Willem Kolff Interview (page: 6 / 9) Pioneer of Artificial Organs	Print Interview

Dr. Kolff, your work on the artificial heart, does it have anything to do with people thinking that a person's heart is where their soul is?

Willem Kolff: Yes. The heart, as you know, is the symbol of love, the habitat of the soul, and the source of life. To replace that by a simple pump goes against everybody's feeling. People are also afraid that if they have an artificial heart maybe they can't love anymore. We had Barney Clark to prove the opposite. We knew that the artificial heart could sustain the circulation, because we'd seen it in animals many times. But Barney Clark proved that the artificial heart did not cause any pain, did not cause any disagreeable sensation. The click-click noise of the pump did not bother him. He still loved his family, he still had a very considerable sense of humor, and he still wanted to serve his fellow man.

Dr. DeVries, tell us about the day of the surgery.

William DeVries: According to the rules at that time, we had to take the patient when he was almost dead. He had to be almost drawing his last breath. The criticism had come up that we couldn't take a patient who was already alive and then kill him. So we had to have him sign a consent form, then we had to wait 24 hours and have him sign the consent form again to say, "I've thought about it, and I still want to go ahead with this." Barney came in and saw us about a month earlier, when he was a little more healthy. He saw the animals, saw the implantation, and said he didn't want to go ahead with this because he wasn't ready yet.

He went home and started getting real sick. He couldn't even get out of bed. His family gathered for Thanksgiving dinner, and they carried him down the stairs. Barney was a big man, he was a really tall and heavy guy. They carried him down the stairs and sat him at the Thanksgiving table. He said the prayer, and they carried him back to bed. That was all the strength he had. And that night, when he was with his wife, he said, "I've decided to go ahead and have the operation." And his wife said, "Why, Barney?" And he said, "First of all, I don't think it will work. I'm weaker and more tired than those animals I've seen, and I don't think it's going to save my life. But I have been kept alive for the last year on medicines that other people have given their lives to give me. Now it's my turn to pay those people back." He came back to the University of Utah, and said, "I want to go ahead with this."

He saw this as kind of a mission. His death, his life, his existence, his 118 days on this heart, were going to give other people something. We all felt that call when we got involved in this. It was something that had to go on.

We put him in intensive care, and we took a lot of time to inform him of what was going on. He signed the consent form. We left him in intensive care, and we had to wait 24 hours. And as we were waiting, his heart started going bad. One of the things that people die of in end-stage heart disease is arrhythmia. This is very sudden and it happens unpredictably. We started watching his monitor from the desk, and he started having all these abnormal rhythms. We kept saying, "Let's wait the 24 hours." We thought we weren't going to be able to do it. We couldn't let his wife see him because every time she went in, his heart started getting excited and we thought he was going to go into an arrhythmia and die. We had to keep him in a dark room with on one else around. After a while, Barney said, "I've had enough of this. I want to get on with this." When we took him into the operating room he was truly breathing his last breath.

Talk us through that operation.

William DeVries: The operation was at the University of Utah Medical Center, which sits on a hill. It was a snowy day in December. It snowed so much during the 24-hour waiting period that I asked the operating room team to stay, because I knew if they went home and got off the hill, they wouldn't be able to get back. So we had everybody stay there. Everybody was waiting. We decided around ten o'clock that he wasn't going to make it much longer and we went ahead in the middle of the night.

There was a blizzard outside, and you couldn't even get up to the medical center. About 2:30 at night, while we were still in the middle of the surgery, I said to this circulating nurse, "How is it outside?" Meaning, "Is it still snowing? What are the conditions?" And she said, "Dr. DeVries, you wouldn't believe it. I just went down to the cafeteria for a cup of coffee, and there are 288 reporters down there." At that point I realized what this was going to be like. Some of these guys had put on snow shoes to get to the medical center.

That was the first time it really struck us that there was so much interest in what we were doing. Up until that time, we had spent so much time getting ready, getting things going that we never really thought about it. It was like being on a train. It stops, some people get off and more people get on, and it keeps going. It just keeps moving forward. People say, "What was it like?"

