Proof that when you are a heart patient, there probably isn’t such a thing as an ordinary day.

On Sunday, October 6, 2019, the Washington Post Magazine had an article that is the most memorable and touching article I have read in a long time.  It is one story in a book to be published October 22 called “One Day”.  The premise is that the author asked 3 separate individuals to pull 3 separate pieces of paper out of a hat and together they pulled the one day that he would write about:  December 28, 1986.  The author then conducted research to in his words:  “explore whether, in the insistent gyre of human experience, there even is such a thing as “an ordinary day.”

The story in the Washington Post Magazine was called The Beating Heart, and presented a multi-faceted view of a heart transplant operation that of course recounted the medical side of the story.  But The Beating Heart also portrayed the very human account of how a tragic series of events led to a Northern Virginia hospital’s first heart transplant in a woman who was and still is (after more than 30 years), an admirable and wise and vital person. 
​

I went on-line and reviewed the description of other stories in the book “One Day”, and the rest of the book is filled with intriguing, thought provoking stories.  Sounds like a some pretty serious material to write about – correct?  So imagine my surprise when I realized that the author was Gene Weingarten who writes a weekly humor column that is nationally syndicated. 

So who is this Gene Weingarten who has written such sober yet also heartening and intriguing stories?  Well, in addition to his weekly column, Weingarten has also written a number of other books.  I learned the publishing company Simon and Schuster published another Weingarten book called “The Fiddler in the Subway”.  On the Simon and Schuster’s Publishing Page for this book it says: 

• Gene Weingarten is the O. Henry of American Journalism.  Simply the best storyteller around, Weingarten describes the world as you think it is before revealing how it actually is—in narratives that are by turns hilarious, heartwarming, and provocative, but always memorable.   

 
For those who are not familiar with 19th century literature, the website EncyclopediaBritannia.com says that O. Henry was a pseudonym for William Sydney Porter, an American short-story writer “whose tales romanticized the commonplace—in particular the life of ordinary people in New York City. His stories expressed the effect of coincidence on character through humor, grim or ironic ***.”   I am familiar with a number of O. Henry stories, and enjoy them, especially the Christmas-themed “Gift of the Magi”.
 
I agree with the comparison between O. Henry and Gene Weingarten, especially after reading the October 6 story, which discussed ordinary people in touching and occasionally humorous detail.  What appealed to me is that he portrays a patient and her medical team as everyday people who have been thrust into uncommon circumstances – and transformed into extraordinary heroes.  When you have a potentially serious chronic illness that can impact your life expectancy, this is an inspiring concept.
 
As you might imagine, the subject of the story is very relevant to me and my fellow heart patients.  So I wrote this post from a a patient’s perspective, a patient who may at some point have a transplant in my future. (Although since the upper age limit is 70, if it is going to happen, my window of time is limited).  But I believe that other readers will also find this story, which again has many other facets, to be riveting.

I was also interested because the transplant described in the story occurred about 33 years ago at the Northern Virginia hospital where I am treated for heart failure.  As can be expected, the personnel have changed since 1986.  Today, the hospital I go to is one of the centers well known for heart transplant work.  Since this operation was the first heart transplant ever performed at the hospital, how did the growth to a renowned heart transplant center unfold?  I did some research and here is what I found.

Around 2006 this Northern Virginia hospital and other transplant centers were on shaky ground as to whether the programs would continue.  At the time, some local residents were traveling to places like Baltimore and Charlottesville for their transplants, usually because of physician referrals or the centers' reputations. 

It appears that my doctor was one of the doctors recruited to the make sure the program continued (Yay!).  He indicated in a story I found on-line that he was convinced that the low volumes and waiting lists in the Washington area were an indication of how many people with failing hearts were not getting the care they needed.  He referred to the Washington area as “absolutely an underserved area".  I am so thankful that he chose to answer the call to serve in this area, because he and his team have provided such skillful yet compassionate medical care that benefits me and so many of my heart failure comrades.

