Christiaan Neethling Barnard

Surgeon (b 1922; q Cape Town 1946), d 2 September 2001.

On 3 December 1967 Christiaan Barnard completed the first human to human heart transplant and earned a place in history. That operation ranks with the assassination of John F Kennedy and the first moon landing as among the best remembered events of my generation. Barnard's death, from a suspected heart attack while on holiday in Cyprus, ended an illustrious and colourful life, and a highly controversial career.

That first heart transplant brought together two burgeoning areas of surgical endeavour. Kidney transplantation had started in the mid 1950s at about the same time as the use of the pump oxygenator for open heart surgery, which by the mid 1960s had become routine. Heart transplantation had been studied in the animal laboratory for 10 years and a few patients had received apes' hearts, to no avail. Kidneys could be taken from clinically dead donors, but to transplant the human heart required the ethical leap of declaring a patient dead while the heart was still working. The concept of “brain dead” had yet to be defined. Barnard's detractors argue that he jumped the gun and took the place in history that others should have had. But once Barnard broke the medicolegal impasse, surgeons all over the world joined the bandwagon and within a year over 100 heart transplants were performed. Few patients survived more than a fortnight. By the end of 1968 enthusiasm waned to be followed by what amounted to a worldwide moratorium for about 10 years.

During this flurry of transplant activity the surgeons, hospitals, and the patients and their families were surrounded by a media circus, which many found deeply distasteful and regrettable. Barnard, however, thrived on it, handling the press and television with panache. An outspoken advocate of …