Bad News May Impair Heart Patients’ Progress, Humana Doctors Fear

When Murray P. Haydon, the world’s third artificial heart patient, asked his nurse to turn on the television Tuesday, he added: “I’d like to see if I’m alive and how I’m doing.”

After reports that William J. Schroeder was doing poorly upset the Schroeder family, the second artificial heart recipient was wheeled outdoors Tuesday--the first time an artificial heart patient had left the hospital. “With all the news reports, this was a sign to him that he’s doing better,” a spokesman said.

Doctors’ concern about what the Schroeder and Haydon families see and read has made them cautious and reduced the flow of information on the progress of the controversial, government-approved experiment to implant mechanical hearts at Humana Hospital Audubon.

Facing a Dilemma

With two artificial heart patients on the second floor, one recovering swiftly without complication and the other suffering memory loss and speech difficulties from a stroke, Dr. Allan M. Lansing and other spokesmen face a dilemma.

Should they release accurate information without restraint even if it might upset one family and undermine the patient’s recovery?

“I’ve tried to be as open and honest as I can with the press--not completely realizing some of the side effects” on the family, Lansing acknowledged in an interview.

Schroeder’s family, while watching TV in his room Monday, became so upset with the bleak but accurate reports on his condition that doctors worried the family’s mood might hinder the patient’s recovery.

Lansing Worried

Lansing, medical director of Humana Heart Institute International and chief spokesman for the implant team, ran into the problem Monday.

Responding to questions, he said that he was worried about Schroeder’s persistent fever, that the second artificial heart recipient might not make it out of the hospital and that if he lost his spirit he might die.

When Lansing returned to the hospital, he received an angry call from Dr. William C. DeVries, the principal investigator for the artificial heart program.

DeVries, who has not yet made a public statement on the third implant, “was very disturbed with me,” Lansing said. Margaret Schroeder, wife of the 53-year-old patient, had been upset and teary-eyed after seeing Lansing on TV.

DeVries “couldn’t understand why I was saying all those things, why I was talking about Bill Schroeder when it was Murray Haydon who had the implant,” Lansing said.

Accurate Report

Lansing told DeVries that most of the questions had related to Schroeder and that he had felt obligated to answer truthfully, Lansing said. “I gave you an accurate report that upset the Schroeders and that upset Bill (DeVries),” he said.

On Tuesday afternoon, in a surprise move, Schroeder was wheeled into the parking lot for about 15 minutes. Wearing a red baseball cap and with a blanket draped over him, Schroeder blinked at the sun. Temperatures were in the 40s.

Two girls came by to shake his hand and one of them gave him a kiss on the cheek. Later, one of the girls, Kim Nasief, 10, told ABC News: “It was like shaking hands with history.” She said that she asked him how he felt but that he did not reply. “I’m not sure he knew we were there,” she said.

Although he was physically capable of such an excursion several weeks ago, Humana spokesman Robert Irvine said the outing was made Tuesday to shore up Schroeder’s sagging spirits, and was “strictly a medical decision.”

Schroeder, whose ability to speak is limited by a stroke, has not commented on the news of his condition, doctors said. But “when the family feels bad, it affects Mr. Schroeder,” Lansing said.

Fear of upsetting the family has also kept Schroeder’s neurologist, Dr. Gary Fox, and psychiatrist, Dr. Lawrence R. Mudd, from briefing reporters.

‘Tells It Like It Is’

Fox “tells it like it is and the family gets upset,” Irvine explained. Similarly, Mudd thinks a public comment would compromise his relationship with the Schroeders.

By Tuesday, the episode had “a very beneficial effect” by bringing the Haydons and Schroeders closer together, Lansing said. The wives of the two men have spent hours talking to each other privately in the hospital, and Schroeder went by Haydon’s room and they waved to each other Tuesday.

Schroeder’s steady improvement from the fever that sapped his strength and discouraged him during the last few weeks also improved Mrs. Schroeder’s mood, he said.

Haydon was sitting up in bed Tuesday and was eating ice chips. He had a queasy stomach, a common reaction to the stress of surgery, Lansing said.

‘No-Win Situation’

Humana has been criticized for releasing too much information even as it receives hundreds of requests for interviews with heart-team doctors.

“It’s a no-win situation,” Irvine said. “There is a great deal of public interest in the patient--both medically and for human interest.”

Before Haydon, 58, of Louisville, received the Jarvik-7 heart, he and his family told Irvine they wanted to stay out of the limelight. Partly as a result, the amount of detailed information released about Haydon has been smaller than was released about Schroeder.

“We have decreased the moment-to-moment pictures of each breath, each smile, each kiss,” Lansing said.

Humana Criticized

Humana has been criticized by New England Journal of Medicine editor Dr. Arnold Relman, among others, for its blow-by-blow updates, conducted from a podium for the benefit of about 125 news organizations covering the implants.

Some critics also saw the heart-implant program as a public relations gimmick created by Humana Inc., a for-profit firm with 91 hospitals in 22 states and three foreign countries.

Lansing said he agrees that the ideal way to carry out a human experiment is quietly, with full reporting in the medical journals later.

“But I disagree with anybody’s suggestion that that would be possible here,” he said. “The interest was so enormous among the public and the demands on the press to produce articles so great that it would have been impossible to keep it quiet.”