THE ORGAN THIEVES: THE SHOCKING STORY OF THE FIRST HEART TRANSPLANT IN THE SEGREGATED SOUTH Chip Jones New York, NY: Gallery Books, 2020, 389 pages.

Abstract

A career journalist of the Richmond Times Dispatch, Chip Jones reports the first heart transplant performed in Richmond, Virginia, at the Medical College of Virginia Hospital (MCV) in May 1968 in his book The Organ Thieves. The transplant was performed by Richard Lower with David Sewall excising the donor heart from an African American who had died because of a head injury (skull fracture and subdural hematoma) following a fall sitting on a wall at a baseball park. All of the events of the transplant were orchestrated by David Hume, the Chief of Surgery at MCV. The backdrop of the story is that the first heart transplant in the world was performed by Christiaan Barnard months earlier in December 1967 in Cape Town, South Africa. The irony of the story is that Barnard learned how to perform that heart transplant in Richmond—taught by Richard Lower. The backdrop of the history chronicled by Jones is also that the heart donor was an African American, the transplant recipient was White, and Richmond was segregated in 1968. The Organ Thieves is unflattering to David Hume and unfair to Richard Lower. They were not thieves as vultures of body parts. They were not racists. The heart donor was dead. Hume and Lower were tried for murder but acquitted. I knew both of these individuals well, as I arrived Richmond in 1971 to embark upon a career in transplantation and my personal reflections differ from those conveyed by Jones in The Organ Thieves. Dr. Hume was indeed a “restless genius”—the title of a chapter in the Jones book describing the compelling race to perform this heart transplant at MCV following the upstaging by Barnard. Dr. Hume had developed one of the first academic Departments of Surgery in the United States—inclusive of thoracic, vascular, oncology, endocrine, burn unit, general surgery—all with experts of these disciplines as members of the department. “Restless genius” was an appropriate characterization of Dr. Hume, derived from the 1973 eulogy of Dr. Francis Moore, Dr. Hume’s mentor from Boston, mentioned as a chapter title but not at all developed in the Jones book as Dr. Moore thought of Dr. Hume: “Genius finds these solutions and puts them to work for mankind. A restless person is one who is dissatisfied with things as they are. His restless spirit leads him to adventures and new ideas, but also to controversy and sometimes to danger. He often upsets or disturbs those who would keep things as they are. David Hume’s restless genius did all those things.” Dr. Lower was a member of that department, recruited by Dr. Hume in 1965 following Lower’s pioneering work in heart transplantation done with Norman Shumway reported to the Surgical Forum in 1960. The Organ Thieves does not properly characterize the regard for Dr. Lower by those of us who trained in that program. For example, the quote by Hunter McGuire about Dr. Lower used in the book is disrespectful and becomes more of a reflection of Hunter McGuire—again for those of us who knew both McGuire and Lower. Important and alternative reflections from colleagues who knew Dr. Lower by their operating room experience and not on the sideline are omitted in The Organ Thieves—see from Mel Williams: “He (Dr. Lower) was a remarkable man combining humility, integrity, and intelligence with an ever-present sense of humor.”1Williams GM. Richard Lower: the other quiet pioneer of cardiac transplantation (1930–2008).Transplantation. 2008; 86I11: 1483-1484Crossref Google Scholar Although The Organ Thieves recounting is largely factual, some inaccuracies should be brought forward for the record. Dr. Hume was not on Dr. Joseph Murray’s surgical team in 1954, but the pioneering transplants had been done by Hume at the Peter Bent Brigham Hospital years earlier.2Hume DM Merrill JP Miller BF Thorn GW. Experiences with renal homotransplantations in the human: report of nine cases.J Clin Invest. 1955; 34: 327-382Crossref PubMed Scopus (362) Google Scholar In the murder trial, the defense by Dr. William H. Sweet was done as he was Chief of the Neurosurgical Service at the Massachusetts General Hospital.3Catalog of Arts & Artifacts, Massachusetts General Hospital website. http://history.massgeneral.org/catalog/Detail.aspx?itemId=396&searchFor=neurosurgery. Accessed October 28, 2020.Google Scholar Dr. Sweet’s testimony was seminal in changing the disposition of the court to conclude that the donor was dead and Hume and Lower were not thieves. The author of this manuscript has no conflict of interest to disclose as described by the American Journal of Transplantation.