您现在的位置: 纽约时报中英文网 >> 纽约时报中英文版 >> 健康 >> 正文

世界首例心脏移植手术的故事

更新时间:2019/5/12 8:19:29 来源:纽约时报中文网 作者:佚名

Cape Town's inspiring medical marvel
世界首例心脏移植手术的故事

Dawn was breaking on 3 December 1967, an otherwise unremarkable day in apartheid South Africa. But in operating theatre 2A, deep in the bowels of Cape Town’s Groote Schuur Hospital, history was being made.

1967年12月3日,是当时仍在种族隔离下的南非的一个普通日子。但在开普敦格罗特舒尔医院(Groote Schuur Hospital)深处的2A手术室里,医务人员正在创造医学史上的奇迹。

Around 06:00, with Professor Christiaan Neethling Barnard watching anxiously from behind his surgical mask, the heart of Denise Darvall lurched unsteadily back to life, slowly finding its rhythm. But one thing had changed. Now, it was beating inside the chest of Louis Washkansky. The world’s first human heart transplant was a success.

6点左右,戴着外科手术口罩的巴纳德(Christiaan Neethling Barnard)教授焦虑地看着达沃尔(Denise Darvall)的心脏不稳定地恢复了生命,慢慢地找到了节奏。但发生改变的是,这颗心脏现在在沃斯坎斯基(Louis Washkansky)的胸腔内跳动。世界首例人体心脏移植手术成功了。

It was a pivotal moment in medical history, an event that made headlines around the world and transformed Barnard into an overnight celebrity. And the journey up to, and beyond, the moment of the world’s first human heart transplant is expertly told in the very corridors where the operation took place.

这是医学史上的一个重要时刻,这件事成为世界各地新闻的头条,巴纳德也一夜间成名。之后,专家们在手术的走廊里,生动讲述了第一例人类心脏移植手术当时以及后来发生的事情。

“This is not just a museum, this is a heritage site,” said Hennie Joubert, founder and curator of The Heart of Cape Town Museum. “This is where it all happened.”

开普敦心脏博物馆(The Heart of Cape Town Museum)的创始人兼馆长的朱伯特(Hennie Joubert)说:“这不仅仅是一个博物馆,还是一个历史遗迹。这里也是事件发生的地方。”

The Heart of Cape Town Museum is housed within the walls of Groote Schuur Hospital, one of the largest public hospitals in Cape Town, South Africa. Visiting the museum today, you’ll wander past orderlies in scrubs and family members visiting with care parcels. For as much as this is a heritage site, it remains a frenetic working hospital and the primary teaching hospital for the University of Cape Town’s medical faculty.

开普敦心脏博物馆建在南非开普敦最大的公立医院,格罗特舒尔医院的围墙内。今天参观博物馆时,你会看到穿着工作服的医护人员以及带着慰问品的病人家属。这里既是一个历史遗迹,也是一个正常运转的繁忙的医院,还是开普敦大学医学院的主要教学医院。

Barnard and the heart transplant have long fascinated Joubert. His father and Barnard became friends while studying together at the University of Cape Town, and before Barnard delved into the world of surgery the pair shared a general practice in the small farming town of Ceres.

巴纳德做的心脏移植手术一直让朱伯特感慨称赞。他的父亲和巴纳德在开普敦大学学习期间成为好友,在巴纳德全神投入外科领域之前,两人还一起在南非的农业小镇锡里斯(Ceres)当过全科医生。

Joubert sold his oncology business in 2006 and opened the museum in 2007 to mark the 40th anniversary of the operation. “I told my wife that I was going to build a museum by any means possible,” he chuckled. Over the years, Joubert has poured more than R8 million (nearly £440,000) of his own money into the project, renovating and restoring the original operating theatres, creating exhibits and collecting memorabilia from the event.

朱伯特在2006年卖掉了自己的肿瘤学生意,并在2007年开设了该博物馆,以纪念手术成功40周年。他笑着说道:“我告诉我的妻子,我会用一切可能的方法来建一个博物馆。”多年来,朱伯特已经自行出资800多万南非兰特(近44万英镑)投入该项目,翻新、修复了原来的手术室,策划了多次展览,并收集了这场手术的有关纪念品。

The museum traces Barnard’s path to medical history across seven exhibition spaces, along with the worldwide research – and rivalry – that paved the way for the first human heart transplant.

