Welcome to the wild West of American medicine.

I'm Chris pine In.

This is Cardiac Cowboys, the gripping true story behind the birth of open heart surgery and the Maverick surgeons who made it happen.

It's nineteen sixty seven, twelve years since Walt lilla High first used his bubble oxygenator to repair a child's heart defect, and over nine years since Lilahi and Earl Bachin developed the portable pacemaker.

We're more than halfway through a decade defined by social unrest and the righting of wrongs, by the nightmare of nuclear war and the dream of new frontiers.

We choose to go to the moon and dis decay and do the other thing not because they are easy, but because they are hard, because that.

Though well, served to organize and measure the beft of.

Our energies and skills, because that challenge is one that we're willing to accept.

In Palo Alto, California, a young doctor sits for an interview with the Journal of the American Medical Association.

His casual dress and self deprecating manner feel more suited to a liberal arts professor than one of the world's leading cardiac surgeons.

This is doctor Norman Shumway, and he's about to make an announcement that will send shock waves around the world.

After training under Walt L.

La High at the University of Minnesota, Shumway has spent the last several years working toward a moonshot within the field of cardiac medicine.

It's an operation long considered impossible, transplanting the human heart.

He and his team at Stanford University have been experimenting with anti rejection drugs and performing test operations on lab animals.

Today, Shumway announces that he's ready for the real thing.

All he needs now is the right patient and a matching donor.

When this interview is published on November twentieth, it will light a fire under all the other surgeons working around the world to beat Sumway to the punch.

The heart transplant race is on.

Really, the heart crisis was about adult heart disease.

That's cardiologist doctor J.

Phillip Sohl.

Much of our story until this point is focused on congenital heart defects and kids, but the cardiac crisis was far from limited to children.

By the nineteen fifties, heart disease was killing over half a million Americans every year.

I say Americans because the problem seemed to be uniquely targeting this country, the richest in the world, where people were living increasingly sedentary lives, commuting by car or train, working long hours at a desk, smoking cigarettes, and eating high fat diets.

Hamburger steak, and lamb chops.

You can almost track and parallel the rise in both heart disease and lung cancer.

Starting about twenty years after the invention of the cigarette machine, cigarettes began to be produced in much greater quantity that almost single handedly explains a huge amount of the heart disease.

Red meat, cars, and cigarettes, the American dream was killing us.

For patients whose hearts were damaged beyond repair, a transplant was the only hope for survival.

Thanks to the experiments conducted by Shumway and his partner Richard Lauer.

By the nineteen sixties, human heart transplantation was beginning to feel less like science fiction and more like an attainable reality.

But Shumway and Lower weren't the only contenders in the transplant race.

In Brooklyn, there was doctor Adrian Cantrwitz, a brilliant and burley surgeon inventor who ran the cardiovascular surgery department at Mimonodes Hospital.

Part surgeons who were capable of doing this kind of surgery seemed the invincible, and that kind of aura was important to win the confidence of the patient.

In Jackson, Mississippi, there was doctor James D.

Hardy as chairman of the University of Mississippi's surgical department.

Hardy courted controversy when he attempted the first human heart transplant back in nineteen sixty four.

The operation did not succeed, but most of the criticism focused on the fact that the donor heart was taken not from another human, but from a chimpanzee.

Once that heart has been removed, then one is looking at a hole in the chest, and then something's got to be put there.

One is going to have to talk to the family.

None of these surgeons hailed from historically elite universities or hospitals, as had been the case for the last decade and a half.

The real innovation in cardiac surgery was happening on the margins.

Of the field.

For much of the world, the heart remained mythically tied to the soul, and the promise of a heart transplant tapped into our wildest dreams and deepest fears.

Whichever surgeon crossed the finish line first, be it Shumway, lour Cantowitz, or Hardy, he could expect to receive both sweeping adoration and rebuke.

Less than two weeks after Shumway's announcement, a shocking news story broke in Cape Town, South Africa.

