February 28, 2022 Issue

Rivka Galchen, one of my favorite New Yorker writers, has a medical piece in this week’s issue. Called “Change of Heart,” it’s about the world’s first transplantation of a pig’s heart into a human. Galchen talks with the surgeon, Bartley Griffith, who performed the operation. She talks with the surgeon, Muhammad M. Mohiuddin, who led the surgery that extracted the heart from a year-old genetically modified pig. She describes the transplantation:

The cold pig heart was delivered to the operating room. “Some people like to blast music in an O.R., but I like to hear pins drop,” Griffith said. “I like to hear the sound of the heart-and-lung machine.” Griffith estimates that he has performed more than a thousand heart transplants, but this one called for a different start: before he made the first incision, he suggested that everyone pause for thirty seconds to “think about what this man is entering into.” He described the transplantation as an opportunity to learn. Griffith told me, “We don’t usually take a moment like that. But I think it relaxed everyone. And then we went to work.” The process of transplanting a heart is both brutal and precise. An eight-inch incision is made in the chest. The breastbone is cut in half with a bone saw. The ribs are opened outward to expose the heart. One large vein and one large artery are connected by tubes to a cardiopulmonary-bypass machine; a third tube washes the organ with a heart-stopping fluid. That’s the beginning.

And, most memorably, she describes what happens when the transplanted pig’s heart starts to beat:

When he first pulled the pig heart out of its container, it looked small and pale. “It had an opaqueness that was off-putting,” he said. “I wondered, Did we do something wacky?” He connected the pig heart to the patient’s vessels. He released the clamp, allowing human blood to flow into the organ. “It was as if we’d turned on a light. And it was a red light. The heart just brightened up. And it went from trembling to pumping.” He demonstrated the movement with his hands. “Hearts don’t just squeeze when they beat, they kind of twist, and this heart—it was doing the hoochy-coochy. It was one of the best hearts I’ve ever seen after transplantation.”

Galchen is a superb describer of complex scientific projects: see, for example, her “Green Dream” (on nuclear fusion), and her “The Eighth Continent” (on the race to develop the moon). She writes clearly and vividly. I enjoy her work immensely.