博物馆通过7个展览空间追溯巴纳德的从医之路,同时还讲述了,为首例人类心脏移植打下基础的世界各地的研究以及竞争对手的故事。

For Barnard certainly wasn’t the only heart surgeon hoping to suture their name into the history books. In the United States, Dr Richard Lower and Dr Norman Shumway spent the late-1950s and 1960s perfecting transplant procedures on dogs, and Barnard drew heavily on their research and methods in his own trials with canine ‘patients’ in South Africa.

巴纳德当然不是唯一一个希望将自己的名字载入史册的心脏外科医生。美国医生洛尔(Richard Lower)以及沙姆威(Norman Shumway)在20世纪50年代后期以及60年代,一直在狗的身上试验移植手术,而巴纳德在对南非犬类“患者”进行的试验中,也大量借鉴了他们的研究和方法。

In exploring these early trials, which took place at the height of South Africa’s apartheid period of racial segregation, the museum also touches briefly on the crucial role black and mixed-race assistants played in the historic transplant. Hamilton Naki, in particular, became famous for his rise from hospital groundskeeper to a skilled member of the team assisting with transplant research in Groote Schuur’s animal laboratory.

开普敦心脏博物馆,在介绍南非种族隔离时期的早期实验的同时,也简要介绍了黑人及混血助理在这一历史性的手术移植中扮演的重要角色。在这些人中,纳基(Hamilton Naki)尤为出名,他从医院场地管理员,一路晋升为格罗特舒尔动物实验室协助移植研究技术团队成员。

And in many ways, South Africa was an unusual place for this medical breakthrough to have taken place. In 1967, the country was in the grips of apartheid, increasingly isolated from the world for its policies of racial segregation.

从很多方面来看,南非是取得这一医学突破不寻常的地方。1967年,该国处于种族隔离状态,也因为种族隔离政策而日益与世界隔绝。

But part of Barnard’s success came down to the legal interpretation of death. While South African doctors could pronounce a patient brain dead and make preparations for organ donation, in the US only the absence of a heartbeat qualified a patient as legally dead. Shumway ridiculed this as an antiquated “boy-scout definition of death”, and it nearly saw Lower prosecuted for murder after performing his first heart transplant, the world’s 16th, in May 1968.

巴纳德的成攻部分归结于对死亡的法律解释。南非的医生可以宣布患者脑死亡,并为器官捐献做准备,但在美国,只有患者停止了心跳才会被法律上认定为死亡。沙姆威嘲笑这是一个过时的“童子军式对死亡的定义”,而这一定义也险些让洛尔在1968年5月进行的自己做的第一例,世界第16例心脏移植手术,被控谋杀罪。

Without locating the family of the donor, Bruce Tucker, Lower proceeded with the operation and removed the man’s heart for transplant. When Tucker’s family learned what had happened, they filed a lawsuit for wrongful death. Lower was eventually cleared of any wrongdoing in 1972, and the precedent ultimately changed US legislation on the determination of death.

洛尔在没有联系到器官捐献者塔克(Bruce Tucker)家人的情况下,就开始手术摘除了这名男子的心脏进行移植。当塔克的家人知道发生的事情后,就以非法死亡提起诉讼。洛尔最终在1972年,被证明没有不当行为,而这一先例也最终改变了美国关于死亡裁定的立法。

Death, as much as life, is a thread that runs through the museum, and its most moving corner comes not from the researchers and surgeons battling for fame, but in the bedroom of Denise Darvall, the 25-year-old bank clerk who unwittingly found herself written into the history books.

和生命一样,死亡也是贯穿博物馆的一条线索,而其中最动人的角落不是来自研究人员和外科医生的荣誉,而是达沃尔(Denise Darvall)的房间。这名25岁的银行职员无意中被写入了历史。

Running errands with her family on 2 December 1967, she and her mother were knocked down by a car on Main Road, which runs below Groote Schuur. While her mother, Myrtle, was killed instantly, Denise sustained brain injuries that would, hours later, prove fatal. In the museum, the walls of her recreated bedroom are filled with personal effects donated by the Darvall family, including sketches from her diaries and a small bible. Scattered across the bed are a handful of her vinyl records, mostly waltzes and opera of the day.