We had a recipient reading, we had the donor identified in Philadelphia's math Act, and that morning my daughter came in and said, some joker down in Africa has done a hards transplant.

On December third, nineteen sixty seven, Christian Barnard removed the heart from a twenty five year old girl and transplanted into the chest of a fifty five year old man.

In case you missed the news that.

Day, performed by a surgeon virtually unknown except to a handful of other surgeons.

Newspapers everywhere Carrie Banner headlines, and from medical men as far away as the Soviet Union, there is a claim for the dramatic breakthrough.

Will you welcome doctor Christian Barnard?

The heart transplant race had just been won by a man who wasn't even considered a contender in a country no one regarded for its medical prowess.

How could this happen?

And who the hell was Christian Barnard?

The world was about to find out Formoso's Studios.

This is Cardiac Cowboys, a podcast about life, death and innovation.

In the American Hartland episode four, The Transplant Race, Here's writer and executive producer Jamie Napoli.

For all the criticism that would be hurled at Christian Barnard throughout his career, and there would be plenty, one thing is certain.

He fought tooth and nail for every success that came his way.

Unlike his American counterparts, Barnard was born into poverty.

His family lived in a small town within South Africa's Great carew, a harsh semi desert region stretching hundreds of miles between Cape Town and Johannesburg.

It's a hell of a place, but I can tell you terrible bliness.

A very country, small little Karuta on the back of ECUs, Nevada or Arizona.

Adam Barnard is the son of Christian's youngest brother, Marius.

A lot of people in life who get to invent certain things, you tend to find quite a lot of them have come from those humble beginnings, and the Barnard brothers were very fortunate to have very humble, peaceful, god loving pirates.

Christian Barnard's father was a minister who preached both at the local jail and at the Dutch Reformed church designated for the town's black and mixed race population.

As a result, the Barnards, who were white were shunned by their white neighbors, and the Barnard children would grow into fierce critics of apartheid.

Chris didn't grow up in a household that entertained apartheids.

That's Cindy Laddigan, manager of the Heart of Cape Town Museum.

When she brought intensive Gate to South Africa, where the rest of the hospital would lay divided.

Even the er itself had a different entrance for white.

He had all his patients laying together, and he had this attitude of if you didn't like it, you could go die at home.

Christian Barnard had three living brothers, Johann, Dodsley, and Marius.

A fourth brother named Abraham, had died at the age of three from a congenital heart defect.

Abraham's death loomed over the Barnard children in the form of their mother's grief.

She became a very hard woman after the loss of Abraham.

They were all terrified of the mother.

She always pushed him to be first, always, and if they didn't come first, they'd be whipped.

Christian Barnard spent his life racing to be first, regardless of the obstacles that lay ahead of him.

As a child, he competed in his town's annual foot race without shoes.

He won his school's tennis championship playing with borrowed racket, and he patched together scholarships to put himself through medical school, leaving no money to buy clothes or to socialize with his classmates.

As a young doctor at Ruth Desciur Hospital in Cape Town, he quickly set himself apart with his pioneering research in the field of gastro intestinal surgery.

He did seminal work on an operation to deal with intestinal a treasure, which is a potentially lethal defect.

That's medical historian and plastic surgeon doctor Gerald Imber.

In nineteen fifty five, Barnard's research caught the interest of an American surgical chief nine thousand miles away.

Barnard earned his way to study with the great Owen Wangenstein in Minnesota.

He said goodbye to his wife, Loki and their two young children with a vague promise that they join him in America at some point in the future.

Whoa the tall, lanky country boy with a mop of unruly brown hair.

Barnard looked younger than his thirty three years as he left behind beautiful Cape Town.

He was filled with visions of a future that until this moment had been unimaginable to him or anyone in his family line of destitute ministers and woodcutters.

When Barnard arrived in Minneapolis on a late December night, thousands of miles from the nearest friends or family, the temperature hovered just below zero.

