Barney Clark – Medical Pioneer

University of Utah Medical Center

Barney Clark & Jarvik 7

Today marks the 29^th anniversary of the death of Dr. Barney Clark, the first permanent artificial heart recipient. On December 2, 1982, Dr William DeVries implanted the Jarvik 7 mechanical heart into 61-year-old Barney Clark at the University of Utah Medical Center in Salt Lake City. He survived 112 days after the implant, dying on March 23, 1983. 

Clark with medical staff
before the operation

Clark, a retired dentist from Seattle, suffered from sever congestive heart failure.  He knew he did not have long to live, so he volunteered to undergo a radical procedure as a way to draw attention to the need for further medical research in this area.  Clark told doctors he hoped that they might learn more during his treatment, so that more lives could be saved in the future. 

In 1976, Clark had contracted a viral infection.  His heart muscles became swollen, enlarging his heart and making it harder for blood to flow there.  By 1982, doctors had determined that Clark was too ill to be given a heart transplant.  The only option left open to him was the implantation of the artificial heart.

Dr. Robert Jarvik
with the Jarvik 7

Dr. Robert Jarvik designed the state-of the-art Jarvik 7.  The mechanical plastic and aluminum heart was the first of its type for permanent use in a human. The artificial heart mimicked a natural heart’s function with two air powered heart-shaped pumps that were implanted into the patient.  These pumps were connected to an external pneumatic compressor, about the size of a refrigerator, weighing over 400 pounds. The pump was extremely noisy and the size of the compressor made it impossible for the patient to move around. Barney Clark never left the hospital after the unprecedented operation. 

Front Page of the
New York Daily News

Barney Clark &
Dr William DeVries

Clark had told doctors before the surgery that he did not expect to survive more than a few days after the implant.  But he did.  Although doctors were elated by his progress, Clark was miserable. He drifted in and out of consciousness and suffered from a multitude of complications. He underwent four more surgeries, after which he battled repeated infections, experienced several episodes of sever bleeding, suffered a broken heart valve, and endured chronic clotting, which led to a series of strokes. Several times, Clark requested to be allowed to die.

Clark tethered to his machines

Through it all, the mechanical heart continued to pump, maintaining Clark’s normal blood flow and sustaining his life for 112 day. Doctors continued to express their concerns about the threat of infections and pulmonary problems that could arise since Clark was immobilized.  Then on the evening of March 23, 1983, medical officials announced that Clark had died of “circulatory collapse and secondary multi-organ system failure.”

Dr Robert Jarvik in 1982

Medical professionals were divided as to whether the research done at the time of Clark’s implant had been conclusive enough to warrant attempting to implant an artificial heart into a human.    Articles were published and the media reported that the Jarvik 7 heart was banned from use.  However, aHowever, a version of this artificial heart still functions today.  Known as the SynCardia Temporary CardioWest Total Artificial Heart, it has been implanted in more than 800 people as a temporary heart, helping patients’ bridge the time until a donor heart can be found.

William Schroeder

Medical research into the artificial heart did not die with Barney Clark.  On November 25, 1984, William Schroeder, of Jasper, Indiana became the second man to receive the Jarvik 7 artificial heart.  He lived for 620 days; the longest that anyone had survived with an artificial heart.

Peter Houghten

Jarvik 2000

Today, artificial hearts have been transplanted in people, even children, around the world. The artificial heart is the size of a C battery and is connected by a small cord to a battery pack that is worn around the body. The longest living artificial heart recipient, Peter Houghton of England, lived for seven years.  He died in 2007 of multi-organ failure.  The artificial heart had to be turned off.

Commemorative Stamp

At the time of Barney Clark’s death a hospital spokesman told reporters, ''He was an incredible man, one of the strongest men I have ever known…. He did a service to mankind and the knowledge that we will gain from him will serve us all.''

Barney Clark's Grave
(Courtesy E.J. Stephens)

Clark's Memorial in Utah

Barney Clark was laid to rest in Washington Memorial Park Cemetery in SeaTac, Washington.  In Provo, Utah, a memorial stands to Dr. Clark, a medical pioneer, and a man who helped make the dreadful wait for a donated heart a little easier to handle.