Get the Flash Player to see this video. We had prepared ourselves so much and run mock circulations and everything that it was just automatic. It didn't ever really hit you what had gone on until after it was all over. And, we were all sitting down, and this patient was sitting up with this artificial heart, and someone said, "My God, look at it! He doesn't have a heart anymore. He's got a machine in his chest." Then you realized what was going on.

But you couldn't stop and pat everybody on the back and high five and say "Didn't we do a great job?" because it had just started at that point. We were always going to have a party in which we were going to thank everybody and say, "You all did a great job." We never had it, because every day something else came up, and then he died. After he died, everybody was so sad they didn't want to have a party anymore. So we never had a chance to sit down and realize what it was until it was all over. It took people several years to find out what they had gone through. People who worked with him every day would come back to me and say, "I didn't realize what this meant until I went home, and my mother in Tallahassee understood what this was all about." Then they would understand it. The people around it didn't realize it was such a big deal.

Dr. Kolff, what are your memories of the Barney Clark surgery?

Get the Flash Player to see this video. Willem Kolff: When that heart was put in Barney Clark, when it worked, I remember that I cried for a moment because I had started to work on the artificial heart in 1957, and this was 1982. So, you have to have some staying power if you do this kind of stuff. And then the publicity around it was incredible. They had to cordon off one-half of the hospital cafeteria, and there were seven television teams, if I'm correct and about a hundred reporters who camped there day and night. And, some of them tried to bribe personnel to give them information. When that became apparent, the vice president of medicine of the university gave a press release twice a day. Even then, reporters tried to get information from a resident, or a nurse, or a cleaning woman, or a janitor.

So, don't ever underestimate the enormous pressure that was on the people who put the heart in Barney Clark. Dr. DeVries the surgeon, and others, including myself. Whatever happened during those days, I will forgive anybody, because the pressure was almost unbearable. When Barney Clark, finally died after 112 days, and we went to his funeral, there were helicopters overhead to film it.

Do you ever have a feeling when something like that is accomplished that there's an end to the project, or does that just make you think about moving on to something else?

Willem Kolff: No. You see immediately what your next task will be. I've been asked all kinds of silly questions like, "Aren't you proud? Aren't you this? Aren't you that?" I have no time for that, because the next project is upon me.

Dr. DeVries, it seemed to hit you pretty hard when Barney Clark finally died.

William DeVries: Yeah. But he was ready to die. It was over for him, and he did the best he could do. The world was a better place for the fight he fought. He died for something that was very important. This guy gave everything he could -- his very being -- in order to do this. We felt very strongly that we had an obligation to carry the project on. It was not a failure in any of our eyes. It was a call to arms.

There was criticism afterwards, about the quality of his life after the implant. How did you respond to that?

William DeVries: There was a lot of criticism. But the quality of his life wasn't that good before. He was in a darkened room, his wife couldn't even go in to see him. Then, suddenly, he's up and around. He was putting golf at one point. It was a much better quality of life than he had before. He wasn't afraid of dying all the time. Whenever we got real down, we'd just walk into a patient's room and talk to him. They were glad to be alive.

Get the Flash Player to see this video. I can remember, after Bill Schrader had been alive for over a year with an artificial heart, I had Christmas morning with him and he grabbed my hand, and pulled me in. And, by this time he'd had like two strokes by this time and everything, and he grabbed my hand, and he said, "Thank you for giving me this day." You know, and at that time it didn't matter what anybody in the world said. This guy was alive, and he was happy to be alive. He'd seen the wedding of his son, the birth of a grandchild, and he was happy to be alive. And anybody could have said anything they wanted to about the project, but this man had a gift. Now, I can look back on it philosophically. Now there are almost over 200 patients that have had life because of the Jarvik ventricle and the bridge to transplant. They simply would not have had it. They would be dead right now if it wasn't for those gifts that those early pioneers gave, and we can go back and look at it, and it's incredible contribution.

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