T10.mp37:21
来自图说英语
HEART TRANSPLANTS
On 3 December 1967 Dr. Christiaan Barnard transplanted the heart of a 24-year-old girl into the chest of a 50-year-old man. The operation caught the imagination of the world, and there was a story that a television company offered a million dollars for one single photograph of Washkansky's old heart.
But the optimism was short-lived. Eighteen days after the world's first heart-transplant operation, Washkansky died of pneumonia at his hospital in Cape Town. The main problem facing Christiaan Barnard was how to prevent the body's rejection of the new heart. Anti-rejection drugs, it turned out, also weakened the body's resistance to any disease-carrying germs which came its way. It was a side effect, but it killed the patient.
Within a few days of Washkansky's transplant, another operation was performed in the United States, by Dr. Adrian Kantrowitz. The recipient, a two-and-a-half-week-old baby boy, died six hours later. A month afterwards, at the Stanford University Medical Center in California, Dr. Norman Shumway carried out a third. But his patient lived only slightly longer.
By now optimism had given way to doubt. There were those who believed that the heart was the home of the soul and the thought of a heart being transplanted from one body to another caused them a great deal of pain.
Another question asked was, was it all worth the trouble and money that went into it if at the end of the day the patient died?
But these early misgivings were not shared by everyone, and, in May 1968, one of Britain's most eminent cardiac surgeons, Donald Ross, decided to perform the operation on 45-year-old Frederick West. For the patient, it was a last chance. He had already suffered several heart attacks, and there was little hope of his living much longer in his condition. As Mr. Ross said at the time: "If the patient has no other future short of this transplant, we think we are morally justified, in the present state of our knowledge, in doing it."
For the following five weeks, Mr. West said he felt like a new man. But 46 days after his operation, Britain's first heart transplant patient died.
It was a great ordeal for Mrs. West, but an even greater ordeal had been publicity. Hundreds of reporters from the newspapers, radio and television besieged the narrow road outside the Wests' home, all wanted a glimpse of the family whose breadwinner had made British medical history. "I used to be afraid to go outside the front door," Mrs. West recalled. "People would jump on you, and others would drive by in the car and point at the house. It was frightening. All I wanted to do was hide."
The poor record of survival, plus public reaction against the media's use of heart transplants for publicity (and perhaps also entertainment), gave rise to wave of anti-transplant feelings both in and outside the medical profession. After that heart transplants as good as ceased.
One man in America carried on the research. It was Norman Shumway, who taught Christiaan Barnard his transplant techniques, after spending 20 years experimenting on animals. Today the American is one of the few foremost heart-transplant surgeons in the world, having overcome many of the earlier problems, like rejection. His rate of success speaks for itself. Out of 143 operations in the past decade, 59 patients are still alive. One man continues to lead an active life after eight years with someone else's heart beating inside him. Eight patients have survived for over five years, and 70 per cent of all Shumway's transplant cases live for over a year.
Meanwhile, we have the testimony of Mrs. Josephine West, to whom the 46 extra days she had with her husband were priceless. "They were good times," she told a friend. "And Fred had no regrets. He said, if he died tomorrow, he'd really enjoyed himself. It was like seeing him as he used to look before his heart trouble. It was all worth it, and I'd do the same again."
心脏移植
1967年12月3日，克里斯蒂安·巴纳德医生把一位二十四岁姑娘的心脏移植到了一位五十岁男人的胸内。这一手术轰动了整个世界，据说一家电视公司曾出一百万美元的高价来购买沃什坎斯基原来心脏的一张照片。
然而，人们不久就不再感到乐观了，因为在这次世界首例心脏移植手术后的第十八天，沃什坎斯基在开普顿的一家医院里因肺炎而死去。现在，克里斯蒂安·巴纳德所面临的主要问题是，如何防止人体对新心脏的排斥。服用抗排斥异体药物会削弱人体对入侵病菌的抵抗力。这种副作用能将病人致死。
沃什坎斯基心脏移植手术后没几天，美国的亚德里恩·坎特罗威茨医生完成了另一例手术。这个出生仅两周半的男婴在接受手术六小时后便停止了呼吸。一个月后，在加利福尼亚州斯坦福大学医学中心，诺曼·萨姆威医生做了另一例心脏移植手术，但是，病人活的时间只比那个男婴稍长一点。
至此，人们不再乐观，反而疑虑重重。有些人认为，心脏是人的灵魂归宿，一想到一个人的心脏移植到他人身上，就令人痛若不堪。
另一点疑问是，假如病人手术当天就命归黄泉，那么是否还值得花费人力财力进行这种手术呢？
但是，并不是所有人都怀有这种疑问。1968年5月，作为英国最著名的心脏外科医生之一的唐纳德·罗斯决定给四十五岁的弗雷德里克·韦斯特进行心脏移植手术。对病人来讲，这是最后一线希望，因为他的心脏病已发作好几次，以他的病情，他的生命已没有几天了。正如罗斯先生当时所说：“如果除了做移植手术之外，病人别无出路，那么我们认为，在现有的医学条件下，施行这种手术在道义上是无可非议的。”
韦斯特先生说，在手术后的五周里，他觉得自己像是另外一个人。可是，在手术后的第四十六天，这位首例接受心脏移植手术的英国人离开了人世。
这对韦斯特太太打击不小，但是宣传报道对她的打击更为沉重。数百名报纸、电台和电视台的记者围在韦斯特家外面的狭窄街道上，想亲眼目睹这位创造英国医学史奇迹的当家人的家。韦斯特太太回忆说：“我当时很害怕出前门，人们会拥到你跟前，有人驾车路过，也会用手指一指这座房子。这太可怕了。我当时只想躲起来。”
由于手术后病人存活时间短，加之公共舆论反对新闻界利用心脏移植来进行宣传（甚至娱乐），所以，医学界内外掀起了一股反对心脏移植的浪潮。随后心脏移植手术几乎停止了。
然而，一个美国人却在继续进行这一研究。他就是在动物身上做了二十年的试验，后来向克里斯蒂安·巴纳德传授心脏移植技术的诺曼·萨姆威。现在，他攻克了许多像异体排斥这类的早期的难题，是世界上少数几个做心脏移植手术的先驱者之一。他的手术成功率就很具说服力。在过去十年里接受手术治疗的143位患者中，有59位仍然健在。有一位病人在靠别人心脏维持了八年生命之后仍然健壮地生活着。8位病人手术后活了五年多。百分之七十的接受萨姆威治疗的病人存活时间超过一年。
同时，我们有约瑟芬·韦斯特太太作证。对她来说，和丈夫多呆的那四十六天是无比宝贵的。她对一位朋友说：“那是一段美好的时光。弗雷德毫不后悔。他说他即使第二天就离开人世，他也已经真正尝到了生活的乐趣。他看上去和患病前没有两样。这样做完全值得，再做一次我也愿意。”
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