~ Joy

The Cost of Dying – Cremation

Last week, we looked at the various costs associated with dying in the United States.  All told, death is a $12 to $15-billion industry in this country. According to the 2010 Funeral Price Survey by the National Funeral Directors Association (NFDA) http://www.nfda.org/, Americans spent, on average, $7,775.00 for a traditional adult funeral.  (This does NOT include the burial plot and cemetery expenses.)

But not everyone wants a funeral that includes embalming, a viewing, a religious ceremony, and a graveside service.  Not to mention a state-of-the-art casket with burial vault, obituary notices, flowers, music, prayer cards, memorial cards, acknowledgement cards, hearse, and limousine for transportation to the cemetery for the interment.  National trends show that we are moving away from these traditional religious funerals.  For those seeking less pomp and circumstance, there are options.

Cremation is the alternative that more people are deciding on.  In 1985, only 15% of the deceased were cremated.  According to the Cremation Association of North America, (CANA) http://www.cremationassociation.org/ today, 36% of deceased are cremated.  And projections show that by 2025, almost 56% will be cremated.  (The revenue on cremations alone has increased almost 1-billion dollars in just five years.) 

Cremation in the U.S.

The acceptance of cremation varies widely across the country as shown on this 2006 map.  Western states favor cremation more than other states, with almost 67% of Hawaiian residents, along with 65% of residents in Oregon and Nevada opting for cremation.  Southern states such as Alabama and Mississippi only show 11% of those deceased being cremated.  Studies indicate that the drastic difference of acceptance for cremation in this country may be due to religion and religious beliefs.

With that in mind, cremation is growing in acceptance as our ties to tradition diminish.  According to the funeral industry-sponsored 2006 Wirthlin Report, the top five reasons why a person selects cremation are:

• Cremation saves money (30%)

• Cremation saves land (13%)

• Cremation is simpler (8%)

• The body is not in the earth (6%)

• Personal Preference (6%)

Questions to Ask

When considering cremation, the Cremation Association of North America suggests you ask the following questions before deciding on a funeral home or crematory:

•  Do they have their own crematory or do they work with a cremation firm? 

If the latter, which crematory do they use?

•  Who owns the crematory facility?

•  How often do they inspect that facility?

•  Are licenses and permits current?

• How many operators do they have and what type of training 
do they require? 
Are they CANA certified?

• Does the crematory have refrigeration?

• How long does the crematory hold the body prior to cremation?

• Does the crematory have liability insurance?

• Does the crematory facility allow witnessing by family members?

Cremation Box

Remains Box

When selecting cremation you do not have to purchase a casket.  Check with your local funeral home about renting a casket if you would like to hold a public viewing.  If you decide on direct cremation, (having the remains cremated immediately after death,) you can choose an unfinished wooden coffin or a heavy cardboard enclosure for the cremation.  You are also not required to purchase an urn for the remains. You may keep them in the box provided by the crematory.

What is Cremation?

Cremated Remains

Cremation is a process that reduces the body to ashes, known as cremains.  But the cremains are more than just ashes.  They also contain bone fragments that are pulverized and resemble gravel or broken seashells.

Cremation, like a traditional funeral, will vary in cost depending on what you decide on.  Basic cremation can cost as little as $300.  Or it can run several thousands if you decide on an Urn Committal Service, (similar to a traditional funeral service with cremation.)

Cremation Options

Private Viewing

You may choose to hold a private family viewing, without embalming, before the cremation. Embalming is never required for the first 24 after death. You also have a set amount of time to arrange for the body to be cremated before embalming may be required according to your state law.

Memorial Service

You may decide on direct (immediate) cremation and then hold a memorial service for the deceased at a later time when all of the family and friends can gather together.

Memorial Bench for Urns

Urn Committal Service

Or you could choose to have a more traditional ceremony, known as an Urn Committal Service. The deceased is embalmed and casketed for a public viewing and a funeral service is held before the cremation.  You can also purchase a burial spot for the receptacle to be buried in.

A typical cremation with memorial service and urn can cost between $1,500 and $2,000.

The Remains

Earthen Urn

Outside Columbarium

Once the body is cremated you may elect to keep the remains in a container at home, place them in a columbarium, or have them buried.

Cowboy Urn

Fingerprint Heart Jewelry

Urns and receptacles come in many options including biodegradable, hardwood, granite, marble and metal.  Urns can be very simple or as unique as you would like.  Jewelry is also offered which holds a small amount of ashes, keeping your loved one close to you.

