Pioneering cardiac surgeon who did the first heart transplantation in the USA. Born on Feb 9, 1923, in Kalamazoo, MI, USA, he died of cancer in Palo Alto, CA, USA, on Feb 10, 2006, aged 83 years.
Norman Shumway's entry in medical history will always have the qualification “in the USA”. On Jan 6, 1968, he undertook the first heart transplantation in that country on 54-year-old steel worker Mike Kasperak, who lived for 14 days. Shumway and his colleague, Richard Lower, had been working on heart transplants since 1958, when they transplanted a dog heart from one dog to another. He and Lower perfected the technique, and in 1967 Shumway said he was ready to transplant a human heart. But by the time Shumway and Lower did the surgery, at Stanford University, Palo Alto, CA, USA, South African surgeon Christiaan Barnard had completed the first successful human heart transplantation in December, 1967.
In 1981, Shumway and Bruce Reitz did the first heart-lung transplant. Scrubbing in with Shumway, said Reitz, who now holds Stanford's chair in cardiac surgery named for Shumway, was “unlike anything else I experienced as a young trainee. He was always calm, and in control, and always knew what the next step would be. Everyone working around him was relaxed. There was no feeling of tension in the room, which is so unusual. He was incredibly gifted as a surgeon, but he was also a great psychologist in working with other people.”
Under Shumway's direction, Stanford became the international leader in heart transplantation. Shumway's dedication to heart transplantation sustained the procedure through decades in which many centres stopped doing transplants because of the high death rate after the operation, said Reitz. “It was the recognition that the surgery was easy but that you had to have a complete dedication to prepare the patient afterward”, said Reitz. Shumway believed that “no one could be more dedicated and could care more about the outcome than the surgeon who performed the operation”, Reitz told The Lancet.
In 1990, German-trained cardiologist Mario Deng met Shumway at a conference. “From my perspective and probably from the perspective of all 250 heart transplantation centres in the world, Stanford was the mecca of heart transplantation, because all the important scientific advances, starting with the technique of transplantation, had occurred there”, said Deng, who went to Stanford to complete a fellowship with Shumway and now directs Columbia University's cardiac transplantation research centre.
Shumway would become best known for his work on heart transplantation, but he also made other important contributions, said Reitz. Shumway worked on the post-cardiac biopsy procedure; preservation of the heart outside of the body to allow it to be transported; new drugs to improve immunosuppression, most notably the introduction of ciclosporin in transplant surgery in 1980; the physiology of the transplant; and denervation in autotransplants. “He also made a lot of suggestions about the management of aortic dissections and also various congenital defects”, Reitz said. His studies of how to protect the heart during routine cardiac surgery using topical hypothermia “made a huge difference in the 1970s in the results of the surgery when a lot of programmes were having a lot of difficulty protecting the heart”, he said.
Shumway earned his MD from Vanderbilt University, Nashville, TN, USA, and completed his internship and residency at the University of Minnesota, from which he would earn a PhD in cardiovascular surgery in 1956. It was in Minnesota that he and Barnard would cross paths as trainees.
Shumway was himself a dedicated mentor, and trained many of today's major players in cardiac transplantation. “He let people grow and take the front seat”, Deng said. “This was a beautiful attitude of a teacher and mentor.”
Colleagues remembered Shumway's unique sense of humour. He would play on medical and scientific terms. “Don't deviate from the Norm Shumway”, he used to say, according to John Wallwork, director of the transplant service at Papworth Hospital Foundation Trust in Cambridge, UK. Shumway would see a ward full of doctors rounding and would say “look at the shifting dullness”.
“He was very self-effacing and he avoided the spotlight in many ways”, said Wallwork. Shumway detested the media circus that resulted from his first 1968 transplant. “He liked being acknowledged but he hated being lauded”, Wallwork said; “at his 70th birthday party, he stood up and said ‘this is like being at an awake wake’.” Shumway is survived by his former wife, Mary Lou, and his four children, Lisa, Amy, Michael, and Sara, who directs the University of Minnesota's heart transplant programme.