On May 25, 1968, surgeons in Richmond, Virginia, performed a successful one heart transplant, one of the first in the world, on a white businessman. The heart they used was taken from a Black patient, named Bruce Tucker, who had been brought to the hospital the day before, unconscious and with a broken skull and traumatic brain injury. He was pronounced dead brain less than 24 hours later.
Tucker ‘s still beaten heart was removed without his family’ s knowledge or prior permission; their horrific discovery – by the local funeral director – that Tucker’s heart was missing was a devastating blow.
The actions of the surgeons, which led to America̵7;s first civil suit for wrongful death, are brought to light in the new book. “Organ Thieves: The Shocking Story of the First Heart Transplant in the Isolated South(Simon and Schuster, 2020) by Pulitzer Prize-nominated journalist Charles “Chip” Jones. Jones raises troubling questions about the ethics of this pioneering transplant, revealing its deep roots in racism and discrimination against black people in health care.
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The first human organ transplant, a kidney, was done in 1954, and by the late 1960s, “superstar” surgeons were claiming to be the first to successfully transplant a human heart, Jones told Live Science.
“In terms of science, it was a medical parallel to the space race,” Jones said.
Dr. Richard Ul and Dr. David Hume, surgeons at Virginia Medical College (MCV) in Richmond, were at the forefront of that race, but it was South African surgeon Dr. Christiaan Barnard who performed the first heart transplant in December. 3, 1967. In May 1968, MCV admitted to her hospital a critically ill patient coronary heart disease who was a promising candidate for a heart transplant. But Lower and Hume did not have to find a viable heart donor.
And over time for their sick patient, they needed a quick one.
Tucker, a Richmond factory worker who had suffered a severe head injury during a fall, was brought to MCV Hospital on May 24, 1968. Although Tucker’s personal effects included one of his brother’s business cards, officials were not in able to locate a family member on behalf of the unconscious person. And because the hospital claimed Tucker had no family and had spirits (he had drunk before his accident), he was profiled as a “charitable patient” and listed as a potential heart donor.
“He was in the wrong place at the wrong time,” Jones said.
Tucker was connected to a ventilator, able to breathe on his own. A new medical examiner performed an electroencephalogram (EEG) to determine electrical activity in Tucker’s brain; the examiner stated that there were none. The surgeons cited this as sufficient evidence for brain death; Tucker was removed from the ventilator, and Hume and Lower removed Tucker’s heart for the transplant, Jones wrote.
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Decades later, in 1981, the Uniform definition of the law of death provided a legal definition of death: “irreversible cessation of circulatory and pulmonary functions” and “irreversible cessation of all brain functions”, meaning that the whole brain – including the brain – has ceased to function, according to Johns Hopkins Medicine.
But in 1968, the legal concept of death was not so clearly defined, Jones said.
“There was no legal framework that would let doctors know how to proceed in a situation like this where they had a patient they thought they had no chance of recovering,” Jones explained. “And time was essential, in their opinion, to rescuing a very sick man.” However, doctors were also quick to assume Tucker was indigenous and familyless – a rationally motivated trial, according to Jones.
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Tucker’s family learned that his heart was missing from the funeral director; they tore together what had happened from the news reports (Tucker’s identity was not initially made public, Jones wrote). Eventually, the Tucker family would file a civil lawsuit for wrongful death, which went to trial in 1972. Their representative was attorney L. Douglas Wilder, who later became the first Black elected governor in the US.
According to Wilder, Lower “intentionally, erroneously, unintentionally and intentionally pronounced Bruce O. Tucker dead before his actual death, contrary to the law, knowing that he was not legally qualified to do so.” State law required notifying the family and waiting for 24 hours before performing the operation.
“They blocked the process that was in place in Virginia because they were so eager to eventually do the operation,” Jones said.
The famous case of Henrietta Lacks presents a similar clash between medical ethics and racism. Lacks, a Black woman (also from Virginia), was diagnosed in 1951 with cervical cancer. A doctor collected cells from one of her tumors and then reproduced them indefinitely in the laboratory; after Lacks’s death, those cells were then distributed among scientists for years without the knowledge or permission of her family. Known as the HeLa cell line, they were used in research that led to cancer treatments and in the detection of polio vaccine, but decades passed before the Lacks family learned of her medical “immortality.”
In 2013, the National Institutes of Health (NIH) reached an agreement with the family to allow future research involving data from HeLa cells; the new process requires application through a panel that includes descendants and relatives of Lacks, Live Science previously reported.
“Man of the body”
The injustices suffered by Lacks, Tucker and their families stemmed from racism that is deeply ingrained in America’s medical infrastructure, Jones noted. In fact, when medical colleges in America adopted a narrower approach to anatomical studies during the 19th century, instructors often trained their students in human anatomy using the coffins of Black men that had been stolen from African-American cemeteries. wrote Jones.
Aggravated robbery was technically illegal, but when black people were victims, authorities tended to look the other way, according to Jones. Medical schools would employ a “body man” (also known as a “resurrector”) to buy organs; at MCV, a certain hangman was a black man named Chris Baker, a school security guard who lived in the basement of the Egyptian College Building.
Most of the country’s medical schools abandoned this racist method of buying cadaver until the mid-1800s, but records suggest it continued in Virginia until at least 1900, Jones said.
“There were news reports that the bodies were being ‘snatched’ by the Virginia State pen, which is about five blocks from the medical college,” he said.
Jones suddenly discovered a memory of this crime while researching his book, on a masonry display at MCV McGlothlin Medical Education Center. Painted between 1937 and 1947 by Richmond artist George Murrill, the mural celebrates the history of medical college. And it includes the image of a corpse being carried away from a grave in a wheelchair.
“It shows how the legacy of racism is literally right under people’s noses,” Jones said.
“Organ thieves” is available to purchase on August 18; read an excerpt here .
Originally published in Live Science.