Casting Ashes to the Wind

Cremation Garden

The ashes may also be scattered or cast at a Cremation Garden or a location that was special to the deceased.  Just make sure this is in compliance with the local health department’s regulations.  It is legal in all states to scatter or bury cremated remains on private property, as long as you have the landowner’s permission.  You may also consider scattering ashes at sea.

The most important thing to remember is that no amount of money can express how we feel about those we have lost, so we owe it to them to handle their remains in the manner that they would have wanted – with love and respect for the life they lived.

~ Joy 

The Cost of Dying – Traditional Funeral Services & Burial

A Wedding

We love to plan and prepare for the major events in our lives; graduations, weddings, births, anniversaries, reunions, but when it comes to planning our death – that seems to flummox us like nothing else.  Yet, it is a major life event, and it does need our attention and planning.  Maybe now more than ever!

Invoice Example

Death is a $12 to $15-billion industry in the United States. As we continue to die, rates continue to climb.  Expenses for a funeral service can vary dramatically, depending on what type of funeral you decide on and where you are located.  According to the 2010 Funeral Price Survey by the National Funeral Directors Association (NFDA) http://www.nfda.org/, Americans spent, on average, $7,775.00 for an adult funeral in 2009, based on the elements of a regular, traditional funeral.

Grave monument

Opening a Grave

This does not include the cemetery costs which include the gravesite, vault, opening and closing of the grave, or the grave marker.  These charges can run another $2,000 to $3,000 for interment in  ‘regular’ cemeteries.  (Remember, the larger, more popular or exclusive a cemetery is, the higher the cost to get admitted.)  And the price of a grave marker or monument depends on what you choose.

Traditional Funeral

So what elements make up a traditional funeral?  What are you paying $7,775.00 on average, for?  Note: a funeral service involves a body being present, it occurs soon after death, and usually includes a viewing of the body.  If there is no body present – it is called a memorial service, does not require a funeral director to be involved and may be held at any time.

To begin the funeral process, you will need to pay for copies of the death certificate.  Then there’s a transportation charge to take the deceased to the funeral home of your choice. 

Studies have found that people make the decision on the funeral home based on these criteria:

Location – usually it’s the funeral home closest to them, or to where the deceased lived.

Family history – they continue to go to the funeral home the family has always used.

Personal recommendations – these are based on suggestions from friends and family. 

Funeral Planning

The National Funeral Directors Association (NFDA) encourages customers (And yes, that is what you are,) to ask questions about anything you do not understand. If plans were not already in place and you are feeling stressed and emotional, ask a trusted friend to assist you in getting the funeral arrangements decided on.  A clearer head can be an asset to you and the funeral director when planning a funeral in a time of grief.  You do not necessarily have to accept the pre-bundled funeral services offered by funeral homes, although it may be easier to do so in certain circumstances .  You can pick and choose from the options available to find those that best suit your intentions and finances.

Itemized Statement

Once you have decided on the arrangements you want, the funeral home will present you with an itemized statement of the services and merchandise you have selected.  This includes an estimate of all cash advance fees paid on your behalf to third parties, such as the cemetery, organist, florist, clergy, etc.

A Funeral Cost Breakdown:

Offering Professional Services

Professional Services involve the services provided by the funeral director regarding advice, support, and dealing with third parties, external cleansing of the body, burial arrangements made with the cemetery, and securing all necessary certificates and permits.

Use of Funeral Home

Funeral Cars

Supplemental or Optional charges include transporting the deceased to the funeral home, use of the funeral home, the services of the funeral home attendants for custodial care and arranging the funeral, embalming, cosmetology, charges for the casket or urn, burial vault, obituary notices, flowers, music, prayer cards, memorial cards, acknowledgement cards, providing the hearse, and limousine or funeral cars for transportation to the cemetery for the interment.

Embalming is Optional

You do not have to have the deceased embalmed.  Embalming is never required for the first 24 hours after death. Also, you have a set amount of time to bury a body before embalming may be required according to your state law. There are several religions in the United States that do not allow a body to be embalmed.

Embalming Table

According to Funeral Consumers Alliance, http://www.funerals.org/  “There is no public health purpose served by embalming.” However, the Federal Trade Commission does allow funeral homes to require embalming for public viewing.

Embalming does not preserve the body nor does it not stop decomposition.  It only slows it down for a period of time.

