People.com Archive A Second Chance at Life By Mary Chandler and People Staff Published on June 8, 1987 12:00 PM Share Tweet Pin Email Twenty years ago Dr. Christiaan Barnard stunned the world by transplanting a new heart into a human patient. Today, the once-perilous procedure has become almost routine. Last year, in the U.S. alone, there were 1,368 transplants, and up to 80 percent of those patients will live at least a year. Yet the operation still demands great courage of patients, as correspondent David Chandler, 50, has discovered. Last year Chandler was told he had three to six months to live. After four days of tests at a Denver hospital, my cardiologist, Dr. Arthur Levene, came in to give me his preliminary report. A gangling man with hands as big as shovels and a face like Walter Matthau with a mustache, Levene was a climber and a hiker. As he stood by the window, he seemed to be studying the mountain view wistfully before turning to me to say, “You need a heart transplant.” Transplant! I immediately saw myself as Barney Clark, a prisoner in a wheelchair, my chest tethered to a machine by an accordioned hose. My mind switched away. We’ll have none of that! No, sir! As I got up and started pacing the room, Levene explained to me that heart transplants were no longer experimental, thanks to improved surgical techniques and the approval by the Food and Drug Administration in 1983 of an anti-rejection drug called cyclosporine. “The current stats are good,” he said. “The public still thinks of transplants as a freakish thing, but they aren’t.” Levene told me he wanted to perform some more tests but he added, “Chances are, without a transplant you won’t be here six months from now.” The story of how I got a new heart had begun six months before, when I first felt severe neck and chest pains that I feared might signal heart trouble. A triple bypass operation at the age of 37 had given me a new lease on life 12 years before, but the concern was always there. With Mary, my wife of five years and a fellow journalist, I was living in our three-bedroom chalet 9,000 feet up in the Colorado Rockies. In the days before Christmas, my breath had been coming so short that I could barely make it up the snow-covered hill from our house to the mailbox. As relative newcomers to the mountains, Mary and I knew virtually nothing about local medical facilities, so we went to the Yellow Pages to choose our doctors—a mistake. Twice that fall, they diagnosed my condition as simple fatigue, unrelated to my past heart disease. By Thanksgiving morning, however, the pain and shortness of breath were so bad that our puzzled local doctor insisted I check in at a Denver hospital. Doctors there found fluid in one lung but were baffled as to the cause. Yet they too concluded my symptoms weren’t due to any cardiac problems. They urged me to check into the hospital for three more days of tests, but I declined and, comforted by their words, flew to Florida for a business meeting the next day. We all agreed—the doctors, Mary and I—that right after Christmas I’d come back. We had wonderful holidays, and I had no intention of going back to the hospital for those extra tests. Hospitals were where people died. The day after Christmas, however, Mary’s long looks of gentle reproach began to get to me and I went to another rural clinic, where I met Tom Syzek, a general practitioner who had been recommended to us. Syzek took a routine chest X ray and came back alarmed. “Did you know that your heart is about twice normal size?” he asked. Dumbfounded, I shook my head. No. “None of the other doctors told you?” No. “Not even at the emergency rooms?” Again I shook my head. “Well, it’s bad news. I want you to see a cardiologist as soon as you can.” Grimly, I drove back home, where I gave Mary the incredible news, then phoned the cardiologist for an appointment. Two days later, expecting to be back in a few hours, I left Mary a note on the door. MARY: I was out doing errands when I came back to find the note: “Gone to cardiologist, will get groceries on way home.” At 3 that afternoon, though, David called. He had been put in the hospital for tests and was to stay seven to 10 days. I was thinking, “This is getting serious.” I had managed to put David’s heart history out of mind in our five years of marriage. Suddenly it loomed large and I wondered if the bypasses were failing. After my fifth day of tests, I came back to my room and left the lights off, looking out at the mountains and waiting for Levene to bring his report. Mary arrived and we sat together in the darkening room. Then Levene came in and said right off that my heart was “wiped out. The grafts [from the 1974 bypass] are all closed down. Of the original arteries, one is all closed and the other 90 percent closed. Your heart is large and flabby and in terrible shape.” I asked him about the possibility of a bypass. He shook his head. “You’ll never make it.” My chances of surviving a bypass would be 30 percent, he said. My chances of surviving a transplant were 70 percent. With a strong, new heart, he said, “the chances are high that you’ll live a long life.” Then, with a bluntness that jolted me, he asked about insurance. “If it can’t be paid for, it can’t be done.” Firmly, I told him the insurance covered it, not knowing if it did or it didn’t. He left. I sat there on the edge of the bed trying to deal with it without feeling sorry for myself. Mary and I looked at each other, searching faces, each of us trying to avoid a breakdown. “Well,” I told her, “about the only thing he didn’t find wrong was a stake through it.” She didn’t laugh. Then and there, on a legal pad, I wrote a will. I asked Mary to bring my checkbook when she came back the next day so I could transfer my private checking account to our joint account. She nodded. Left unsaid was the reason why: It was to reduce problems if I died. MARY: When it became clear at the hospital that David and Dr. Levene had earlier discussed the possibility of a heart transplant, I was startled that David had not told me, but I figured he was trying to shield me, and I appreciated that. Rarely am I speechless. But as Levene went on, talking about how the operation is now quite successful, about how he hoped our insurance covered it, I could only think of the thousands of transplant stories