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"A Cup of Tea." Exercising the captain's prerogative, Dr. Christiaan Barnard moved into the first operating room and cut eight blood vessels to free Denise Darvall's heart; then he severed it from its ligament moorings. It was disconnected from the pump, and was carried to Washkansky's room, where it was connected to a small-capacity heart-lung machine. There it lay, chilled and perfused with oxygenated blood, while Surgeon Barnard removed most—but not quite all —of Washkansky's heart. He left in place part of the outer walls of both the auricles, the right carrying the two entrance holes of the venae cavae, the left carrying the four entrance holes of the pulmonary veins. The rest of the heart, flabby and scarred, he set aside.
In painstaking sequence, Dr. Barnard stitched the donor heart in place. First the left-auricle, then the right. He joined the stub of Denise's aorta to Washkansky's, her pulmonary artery to his. Finally, the veins. Assistant surgeons removed the catheters from the implant as Barnard worked.
Now, almost four hours after the first incision, history's first transplanted human heart was in place. But it had not been beating since Denise died. Would it work? Barnard stepped back and ordered electrodes placed on each side of the heart and the current (25 watt-seconds) applied. The heart leaped at the shock and began a swift beat. Dr. Barnard's heart leaped too. Through his mask, he exclaimed unprofessionally but pardonably, "Christ, it's going to work!" Work it did.
The heart-lung pump was still running. Now it was reset to warm the blood. After ten minutes it was switched off to see whether the transplanted heart could carry the whole burden of Washkansky's circulation. It was not yet quite ready, and on went the pump again for another five minutes. This time, when it was stopped, the heart did not falter. It could do the work. The surgeons closed Washkansky's chest. The operation, "from skin to skin," had taken 4¾ hours. It was 7 a.m. "I need a cup of tea," said Dr. Barnard.
Space to Spare. An hour later, Washkansky regained consciousness and tried to talk. So carefully isolated from possible infection that even his wife Ann was persuaded not to visit him for four days, he showed improvement day by day. After 36 hours he complained of hunger and ate a typical hospital meal, including a soft-boiled egg. As a further guard against infection, the doctors dosed him with antibiotics. His donated heart, healthy and compact, jumped around somewhat uneasily in the cavity left by his own enlarged heart, but this space would soon shrink naturally. The heart gradually slowed its beat to 100 per minute. (Surgeon Barnard's had been a frenetic 140 when he finished the operation.)