all prizes-because our work must not die. That is how I feel.’
Garrett tried to smile his understanding but could not. ‘I have stopped thinking of two people-Farelli and Garrett-and begun thinking of only one-Count Ramstedt. My personal concerns have left me. They’ve been made too small to live on a morning like this.’
‘But now, what is to be done, Dr. Garrett? I told the Swede I want to fight for that one man. It was bravery without arms. I can think of nothing. I depend on you.’
Garrett received Farelli’s dependence upon him without feeling superiority, but with all the comfort that collaboration often produced. He had left the butt of his cigar in an ashtray, and now he retrieved it, and lit it, thinking all the while. His head had never been clearer.
‘One idea keeps recurring,’ said Garrett, as he slowly circled the room. ‘Even though we have learned to neutralize the rejection mechanism with Anti-reactive Substance S, I have had my secret fears about potential steroid dangers-the side effects, that is. And so I always sought to improve it. I have never written this in a paper, but once, for a period, I experimented on dogs with another version of the serum, an anti-histamine I called Anti- reactive Substance AH-and the early experiments were remarkably effective.’
‘Substance AH?’
‘Yes. While it’s been somewhat less reliable than the steroid version in blocking phlogistic response, it has been far superior in other respects-more selective-more effective in holding off the rejection, yet permitting immunity, strong immunity, against infection.’
‘Would it be possible?’ Farelli wondered.
‘I have never tried this mixture on a human being,’ said Garrett. ‘I intended to do more experiments on animal specimens when I returned to-’
‘Dr. Garrett, I would be willing to take the chance here, now,’ said Farelli suddenly. ‘Can it be prepared here?’
‘Easily,’ said Garrett, but his mind was elsewhere. ‘If only we had some insurance,’ he mused.
‘What do you mean?’
‘If there were something else in the event that this failed.’
Farelli pursed his lips thoughtfully. ‘We could try a modified outside pump, a portable pump-’
Garrett shook his head. ‘Too impermanent. I am thinking-you know-possibly-’ He halted, privately weighing something.
‘Possibly what?’
‘Something else is on my mind,’ said Garrett slowly, ‘something more permanent. I hesitated, because it is premature. Still-at a time like this-’
‘Please-what is it, Dr. Garrett?’
‘In this last year since our discovery, I have gone along on an entirely new offshoot, new tangent, of cardiac grafting. I have not published preliminary data, because I have not gone far-there has not been time-but I must openly confess what I have in mind. As you doubtless know, there is one tissue that can survive the rejection mechanism-I refer to living embryonic tissue. It is virtually nonreactive-it doesn’t have any antigenic specificity. I confirmed this, to my satisfaction, with recent tests on rats. I determined to attempt a pancreas transplantation. I started by transferring a mature pancreas from one adult rat to another, and it wouldn’t grow at all, it was rejected. Then I did something else. I typed a rat’s estrogen cycle to find out when the rat was pregnant, and then-listen to this-at an early stage, I took pancreas tissue out of the f?tus-although pancreatic tissue per se was not the object-and grafted this embryonic tissue into another rat, and, Dr. Farelli, it grew healthy and strong. It was not rejected at all. I kept wondering if the same could be undertaken, successfully, with an embryonic heart.’
Farelli was staring at Garrett, his mind bounding ahead, his temples corded with concentration. ‘But why not?’ he asked suddenly. ‘Let us say that a pregnant mother miscarries in the first trimester-’
‘Remember the obstetrician who looked in on Ohman early this morning? He has a miscarriage he is handling, under this roof, in the fourth week of gestation.’
Farelli could hardly contain himself. ‘We take this tiny four-week-old heart tissue and hook it up with an external circulation pump, induce speedy growth-even apply the new growth hormone those men down in-’
‘Wait, Dr. Farelli, you’ve given me a better idea. Why develop this four-week embryonic heart externally? Why not internally? It won’t be rejected. We graft this embryonic heart into Count Ramstedt’s groin-the way kidney transplants have been placed in the neck-a heterotopic graft. We put the embryonic heart in the inguinal area, because the blood vessels there are twice as big as-don’t you see? We hook it into the arteries and veins-we keep Count Ramstedt on Substance AH as well as Anti-reactive Substance S while the embryonic heart grows. Shortly after, as it develops, we-or Ohman, for that matter-begin to waltz it-move it into the abdominal area where it can work on bigger blood vessels.’
Garrett flung his cigar aside, and paced a moment.
‘Yes, Farelli, it is possible,’ he resumed. ‘There would be no discomfort. A woman’s pelvic site accommodates a large mass in pregnancy, enough to hold a full-grown human heart in her twelfth week. A man with a stomach tumor suffers greater displacement. Why not an embryonic heart? Then we keep injecting the new growth hormone. In four or five months, the embryonic heart, unrejected, is full-grown. It is ready for a final transplantation. Now we have everything in our favour. We keep Ramstedt alive with the anti-reactives and booster pumps. If Anti-reactive Substance AH works, we let Ramstedt go on with the calf’s heart Ohman put in this morning, plus the secondary human heart in his abdomen-they do not have to be synchronized in their beat-
Farelli had his big hands on Garrett’s shoulders, rocking him with love. ‘Dr. Garrett, you are a genius, a genius! When everything is lost, there is nothing more to lose-but now, I can only think of what can be gained. We will work as we have never worked before. I will get hold of Ohman and obtain that embryonic heart tissue from the miscarriage-’
‘And I’ll start preparing the new anti-reactive serum.’
For an instant, Garrett’s mind was not on the serum, but on his recent past. He had the curious feeling that he would never know the end to Mrs. Zane’s amorous dilemma. He was sorry for that-that, and the loss of Dr. Keller, crutch and friend-but suddenly he knew he did not care. For the first time in what seemed eternity, he felt released of the genetic shackles that had bound him to shadowed ancestors. He wanted to sing, but he did not, for he could never carry a tune. So he sang inside, ever so briefly, until Farelli’s musical voice blended in to conduct him back to the present.
‘We will do this wonderful experiment together,’ Farelli was saying, with enthusiasm.
‘Yes,’ said Garrett, smiling at last, ‘for better or for worse.’
It would not be until three hours later that the electric duplicating machine in the clerical office of the Caroline Hospital began to revolve, imprinting Ohman’s official release to the press:
On behalf of His Royal Highness the King, the directors of the Stockholm Caroline Hospital are pleased to announce that a heart transplant has been successfully performed on Count Rolf Ramstedt, seventy-two. The graft was dramatically accomplished by the two current Nobel Prize winners in medicine, Dr. John Garrett, of Pasadena, California, and Dr. Carlo Farelli, of Rome, assisted by Dr. Erik Ohman, of the Caroline staff. Early complications were overcome by the two brilliant visiting laureates, working side by side as a team, through improvisations based on their earlier experiments. As a result of the Ramstedt case, the directors of the Caroline Hospital believe that a new method, to supplement the Garrett-Farelli method that is being honoured in Concert Hall this afternoon, has been found for cases where organ transplantation is rejected by the immunity mechanism which…
It was 11.14 in the morning.
Andrew Craig, one knee pressing his tan, lightweight valise to his bedroom floor, grunted as he tightened and fastened the straps of his luggage. Tired of awaiting Leah’s return from Dalarna, Craig had begun to empty his drawers and cupboard ten minutes before, throwing his effects helter-skelter, without care or economy, into his luggage. Now the necessary task was finished. What remained was to telephone the
