Bruce Tucker deserved better.
On a warm spring Friday afternoon in 1968, he was sharing a bottle of wine with friends while sitting on a wall behind a gas station in Church Hill when he fell, cracking his skull and bruising his brain.
And then he fell through the cracks.
He was in the wrong place — the city of Richmond — at the wrong time, a South that was beginning to rise out of the era of segregation and Jim Crow. And here was Tucker, a Black man with the smell of alcohol on his breath, in need of immediate medical attention. He was taken to the Medical College of Virginia for treatment.
The prognosis was poor, with death imminent, and doctors decided that Tucker was the prime candidate to be the organ donor for a heart transplant that would be a prestigious first at the school and for its program. But MCV, the forerunner of VCU Health, and authorities were lax in their search for his relatives: They did little more than send police out twice on door-knocking excursions, even though Tucker had the business card of his brother, William, in his pocket. (It was returned to him when he claimed Tucker’s effects long after his death and the surgery.)
After the accident, Tucker’s heart was still beating, crucial in preventing damage to the organ, but his brain was showing no activity. This was a time before brain death was an accepted standard, but it was a determining factor in having Tucker declared dead and allowing the MCV team to perform the transplant.
Tucker’s place in the transplant story wasn’t announced initially by the hospital — he was anonymous. It took a mortician to make the connection and give some sense of dignity and acknowledgment, through his obituary.
“He was caught in the crosshairs of history,” says Chip Jones, author of “The Organ Thieves: The Shocking Story of the First Heart Transplant in the Segregated South” (Gallery/Jeter Publishing), which details the story of that procedure and the court action that followed. The book, which was released in August, looks at the outsized egos of the doctors behind the operation, and the race to perform the procedure, which had made a worldwide star out of Dr. Christiaan Barnard, the South African surgeon who, five months earlier, had performed the first successful heart transplant. The book also profiles some of the recipients of those organs, as well as the all-too-often-overlooked men whose organs made the procedures possible.
But the book’s focus is on Tucker and the lack of care and concern over the donor and his family, which was part of a long, sordid history of medical mistreatment and indifference to African Americans and the poor — not just in Richmond, but throughout the world. Jones delves into this, tracing the practice in Richmond of using the bodies of enslaved people whose graves were desecrated by “resurrection men” and medical school staff and workers in search of cadavers for use in training, with the bones later discarded into an old well.
The Richmond Times-Dispatch's first report on the donor, Bruce Tucker, from May 28, 1968, by reporter Beverly Orndorff. The transplant occurred three days earlier. (Image courtesy Jeter Publishing / Gallery Books)
Rash and Brash
The tale of the first MCV heart transplant is one of actions taken in haste.
A successful human heart transplant was a surgical holy grail in the mid-20th century, the medical equivalent of the space race, the international competition to place a man on the moon. Donald McRae’s 2006 nonfiction book “Every Second Counts: The Race to Transplant the First Human Heart” details the timeline and personalities of the leaders in the field seeking to perform the first human heart transplant, looking at South Africa’s Barnard, who earned that distinction while besting other pioneers, including Dr. Richard Lower at MCV.
Jones tasked himself with finding another approach to telling this story, focusing on Tucker and the legal aftermath. Honing his writing and reporting skills with stints at newspapers such as the Roanoke Times and the Richmond Times-Dispatch, Jones also served as the communications and marketing director for the Richmond Academy of Medicine. He began mulling a book on the heart transplant race in 2016, talking with people at the academy, then digging into various archives and records. He supplemented the paper trail with interviews.
It is a tale of frustration.
The halfhearted effort in tracking down Bruce Tucker’s family was indicative of the indifference to the life of working-class African Americans at the time of the transplant. His tale may initially have been ignored altogether but for the efforts of his older brother, William.
The owner of a shoe repair business, William Tucker got a heads-up call from someone at the hospital the day after the accident, saying that his brother Bruce’s situation was dire. William Tucker went to the hospital that evening and was told that Bruce had died earlier that afternoon. No mention was made of harvesting his organs for transplant. William Tucker didn’t learn about that until after the body had been taken to a funeral home in Stony Creek, near the family homestead. The mortician there told him that the body was missing its heart and its kidneys, which were also culled for transplant.
Meanwhile, MCV was announcing that it had joined the international ranks of successful heart transplants. News reports focused on the team and on the heart recipient, Joseph Klett, a white businessman from Orange County who was 54, the same age as Tucker. There was no mention of the donor.
