharp intellectual powers, that he Goetz went on to invent the intra-aortic balloon pump. quickly picked up on the nuances of so many aspects of this complex environment, was able to identify congenital At this time, Christiaan Barnard was studying cardiothoracic anomalies, and more than held his own in clinical surgery at the University of Minnesota. On leaving discussions with professors. When, after his retirement, a America in 1958, he was given a heart-lung machine. journalist asked how he learnt the complexities of surgery, He set the instrument up in the research laboratory and he replied: “I stole with my eyes.”

22 23 CBMH The 1960’s – Floor 14 the decade that made it possible “…The thing the sixties did was to show us the possibilities and the responsibility that we all had. It wasn’t 14 the answer. It just gave us a glimpse of the Medical wards The 1960’s was a strange and contradictory decade, especially for South Africa. While the western world possibility…” GIT Unit embraced freedom and change, South Africa retreated Nuclear Medicine into a laager of isolation and racial oppression. As the Professor Christiaan Barnard before his United States of America was eliminating the last vestiges Doctor’s consulting rooms retirement at Groote Schuur Hospital of segregationist laws, South Africa was refining the legal With the fame and frenzy of the first heart transplant, came much © Heart of Cape Town Museum edifice that would turn many of her people into non-citizens. criticism and scepticism. Professor Barnard had to present at many conferences around the world, where he was questioned, probed Exhibition Overview and often criticised for being the first surgeon to transplant a human But, humanity has a way of evolving, in spite of the limitations heart. USA, 1967. Photographs Courtesy of Karin Berman of the prevailing political system. Marginalised South Africans A glance at the monumental decade of the 1960’s drew strength from the liberation struggles in Africa, America When Ann Washkansky was told her husband would receive Professor Barnard on the transplant and other parts of the world. They became emboldened by another’s heart, she feared he would become a different the actions of international bodies like the United Nations, person. In America the law stated that a beating heart meant who became increasingly vocal against apartheid, and they the patient was still alive, regardless of brain death. In South confronted the ‘divide-and-rule’ tactics of the oppressor by Africa the more scientific definition, brain death, could apply. committing to the principle of non-racialism. So, while American surgeons tiptoed around outdated laws, The sixties was a decade in which limiting social myths Barnard and his team made medical history, capturing an about race, women’s roles, religion, and homosexuality iconic sixties moment for an unlikely part of the world – were turned upside down. As Senator Robert Kennedy South Africa. The apartheid government tried to use the had said to University of Cape Town students in his 1966 moment to claim legitimacy for its evil system. But key Ripples of Hope speech: “We stand here in the name of figures in the operation, including the Barnard brothers, freedom. The heart of that Western freedom and democracy were against apartheid. is the belief that the individual man, the child of God, is the touchstone of value, and all society, groups, the state, exist This was not a triumph for some narrow ideology, but a for his benefit.” triumph for all humanity, a triumph for the values of the sixties.

Medical pioneers new that this essence did not reside in the physical heart, what Barnard called “just a pump”. But, thousands of years of poetry extolling the heart as the seat of the soul could not be wished away overnight.

26 27 CBMH The Transplanter “…His death is a great Floor 15 of and the loss to the country after all Transplanter of Souls the contributions he made. He was also very vocal against apartheid…” – Nelson Mandela on the passing 15 of Doctor Christiaan Barnard

When the architects of apartheid, the National Party, While at the University of Minnesota, Barnard had learnt won the 1948 elections, Barnard considered it, “a great about intensive care, and on his return established the disaster.” But his father Adam provided some consolation, first working ICU at Groote Schuur Hospital. He insisted saying to him, “Son, for some people the mills of God that the ICU be open to all races and did not allow for the Doctor’s consulting rooms grind slowly but surely.” discrimination in the treatment of any of his patients.

In 1950, Nelson Mandela became president of the On 13 June 1964, Mandela and his Rivonia Trial co-accused African National Congress (ANC) Youth League. were taken to , less than 20 km from Groote Exhibition Overview Under its ‘Programme of Action’ (in the 1950’s), the ANC Schuur, where Barnard and his team were pushing the organised mass protests, strikes, and civil disobedience. boundaries of heart surgery. Mandela and his co-accused Two of South Africa’s most famous icons Mandela played a central role in this new black militancy were confined to tiny cells and terribly hard conditions of Life Magazine celebrates the first heart transplant against apartheid. imprisonment which included spending much of their day Photographs of the first successful heart transplant patient breaking rocks under the hot sun; contact with loved ones Louis Washkansky’s ECG the moment his new heart For Barnard, the 1950s was a time of incredible learning was limited to a half-hour visit once a year and the receipt began to beat and growth. At the University of Minnesota, (1956 - 1958), of two letters a year. he witnessed the great Dr Walt Lillehei performing open heart surgery, and in an instant his future opened up before When freedom dawned, and Mandela became South him. He determined to complete his studies as quickly as Africa’s first democratically elected president, Barnard possible so that he could return to Groote Schuur and commented: “And here we are in Mandela’s South Africa pioneer South Africa’s open heart surgery programme. and we’ve seen for ourselves the slow but sure grinding of the mills.” In 1961, the ANC launched its armed wing Umkhonto weSizwe (Spear of the Nation), and in 1962 Mandela Chris Barnard and Nelson Mandela are South Africa’s travelled to Algeria to undergo military training. He was two most recognised icons. While Barnard spent his life captured soon after his return to South Africa and put transplanting the physical hearts of man, Mandela spent on trial. his transplanting the souls of people.

Nelson Mandela revisits his prison cell on Robben Island, where he spent eighteen of his twenty-seven years in prison, 1994. © Gallo Images, Jürgen Schadeberg

30 31 CBMH The hope Floor 16 that medicine 16 brings While studying at the University of Minnesota in the “…There must always mid-1950’s Barnard consulted a specialist about pain and swelling he was experiencing in his limbs. He was be hope, because when diagnosed with rheumatoid arthritis, a potentially crippling there’s hope, there’s disease that threatened to end his dream of becoming that fight for life. …” a surgeon. But the specialist had some words of Doctor’s consulting rooms encouragement for the young doctor, “You seem to have a high resistance to the disease. Perhaps it will stabilise at this point . . . We can only watch it – and stay active. It intrigued Barnard that medical science had a definition Exhibition Overview The more you move, the better it is.” for death, but not for life. His own definition was, “Life is the joy of living; it is the celebration of being alive.” He Professor Barnard remembered by those who knew him It was an important lesson for Barnard, as he later reasoned that, “Medicine must bring back the joy into the Barnard’s personal struggle with arthritis recounted: “I learnt something from that, even if you have to life of the patient. Medicine must give the patient something Barnard’s first autobiography “One Life” give a patient bad news, always put a bright side to it, never to celebrate.” He found immense joy and satisfaction from totally destroy a patient by giving them the news of their giving people hope, from celebrating the potential for another illness, there must always be hope, because when there’s chance at life. “I’ve never ceased to be amazed by the hope, there’s that fight for life. That hope that he gave me, heart’s ability to respond immediately to the call of the body that I would never be crippled, carried me through my for blood – even after being assaulted by disease whole surgical career.” and by the surgeon’s knife. It doesn’t give up easily.”

Barnard examines himself in a hospital bed, where he was being treated for a severe bout of viral hepatitis after travelling abroad. © Heart of Cape Town Museum

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