Faculty Bibliography

Nina Trasoff, the spokesman for the medical center, which is an affiliate of the University of Arizona, said the prospect that the donor's heart was appropriate appeared good. She said that Dr. Jack G. Copeland, head of the heart transplant team, thought the blood-type match was good, the size of the heart appropriate and that the condition of the donor led him to believe ''the heart would be in good shape and viable for transplant.'' Meanwhile, doctors removed Mr. [Michael Drummond]'s name from the critical list and said his condition was ''quite stable,'' according Miss Trasoff. Miss Trasoff described Mr. Drummond as ''sitting in a chair, watching television with his dad,'' asking for ''a big Mac'' and ''feeling much better'' than he did Thursday

Dr. [Jack G. Copeland] spoke just after leaving Mr. [Michael Drummond]'s bedside, at which time he said Mr. Drummond was ''answering appropriately'' and he was ''receptive to all stimuli and understands.'' ''From our point of view, it is not yet a major catastrophic event in his course,'' he said. ''But it certainly is a major event in terms of changing our approach and motivating us to proceed with the transplant as soon as we can.'' Dr. Copeland said he experienced two kinds of personal feelings at the time. ''I couldn't help but notice what was going on and I had to admit to myself but I didn't want to,'' he said. ''Initially I looked for anything that could possibly explain it besides'' blood clots

Dr. Mark M. Levinson, a member of the surgical team, said it would still be a ''few days'' before a search is begun for Mr. [Michael Drummond]'s new heart. Dr. [Jack G. Copeland] has said that once Mr. Drummond's name is listed with a national registry, he hopes the transplant could be done within a week. Mr. Drummond, Miss [Nina Trasoff] said, ''wants to direct all of his attention and all of his energy to getting well, to getting strong enough to be able to have the heart transplant and expressed the desire that everybody not lose focus of that goal.'' She added: ''He wants to live, he wants to get better and he wants to walk out of here.'' ''He's not panicked, he's a very calm fellow,'' Dr. Levinson said

Dr. Jack G. Copeland, who implanted the artificial heart in Mr. [Michael Drummond], when asked at a news conference today about the effect that Mr. [Leif Stenberg]'s latest stroke would have on Mr. Drummond's case, said: ''I think that we can't help but notice that and be concerned about it.'' ''My feeling is that the longer we wait, the greater perhaps the chance'' for strokes and other complications, Dr. Copeland said. ''Therefore we are using that as part of the equation for trying to decide when to go ahead with the transplant.'' Mr. Drummond still has a fever of about 100 degrees that Dr. Copeland said he believed was linked to the lowered cardiac output. But the doctors said they had decreased the cardiac output because Mr. Drummond is jaundiced, or has a yellow tinge to his skin. The jaundice has resulted from the breakdown of red blood cells, or hemolysis, by what Dr. Copeland said he called ''the Waring blender effect on the blood'' of the artificial heart

In fact, only a few hours after the artificial heart was implanted, Richard Smith, a biomedical engineer who operated the machinery powering Mr. [Michael Drummond]'s heart, was excited. He said he ''couldn't draw more perfect graphs'' of the pressures in the left and right sides of the artificial heart. ''I must have felt his feet 100 times or more during the course of the day,'' Dr. [Jack G. Copeland] said, but graphs of the mechanical heart and other test results looked so good that he believed ''everything was going to be O.K.'' ''We were caught in a bit of a trap there,'' Dr. Copeland said. ''It's a lesson that we learn over and over again - that you have to follow the patient, you have to feel the patient, you have to look at the patient, you have to be on top of the patient at all times.''

''He is doing very well,'' Miss Trasoff said. ''He is alert and responsive and everybody seems very pleased at the progress he has made so far.'' At today's news conference, Richard Smith, a biomedical engineer who regulates the system that powers the air-driven Jarvik-7 heart, said Mr. [Michael Drummond]'s first words after the implant were: '' 'What's this clunking?' in his chest.'' ''For example,'' Mr. Smith said, ''not only do you have a heart, but then you have your tubes, drive lines coming down the side, and you've got this machine at the end of the bed. Maybe he was aware that he was going to get an artificial heart, but doesn't understand what that all entails.''

His mother, Joan Drummond, said she had known ''very little about the artificial heart'' and was ''dead set against them using it'' but relented when there was no alternative but death. ''He would sooner have had a heart, a human heart,'' [Clarence Drummond] said. ''But he seems to be well satisified that he's got this, and he's hanging on until he gets one.'' Just after the implant operation, Dr. [Jack G. Copeland] took Mr. Drummond off the list of most severe cases. ''If a donor heart became available, for instance today, we would not accept it,'' Dr. Copeland said, because he wanted Mr. Drummond's condition to remain stable for ''four or five days.''

Mr. [Michael Drummond]'s condition was reported as critical but stable. Dr. [Jack G. Copeland] said his team was ''very surprised and extremely pleased at'' his progress to date. ''He couldn't be doing any better,'' Mr. [Richard Smith] said. In an interview Dr. Robert K. Jarvik, the designer of the artificial heart used in Mr. Drummond, said he was particularly pleased that Mr. Drummond had avoided the severe bleeding complication that forced most other artificial heart recipients back to the operating room in the first few hours after the implant. First, he said, he used ''meticulous care'' in placing the sutures in the artificial heart and blood vessels in Mr. Drummond's chest. He also took special care to make certain that there was no bleeding before he sewed the chest closed

The recipient in the current operation, Michael Drummond of Phoenix, an assistant manager of a grocery store, was reported doing ''fine'' and in critical but stable condition after the operation, which lasted about 4 hours and 15 minutes. Last Aug. 22, Hershey doctors left the severely damaged natural heart of Peter Dowger, 48, of McAdoo, Pa., in place while they implanted two partial artificial hearts, or ventricular assist devices, in his body. Since then the ventricular assist devices, acting in tandem, have been sustaining Mr. Dowger's life while doctors give his circulatory system a chance to stabilize. Mr. Dowger went into shock after a heart attack. Mr. [Carl Andrews] said that Mr. Dowger was in critical condition yesterday. Three of these individuals are alive. They are William J. Schroeder, the longest surviving artificial heart recipient, and Murray P. Haydon. Both are living in Louisville and have suffered serious complications of the procedure. Mr. Schroeder's memory and speech have been severely impaired by two strokes. Mr. Haydon has suffered a stroke that has left him with no apparent permanent damage. But Dr. [William C. DeVries] has said that Mr. Haydon is psychologically dependent on a mechanical respirator to breathe for up to several hours each day

The Milbank Memorial Fund Quarterly, which devoted a special issue of the prestigious journal that highlights the problems of health and society to the oldest old, makes clear that not enough is known about the economic impact on the aged. Most members of this group have their assets in home equity, which is not easily converted to income when medical bills are due. Moreover, the consequences of a public policy that might try to contain costs by placing greater reliance on the economic resources of the oldest old could be self-defeating. Such a policy could eventually force this age group to rely even more on publicly financed health care