Seems like every time you flip on a TV, you see Dr. Robert Jarvik these days. There he is in jogging gear, imploring you to take care of your heart and to take Lipitor. But long before he became the ubiquitous pitchman for Pfizer Pharmaceutical's anti-cholesterol drug, Jarvik was an ever-present character on camera.
The year was 1982, and a surgeon had just implanted the world's fi rst artificial heart inside the chest cavity of retired dentist Barney Clark. That device bore Jarvik's name - the Jarvik 7. For the next 112 days, Jarvik and head surgeon William DeVries conducted near-daily briefings, updating the world on Clark's condition. Jarvik was a media darling. His accomplishment compelled the Intellectual Property Owners Association to name Jarvik National Inventor of the Year in 1983.
When Clark died, international media attention waned and with it seemingly the possibilities of artificial organ transplant. Four others received Jarvik 7 hearts intended to serve as permanent replacements. About 350 other patients received artificial hearts as bridge transplants until real donor hearts were found. But for the most part, the mainstream media lost interest. Indeed, many erroneously reported that the U.S. government has banned the use of artificial hearts. Moreover, some even wrote that Jarvik himself had died of a stroke.
As the Lipitor commercials and our own recent interview with Jarvik attest, however, he's very much alive, thank you. Jarvik is at once a maverick, medicine man and capitalist. His story is a classic American saga of setbacks (he lost one of his artificial heart businesses in a hostile takeover) and meteoric achievements (hey, he's married to Parade magazine brainiac columnist Marilyn vos Savant).
"There's always a place for invention," Jarvik says. "Sometimes you come to a roadblock and you need an invention to get past it."
The quest for an artificial heart certainly fits that bill. Fortunately for thousands of people with bad tickers, he continues to improve on his invention through his New York based company, Jarvik Heart Inc. His risk-taking innovation - not to mention the chutzpah of patients willing to undergo what's still widely regarded as experimental surgery - epitomize the possible when it comes to medical breakthroughs. In an era of a growing and aging population burdened with high blood pressure, obesity and a catalog of other ailments, we're going to need all the breakthroughs we can get. About 5 million people in the United States suffer from heart failure, when a weakened heart doesn't pump enough blood. Doctors diagnose 550,000 new cases each year, the American Heart Association reports. Some 300,000 die annually.
The National Academy of Sciences' Institute of Medicine, a quasi-public think-tank that advises the government, has reported that as many as 50,000 to 60,000 patients nationwide could benefit from a heart transplant. But only 2,000 donor hearts become available in any given year.
On the heart frontier, Jarvik reveals himself as an optimist. "I'm coming to believe," he says, "there are no serious technological or medical limitations."Jarvik has since moved on from developing artificial hearts, however.
Another firm, Tucson-based SynCardia Systems, is the market leader. The New England Journal of Medicine found that SynCardia's CardioWest heart gave patients about an 80 percentchance of survival until a real donor heart could be transplanted.
Now Jarvik is pumping his Jarvik 2000. The so-called ventricular-assist device is an electric rotary pump about the size of a C battery. It attaches to the heart to keep it ticking. It can be used as a bridge technology until a transplant operation, but it's designed to serve as a heart booster.
Any muscle that gets too little exercise atrophies. The heart is no exception, Jarvik says. The Jarvik 2000 allows the patient's heart to continue to exercise as it recovers after surgery.
The Jarvik 2000, far smaller and quieter than early iterations of artificial hearts, has solved the major problems of device durability and infection, says Jarvik. One patient has survived for the past seven and a half years with a Jarvik 2000. About 250 patients worldwide are walking around with the devices in their chests. Yet the technology is still in its development stage, and lingering problems remain, Jarvik concedes. Some implants accumulate platelets, which can contribute to blood clots in the brain and elsewhere in the body.
Yet Jarvik has overcome significant technological challenges. On smaller versions of Jarvik 2000 devices for children, the pumps seized after a month or two. "We had to develop a new kind of bearing," Jarvik says. The company filed for a patent on the new design earlier in 2007. "It was definitely a situation where necessity caused an invention to be made."
Without prompting, Jarvik argues it's not just the device that determines success, but the existing condition of patients, and their behavior post-surgery.
"In many cases," he says, "these devices are used in nearly hopeless situations. Rather than waiting until they're so desperately ill that they're dying right there, we need to address them earlier. It's a combination of medical knowledge and medical selection."
He notes the case of one Jarvik 7 patient, Michael Drummond - no relation to the author. At 25, Drummond was the youngest patient to receive an artificial heart. Drummond lived with the Jarvik 7 for a week before an organ transplant. It was the first authorized use of an artificial heart as a bridge to organ transplantation.
"But he didn't take care of himself," Jarvik says. "He became grossly obese." Drummond died five years after his heart transplant operation.
"The public expects absolute perfection," Jarvik continues, when asked what's broken about our nation's healthcare system. He cites pacemakers.
"Pacemakers are superb," he says. "People have a 99 percent one-year survival rate. But if you have 1 percent failure, that becomes unacceptable. There's too much litigation and criticism out of context. You come across a few people who have a bad outcome, and have certain personalities and become very vocal. They pair up with lawyers and bring things to fairly large confrontations."
He mentions silicon breast implants by way of another example. Plaintiffs accused Dow Corning, among others, that materials inside the breast implant were leaking and causing serious autoimmune diseases and tissue damage. Courts awarded huge awards for plaintiffs against Dow Corning.
Later "it turns out there was no connection between silicon and the diseases it was convicted in court of causing," Jarvik says.
He also takes the opportunity to defend big pharma and his role in supporting Pfizer's Lipitor.
"Isn't it interesting that there's even a name for it? Once there's a name, 'big pharma,' that's a negative."
The large pharmaceutical companies have the money and resources needed to conduct large-scale clinical studies.
"It's not possible to learn enough about the interaction of drugs without large-scale studies. Most of the large clinical studies are very, very costly. I think it
works for the benefit of the public, because the government doesn't conduct these types of trials."
In the end, Jarvik says prevention and personal responsibility often are the best types of medicine when it comes to the heart and overall health.
"Prevention is so much better than treatment, where feasible," he says. "It's one of the reasons I was willing to be a spokesman for Lipitor (which prevents high cholesterol).
"There's a relatively high percentage of (health-care) costs going to a relatively small proportion of the population. Too many people just don't take care of themselves. Many don't get the message, particularly when it comes to obesity or smoking."
So when you see Jarvik on TV these days, extolling the virtue of Lipitor while getting ready to jog, that's for real. At 61, he's a runner.
"When you get to a certain age and not stay in shape," he says, "then you're losing something that contributes to your whole mental fitness and attitude. People at a certain age should not accept getting weak as part of growing old."
Although he advocates staying fit throughout your life, he's not obsessed with living well into his 100s. For him, it's more about quality of life, than quantity. That ethos has informed his inventive career. It's one reason why he has helped develop technology to help improve lives.
"I'm more concerned about staying in shape and staying young," he says, "rather than living until I'm 114."