What was the rush at MCV?
For starters, the clock was ticking on keeping the organ viable. Though a donor may be brain-dead, blood flow may be continued to the heart. Without that flow, cardiac arrest ensues, and tissue is damaged. That is part of what drove the decision to proceeded quickly with the transplant, and the lack of an exhaustive effort to locate family and kin.
Also, there were no precedents. It was a different time, and there were no policies or procedures in place, as the medical team was making it up as they went. “There was really no system in place to slow down the system,” Jones says.
Most troubling was the lack of personal or hierarchical concern.
“I felt like every second really didn’t count for Bruce Tucker: No one slowed it down,” Jones says. “It literally sent shivers down my spine. Imagine what it was like to be him.”
The other missing piece in telling this story was the part played by future Virginia Gov. Douglas Wilder in bringing the rights of the donor’s family to the courtroom and to the attention of Virginia’s power elite. The Tucker family filed suit seeking damages for wrongful death.
No transcript can be found of the proceedings, so Jones relied on accounts from participants and from access to the notes of the presiding Law and Equity Court judge, the late Christian Compton. The family was denied major damages in the suit, but courts later determined that Bruce Tucker was brain-dead before the surgery, though his heart and lungs were still working. Wilder at the time was a state legislator and an attorney with a small practice. He was taking on the medical establishment and was the decided underdog facing a juggernaut that was “too big to fail,” says Jones. “Wilder was on his own and knew he was challenging the medical establishment, but that was what he always did.”
"The Organ Thieves" author Chip Jones at the Egyptian Building at Virginia Commonwealth University. The building dates from the 1800s and was home to the predecessor of the VCU School of Medicine. (Photo by Jay Paul)
Setting Standards
The first heart transplant in Richmond had followed by five months the world’s first human heart transplant, performed in December 1967 in South Africa by Barnard, who had earlier come to Richmond to learn from MCV’s transplant team. That was followed by more than 100 such procedures at more than 17 sites around the world in the following year, including Richmond, according to Dr. Mohammed Quader, heart transplant surgical director for the VCU Health Pauley Heart Center. It wasn’t until an ad hoc committee was formed later in 1968 that a uniform interpretation act was conceived that would cite brain death as a criterion for vetting a donor.
Today, the Richmond-based United Network for Organ Sharing (UNOS) serves as the national coordinator for organ donations. You can declare yourself an organ donor by registering to be one when you get your driver’s license. In the event of death, family members will be counseled about donation, about whether the deceased has registered as a donor and about the donation process as part of the procedure to gain authorization, according to the UNOS website. It’s all to “ensure it’s understood by the family and next of kin,” Quader says.
Klett, the first recipient of a transplanted heart at VCU, survived for a week. Heart transplants captured the imagination at the time, but the complications, especially the rejection of the organ by the body, were a major problem. After the first year, there was a moratorium imposed on heart transplants, with only four centers around the world allowed to continue, says Quader. MCV was one.
“If it was not for the four pioneers to continue, we would not be doing heart transplants today,” he says.
Over the decades, procedures and techniques have evolved and improved, with a median survival after transplant of 14.8 years, according to Quader. There have been more than 22,000 heart transplants done since Barnard’s pioneering procedure, with 3,552 of them performed in 2019, according to UNOS.
Without a transplant, the average patient would live about two additional years. “The heart transplant has delivered more than the hype it has created,” Quader says.
Rectifying the Past
In response to “The Organ Thieves,” VCU in July issued a statement that says the book’s release gives the school an “opportunity to reflect and learn,” noting that learning and understanding the institution’s history can help improve VCU Health and its relationship with the communities it serves.
“Treating all patients with dignity and respect is an unwavering commitment of our health system,” the statement reads. “That said, we humbly acknowledge that there have been times when we have fallen short of this goal and damaged the trust communities place in us that is vital for us to best serve our patients.”
VCU says it will craft a new diversity, equity and inclusion statement as a guide, according to the release, and the university “recently vowed to fearlessly accept criticism and continuously learn from our mistakes in transparency and humility.”
The school touts its transplant program’s accomplishments in terms of providing services to more than twice the national average of African American heart transplant recipients, and in being a top destination for transplant patients of minority communities.
VCU also has taken steps to help new generations of medical professionals be more aware and responsive to the communities they seek to help.