Caskets

One of the largest expenses of a funeral is the casket. Caskets come in all makes and models.  There are very basic caskets - the unadorned pine box, - usually running $500 to  $1,000. 

14K Gold Casket

Bronze Casket

  More detailed caskets with gaskets, seals and liners can cost up to several thousands of dollars, depending on what extras you select.  Up to $10,000 can buy a bronze casket. $40,000 or more will buy you one adorned with gold or jewels!

Here is a break down of funeral costs, provided by the National Funeral Directors Association for 2010.

Average Funeral Service Costs:

Professional Services                               $1,800

Transfer of Remains to Funeral Home       $250

Casket (Metal)                                       $2,295

Embalming                                            $628

Cosmetology                                          $200

Use of facilities/staff for viewing               $395

Use of facilities/staff for Funeral Service    $450

Use of Hearse for funeral                         $275

Use of Limo                                            $125

Service Van                                            $125

Basic Memorial Cards                               $125

Graveside Service                                    $405

Average Funeral Service Costs                $7073.00

This does not show average cost for flowers, death certificate, refrigeration fee (when embalming is not selected,) publishing obituaries, organist, clergy, etc.

Cemetery Burial Costs:

Digging a Grave by Hand

The first cost for a traditional interment is the price of the burial.  The charges associated with this include the grave opening and closing.  (Formerly known as digging the grave and filling it in.)  And there may be a charge for annual or perpetual care, (also known as grounds and grave maintenance.)

Installing a Vault

Concrete Vault

Most cemeteries also charge for a vault.  Known as the outer burial container or a grave-liner, these vaults may be made of concrete, steel or fiberglass.  Their purpose is to keep the ground from sinking in as the casket deteriorates over time.  This also makes it easier to use heavy equipment in the cemetery when needed.  Just as caskets do not prevent the body from decomposing, neither do vaults.  No state requires a vault be installed, but most cemeteries do.  Vault prices range from $1,200 to $2,000.  The price of installing the vault may be included with the vault price.  If not, figure another $300 on average.

Family Mausoleum

Stacked Mausoleum

Other burial options instead of in-ground burials include mausoleums and columbariums.  Mausoleums are above ground structures where the casket is placed in a drawer-like space.  Mausoleums may be private or public.  Private mausoleums were especially popular during the late 1800’s through the 1920’s, mainly for well-to-do individuals and families.  Private or family mausoleums have regained some popularity, but look less like small buildings and more like stacked drawers.

Public mausoleum

Some cemeteries also offer public mausoleums.  This consists of a large public building where hundreds, even thousands of people are entombed.  Many public mausoleums offer the advantage of visiting in a quiet, comfortable place, regardless of the weather.

Columbarium

Columbariums are smaller versions of mausoleums, offering a niche for urns to be placed.  The urns are the receptacles for cremated remains.  Plaques attached to the niches bear the name and information about the deceased.

Rules on Decorations

Cemetery Information

As with funeral homes, cemeteries should provide you with an itemized price list before you buy.  Be sure to read and get a copy of the cemetery’s rules and regulations.  Information on stone size and requirements will be listed here.  Also find out the rules on grave decorations and plantings, and become familiar with the cemetery’s hours for visitation.  Public cemeteries may cost more than not-for-profit cemeteries, especially when considering their location and popularity.

According to the National Funeral Directors Association, cemetery charges for 2010 average as follows.

 Average Cemetery Burial Costs:

Cemetery Charges                                    $1,400

Vault                                                       $1,195

Average Burial Costs                                 $2,595

(Perpetual Care is usually between 5 to 15% of the total sale.)

This number does not include the cost of a gravestone, monument, urn, or space in a mausoleum or columbarium.   These costs vary greatly depending on what you have selected and where the cemetery is.

Total Cost for Average Funeral & Interment       $9,668

(Not including third party charges as listed after funeral service costs and cemetery burial costs.)

Graveside Service

Direct Burial

You also have the right to select direct burial.  This means there is no embalming, no public viewing of the body; no funeral home services need to be performed. You will need to get a death certificate and set up burial with the cemetery.  You also have the option of holding a graveside service at the time of burial and or/a memorial service at a later date. 

All told, for a basic, traditional funeral with viewing, hearse and burial, expect to spend around $10,000 to $15,000 dollars.  As my grandfather used to say, "Death is not for the faint-of-heart!"

~ Joy