In addition to freezing his butt off, what he found out was the longest seem didn't want to teach him clinical surgery.

He wanted him working out projects in the lab because he had great lab credentials.

Einstein was extremely impressed with the amount of drive that the sky had.

Chris actually did his PhD in two years, where it would normally take six years to accomplish.

Barnard joked that he only slept on Sundays when he was kicked out of the lab, and that may not have been far from the truth.

To fund his family's eventual move to Minneapolis, he supplemented his hospital income with odd jobs around town, shoveling snow in the winter, washing cars, and taking night nurse shifts for wealthy patients.

At the University of Minnesota, Barnard developed a reputation not just for his obsessive work ethic, but for the brash, confident charm that masked insecurities about his finances and his foreignness.

It made him popular with senior surgeons and administrators like Owen Wangstein, less so with his peers.

Here's Christian Barnard's nephew, Adam Barnard.

Again, he was very charismatic.

He had a good looking, toothy smile.

He could make you feel a million dollars and two seconds, but he could also make you feel the biggest fool and two seconds.

Chris Barnard was beloved by everybody who didn't know him, and not by anyone who did.

But Barnard hadn't left behind his family and flown halfway around the world to make friends.

He was there to make a name for himself.

Early in his residency, Barnard's ambition came into sharp focus when he was introduced to the heart surgeons down the hall.

He began observing open heart operations from the upper level of the glass domed o ar.

Down below, Walt Lillahigh was repairing cases of tetrology of below, the condition that had taken the life of Barnard's three year old brother Abraham.

As he watched Lillihigh and his ingenious bubble oxygenator save a dying child, Barnard sensed that this was the work he was meant to be doing.

It wasn't long before he asked Wangenstein to be transferred to cardiac surgery.

By now, Lillihi was already a legend within the department, inventing new life saving procedures on a monthly basis.

Barnard worked tirelessly to impress him, studying the bubble oxygenator and assisting in operations until he was promoted to Lillihig's chief resident.

It was then that he made the first catastrophic mistake of his young career.

In his autobiography One Life, Barnard details exactly what went wrong.

As he was prepping a seven year old patient for open heart surgery.

As the boy's anxious father watched from above, Barnard and his assistant accidentally sliced into the exposed heart.

Blood erupted from the boy's heart and filled his open chest cavity.

Barnard panicked.

He struggled to staunch the bleeding, but he couldn't locate the hole in the rising pool of blood.

By the time Lilahi arrived to help, the boy was dead above them on the operating theatre's upper level.

The boy's father had seen it all.

Barnard wandered aimlessly through the hospital before finally dragging himself to Lilahi's office.

He didn't know whether the senior surgeon would show him out or fire him.

Look, Chris, Lilahai.

Said, calmly, we've all made these mistakes that cost the lives of patients.

The only thing you can do is to learn.

By your mistake.

Lila High task Barnard with prepping another young patient for surgery the following day.

Rather than hovering behind him, la High remained absent from the r until the last possible moment, show that Barnard had retained his full confidence.

This early surgery was going to be fraught with trouble, and Dad knew that.

That's Walt lilla High's son, doctor Craig Lilihigh, what.

He realizes, good judgment comes from experience, and experience comes from bad judgment.

It was clearly something they embraced in those early days, that it was Okay, this didn't work, We've got to figure out how we can try to solve it next.

Lillahigh valued ingenuity and work ethic far above technical prowess, which favored Barnard, whose surgical ability didn't always measure up to that of his colleagues.

One such colleague was a young surgical resident who would one day lead the heart transplant race, Norm Shumway.

Compared to the charming and outwardly ambitious South African, Humway was self deprecating and low key.

Dad always felt that in academic medicine people took themselves too seriously.

That's Norm Shumway's daughter, doctor Sarah Shumway.

She's a surgeon at the U of M who specializes in heart and lung transplants.

He told me when I started in my own operating room to keep things light so people didn't get too overwhelmed by the fact they were cutting out people's hearts.

