And the Beat Goes On

By Anastasia Toufexis

And the Beat Goes On Clark has a setback, but the artificial heart keeps pumping

Barney Clark's heart was the least of his worries last week, and that was a welcome change. The air-powered artificial heart permanently implanted in place of his own failing organ continued to work perfectly, just as it had from the time of the landmark operation in Salt Lake City on Dec. 1. The plastic pump clicked steadily at an unvarying 90 beats a minute as Clark made remarkable initial progress. And it pulsed without pause as Clark suffered, and survived, the first major setback in his recovery. The heart's unflagging performance led Dr. Chase Peterson, a vice president of the University of Utah Medical Center to assert: "Barney Clark is not an artificial-heart patient now. He's simply a seriously ill post-operative patient who has had complications and could have more."

The major complication occurred before dawn Tuesday as Clark lay in bed in the security-guarded third-floor intensive care unit. He was chatting with Dr. William DeVries, the surgeon who had implanted the mechanical organ. Asked Clark: "How am I doing?" Replied DeVries: "Just fine." The words were hardly spoken when Clark suddenly bejan to shudder uncontrollably. DeVries immediately placed Clark on a respirator and then injected him with the tranquilizer Valium and Dilantin, an anticonvulsant medication most commonly used to control epilepsy. During the next 2 1/2 hours, the unconscious Clark suffered intermittent seizures, but the quivering was confined to his left leg and arm. Worried, lis doctors downgraded his condition from "serious" to "critical."

The physicians' greatest fear was that Clark had suffered a stroke. To check, they ordered sophisticated X-ray images of the brain and heart, using a CAT (computerized axial tomography) scanner. In Clark's case, this proved to be a major undertaking. The scanner is on the first floor, and Clark is tethered by two 6-ft. tubes to 375 Ibs. of equipment that powers his heart and is in turn plugged into outlets for electricity and compressed air. Clark had to be switched to an auxiliary battery and air-supply system that allows temporary mobility. Then he and his cumbersome life support (which may for future patients be replaced by a smaller portable power unit) were delicately maneuvered through the halls and in and out of elevators for the 100-yd. trip. The CAT scans, doctors noted with relief, showed no sign of a stroke.

By Wednesday Clark's condition had stabilized. He slowly regained consciousness and was able to move his arms and legs. The next day he was pointing to his mouth, indicating that he wanted his teeth brushed. Physical therapists exercised Clark's arms and legs to prevent the muscles from atrophying. He was fed a gruel-like mixture through a tube inserted in his nostril and snaked down his throat and into his stomach. At week's end Clark was still slowly improving, although his doctors remained concerned about the possibility of brain damage.

Doctors attributed the seizures to a chemical and fluid imbalance, which was related to the minor kidney failure that Clark experienced just after the artificial-heart implant. Surprisingly, the artificial heart, far from proving a liability, considerably aided doctors in correcting the kidney problem. By adjusting dials on the support equipment, the physicians were able to increase the flow of blood through the kidneys, flushing out waste products and fluid. Similar adjustments also helped clear the lungs of excess fluid. Says Peterson: "The heart has helped us diagnostically and therapeutically."

Until the seizures, Clark, a 61-year-old retired dentist from Des Moines, Wash., had been making an impressive recovery. He joked with nurses, listened to tapes of music brought by his family (a favorite: Handel's Messiah sung by the Mormon Tabernacle Choir), and had even begun doing light exercises, sitting on the edge of his bed and swinging his legs for five-minute stretches.

This was a dramatic change indeed for the man who had been so close to death that his heart implant was performed ten hours ahead of schedule. Dr. Jeffrey Anderson, the Utah cardiologist who had arranged the fateful first meeting of his patient and DeVries, recalls that when Clark's heart was carefully cut out of his body and set in a stainless steel tray it was still quivering. Says Anderson: "It was an irreversible step. From then on everyone was going on faith that the machine would work."

When a drained DeVries finally stepped away from the operating table, he exclaimed, "Damn, I need a Coke." Beverage in hand, he sat quietly in an adjoining room, munching a cheese sandwich and chocolate-chip cookies that he had brought from home. An equally exhausted Dr. Robert Jarvik, who designed the artificial heart, which is called the Jarvik-7, wandered down to the cafeteria for a soft drink and chatted with reporters. DeVries' and Jarvik's mentor, Dr. Willem Kolff, who invented the artificial kidney and heads Utah's artificial-organs program, celebrated the operation's completion at home with champagne.

The bionic breakthrough has sparked a wave of well-wishing telegrams to Clark and his family, including one from President and Mrs. Reagan, and calls from all over the world--one from a Soviet reporter requesting information. One unhappy occurrence: perhaps alerted of the Clarks' absence by news reports, vandals ransacked their home.

Others are trying to capitalize on the historic surgery. Clark's wife Una Loy has been besieged with requests for exclusive rights to her husband's story. And Hollywood is about to release Threshold, a film about a surgeon who implants the world's first artificial heart. The designer of the mechanical organ in the movie? Jarvik, of course.

--ByAnastasia Toufexis. Reported by Cheryl Crooks/Salt Lake City

With reporting by Cheryl Crooks/Salt Lake City

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