*Hamilton Naki; An African Self-Taught Surgeon Aided Heart Transplant* *Network News*
X<http://www.washingtonpost.com/ac2/wp-dyn?node=admin/registration/manage&destination=hpPref&nextstep=update> Profile <http://www.washingtonpost.com/wp-srv/network-news/> Associated Press Monday, June 13, 2005 Hamilton Naki, a former gardener who was so skilled in complicated surgery that he helped in the world's first human heart transplant -- but had to keep this secret in apartheid South Africa -- died May 29 at his home near Cape Town. He had heart- and asthma-related problems. He was in his seventies. "He has skills I don't have," Dr. Christiaan Barnard, who performed the heart operation, told the Associated Press in 1993. "If Hamilton had had the opportunity to perform, he would have probably become a brilliant surgeon." A black man from a poor family, Mr. Naki left school without qualifications and found his first job at age 14 cutting grass and tending the tennis courts at the University of Cape Town. In 1954, he was promoted to helping with the care of laboratory animals. He soon progressed from cleaning cages to more advanced laboratory work after a professor at the university asked him to help anesthetize animals used to train students in surgery. Barnard asked Mr. Naki to be part of the backup team in what became the world's first successful heart transplant, in December 1967. This was in violation of the country's laws on racial segregation, which, among other things, dictated that blacks should not be given medical training nor work in whites-only operating theaters nor have contact with white patients. Mr. Naki was especially known for teaching medical students to perform intricate liver transplants on pigs, a procedure that is said to be more complicated than human heart transplants. Doctors who observed Mr. Naki's work used to describe how he managed to join tiny blood vessels with amazing delicacy and accuracy and quietly finish operations the medical students had started. Prof. Ralph Kirsch, head of the Liver Research Center, described him as "one of those remarkable men who really come around once in a long time." "As a man without any education, he mastered surgical techniques at the highest level and passed them on to young doctors. I don't think that happens very often anywhere in the world," he said in a Web site tribute. Mr. Naki frequently recalled how the medical students came to him for guidance. "That's why they call me a surgical father," he had said. By the time he retired in 1991, he had reached only the level of laboratory assistant. But he had to be content with the meager pension of a gardener, given that his more skilled work had never been made public. Mr. Naki told an interviewer: "Those days, you had to accept what they said, as there was no other way you could go, because it was the law of the land." It was only in 1994, after the end of apartheid, that Mr. Naki's contributions became known. In 2002, President Thabo Mbeki gave him the country's highest order for his years of public service. The next year, Graca Machel, the University of Cape Town's vice chancellor and wife of former president Nelson Mandela, bestowed an honorary degree in medicine on Mr. Naki in recognition of the years he spent training young doctors who later become leading surgeons throughout the world. For most of his professional life, he lived in relative obscurity in a cramped one-room house without electricity and running water in the grim Cape Flats townships, which were created for nonwhites by the apartheid government. The City Vision newspaper said that just before his death, Mr. Naki wrote a letter detailing his childhood life and how he grew up in the rural Eastern Cape, pointing out the difficulties he encountered and the struggle to become educated. He pointed to famine and the poverty that forced him to leave the Eastern Cape and come to work in Cape Town. During his retirement, he achieved a longtime ambition of collecting money for a school in his deprived home province, hoping to provide an education he was never able to afford for his own four children. * *Hamilton Naki** *Hamilton Naki, an unrecognised surgical pioneer, died on May 29th, aged 78 * Jun 9th 2005 |From the print edition<http://www.economist.com/printedition/2005-06-11> · · ON DECEMBER 3rd, 1967, the body of a young woman was brought to Hamilton Naki for dissection. She had been knocked down by a car as she went to buy a cake on a street in Cape Town, in South Africa. Her head injuries were so severe that she had been pronounced brain-dead at the hospital, but her heart, uninjured, had gone on furiously pumping. Mr Naki was not meant to touch this body. The young woman, Denise Darvall, was white, and he was black. The rules of the hospital, and indeed the apartheid laws of the land, forbade him to enter a white operating theatre, cut white flesh, or have dealings with