“Treating all patients with dignity and respect is an unwavering commitment of our health system. That said, we humbly acknowledge that there have been times when we have fallen short of this goal.” —VCU statement
As part of their training, VCU School of Medicine students learn about historical trauma and harmful actions and policies that VCU’s predecessors and other medical institutions engaged in over the course of approximately 200 years, according to Dr. Mark Ryan, an associate professor of the medical school’s family medicine and population health department. He’s a co-director for the medical school’s patient/physician society course.
The course addresses issues such as segregated institutions and the infamous syphilis study in Tuskegee, Alabama, that ran from the 1930s into the 1970s, in which the Black men in the federal experiment were never informed of the nature of the study and were given placebos instead of being treated for the disease.
There’s also the matter of VCU’s past, including the infamous well of discarded bones and remains that was found during a construction project in the 1990s. The remains were taken to the Smithsonian Institution in Washington, where they were studied before being returned to Richmond in 2019. Officials and a citizens group will determine a final resting place.
“We bring those historical facts into play,” Ryan says.
The course helps students understand why some people may be leery of doctors or lack trust in medicine, and it aims to give future doctors training and skills to use when working with patients of different experiences, helping them “to be thoughtful so as not to re-create the trauma or bring new issues to bear,” Ryan says.
EXCERPT
From “The Organ Thieves: The Shocking Story of the First Heart Transplant in the Segregated South” by Chip Jones
CHAPTER 11
THE FALL
Image courtesy Jeter Publishing / Gallery Books
3:00 p.m., Friday, May 24, 1968
BRUCE TUCKER’S FRIENDS LIKED to gather behind the Esso station on Church Hill, catching up on gossip, news, and sharing a joke or two. In the shade behind the gas station, the group passed around a bottle of wine to mark the end of another hard workweek.
Though drinking in public was against the law, they knew if they kept to themselves and didn’t get too loud, nobody would notice. They could blend into the tree-lined neighborhood of comfortable homes, brick churches, and small businesses and offices. It was friendly territory for these working-class black men. As long as the sun was still up, they were reasonably certain they wouldn’t be hassled by the police.
Bruce Tucker settled back on a brick wall. Lighting a cigarette, he took in some of the latest news. There was a story in the Richmond Afro American about a preacher arrested in a civil rights protest after his son had been handcuffed. The black-owned newspaper served its news straight up — on that everyone could agree. It was better than the morning Times-Dispatch or evening News Leader, which only gave the white point of view.
He’d left his family farm in 1954 in search of a better job in the city. During his boyhood and teen years in his native Dinwiddie County, he slept in a room crowded with his brothers and shared the limited space, food, and attention with several sisters, too. His parents, Spencer and Emma, had done the best they could, working odd jobs and raising crops on a small plot of land. As he got older, Bruce could see his career options didn’t stretch beyond the rows of the family’s soybeans. Virginia’s capital, only an hour’s drive to the north, beckoned.
He was following in the footsteps of his younger brother William. Even though he’d contracted polio in his youth, William was bright and had a strong work ethic. His crutches didn’t deter him from learning the cobbler’s craft. Eventually he earned enough money to open his own shop. Tucker’s Shoe Repair was on East Main Street, not far from where Bruce found work at the egg-processing plant. The shoe business was as steady as delivering newspapers, eggs or milk. Just as folks would always need something to eat and drink and read in the morning, they’d also needed to keep their shoes in good repair. By 1968, there were more than thirty shoe-related businesses around town.
Bruce made more than $3,000 a year working at the plant — enough to pay the rent in a rooming house about a mile away from Church Hill. He also sent $175 a month to his mother down in Dinwiddie. That helped support his only son, Abraham, who was a fourteen-year-old freshman at the county high school. Bruce’s wife had left a few years before, so it made sense to leave Abraham down on the farm.
A breeze picked up from the south. A storm was brewing. The afterwork bunch passed the wine one last time. There was plenty more news to discuss — like how the Richmond Braves — a minor league baseball team for Atlanta — had won the night before over the Mets’ minor league club at Parker Field . . . and how up in DC, Frank Howard of the Washington Senators was leading the American League in hitting with a .348 batting average and seventeen homers.
A thunderstorm rumbled. Storm clouds gathered. Then someone shouted behind the Esso station: Bruce! Like Humpty-Dumpty, the egg man had fallen off the wall.
Copyright © 2020 by Chip Jones. Reprinted by permission of Jeter Publishing / Gallery Books, an imprint of Simon & Schuster, Inc.
