The headlines announcing her death were classics of the genre. "Baby Fae Dies," read one, "But Doctor Sees Gain for Science."
The words relayed from Loma Linda dressed this tiny casket with a silver lining of progress. Dr. Leonard L. Bailey, who oversaw the 21-day drama in the 32-day life of the girl with the baboon heart, called her and her parents "pioneers." The university spokesman at the memorial service said solemnly, "Baby Fae has not lived in vain, nor has she died in vain." Even the mother, we are told, gave one last wish, to the doctor for his experimental work: "Carry it on."
By the time Baby Fae is laid to rest, the choreography of this public medical ballet will have been complete and completely familiar. We have been through this enough to see the shape of a ritual drama.
The plot opens and concludes with "hope." At the beginning, the doctors announce that they are trying to save a patient, a life. The technique is new, daring, promising. There are risks, yes, but Barney Clark may yet be back on the golf course with his artificial heart and Baby Fae may turn 20 with her baboon heart. The story ends with a claim of victory for "science" -- and a funeral.
Each time the curtain rises, the public audience suspends a bit of its disbelief in preference for medical magic shows. We have watched so many impossible cures become routine treatment that even when faced with a baboon organ beating inside a human body we do not want to be considered anti-science, anti-progress, pessimistic.
"What if it works?" we say. After all, when Christiaan Barnard did the first human transplant, the patient lived for only 18 days. Now, 65 percent of those who receive transplants at Stanford live a year, and half are alive after five years. Yes, Barney Clark may have died after 112 days, but Dr. William DeVries announced this week that he is ready to try again.
We don't know whether "frontier-blazing" experiments such as animal-to-human transplants are headed down dead ends or onto new paths, whether we are talking laetrile or penicillin. We don't know whether Dr. Bailey is a committed crank or unrecognized genius. So, the human and the editorial response is that this situation "bears watching" and "raises questions."
But I don't think we have to be quite so reticent to judge this medical event. The issue of experimenting on terminally ill human beings has not always been handled honestly. Dr. Barnard admitted in his memoirs that he lied to the first transplant patient. Barnard told Louis Washkansky the strong odds in favor of survival; he did not tell him that these were the odds of surviving just the operation.
Barnard describes quite accurately the state of mind of terminally ill patients who become subjects for experiment: "If a lion chases you to the bank of a river filled with crocodiles, you will leap into the water convinced you have a chance to swim to the other side when you would never accept such odds if there were no lion."
We have all known people chased by the lions of cancer or heart disease. Barney Clark signed an 11-page consent form for an artificial heart, and leapt into that water. He had the right to do so.
Here the question is whether a parent has the right to throw a child in. All the medical evidence of this case -- except for the original boasting testimony of Dr. Bailey -- suggests that this infant had no chance to survive into toddlerhood, let alone adulthood. Given that, we have to conclude that Baby Fae's body was donated, alive, to science. The rationale, that she was "going to die anyway," implies that it is open season on the dying, that we can try even the most outlandish experiment on these human beings.
Bailey, who called this transplant a "tremendous victory," is planning to do it again. It is entirely possible that he found what he was looking for, a reason to go on tinkering with newborns and baboons. But whatever rationale there was for the first experiment -- the idea that a newborn with an undeveloped immune system could absorb a foreign body better than an adult -- there is none for a second experiment.
Those who cannot give consent should be the last, not the first, people we use for experiment. It may be difficult to stop at the shoreline when the lion is gaining on your child. But when the crocodiles are hungry and the baby can't swim, there is no mercy in throwing that child in the water.