1967年12月2日,达沃尔和家人一起外出办事时。她和母亲在格罗特舒尔医院下方的主干道上被车撞倒。达沃尔的母亲默特尔(Myrtle)当场死亡,而达沃尔的脑部受了致命伤,几个小时后就会丧命。博物馆重现了达沃尔的卧室,墙壁上挂满了达沃尔家庭捐赠的各类私人物品,包括她日记里的素描和一本小的圣经。床上散落着她的许多黑胶唱片,主要是当时的华尔兹和歌剧。

But what is most striking here are the words, tucked away on a wall display, from her father. Just hours after losing his wife and daughter, doctors asked his permission for Denise’s heart to be transplanted into the chest of a desperately ill 54-year-old patient. His reply?

但最震慑人心的是墙壁上写着的她父亲说的话。在失去妻女几小时后,医生询问他是否同意将达沃尔的心脏移植到一位垂危的54岁病人体内。他是怎么回答的?

“Well, doctor, if you can’t save my daughter, try and save this man.”

“好吧,医生,如果您救不了我的女儿,就试着救这个人吧。”

That man was Louis Washkansky, who we find – in mannequin form – in a ward bed in another room. He’d been admitted with little hope of a cure for his progressive heart failure. Look carefully at the copies of the medical charts above his bed and one scrawled doctor’s comment stands out.

这位接受心脏移植的人就是沃斯坎斯基,我们在另一个房间的病床上找到了他的人体模型。他当时因患进行性心力衰竭住院,已经没有治愈的希望。仔细看看他床头的医疗表格的复印件,是一位医生用潦草的字迹写下的很特别的诊断。

“No operation will help. Let nature take its course.”

“任何手术都帮不上忙。顺其自然吧。”

Barnard disagreed, and the ambition of this young surgeon is well told in the recreation of his office. Wall panels trace his journey from humble beginnings as a pastor’s son in the semi-desert town of Beaufort West to his frustrations in general practice to his later surgical training in the US. In the adjoining auditorium, a 26-minute documentary unpacks the many facets of Barnard: a brilliant surgeon, but a man who generated controversy throughout his career.

巴纳德并不同意这个结论,这位年轻外科医生的雄心壮志也在这间重现的办公室里得到了很好的体现。墙上的镶板记录了他的经历,从一个半沙漠小镇博福特西(Beaufort West)的牧师儿子的平凡出身,到备受挫折的全科医生,再到后来在美国接受的外科专业培训。在毗邻的礼堂里,放映着一部26分钟的纪录片,揭示了巴纳德的许多方面:他是一位才华横溢的外科医生,也是一位在职业生涯中引起不少争议的人。

All of which is a prelude to the pair of operating theatres where the historic transplant took place in the early hours of 3 December 1967. Theatre 2A, where Washkansky lay waiting on an operating table for a new heart, and 2B, where Darvall lay ready to donate hers.

所有这些都是这两间手术室的前奏,这一具有历史意义的移植手术是在1967年12月3日凌晨的几个小时进行的。当时沃斯坎斯基躺在2A手术室的手术台上,等待新的心脏,而达沃尔则躺在2B手术室里,准备捐献她的心脏。

“I wanted to make the museum back to exactly how it looked the night of the operation. I became obsessed with it,” Joubert reminisced.

朱伯特回忆说:“我想让博物馆回到手术当晚的样子。我对此非常着迷。”

Happily, the bureaucracy of South Africa’s public health system proved useful.

令人高兴的是,南非公共卫生系统的繁文缛节还是有用的。

“The documentation of Groote Schuur Hospital was very accurate, so all the serial numbers of all the equipment that was in the theatre the night of the operation was available,” Joubert recalled.

朱伯特回想说:“格罗特舒尔医院的记录非常准确,所以当晚所用手术设备的序列号都能查到。”

Returning the equipment to its original home didn’t always prove simple, though. The theatre bed on which Darvall lay in theatre 2B had been donated to the Roman Catholic Hospital in the Namibian capital, Windhoek.