Within a decade, Christian Barnard and Norm Shumway would become the two biggest names in heart transplantation, and their work would define the future of cardiac surgery.

For now, they were lowly U of M residents whose personalities didn't always mesh.

I think they were cordial, but they weren't really friends.

Chumway thought he was a self serving bit of a jerk and wanted nothing to do with them.

While Schumwey struggled to stand out among many ambitious surgical residents, Barnard had grown into the department's golden boy.

As his residency came to an end, Wangenstein begged Barnard to stay in Minnesota, offering him a position with the u of M faculty.

Though Barnard turned down the offer, Wangenstein sent him back to Cape Town with a life changing gift.

Here's an archival recording of doctor Norm Schomwey.

When he went back to South Africa.

Wangenstein, such a generous man, gave Bernard ten thousand dollars for cardiopulmmeter bypass equipment, so he had substantial backing.

Rutskiur is a large, picturesque hospital nestled into the base of the precipitous Devil's Peak, which overlooks Cape Town.

In nineteen fifty eight, Barnard rejoined the faculty as a returning hero.

He'd studied with the greatest heart surgeons in the world, and thanks to Wartenstein, he brought back with him the famous duwal Lillehigh bubble oxygenator.

Now he was setting out to bring South Africa into the era of open heart surgery.

Like his mentor Walt Lillehigh, Barnard had his own ticking clock.

In the frigid Minnesota climate, he'd begun experiencing crippling flashes of pain, first in the joints of his feet, later in his hands.

He was diagnosed with rheumatoid arthritis, an excruciating autoimmune disease.

Barnard tried all kinds of traditional and non traditional medicines, everything from guava to break fluid, but rheumatoid arthritis has no cure.

For the rest of his career, he'd live in fear that the pain and deformity in his hands would grow so advanced that he'd no longer be able to operate.

If he was going to leave his mark on the field of cardiac surgery, Christian Barnard would have to do it quickly.

Barnard's mission crystallized after he learned of a breakthrough experiment performed at Stanford University by an old colleague, doctor Norm Shumway.

After finishing his residency in Minnesota, Shumway had spent years struggling to find his footing, first in Santa Barbara, then in San Francisco, as he labored to support his young family.

No job was too small, from working night shifts operating an artificial kidney machine to performing simple open heart operations at a hospital across town.

Anytime Shumway was referred to patient for surgery, he and his partner, Richard Lower would pack their heart, lung machine, and other equipment into a moving van and brave San Francisco traffic to get from their Stanford Lane laboratory to the o RS at the Children's Hospital.

When Stanford's Medical school relocated to Palo Alto in nineteen fifty nine, Shumway was asked to take over the Department of Cardiac Surgery.

Thrust into a leadership role for the first time, Humway excelled.

His management approach was as low key as his personality.

He liked to describe himself as the world's greatest first assistant.

Here's an archival recording of one of Shumway's chief residents, doctor Jack Copeland.

He used to say that when you go to Houston, you think that Denton Cooley's the only one that can operate, because he's the only one that was operating.

When you go to Stanford, you think that anybody can operate because we were in there doing all the cases and he was helping us.

In December, Chumway's team performed the first heart transplant in a lab dog, proving to surgeons the world over that human heart transplantation was within reach.

The obstacle to getting there was the lack of a viable donor.

The ideal heart for transplantation is still beating up until the instant it's removed from the donor.

The problem was that, up until this moment in history, a beating heart meant that the donor was still alive.

Before a human heart transplant could occur, Shumway and his colleagues would need to convince the world that death could be defined as the loss of brain function, not just the stopping of the heart.

I used to call it the boy scout definition of death.

That's doctor Norm Shumway again.

Even our neurosurgeons were very slow to come to grips with brain death.

That philosophy or misjudgment, or lack of education, tradition, whatever you want to call it, was very slow.

This was a difficult problem.

