EVERY SECOND COUNTS

When the South African surgeon Christiaan Barnard performed the first human heart transplant in 1967, his success dashed the hopes of three American cardiac surgeons.

Adrian Kantrowitz, Richard Lower and Norman Shumway were also on the brink of accomplishing that feat. McRae, a South African writer now living in London, interviewed Barnard’s brother Marius and other surviving members of Barnard’s family, the rival American surgeons and the doctors and nurses who worked with them, to create an often dramatic account of the competition. He recounts the years of research on animals, the development of techniques for transplanting other organs and the beginnings of open-heart surgery—all American advances that made it seem likely that an American would be the first to transplant a human heart. Finding the right donor and the right recipient is not a simple matter, with race complicating it in apartheid South Africa, and the controversy surrounding brain death creating problems in the U.S. As luck would have it, the necessary factors came together first for the upstart Barnard, who is depicted here as a surgical hustler, a womanizer, a morally frail man who sadly succumbed to the seductions of fame and was ruined by them. McRae captures the personalities of the surgeons, their ambitions, their drive, their collegiality (or lack thereof) and their pride and resentments, and he depicts graphic and tense operating room scenes, with doctors winning some battles and losing others. One, Lower, was even put on trial for murder before brain death was formalized in the U.S. as a medical and legal concept.

While the outcome is known from the beginning, the author’s account of the experiments and research that preceded it and his focus on the participants make for a dramatic read.