Medical school dean recalls historic transplant during Hardy forum
On the 45th anniversary of the world’s first lung transplant into man that brought the University of Mississippi Medical Center into the nation’s consciousness, a key participant in the groundbreaking procedure was back at the Medical Center.
Dr. Martin L. Dalton, Jr., dean of the School of Medicine at Mercer University in Macon, Ga., recalled the events surrounding that historic four-hour operation to a capacity crowd of Medical Center faculty and residents during the annual James D. Hardy Lectureship in Surgery, “James D. Hardy and the First Lung Transplant,” June 11.
“He (Hardy) was truly a great man, a great surgeon, a great medical educator, a great friend, and a profound influence in my life,” said Dalton, who completed his general and thoracic surgery residencies at the Medical Center under Hardy’s tutelage. “I admired and respected him more than anyone whom I worked with and he is deserving of praise.”
Dalton’s lecture culminated the daylong James D. Hardy Surgical Forum, which included presentations of original scientific investigations by chief residents in the Department of Surgery: Dr. John D. Adams, Dr. Daniel E. Careaga, Dr. Michael S. Dolan, Dr. Joel R. Epperson, Dr. Paul Jason Shannon, and Dr. George Varkarakis.
“This day is really the highlight of our academic year,” said Dr. Marc Mitchell, James D. Hardy Professor and chairman of the Department of Surgery. “Dr. Hardy was a force in this medical school for 35-40 years. I’m sure that if Dr. Hardy were to have looked at his accomplishments, his greatest would be the people he had trained and the lives he had influenced.
“There are many people who are either cardiovascular or thoracic surgeons because of the influence Dr. Hardy had on them during their residency training.”
Chair of surgery from 1955-87, Hardy died on Feb. 19, 2003.
Dalton said Hardy trained more than 100 young men and women to be surgeons, but taught far more than how to operate – he instilled integrity and compassion into his residents and interns. As an example, Dalton recalled the first time he visited the Medical Center while seeking an internship.
“My visit was on a Saturday, and I went to the surgery department,” Dalton said. “Dr. Hardy was the only faculty member who was here. He showed me around, and I was enamored by Dr. Hardy for giving a tour to a visitor seeking an internship.” Dalton arrived on campus in June 1958.
The Hardy family history Dalton provided painted a vivid picture of the world-famous surgeon. Hardy’s father ran a lime plant from an office that featured one solitary sign that read “Do It Now;” his mother was a Phi Beta Kappa graduate of Alabama who taught Latin.
Dalton described Hardy as an “all-around individual,” who played on an eight-man football team at Montevallo, Ala., and, along with two siblings, performed with the Bama Skippers, a local high school band. Although he was an accomplished clarinetist, when Hardy discovered the band needed a trombonist, Dalton said he bought a trombone from a “hock shop” in Birmingham and learned to play on his own. Dalton said Hardy also taught himself to play the piano a few years later.
It was while he was serving in the U.S. Army’s 81st Field Hospital that Hardy decided to become a surgeon, Dalton said. “He felt the rewards, duties and responsibilities were preferable to him.”
Hardy came to the School of Medicine when it transferred to Jackson in 1955. “Dr. Hardy was a wonderful chairman,” Dalton said. “He took over immediately. Things were well under control and humming. He assembled a wonderful faculty.
“Dr. Hardy loved contact with students. He loved to spend time imparting knowledge, gaining knowledge, working with active learners.”
Although Dalton said he is unsure why Hardy decided to concentrate on lung transplantation, an announcement he remembered his mentor make in 1962 turned prophetic within a year.
“He said . . . ‘cautious attempts to achieve permanent survival of homologous lung transplants is morally justified at the present time.’” Dalton said. “Dr. Hardy thought it could be done and should be done, and he made a moral case for it.”
Among the criteria Hardy set for the first human lung transplant were that the recipient have a likely fatal disease, that there be a reasonable possibility of patient benefit and that removal of the donor lung not result in loss of lung function. Dalton said in the absence of brain death laws in 1963, the only way the surgeons could obtain a donor lung would be from a recently expired patient.
Dalton recalled the first potential candidate for the lung transplant, an inmate at the Mississippi State Penitentiary at Parchman, was “very agreeable to what we were going to do. He was an ideal candidate for this particular operation.”
At 7:30 p.m. on June 11, 1962, Dalton called Hardy at his home. “I said we have a donor, and Dr. Hardy promptly appeared.”
Dalton played a three-minute video of the operation. “I brought the lung in from the donor,” he said while the video played. “I can almost hear Dr. Hardy saying, ‘Can you see this?’ to the photographer as he was filming.”
Following the operation, the patient was “alert and active,” according to Dalton. However, the patient developed azotemia, renal failure and malnutrition, and died 18 days after the operation. “This patient, we believe, would have lived considerably longer . . . if not for malnutrition and his renal condition,” Dalton said. Nevertheless, Hardy’s presentation at an American Medical Association conference in Atlantic City, N.J., in June 1963 “created a lot of interest.”
“At autopsy, there was no infection, the transplanted lung was grossly normal and we could find absolutely no evidence of rejection whatsoever,” Dalton said. “A biopsy of the lung taken when it was implanted June 11 and another (biopsy) 18 days later at autopsy were normal.”
Dalton said the operation proved that lung transplants were technically feasible, the transplanted lung functioned well and that donor preservation measures were successful.
“This experience opened the way for further human lung transplants,” Dalton said. “It attracted the curiosity of thoracic surgeons and future transplant surgeons that this was something that could be done and should be done.”
Over the next 20 years, however, only 40 lung transplants were reported. In 1982, cyclosporine, a potent immunosuppressive medication Dalton called a “miracle drug,” became widely available, and the following year, the first long-term survivor of a human lung transplant lived for more than two years. Successful lung transplants began to become much more common.
Hardy went on to perform the world’s first successful heart transplant into man in 1964. Thirty years later, the James D. Hardy Clinical Sciences Building was dedicated on campus, and the James D. Hardy Society was formed. The Department of Surgery dedicated the James D. Hardy Library in 2001.
Dalton said Hardy and his wife, Louise “Weezie” Scott, had four daughters, each of whom earned doctorate degrees. He recalled visiting Hardy when his daughters were young and how one of the girls demonstrated her father’s tremendous literary prowess.
“She excitedly took me to a room and said, ‘This is a special room because this is where my daddy makes books,” Dalton said. Hardy authored 23 books and more than 500 journal articles.
Dalton closed his presentation by drawing attention to a painting of Hardy that hangs outside the Hardy Library.
“It shows Dr. Hardy standing resolutely in a leadership position with an aura of confidence,” Dalton said. “We always think of him standing tall, ready to lead, ready to move forward.”