Doctors and administrators alike feared that removing the heart of a brain dead patient might result in a murder charge against the surgeon, and not without reason, Norm Shumway would be threatened with such charges in the years to come.

The other problem looming over the dream of a human heart transplant was organ rejection.

Some animals would live two or three weeks, others would die in a few days because of rejection.

The heart transplant is such a bigger procedure and the preparation is so dogone, fragile, and delicate that when we use the same menu of immunosuppression that others were using in kidney transplants, our animals would all die of toxicity.

Norm Shumway and Richard Lauer spent years working out the rejection problem, devising a precise cocktail of steroids and immunosuppressants to give transplant recipients the greatest probability of accepting their new hearts.

Facing the same problem, Christian Barnard took a different approach.

In the summer of nineteen sixty seven, he made a trip to Richmond, Virginia, where Richard Lower was working.

At the time, the Medical College of Virginia was renowned for its kidney transplantation program, and that's the reason Barnard gave for his visit.

He was preparing to transplant a kidney, he said, But while he was there, Lower happily showed him the immunosuppression techniques he and Shumway had developed for a heart transplant.

So he'd go down to the lab and see Laurer doing these heart transplants with the same facility and success he'd had at Stanford.

Barnard had one of his technicians with him on this trip, and the technician told Lawyer, he said, you know, Bernard's going to go home and do that apparition, and Loward just shrugged it off as ridiculous.

And yet Barne had set out to do exactly that.

Here's Cindy Ladigan again.

He had watched Richard Lower practice and experiment on dogs on that side, so he had to come back and teach the site everything that he'd seen, everything that he'd learned.

Barnard had spent the last several years assembling an elite cardiac surgery team in Cape Town.

His most trusted confidante was a young vascular surgeon named Marius Barnard, Christian's younger brother.

I thought they never wanted to do hot surgery, and he never wanted to work with Chris.

That's Marius's son, Adam Barnard.

Again in her brothers the competitive and that can be very brutally honest with each other.

Prior to joining his brother's team, Marius had spent a year in Houston training under Baylor's demanding surgical chief, Michael DeBakey.

When he worked on to the Beaky, he didn't really learn a lot because the Beky just wanted to control all ofs and didn't want anyone else to operate.

He liked Denton Cooley, he learned a lot from him, but obviously surgeons, they all got a huge eager and they all think they're the best.

Denton Cooley used to say, just call me GLD which stands called Good Old Denton.

Christian and Marius Barnard employed many of the techniques they'd picked up in the US from Walt Lillaheigh, Michael DeBakey, Denton Cooley, Richard Lower, and Norm Shumway.

Together, the brothers performed dozens of heart transplants on lab dogs as they prepared for their first human patient.

In the fall of nineteen sixty seven, Christian Barnard found himself in the same position as Norm Shumway, ready to transplant, but waiting on the right patient and donor.

That's when a cardiology introduced him to a Cape Town grosser named Louis Wishkansky.

Here's heart of Cape Town Museum manager Cindy Ladigan.

Again, Louis had heart failure.

He had had two heart attacks prior to this, and he was actually admitted to krutsky At Hospital purely because he was in such a bad state.

In his youth, Louis had been a powerful amateur boxer.

Now in his fifties, his heart failing, he was using all his strength to fight for survival.

Louis had already outlived his prognosis by two years when Barnard met him in addition to heart disease, he suffered from diabetes, liver failure, kidney failure, and a host of other serious ailments.

Without an immediate heart transplant, Louis didn't have long to live.

Thankfully, While Sumway and the.

Other American surgeons were still struggling to garner widespread acceptance for the concept of brain death, Barnard's job was easier.

What was the upper hand for Chris to actually be the first here was the declaration of death.

In South Africa, medical law stated that she needed two doctors to do a death declaration.

America was way stricter.

Barnard didn't need to change anyone's mind about the definition of death.

All he needed was a brain dead patient with a matching blood type.

He wouldn't need to wait long.

