Chris Barnard 50 years on: The contested legacies of a medical pioneer

Ray Hartle delivers his fascinating Think!Fest talk in front of a slide showing the new Chris Barnard Memorial Hospital

In a very tangible and significant way, journalist Ray Hartle is an inheritor of heart surgeon Chris Barnard’s greatest achievement. Like Louis Washkansky in 1967 , Hartle was recently the recipient of a donor heart which replaced his own failing organ.

Hartle’s talk yesterday, entitled “Contested Legacy: Marking the 50th Anniversary of Prof Chris Barnard’s Pioneering Heart Transplant” saw him tracing the complexities of this very personal and life-saving connection between Barnard and himself. Hartle’s paper also considered our tendency to rewrite and revise history, especially when it comes to larger-than-life figures like Barnard, who was himself a master storyteller.

Hartle’s approach to Barnard’s biography is also in a sense revisionist, as he attempts to both re-locate Barnard in a specific historical context, to probe the myths and controversies surrounding Barnard, and to provide a long view of his disputed but enduring legacy.

For instance, Hartle provided a fascinating account of Barnard’s complicity with the propagandistic Department of Information, who co-opted Barnard’s achievements in service of telling a “good story” about apartheid South Africa.

Hartle considered Barnard’s membership of an Afrikaner elite and his associated racism and paternalistic liberalism alongside his relentless commitment to medical innovation and his unstinting concern for his patients, which set a precedent for standards of patient care.

Hartle’s commitment to telling the truth about South Africa’s past rather than spinning a palatable tale is evident in his re-assessment of the myths surrounding Hamilton Naki, the black surgical assistant who some suggested was the unsung hero of the first human-to-human heart transplant: they say he removed donor Denise Darvall’s heart. But Hartle (like Barnard himself) contests this story, arguing that it is unlikely a black technician would be given this honour over the eminent white surgeons in the room.

I think that Hartle’s brief discussion of Naki’s position in the narrative raises important questions about South Africans’ approach to our history. Does rewriting the story to give Naki a more prominent role than he probably had allow us to celebrate this momentous medical milestone without glorifying the apartheid context in which it was embedded? Is this story an idealized way of recognizing the unwritten achievements of individual black medical staff and researchers, rather than acknowledging the insidious systematic barriers to education and excellence that hindered black South Africans of all professions?

Hartle certainly recognises the enduring legacy of the inequalities of apartheid in the medical sphere, and particularly in cardiology. While the new (private) Chris Barnard Memorial Hospital offers the very latest in medical innovation and excellent patient care, public hospitals in South Africa are perilously under-resourced. Hartle told of a Port Elizabeth cardiologist, Basil Brown, who was until recently the only heart specialist serving all the public hospitals in the Eastern Cape. Although the government has now appointed a further cardiologist to the region (while Brown continues to work tirelessly on contract), Hartle suggested that this was “too little too late”, as South Africa is the “cusp of a heart disease epidemic”.

As he told these important stories past and present, it was evident that Hartle is himself a masterful storyteller. Even knowing the bare facts of the first heart transplant, I was enthralled by his detailed account of this world-changing event, and at the end of the talk he provided a breathtaking stream-of-consciousness narrative of his own transplant. Although Hartle’s tale would make for an incredible book, it’s more than a story for him: he lives through Barnard’s legacy.

By  Andrea Thorpe

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