For 112 days - from Dec. 2, 1982, to March 23, 1983 - the world watched and waited. The daily - sometimes hourly - fortunes of retired Seattle dentist Barney Clark were reported in detail as he weathered the ups and downs of life with an The University of Utah Hospital was besieged with requests for information about its famous patient - the first human to be implanted with a mechanical device on which his life would depend until it was over. The faces of the implant team appeared on the covers of virtually every leading publication around the world.They were a fascinating group: Dr. Willem Kolff, inventor of the artificial kidney and the nucleus around which the implant team gathered; Dr. William C. DeVries, gangly young surgeon who appeared more suited for a basketball floor than a surgery suite; Dr. Robert Jarvik, boyishly handsome physician-inventor who had taken a device already under development at the U. and refined it into the Jarvik-7, object of the experiment; Barney Clark, who knew his life was slipping away, his heart irreversibly damaged by disease, but who was willing to make a contribution to medical science; his wife, Una Loy, whose life as housewife and mother had prepared her to participate loyally through the duration of an often heart-wrenching ordeal, but had not prepared her for the constant limelight and total loss of privacy; Dr. Chase N. Peterson, U. vice president for health care, upon whose every word the media hung.
The public had an unprecedented opportunity to peek over the shoulders of doctors and technical experts as they evaluated the long-term potential of a new medical device. The results of scientific experimentation that generally is noted only by scientists in the quiet retreats of their labs was splashed across newspaper pages and TV screens.
The drama and immediacy of the artificial heart experiment led a fascinated public to some misperceptions about the science. Many supposed that within a few years thousands of people whose hearts had failed them would be walking around, playing golf, dancing, working, pursuing normal lives, with man-made devices clicking away within their chests. What really happened - as the scientists could have anticipated - has been a laborious step-by-step ongoing progress toward more practical artificial hearts.
The team began scattering a couple of years after the Clark experience. Interviewed by telephone, they shared these perceptions, 10 years later, with the Deseret News.
William C. DeVries
DeVries, who was frustrated that the U. was moving so slowly toward a second artificial heart experience, left in 1984 for the
Humana Heart Institute in Louisville, Ky. The huge Humana Hospital organization had agreed to underwrite the costs of up to 100 implants.
"I was enormously excited about the Clark experience, but it hadn't caught on in medical circles. The profession was looking at the artificial heart as a passing curiosity," DeVries said.
That less-than-enthusiastic response, which since has reversed itself, coupled with some internal dissensions that had the Utah program in limbo, sent DeVries looking for greener pastures. He found them at Humana's Audubon Hospital, a large, active medical center with a strong car-di-ology program.
"I was ready to do anything. (The heart project) was the most important thing in the world to me. I wanted to keep the momentum building," DeVries said.
In a new community, his case load was light enough to allow him to concentrate on several more implants, including the surgery on John Schroeder, an Indianan who lived almost two years with a Jarvik-7.
Schroeder's experience was important, DeVries said, because it taught the researchers more about what they could expect regarding the functional life of the plastic-and-metal heart itself. "It was beginning to fail when Schroeder died," he said.
But when a feisty Schroeder chided then-President Reagan over a Social Security problem, DeVries added it to a growing list of evidence that the artificial heart could someday offer a reasonable alternative for many people whose natural hearts gave out.
With the Schroeder case, some of the most vocal critics began taking a second look, he said. Some who had dropped out of the research dropped back in.
The trend toward using artificial hearts to keep patients alive until human donor hearts are available is important, DeVries believes, but he has faith in the future of mechanical alternatives.
"Someday there'll be an old farmer out in the field plowing and they'll come to tell him there is a donor heart available to replace his artificial heart, and he'll yell back to forget it and go on plowing," he predicted.
"The permanent heart got a bum rap. It did what it was supposed to do. It gave us a lot of information," he said. "There were those who said it couldn't be done, that Clark would never get off the table. It was done and it contributed to the good of mankind."
DeVries remains interested and peripherally involved in artificial heart research and expects some-day to do more implants. But the bulk of his time today is devoted to a large practice in conventional heart and pulmonary surgery. He teaches in the University of Louisville medical school and has become interested in medical ethics and the politics of medicine. When he retires from surgery, he may involve himself more deeply in one of these areas, he said. Pure politics also has some allure.
Una Loy Clark Farrer
Farrer spent more than four years after her husband's death as a spokeswoman for the American Heart Association, traveling the country as an advocate for healthy lifestyles that help prevent or delay heart ills.
About two years ago, after the death of a sister, she struck up a deeper friendship with her brother-in-law, Glen Farrer, and they eventually married. They now divide their time between Provo and St. George.
When she recalls what her family went through 10 years ago, memories are bittersweet.
"As hard as it was, all of the experience was worth it. I can't see where anyone could feel it wasn't successful. Barney did what he thought was right. There's no more you could ask."
When times got rough and her husband seemed to be suffering beyond his capacity, she had moments when she wanted to end the experiment, Farrer said. "But every time I'd come to that conclusion and would have said something to one of the doctors, I kept quiet. That was what he wanted. He didn't want us to expect anything from the experience. He didn't ask for any promises. He just felt good about making a contribution, helping out in a way that he could."