On December second, the darval family stopped outside of bakery in the Salt River suburb of Cape Town.

Twenty five year old Denise and her mother ran inside to get a cake.

Denise's brother, Keith and their father, Edward, waited in the car.

As the Darvall women made their way back to the car, a drunk driver careened down the street toward them.

Denise was flung forty feet in the air.

She hit her head on the back of a vehicle and she fractured her skull in two areas.

Her mom passed away at the scene.

Louie Wishkanski's wife, Anne, was leaving the hospital when she drove by the scene of the accident.

As police waved her on, she could make out two women lying.

In the road.

Christian Barnard was at home when he got the call.

There was a young woman.

At the hospital who'd suffered severe brain damage.

It was possible her heart might serve as a viable replacement for Louis Wishkansky's.

One can only imagine what her father, Edward, must have felt like knowing that his wife had passed away.

Sitting at the hospital ten o'clock at night, He's hoping for some kind of good news about his daughter, and these doctors come out and say to him that there isn't any that he needs to accept the fact that his daughter's gone, but while she's on life support, she could help this patient in the hospital, Louis Washganski.

Edward Darval would later recount that in that moment, he remembered how Denise had spent the first paycheck she ever made on a gift for him.

She was always giving away things to other people.

He'd say giving would be her legacy.

They say he took four minutes to think about it, and his first words were, if you cannot save the life of my daughter, then you need to save the life of that man.

We do consider Edward Duvall a hero because he at a heart of no other.

Christian Barnard arrived at the hospital ready to save Louis Wishkanski.

Denise was examined by the senior neurosurgeon at Route descure and declared brain debt.

She was relocated to one of two adjacent oars B theater.

Louis Wishkansky was moved to a theater.

The Americans and the French, and in most European countries at the time, they had much better cardiac facilities than Manhatto, South Africa, so that it came down to the theater, nurses, the nethetists.

You name it.

Every single little aspect of that had to be right.

It was no room for error.

That's the type of person christ was in the workplace.

It was all or nothing.

Initially, the plan was for Marius Barnard to remove Denise's heart and for Christian to transplant it, but Marius suggested a last minute change.

Unless you cut it out yourself, he told his older brother, it's not going to be familiar.

It's better you get acquainted with it from the beginning.

Christian Barnard dashed madly between the two ops rating theaters as donor and recipient were.

Prepped for surgery.

In a theater, Woshkanski's chest was sliced open, his sternam was sawed down the middle, and his ribs were cranked apart with a retractor.

The beating organ that lay inside was enlarged and scarred beyond recognition.

Barnard described it as the waste and ruin of a ravaged heart.

In b theater, Marius Barnard turned off Denise's respirator.

Despite the comparatively laxed medical definition of death in South Africa, this team wasn't taking any chances.

They waited as Denise's heart began to fail.

The moment it stopped beating, Christian Barnard called out start cutting, and then he scrubbed up for surgery.

With her chest spread open, Christian Barnard finally got his first look at Denise's heart.

It was tiny, but it would have to do painstakingly.

Barnard severed the eight blood vessels leading into and out of Denise's heart.

When the heart was finally liberated from her body, Barnard placed it in a metal basin, and then he carried it slowly and carefully.

To a theater.

Denise's heart looked absurdly small inside Louis's massive chest.

Barnard had to trim her blood vessels at an angle to match their wide counterparts in Louis's body.

His hands ached, but he ignored the pain.

This was the moment his entire life had been racing to her, the moment that would determine whether Louis Wishkanski lived or died, and whether Christian Barnard went down in history or became a mere footnote in someone else's story.

Blood vessel by blood vessel, he began to suture Louis's new heart into place.

When I left the hospital that morning, it was summer and the sun of just ride.

There was not one photographer, not one television camera, not one reporter outside at hospital.

That's an archival recording of doctor Christian Barnard.

I said to my brother who was with me.