Certainly, it helps that the place where I would be able to have a heart transplant is only 12 miles away from me – as opposed to all the way over in Charlottesville or Baltimore.  But even though it is so close distance-wise, a heart transplant if needed may be an uncertain possibility.  Why?  Well one thing that concerned me was that one of the factors they consider in a transplant was whether there is a support network at the home to help the transplant patient because it is a rough process. 

Well I’m single and I live by myself.  Would that be counted against me in the transplant equation?  I’d like to think the fact that I follow instructions to the letter and that I have a support network of family, friends and church community that would be there to assist me would count for something.  But for right now all this is hypothetical.  I am learning that anxiety is not the heart’s best friend, so I figure the best approach is to just chill and see what the future brings.

Getting back to the article, as I read along, I realized that the piece would describe the medical procedures that took the donor and recipient’s hearts out and then the procedure that would put the donor’s heart into the recipient.  I don’t like to even see my own blood, so I wondered if I would be able to read this graphic detail – especially as I know that this could eventually be me on the table at some point.  How did I react to an up-close view of what it would be like if my heart was being cut out of me?

Although it was a very detailed description, I was able to make it through.  I even found some of the comments from people who assisted in the procedures to be fascinating.  Some of the descriptions sound like they could have come from my own lips.  For example, my own mind often imagines my heart as a cartoon figure on a treadmill, overweight and trying to keep up with her fitness obsessed owner.  I can almost see my cartoon heart mopping it’s sweaty brow and saying “Slow down!!!!”  So I really related to the description of how the recipient’s heart was so large, but when they finally disconnected it, it went back to a normal size and everyone in the room felt like it was going "whew".

I love the other descriptions from the operating theater that make me feel that it is a place I would be at home in – if I should ever become a transplant patient.  One thing that appealed to me was the music connection with the surgeon:

• Ed Lefrak was that extreme rarity: a devoutly liberal northeastern Jewish urban Yankees fan who happened to have a taste for country music.  As was his custom, he’d brought a cassette tape, most likely Waylon Jennings or Emmylou Harris, or both.  The music was just loud enough to provide a benign soundtrack that out-noised the respirator and other ambient distractions.  It also discouraged talk.  Some surgeons like chatter.  Lefrak hated it. 

I could relate to this because when I am focused on something, the thing that distracts me is someone talking.  But I have found that music and a rhythmic beat motivates me and helps me to maintains my focus.  It is why I have often complained to the doctor that they really should allow the patients to listen to music of their choice during the treadmill stress test.  It is why I like the fact that the cardiac catheterization lab personnel usually have some rocking music going on while conducting your procedure.  And music is the thing that calmed me and kept me focused pre-heart failure diagnosis when I was having an MRI.  I swear that the song playing helped me focus on taking my life in a new direction.  This ultimately helped me accept that I had a serious heart issue. 

I also like the description of Lefrak now that he is retired.  He seems so approachable: 

• *** Ed Lefrak had an unforced retirement.  His hands are fine.  He uses them to resew his granddaughters’ love-ragged stuffed toys, and sometimes hauls out the surgical spectacles with those little telescopes to untangle his wife’s necklaces  ***.”

I particularly like the attention to detail that exquisitely blends the empathy of the medical team with their extraordinary expertise and grace under pressure.  I know that as a reader (and a potential future heart transplant patient) I walk away from the story thinking that if I had to ever undergo a similar procedure, I would be in good, competent and compassionate hands.

The bottom line is that I can’t wait to get the book “One Day” and see what other fascinating events happened in the lives of other folks on December 28, 1986.  But I want to close by saying “well done” to Gene Weingarten on his story The Beating Heart.  He has portrayed so well the very unique journey a number of heart patients may ultimately travel.   As he has shown, and through my experience as a heart failure patient, there is no such thing as an ordinary day. But as heart patients we are blessed to be treated by human but very extraordinarily gifted medical personnel.