Medicine: Five Million Beats and Counting

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After a month, Clark and his new heart are making progress

Surgeon William DeVries was working in his office at the University of Utah Medical Center last week when he heard a faint but familiar swooshing sound. He looked up from his desk and was happily surprised to see his most famous patient, Dentist Barney Clark, roll into the room in a wheelchair. With a little assistance from his nurses, the world's first recipient of a permanent artificial heart was enjoying an afternoon outing in the hospital corridors. A few feet behind Clark, and connected to his chest by two tubes, was the source of the noise: the power unit that has kept him alive for more than a month.

Although he is still listed in serious condition and has some lung and kidney problems, Clark is improving daily, according to the hospital. He has been moved from isolation to an intensive care unit, which he shares with other patients. Clark is frequently visited by his wife Una Loy, who lives in a private suite three floors away.

Clark's day begins at 8 a.m. when a nurse awakens him for a sponge bath and a series of tests. At least once every eight hours his blood chemistry, cardiac output and other vital signs are checked. After a morning visit from his doctors, Clark rests briefly and then is helped into an overstuffed recliner chair, where he sits until 5 or 6 p.m. His frequent catnaps are interrupted by two 20-minute sessions of exercises to strengthen his muscles and improve his circulation.

Clark's mental progress, however, has not kept pace with his physical recovery. Though often able to converse with family members and doctors, Clark suffers frequent bouts of confusion. One hospital staff member reports that the patient sometimes thinks that he is still a dentist back in Seattle. Though tests have not detected any brain damage, Clark's confusion probably stems from seizures he suffered one week after the implantation of his artificial heart. Utah doctors have conceded that there may have been an imbalance in the supply of fluids, and salts that Clark received. A proper balance is necessary to maintain normal brain function.

The artificial heart was working well last week, having beaten, or clicked, more than 5 million times. Part of the device had to be replaced when a valve broke two weeks after Clark's original surgery, but Dr. Robert Jarvik, the heart's designer, insists: "That was just bad luck." There is, however, some discussion by the Utah heart team about using a different kind of valve in future models.

Though two Salt Lake City families have offered the Clarks the use of their homes, "Dr. Clark is not nearly ready to go," says Hospital Spokesman John Dwan. The quality of the life he will lead at the end of a 375-lb. power unit remains a source of speculation and controversy, but at least one former critic has modified his views. "I must confess I am impressed with the results achieved so far in Salt Lake City," says Dr. Denton Cooley, the famed Houston heart surgeon. Cooley had earlier likened the bold use of the cumbersome device to "putting John Glenn in a rocket in 1950 and aiming him at the moon." Jarvik feels that his invention has already proved its worth: "We have been able to offer at least one patient who was terminally ill a reasonable level of hope for a good life."