I said, you know, we'd better tell someone in hospital that we've done it out Trance Donna.

The brother's moment of quietude wouldn't last for long.

Hotch truans done at Gucca Hospital in Canton.

Medical history has been made in South Africa ors first.

Heart transplant patients.

Loy Wasashkinski continues to improve.

I had phone balls from all over the world, and that evening there was a television crewer, and then after that it just became impossible to work.

I don't think they recognized as the need that I had to look after my paces and that I couldn't spend all the time answering questions and appearing in front of cameras.

When news of the transplant reached doctors in the United States, there was an immediate shock, followed by frustration.

Here's doctor Adrian Cantrowitz.

Again.

I must say I was disappointed because we were all set to go.

It was just a matter of luck who got the donor in the recipient together.

First, Denton Cooley, though we hadn't yet attempted any test transplants of his own, sent Barnard a playful telegram that read congratulations on your first heart transplant, Chris, I will soon be doing my one hundredth.

There was a sentiment shared by many American surgeons that Christian Barnard did not deserve to be first, that he'd benefited from the hard work of others.

Barnard fought back against these accusations vehemently.

It really amazed me very much.

I was present meetings where senior surgeons got up and stated that I stole the technique from Sway and that I should never have been the first one to do the transplant.

Well, you know, I mean, there's no such thing as a single genius.

We get ideas from everybody, of.

All the Americans.

Rum Shumway had perhaps the most valid reason for begrudging Barnard, but by all accounts, he didn't.

Dad seemed to be quite excited that a transplant had been performed.

I'm sure he was disappointed not to have been the first one, but I think that wasn't the price he was after.

What Barnard did really was to establish that brain death was an acceptable definition of death.

Barnard's operation had set a precedent, and while the concept of brain death would remain divisive for years, to come, American surgeons felt emboldened to attempt transplant operations of their own.

In the second week after Barnard's historic first, Louis Wishkanski's health took a turn for the worse.

He picked up a bacterial infection in the hospital, and the abundance of immunosuppressants in his body the anti rejection drugs Barnard had given him made it impossible for him to fight it off.

On December twenty first, Louis became the first man in history to die after someone else's heart stopped beating in his chest.

I was completely destroyed that morning.

I went down to my office and I lay on the couchs there, and one of my laborty assistants came in and he saw I was crying because he was a very likable man.

Mister Woshkinsky was a very nice man.

It was great sorrow that we let him down.

Louis Wishkansky's death did little to slow the transplant fever that was spreading rapidly around the world.

Barnard already had his second heart transplant operation on the books.

His face had appeared on the covers of Time and Life magazine, and his days in the spotlight were just beginning.

He literally became moullightly one of the most famous people on the planet for two three years.

That's Adam Barnard again.

Aim, It's Johnson, the prison of the United States.

He met the Queen, he met the Pope.

Not many people do that in the space of a year.

It's very easy for it to go to your hit.

The Guinness Book of World Records stated that Barnard received more fan mail than anyone in the history of the world.

He was even the subject of a hit Dutch pop song by Bonnie Sinclair.

Delon Miss.

The swell of celebrity enveloping him was all consuming, and yet there was still plenty to go around.

Fame and fortune awaited any surgeon with the audacity to pull off a heart transplant.

There was enormous media response even for the second and third and fourth heart transplants, and there were television programs in the night talking about heart transplants, and pretty soon it got to be that if she didn't do a heart transplant, he wanted a real heart surgeon, and so therefore everybody who wanted to be a real heart surgeon started to do it including ain't some very real heart surgeons like Mike de Baky and like Denton Cooley.

You feel like, is here something like an astronaut?

You know.

That's an archival recording of doctor Cooley, who leapt headlong into the heart transplant arena.

By September of nineteen sixty eight, he performed ten transplant operations.

The astronaut gets all the credit, and he gets the trip to the moon, but he had nothing to do with the creation of the rocket or all of the navigational problems.

In the early events.

