Faculty Bibliography

Baby Fae's doctors were encouraged that she survived as long as she did. But success with such highly experimental procedures as baboon heart transplants cannot be measured only in terms of survival times. Survival times with transplanted animal organs must be compared with the times that babies with Baby Fae's condition would usually live with their birth defects. Quality of Life Loma Linda doctors have said the baby lived her best days with the animal heart. ''Baby Fae has now lived longer with her transplanted heart than with her own lethally malformed heart,'' they said in a statement Nov. 11. ''Sunday, Day 16, has probably been the best day of her life to date,'' they added, even though on that day her body was struggling to reject the heart in an episode that the hospital was then denying. Dr. [Leonard L. Bailey], the surgeon who performed the operation on Baby Fae, said her case was successful enough for him to plan another one ''by and by.'' It is anyone's guess when that will be, and the date almost certainly will be affected by the debates that physicians, ethicists and others will hold in the weeks to come at Loma Linda and elsewhere

Dr. [Leonard L. Bailey] thanked Baby Fae's parents for offering ''a ray of hope for the babies to come.'' He said her family felt ''the surgery was worth it'' and told him ''not to let this opportunity be wasted.'' ''It has shown us that it is definitely feasible,'' Dr. [Sandra L. Nehlsen-Cannarella]-Cannarella said. But, she added, ''we can define that it didn't work because we lost the patient.'' A memorial service for Baby Fae will be held at 4 P.M. Saturday on the Loma Linda University campus. Dr. Bailey said her parents would probably speak out about their experience in the near future. ''I think you'll find it very impressive,'' Dr. Bailey said

In an interview in The American Medical News, a newspaper published by the American Medical Association in Chicago, Dr. [Bailey] said that after the parents took the baby from the medical center, they ''were notified that one final possibility existed for their child: They were told to think it over and to readmit the child if they were interested.'' The Los Angeles Times, reporting interviews with friends of Baby Fae's mother, said today that after the diagnosis of the fatal heart birth defect was made, a physician told the mother she could take the baby home to die, leave her at Loma Linda to die or put her back in Barstow Community Hospital, where she was born. Mr. Weismeyer said Loma Linda had no comment on the newspaper's report. Dr. Bailey also told The American Medical News: ''In disorders like Baby Fae's, a baboon heart not only may be justifiable, it actually may be preferable to a human heart.'' He added, ''We're optimistic that within three months, she'll be able to go home.''

''This child was drafted in the name of science,'' said Ronald Bayer, a bioethicist at the Hastings Center, a research institute at Hastings-on- Hudson, N.Y. ''These scientists were geared up for a very important piece of experimental research, and that's all that seemed important to them.'' Moreover, Dr. [Leonard L. Bailey] asserted that research organizations that he declined to name had rejected his applications for grants. ''One was actually denied on the basis of my age,'' said Dr. Bailey, who is 41 years old. ''I was apparently too old for a grant from that organization.'' ''Nine out of 10 N.I.H. grants are not funded or approved,'' Dr. [David B. Hinshaw] said. Dr. Bailey had to buck a medical profession that is conservative in accepting new ideas and ''Dr. Bailey does not have an established reputation'' as a researcher, Dr. Hinshaw said

Dr. [Leonard L. Bailey] said at a news conference today that his team had not sought a human infant's heart. ''Our entire research endeavor has been aimed at'' transplanting animal hearts in humans, the surgeon said. ''The availability of size-matched human donors is such it makes that avenue impractical with our current abilities of organ procurement.'' The medical center's Institutional Review Board approved ''the protocol for clinical trials involving cross-species transplantation,'' he said. ''That is the thrust of our limited clinical trials.'' Although Baby Fae's condition was upgraded to serious today and doctors were pleased with her progress in the three days since the operation, Dr. Bailey stressed the risks of such an experiment. She ''may be in for a long battle in the weeks ahead,'' Dr. Bailey said