Several years after Clark died, Una Loy Clark was still reading through the mountain of letters that came, the sentiments of a fascinated public that felt it had come to know Barney Clark and his wife.
"I will always feel deep appreciation to everyone who kept encouraging us. I couldn't answer all of them, but I felt the weight of that responsibility," she said.
Robert Jarvik
Jarvik is heading his own research company in quest of a fully implantable artificial heart - the Jarvik 2000.
"It's a miniature intra-ven-tricu-lar artificial heart. Instead of removing the ailing heart, it goes inside. It's about the size of a pack of Lifesavers, weighs just 90 grams and has 25-cubic-centimeter volume," said Jarvik from his laboratory in New York City.
The designation "Jarvik 2000" may end up having more significance than he intended. It could be the turn of the century before his device is ready for human use, he said. It is now in the animal testing stage. He is collaborating with Columbia University and the Texas Heart Institute on his research.
"In the context of the experience with Dr. Clark, there is no doubt in the minds of the people working in the cardiac area that it represented the beginning of quite common use of artificial hearts and assist devices in humans," said Jarvik.
Although media and public attention has moved on to other things, the progression of artificial heart research has continued without a break, he said. More than 200 patients have been implanted with the Jarvik-7, and other versions also are being used to hold patients until transplants are available.
Jarvik expects very workable devices will be available to alleviate the problems of intractable heart disease, with or without transplant, before another decade has passed.
"There was too much publicity at that time (the 1982 surgery on Clark). We might have done quite a bit better with the evolution without the public misperceptions about it," he said, drawing on the retrospect of 10 years.
The target has not become any smaller, he noted. Hundreds of thousands of Americans still die every year from heart disease.
Chase N. Peterson
Peterson, who was the point man for an avid local and national media throughout the 1982-83 saga, has added several new titles to his vitae - president emeritus, professor and clinical professor of family and preventive medicine. He served for about eight years as U. president, then retired to devote more time to the training mission of the medical center.
"I'm having the time of my life. I'm stretching my brains. I'm teaching the third-year class and seeing patients," said Peterson of his current assignment.
But he'll remember Barney Clark and the 24-hour media vigils in a curtained-off area of the University Hospital basement.
"The Barney Clark experience was important in its own right as the first clinical step in permanent artificial hearts. There will be more steps, and what finally happens, we don't know.
Although Peterson's name became a household word for several months, he said, "We would have preferred to do it quietly. But we had been wired by news people who were going to get a story one way or another. So we provided an educational case study for the American public."
The Jarvik-7 was not the ultimate in artificial hearts, he said, but it was a worthy progenitor for those models yet to come that will be fully implantable.
"We made an enormous contribution to the science, including an understanding of the dynamics involved. We established the fact that the heart would work, that the blood is not destroyed by the action of the heart."
The fragility of Clark's health - necessary under terms of the university's Institutional Review Board requirements - doomed the first experiment to a short term, said Peterson.
"The next cases will be done on less-ill patients who are healthy enough to withstand the surgery."
The international fascination with Clark's medical odyssey did the U. a lot of good, even though the focus eventually shifted to other medical centers, Peterson said.
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(Additional information)
112-day medical odyssey
The first permanent artificial heart implant on Dec. 2, 1982, held worldwide interest. Hundreds of thousands of people followed the up-and-down course of Barney Clark's 112-day medical odyssey. Significant events included:
Dec. 1, 1982 -- Shortly before midnight, Clark is rushed to surgery at University Hospital in Salt Lake City because doctors think he cannot live until the Dec. 3 date set for the operation.
Dec. 2 -- At about 5 a.m., Dr. Chase N. Peterson, university vice president of health care, announces that the artificial heart is in Clark's chest and beating. Dr. William C. DeVries, a young cardiovascular surgeon, performed the surgery.
Dec. 4 -- A seemingly smooth recovery is interrupted by ruptured air sacs in Clark's lungs. He returns to surgery for repairs.
Dec. 7 -- Clark suffers seizures that affect his further progress, compromising his mental condition and generating confusion and depression.
Dec. 14 -- A major crisis develops as a weld in the device breaks, causing a precipitous drop in blood pressure. Another surgery is performed to replace a broken valve. Mild pneumonia contributes to an "extremely critical" listing.
Dec. 19-23 -- Clark has relatively good days, standing and taking a few steps and eating his first food by mouth.
Jan. 18, 1983 -- Nosebleeds lead to more surgery.
Feb. 14 -- Clark is upgraded to fair condition.
Feb. 16 -- Kidney and respiratory problems precipitate his return to intensive care.
March 23 -- At 10:02 p.m. Clark, now 62, is declared dead. The artificial heart is turned off after more than 13 million "heartbeats."
March 29 -- During a funeral in Federal Way, Wash., attended by about 1,500, including the majority of the U. artificial heart team members, Clarak is lauded for a unique contribution to medicine.