white blood. For Mr Naki, however, the Groote Schuur hospital had made a secret exception. This black man, with his steady, dexterous hands and razor-sharp mind, was simply too good at the delicate, bloody work of organ transplantation. The chief transplant surgeon, the young, handsome, famously temperamental Christiaan Barnard, had asked to have him on his team. So the hospital had agreed, saying, as Mr Naki remembered, “Look, we are allowing you to do this, but you must know that you are black and that's the blood of the white. Nobody must know what you are doing.” Nobody, indeed, knew. On that December day, in one part of the operating suite, Barnard in a blaze of publicity prepared Louis Washkansky, the world's first recipient of a transplanted human heart. Fifteen metres away, behind a glass panel, Mr Naki's skilled black hands plucked the white heart from the white corpse and, for hours, hosed every trace of blood from it, replacing it with Washkansky's. The heart, set pumping again with electrodes, was passed to the other side of the screen, and Mr Barnard became, overnight, the most celebrated doctor in the world. Related items · Hamilton Naki: Apartheid's shadow <http://www.economist.com/node/4174683>Jul 14th 2005 · Memoirs of surgery: Cut to life <http://www.economist.com/node/998288>Feb 21st 2002 · Christiaan Barnard <http://www.economist.com/node/770757>Sep 6th 2001 In some of the post-operation photographs Mr Naki inadvertently appeared, smiling broadly in his white coat, at Barnard's side. He was a cleaner, the hospital explained, or a gardener. Hospital records listed him that way, though his pay, a few hundred dollars a month, was actually that of a senior lab technician. It was the most they could give, officials later explained, to someone who had no diploma. There had never been any question of diplomas. Mr Naki, born in the village of Ngcangane in the windswept Eastern Cape, had been pulled out of school at 14, when his family could no longer afford it. His life seemed likely to be cattle-herding, barefoot and in sheepskins, like many of his contemporaries. Instead, he hitch-hiked to Cape Town to find work, and managed to land a job tending lawns and rolling tennis courts at the University of Cape Town Medical School. A black—even one as clever as he was, and as immaculately dressed, in a clean shirt, tie and Homburg hat even to work in the gardens—could not expect to get much further. But a lucky break came when, in 1954, the head of the animal research lab at the Medical School asked him for help. Robert Goetz needed a strong young man to hold down a giraffe while he dissected its neck to see why giraffes did not faint when they drank. Mr Naki coped admirably, and was taken on: at first to clean cages, then to hold and anaesthetise the animals, then to operate on them. *Stealing with his eyes* The lab was busy, with constant transplant operations on pigs and dogs to train doctors, eventually, for work on humans. Mr Naki never learned the techniques formally; as he put it, “I stole with my eyes”. But he became an expert at liver transplants, far trickier than heart transplants, and was soon teaching others. Over 40 years he instructed several thousand trainee surgeons, several of whom moved on to become heads of departments. Barnard admitted—though not until 2001, just before he died—that Mr Naki was probably technically better than he was, and certainly defter at stitching up afterwards. Unsung, though not unappreciated, Mr Naki continued to work at the Medical School until 1991. When he retired, he drew a gardener's pension: 760 rand, or about $275, a month. He exploited his medical contacts to raise funds for a rural school and a mobile clinic in the Eastern Cape, but never thought of money for himself. As a result, he could pay for only one of his five children to stay to the end of high school. Recognition, with the National Order of Mapungubwe and an honorary degree in medicine from the University of Cape Town, came only a few years before his death, and long after South Africa's return to black rule. He took it well. Bitterness was not in his nature, and he had had years of training to accept his life as apartheid had made it. On that December day in 1967, for example, as Barnard played host to the world's adoring press, Mr Naki, as usual, caught the bus home. Strikes, riots and road blocks often delayed it in those days. When it came, it carried him—in his carefully pressed suit, with his well-shined shoes—to his one-room shack in the township of Langa. Because he was sending most of his pay to his wife and family, left behind in Transkei, he could not afford electricity or running water. But he would always buy a daily newspaper; and there, the next day, he could read in banner headlines of what he had done, secretly, with his black hands, with a white heart.
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