In the case of acquired immune deficiency syndrome, or AIDS, scientists have come tantalizingly close to proving that a retrovirus called HTLV-3/LAV is the cause of the usually fatal syndrome. However, scientists have not yet fulfilled [Robert Koch]'s postulates for AIDS, which has struck more than 6,250 people, according to the latest reports from the Centers for Disease Control in Atlanta. In the experiments that researchers at the disease control centers carried out with colleagues at Emory's Yerkes Regional Primate Research Center in Atlanta, two chimpanzees injected with the AIDS virus developed antibodies against it after four months. The animals developed swollen lymph glands but because they did not develop a clear case of AIDS, they did not fulfill Koch's postulates. However, the researchers did recover the virus from the infected animals. In this connection, AIDS researchers have pointed to evidence from two humans who developed AIDS. One was a blood donor. The second received a transfusion of the first individual's blood, which was donated before the donor developed AIDS. The AIDS virus was isolated from both the donor and the recipient

The body forms a specific antibody against each antigen, and no one knows the limit to the number of antibodies the body can make. ''Certainly,'' Dr. [Cesar Milstein] has said, there are ''well over a million.'' The monoclonal antibodies are capable of distinguishing molecules with even subtle chemical differences, such as the difference of just a single amino acid in the sequence of hundreds within a substance. Because the monoclonal antibody technique allows scientists to make pure antibodies against any chosen antigen, Dr. Milstein has also said that ''it is somewhat like selecting individual dishes out of a very elaborate menu: antibodies a la carte.'' Now, with the new techniques, scientists have come closer to a longtime goal of the ''magic bullet'' that Paul Erlich sought at the turn of the 20th century. Doctors have been trying to link drugs and toxins to monoclonal antibodies in the hope that they will hit only the cells affected by cancer or other diseases while sparing healthy cells

''There is not yet clear-cut epidemiological evidence that the virus is transmitted by saliva to cause AIDS, yet this now has to be considered,'' Dr. [Robert C. Gallo] also said. ''The question remains open whether or not saliva is a significant means of transmission. It is there and has to be studied but I don't think saliva is a major route of transmission of AIDS in humans.'' Dr. Gallo said he ''did not think that the virus all of a sudden was going all over the place'' and that he did not want to be alarmist. However, he also said, he ''did not want it underestimated and you have to deal with the facts.'' The work among human patients was carried on by Dr. Jerome E. Groopman at the New England Deaconess Hospital in Boston and Dr. Gallo at the National Cancer Institute in Bethesda, Md., and their colleagues. They found virus widely believed to cause AIDS, called HTLV-3, in the saliva of eight of 18 individuals who had so-called pre-AIDS or who had contact with individuals who had AIDS. ''It looks like the virus is not only there but also'' it causes disease, Dr. [Murray Gardner] said. ''Why the carrier monkey is not sick is another unanswered question, but there are always these kinds of healthy carriers in any kind of infection.''

Dr. Jonas E. Salk, who developed the injectable polio vaccine, said the discovery of delta hepatitis was ''not a quirk.'' Moreover, it was ''not too farfetched to theorize'' that similar mechanisms might be at the root of other now mysterious diseases, he said in an interview. Many doctors have long suspected that infectious agents cause lupus and other so-called autoimmune disorders. Other doctors have reported the ''discovery'' of putative infectious agents as the cause of the inflammatory bowel conditions known as ulcerative colitis and regional enteritis. But their findings have not been confirmed. Still other researchers have reported similar ''discoveries'' of infectious agents as the cause of rheumatoid arthritis. Again, confirmation is lacking. Dr. [John Gerin] speculated that not only might other delta-like agents be found in hepatitis but that he could ''see no reason why it shouldn't be true for other chronic viral infections.''

For instance, Dr. Alton Ochsner, the founder of the clinic that bears his name in New Orleans, said nearly 20 years ago that ''In 1927, as a young professor of surgery at Tulane Medical School, I taught and practiced that an elective operation for inguinal hernia in a patient older than 50 years was not justified.'' Instead such patients wore trusses; surgery was limited to life-threatening complications. In this era of cost consciousness, many health care critics have argued that too much money is spent on the care of old people in the last year of their lives. A question left unanswered is: How old is ''too old?'' More important than chronological age is the strength of an individual's will to live, and yet cost-benefit analyses do not measure that factor. How much are a few extra months of life worth? Maybe the wise old patient said it best: ''Six months in a lifetime is not much in the middle, but is an awful lot at the end.''