The Spectacular That Failed

Neither of the two previous patients to undergo heart-lung transplants lived for more than a few days after their operations. Still, South Africa's Dr. Christiaan Barnard had no hesitation about attempting the surgical spectacular last month. His patient, Adrian Herbert, 49, was near death from emphysema, and Barnard felt that the operation offered the only chance for survival (TIME, Aug. 9). Last week, 23 days after the operation, Herbert died at Cape Town's Groote Schuur Hospital.

Though the patient survived longer than the other two heart-lung recipients had, it was a desperate struggle almost from the beginning. Three days after surgery, Herbert began to have difficulty breathing, and doctors opened his windpipe and inserted a tube to better ventilate his lungs. Later a bronchial leak required a second postoperative repair job. For several days afterward, Herbert appeared to be making progress. But on Aug. 13, his condition began to deteriorate despite further efforts to save him.

Barnard's South African colleagues lost no time in criticizing him for even attempting the procedure. One, quoted in the influential Afrikaans newspaper Die Burger, implied that Barnard had engaged in outright experimentation; another argued that the operation had offered Herbert no real hope for a return to normality and should not have been performed at all. Some, however, withheld comment pending the release of more details, including the precise cause of death. The wait may be a long one. Barnard has refused to discuss the case until after the publication of an article in the South African Medical Journal, perhaps in October.

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