Medical Mission : Fame Clouds a Vision at Loma Linda
After existing for more than three-quarters of a century as an obscure training center for missionary doctors, Loma Linda University Medical Center is suddenly experiencing the exhilaration--and the pressure--associated with being thrust forward as a celebrated center for advanced research.
The hospital, housed in three matching seven-story towers in a clover-leaf design that dominates this small town near Redlands, was propelled to international attention by the infant heart transplants performed by Dr. Leonard L. Bailey, chief of pediatric cardiac surgery.
Buoyed by Bailey’s widely reported accomplishments, which include the controversial baboon-to-human infant heart transplant he performed on Baby Fae in October, 1984, Loma Linda officials plan to use his work as a lure for funds for expansion and additional research. They even dream of one day being mentioned in the same breath as established research centers such as Harvard and Stanford.
Signs of Resistance
But they are running into resistance from older members of the Seventh-day Adventist Church--which owns the hospital--and from conservative former administrators who long for a return to the ideals of “quiet Christian servitude” espoused by the medical center’s founders.
Additionally, there is controversy attached to the methods of the iconoclastic Bailey. His pioneering work has drawn criticism from the National Institutes of Health, from other transplant physicians and even within Loma Linda.
While Bailey first brought international fame to Loma Linda when he transplanted the heart of a baboon into an infant known only as Baby Fae, perhaps as important in the long-range fortunes of the hospital has been Bailey’s more recent infant-to-infant transplants. Parents of sick infants across the nation now are desperately seeking admission to Loma Linda, a hospital few of them had heard of more than a year ago.
Other Parents Seek Help
Since Bailey performed successful infant-to-infant heart transplants on Baby Moses in November and Baby Eve in January, both of whom suffered from an invariably fatal disease called hypoplastic left-heart syndrome, parents of 10 other babies with similar problems have approached the hospital for transplants.
Over the same period, the hospital’s occupancy rate has risen from about 80% to 87% and higher.
Loma Linda was not entirely prepared for all of this.
“I suppose it would sound better if I said we planned it this way, but we didn’t,” said John D. Ruffcorn, president of the medical center.
Last year, in fact, the university’s new Center for Bioethics sponsored a soul-searching seminar for medical center and church officials entitled “What’s a Little Church Like Ours Doing in Big Medicine Like This?”
The center was founded after Bailey’s surgery on Baby Fae. Also after the Baby Fae surgery, Loma Linda invited NIH officials to visit the university and determine whether Loma Linda’s institutional review board procedures were in accord with federal regulations for research on patients.
The federal Office for Protection from Research Risks issued a generally favorable report but criticized Bailey for being overly optimistic about the possibility of the surgery’s success when obtaining parental consent. The NIH also recommended that all future species-to-species transplants be accompanied by documents clearly stating whether a “search will be made for an appropriate human donor heart,” or by a list of reasons for not conducting such a search.
The hospital has agreed to abide by all the recommendations.
More recently, Bailey has come under pressure from Loma Linda’s own Institutional Review Board, which supervises medical research at the hospital and would like to review the human heart transplants.
The board’s chairman, Dr. William Eby, said he has asked Bailey for such a research protocol but that Bailey has not yet responded. Bailey said through a spokesperson that he intends to comply “shortly.”
Additionally, it was disclosed by the Riverside Press Enterprise that Bailey had done an unsuccessful adult heart transplant in 1980, a fact that came as a surprise to the hospital’s official spokesman.
More Transplants Seen
Bailey himself rarely speaks to the press and he refused to be interviewed for this story. But he has made it known that he intends to perform more of the rare cross-species and infant-to-infant heart transplants, raising the hopes of parents of children born with fatally malformed hearts.
Even a former dean of the medical school, however, wonders if Loma Linda has gone astray by charging into medical research.
“The original intent here was to develop an evangelistic thrust to medical practice--not to compete in research,” said Harold Shryock, the 80-year-old former dean of the school of medicine.
“We Adventists have a strong contention that the institution developed providentially; that the Lord had a hand in it,” added Shryock, in an interview at his home only a few blocks from the medical center. “Some of us are fearful of it becoming so concerned over successes (in research) that it will forget its original mission.”
Many others, however, consider Loma Linda, and Bailey in particular, a source of pride, despite the critics.
Important Development
“Baby Fae may come to be known as a turning point in not only American medicine but also in the Adventist Church,” Roy Branson, an ethicist and editor of an Adventist journal, said at the church’s 54th world conference in New Orleans last July.
Branson described Bailey’s work as not only a medical innovation, but “also a moral statement, an embodiment by Adventist physicians of moral and religious values.”
Others at the university also are learning to enjoy the attention.
“I just met with a group of university presidents in Atlanta and found there is more respect for Loma Linda,” said Norman Woods, a tall, balding and bespectacled man who became president of Loma Linda University a year ago. “The institution has more credibility now.”
A major problem facing Loma Linda officials now is how to combine high-powered research and publicity campaigns with those traditions that helped make this the flagship of the vast Adventist health care system, which operates 540 medical facilities in 68 countries, employing 56,000 people.
It is a problem the church has faced before.
Basis of Beliefs
The church, founded in mid-19th Century America, now has a worldwide membership of about 4.5 million. Like conservative Protestants, Seventh-day Adventists oppose smoking, drinking and gambling and believe in the imminent second coming of Jesus and in a creationist view of the world.