We were, I think glorified behind the reason.

Who did the first kidney torn?

Scot Dealer not, but everyone knows he did the first heart Charles glot over Than is the seat of religion, the seat of love, the seat of compassion, is your heart.

That's why it was such a big deal at the time.

For patients living with the death sentence of failing hearts.

The birth of heart transplantation offered new hope.

I feel so much better than I have for twenty five years.

That's a recording of Cooley's first heart transplant recipient, Everett Thomas.

I was getting worse and worse than week and week now I'm getting stronger and stronger at Baby Bovan, I feel exactly the same way I did when I was a young boy.

At nineteen twenty years older.

Even as successful heart transplants were being performed by surgeons all around the world, the public remained fascinated by the man who did it first.

Who is this man who has twice played God, who is greeted like a Hollywood.

Idol, who was adorned by his subordinates, who moves with boyish charm among.

The many races of his native land.

The world wants to know who is doctor Christian Niedling Barnard.

Fame is quite a lethal drug, I thought I used to said that, But the worst drug in the world is somebody claptensity, because it's because you know that did unfortunately get to my uncle if everyone wanted a piece of him.

He made the lives of Francis, Diana, Grace, Kelly, Sophia Lorraine.

He loved the ladies.

That is undeniable.

His wife actually said, you know that he should never have gotten married or had children because he didn't belong to a wife or a hoe.

He belonged to the world.

Newspapers breathlessly covered Barnard's romantic alliances with Gina Lolo Brigida Sophia Loren, a former Miss Italy and Miss South Africa.

Within a year and a half of the first transplant, Barnard's wife, Loki, had filed for divorce.

Marius Barnard took over much of the department's workload as his older brother balanced a surgical schedule with life as a full time celebrity.

I just stay Ordny doctor.

All of a sudden, it was big news.

You know that I had it an affair with a scout.

So people often criticize me pall for what I did, but then must remember that I would never prepear for the situation I was putting.

Overnight.

Months into the rise of transplant fever, the fever broke.

Patients began dying at an alarming rate.

Just as quickly as the public had embraced heart transplantation as the future, they turned on it as well as the doctors leading the charge.

At first, it was no more than a murmur.

Today it can be heard around the world.

Heart swapping is directioning.

Here's Denton Cooley again.

I think we did twelve consecutive ones, and we had about nine living the recipients.

Then the attrition began.

Within eighteen months, all over fading to die.

Chris said letters of congratulations and a lot of letters of hate.

People that were asking for his earlier race because he should be had up for murder, people that said he was unmorl and a bunch of goolds.

A nineteen seventy one issue of Life magazine ran with the cover story a new report on an era of medical failure, the tragic record of heart transplants.

Doctors and politicians alike called for an end to the procedure.

The careers of transplant surgeons and the lives of their dying patients were suddenly under threat.

The future of the field would depend on what these surgeons did next.

On our next episode, an ingenious medical device promises to eliminate the need for heart donor's entirely, and the competition between Houston's virgins Michael Debakean Denton Cooley explodes into an all out few playing out in courtrooms and headlines across the country.

Next time on Cardiac Cowboys.

Cardiac Cowboys is a production of iHeart Podcasts, OsO Studios and Thirteenth Lake Media.

We're presented by Chris Pine and written and narrated by me Jamie Appley.

Our executive producers are Christina Everett for iHeart Podcasts, Dub Cornette and Jason Ross for OsO Studios.

Doctor Gerald Imber, author of Cardiac Cowboys, The Heroic Invention of Heart Surgery, Doctor Eric A.

Rose, John Mankowitz, Joshua Paul Johnson, and myself.

James A.

Smith is our supervising produce editing and sound design by Joshua Paul Johnson.

Our composer is David Mansfield.

Our cover artwork is designed by Alexander Smith.

For more information on the first cardiac surgeons, check out doctor Gerald Imber's book, Cardiac Cowboys, The Heroic Invention of Heart Surgery,