不过,把这些设备运回来并没有那么简单。达沃尔在2B手术室躺过的那张病床已经捐给了纳米比亚首都温得和克(Windhoek)的罗马天主教会医院(Roman Catholic Hospital)。

“I phoned the head of the hospital and explained that I needed the bed back in Cape Town because it’s part of history, South African history,” Joubert said. He replaced the bed with a new one and brought the original back to Cape Town.

朱伯特说道:“我给医院负责人打了电话,解释说我得把那张病床要回来放在开普敦,因为它是南非历史的一部分。”他重新给罗马天主教会医院买了一张病床,并把原来的那张床带回了开普敦。

The theatre light from 2B had also been sold off, but Joubert tracked it down to a local veterinary hospital and convinced the owners to return the original to the museum.

2B手术室的手术灯也已出售,但朱伯特一路追踪,在当地一家兽医院找到了。他说服了兽医院人员将原物送回了博物馆。

The inclusion of original memorabilia lends a definite authenticity to the museum.

原始物件的陈列为博物馆增添了现场的真实性。

In theatre 2A, the original heart-lung machine that kept Washkansky alive stands in place to one side. The scale used to measure blood loss was tracked down in a hospital storeroom, and today can be found at the nurse’s station in theatre 2A. In Barnard’s recreated office, his mannequin sits behind the original desk from his office at the University of Cape Town. The old leather doctor’s satchel on the mantelpiece is from his time as a general practitioner in Ceres.

在2A手术室里,维持沃斯坎斯基生命的那台心肺机器摆在一侧。用来测量血液流失的量表也在医院的储藏室找到,现放在2A手术室的护士站立处。在重现的巴纳德的办公室里,他的人体模型坐在他在开普敦大学时用的那张办公桌后面。而壁炉架上放着年限已久的皮质医生背包,则是他在锡里斯当全科医生时用过的。

In the corridor outside the operating theatres, display cases are filled with the original telegrams and letters that flew in from across the globe once news of the transplant broke. Shumway sent Barnard his congratulations – and no doubt unwelcome advice on post-operative care.

在手术室外面的走廊,展示柜里摆满了当时移植手术成功的消息传出后,来自世界各地的电报和信件原件。沙姆威向巴纳德发来祝贺,也发来了有关术后护理的建议。毫无疑问,这些建议并不受欢迎。

But not everyone hailed the achievement.

但并不是所有人都称赞这次成就。

“To the butcher of Groote Schuur Hospital,” reads a note from Mary Power Slattery in Chicago. “A bunch of ghouls, all of you,” wrote S Peschel from Arlington, Virginia.

来自芝加哥的斯拉特雷(Mary Power Slattery)就写道:“至格罗特舒尔医院的屠夫们。”而来自佛吉尼亚阿灵顿(Arlington)的裴斯切尔(S Peschel)则写道:“你们这群食尸鬼,每一个人都是。”

But of all the artefacts in the Heart of Cape Town Museum, the most important are surprisingly easy to miss.

但让人意外的是,在开普敦心脏博物馆所有的藏品里,最重要的往往最容易被人遗漏。

Inside a glass case set into the walls of theatre 2B, you’ll find two glass cubes filled with formaldehyde preserving two important artefacts. On the left: the diseased heart that had failed Louis Washkansky. On the right: the heart of Denise Darvall that turned Barnard into a household name.

在2B手术室的墙内嵌着的两个玻璃柜里,有两个装满了甲醛、保存着两样重要东西的玻璃立方体。左边是沃斯坎斯基心衰的心脏。右边则是达沃尔的心脏,正是它让巴纳德成为家喻户晓的名人。

Washkansky lived for only 18 days after the transplant, eventually succumbing to double pneumonia. But as he breathed his last, Darvall’s heart was still beating strongly inside the chest of another human being.

沃斯坎斯基在心脏移植手术后只活了18天,最终因双侧肺炎去世。但直到他最后一次呼吸时,达沃尔的心脏仍然在他的胸腔内有力地跳动着。

“全文请访问纽约时报中文网,本文发表于纽约时报中文网(http://cn.nytimes.com),版权归纽约时报公司所有。任何单位及个人未经许可,不得擅自转载或翻译。订阅纽约时报中文网新闻电邮:http://nytcn.me/subscription/”

相关文章列表