They are set apart from Protestantism by their Saturday Sabbath, vegetarian diet and some biblical interpretations inspired by Ellen White, a 19th-Century prophet.
Loma Linda’s roots go back to 1866, when the church established the Western Health Reform Institute at Battle Creek, Mich. Patients from around the world flocked to the institute to partake in a strict regimen of warm water baths combined with diet, exercises and religious training that was considered progressive for the time.
In 1876, Dr. John Harvey Kellogg became superintendent of the facility and emphasized a vegetarian diet. It was Kellogg’s brother, W. K. Kellogg, who developed the corn flakes that became a huge industry later.
But the institute fell into disrepute when its medical officials clashed with Adventist religious leaders over a push for increased emphasis on medicine and separation from church control, according to Adventist historians.
Born in a Vision
Enter Ellen White, a founding member of the Adventist faith. In 1904, White told John Burden, manager of an Adventist sanitarium near San Francisco, to find property between San Bernardino and Riverside revealed to her in a vision as the future home of an educational medical center, these historians said.
Burden purchased a 76-acre expanse of farmland about 4 miles south of Redlands and 60 miles east of Los Angeles for $38,900. In 1905, White instructed church leaders to build there the large sanitarium and educational center she had seen in the vision. They called it the College of Medical Evangelists.
In 1918, the church established a medical center in Los Angeles, White Memorial Hospital, where Loma Linda students received their clinical experience.
The Loma Linda complex attracted Adventists from around the country who sought work as educators, physicians, nurses and in related health and support industries. By 1961, when the name was changed to Loma Linda University, largely to broaden its appeal, the complex had given birth to a largely Adventist community with close ties to the medical center.
In 1967, the 11-story, 516-bed medical center, which has become a landmark in the area, opened and now provides clinical facilities for the university’s 2,500 students. Since 1980, the medical center and university have operated as separate corporate entities.
Links to Religion
“We see some things as constants here,” Woods said, referring to the strong religious flavor of the university medical center complex. For example, he said this is still a place where medical students, including non-Adventists, must attend chapel on given days or face disciplinary action.
But Loma Linda officials these days love to talk more about what’s to come in the way of scientific breakthroughs than about religious tradition.
Foremost on their wish list is to own one of the nation’s rare proton accelerators used for cancer therapy. On the drawing boards is a 250-million-volt machine that would cost an estimated $20 million and, in a departure from the hospital’s usual secretive public relations efforts, be accompanied by “a worldwide marketing program to funnel patients to Loma Linda,” said one Loma Linda official who did not want to be named.
The proton accelerator would attack certain types of tumors with a concentrated beam of protons directed in a such a way as to leave surrounding healthy tissue unscathed, Loma Linda officials said.
Michael Goitein, radiation biophysicist at Massachusetts General Hospital and the Harvard Medical School, which has a 60-million-volt accelerator that is occasionally used to treat cancer patients, said he supports Loma Linda’s efforts to acquire such a machine.
Promising Addition
“As a form of therapy it looks promising,” Goitein said. “But it is not so fantastically exotic that one should be overly excited about it.”
For Loma Linda officials, however, the proposed machine could help galvanize the prominence that Bailey has brought to the medical center as well as serve the needs of cancer patients.
But it may be difficult to raise funds to buy the proton accelerator. With the exception of Bailey’s heart transplants, Loma Linda has had little with which to tempt potential donors and grant foundations.
Still, many believe that Bailey’s accomplishments will help the cause.
“There’s no question but that Bailey’s work has opened doors,” said Gus Cheatham, a former deputy assistant to the secretary of education who was hired last year to head fund-raising efforts.
As the front man for soliciting donations, Cheatham, an Adventist, strikes a boldly dapper image in his designer suit, gold cuff links, silk handkerchief and gold tie-clip on a paisley tie. Adventists generally frown on the wearing of what they call “superfluous jewelry.”
A Better Response
“I can’t tell you large dollars have arrived yet,” said Cheatham, after posting brass name plates of the university’s latest donors in a display case near his office. “But I can tell you when we approach large donors and we say we are from Loma Linda we don’t get asked 10 questions anymore.”
Cheatham added: “The next 18 months to two years are key in terms of being able to translate our notoriety into a bottom line.”
It would seem that the city of Loma Linda, now a community of 12,000 with a population that is about 51% Adventist, is on the same wavelength.
Loma Linda Mayor Ardyce Koobs said she has approached the mayors of nearby San Bernardino and Redlands about the possibility of luring medically related industry to the area. The medical center would serve as the hub for the new development.
“This would be a good time to initiate that,” Koobs said, referring to the media attention Loma Linda has received. She added that “we’ve experienced a lot of growth here in the last few years, much of it related to the medical center.”
New Wing to Open
As it stands, the 550,000-square-foot medical center, which is building a 52,000-square-foot hospital wing scheduled to open in June, currently provides employment for about 4,000 people.
In 1980, it became a state-designated regional trauma center for an area encompassing Inyo, Mono, Riverside and San Bernardino counties.
“If that institution would close,” said Loma Linda City Councilman Norman Meyer, “Loma Linda wouldn’t be worth much.”
In his travels around the country, however, people still ask, “where’s Loma Linda?”
“I tell them Loma Linda is the place where Baby Fae was,” Meyer said.
Times medical writer Robert Steinbrook contributed to this story.