I had read. People broken financially by the operation, the success of which was not carved in stone. How many bake sales would be needed to raise half a million dollars? And what about David? No guarantees on this stuff. Would he be okay? I followed Levene into the hall. He told me David might not live three months. That night, after Mary left, I found myself lying in the dark writing my own obituary. I was shocked and utterly dismayed at how trivial my life had been. Whenever I got that out of my mind, I would switch to a too-vivid picture of my near-dead heart, with its clogged arteries more or less flopping like deflated balloons. I attempted to sleep, but it didn’t work. I was constantly seeing the poor, oversize, struggling thing. I felt not only sadness but a great sympathy for it. We’d been staunch buddies for 50 years. Inseparable, you might say. I’d let it down more than it had me, after years of drinking, smoking and long hours. The next morning Mary arrived early, having somehow, overnight, gathered material on various transplant hospitals. Why not St. Louis? It had a good record and the advantage of her family being there to provide some support. Levene corroborated the reputation of St. Louis’ Barnes Hospital and called a cardiologist to set things up. All signals were go. Thrilled to be on the move, Mary and I arrived home to find a bright, sunny day but the snow knee-deep. Walking down, I slipped on the driveway and fell absolutely flat on my back. Whoof! Packages flying. Mary, who was 20 feet ahead of me, turned with a ghastly look on her face. MARY: I was walking ahead when I heard a loud whumph. He was down in the snow and not moving. Then I heard, “I’m all right.” I have not seen the real color of my hair for years, but as a result of that fall I know that under the dark blond is a white streak an inch wide, like the Bride of Frankenstein. The next day I called our insurance company. Thank God! We were covered for the transplant. Next, I wanted a second opinion and arranged an appointment with another Denver cardiologist. After looking at my records, he said there was a slim hope: If my heart muscle had strengthened enough to make 40 or 50 percent on a pumping efficiency test, another bypass might work. But my heart tested badly, reaching only 26 percent efficiency. The transplant was a must. I was desolate. The prospects seemed so grim that I gave long and repeated thought to killing myself. I’d just drive the car off a mountain curve. Easy enough. Less than a fraction of a second of determination would do it. Neither Mary nor the insurance company would ever know. I’m normally a cheerful and positive type, however, and in the ensuing days the idea of suicide receded. Adjustments came. The days that now passed were wonderful and loving. The skies were brilliantly blue and the temperatures in the 40s and 50s. At times I would wander around dreamlike; then I would catch myself and the nightmare reality would return. Reality also arrived in the form of bills. Our first came in from the Denver hospital—$7,074. A few days later the St. Louis cardiologist called to say he and the transplant team had reviewed my records and they wanted me in St. Louis for more tests to see if I qualified. We now faced the task of planning the logistics for what would be at least a four-month stay in St. Louis. Already Mary had been carrying a heavy load. On top of all the emotional baggage, she had had to do all the physical chores, a burden I was sure she must resent. There were many things I could not do and we both hated it. Our home’s sole heat sources were fireplaces and a wood stove. When the wood was hauled, it was hauled by Mary. When the fire was lit in the morning, it was lit by Mary. When the trash needed to be taken out, it was Mary who took it. When the snow needed shoveling, it was Mary who shoveled it. She never once complained. Never. But one morning, as she was bringing in the wood, there was a frightening scene. The door wouldn’t close and the snow was-coming in. Throwing down the wood, she began kicking the door and pounding it with her gloved fists. Then, suddenly, her expression switched from fury to fright. She began swinging her arms wildly, like a drowning swimmer, her face turning reddish-purple. In her hysteria, she had lost her ability to breathe. “I can’t…I can’t…,” she was gasping. I was unsure of what was happening, but I was frightened. She looked as if she was dying. Not knowing what else to do, I ran for the small oxygen bottle in the hall bathroom. But in those few seconds she got her breath back. Then she slumped against the wall and, sliding to the snow-covered floor, slowly began to cry, her body heaving with sobs. She resented me, we later discovered, because I might drop dead at any moment and rob her of what we had. Every night she would check when she came to bed. Every morning she woke up beside me wondering if I was gone. Dead. ST. LOUIS A 1,054-bed medical and teaching complex founded in 1914, Barnes Hospital has for years been regularly honored by medical journals as one of the 10 best in the nation. I was put through every imaginable test, including tissue typing, to determine if I was a suitable transplant candidate. There was little rest and some pain. Worst of all was the absolutely fiendish humiliation of the barium enema, during which doctors strap you to a table that rotates and tilts in all directions, jam a large tube up your rear end, pump you full of gas and liquid, stand you on your head and other positions and then ask you how you feel. At other times I was examined psychiatrically, scanned, neurologized and had all my bottom teeth removed because of a gum infection. Social workers probed my psyche and dieticians analyzed my eating habits. Cardiologist Dr. Ed Geltman’s preliminary report showed my condition had been deteriorating for a couple of years and had caused several small, undetected heart attacks. One by one the bypasses of 12 years earlier had all closed down. The pain that had been misdiagnosed as fatigue was angina—my starved body shrieking for blood and oxygen. A healthy artery feeding the heart should be big enough to insert one’s little finger. Mine had closed down to the size of pencil lead. It might stay open for a while, but theoretically the least shock could kill. When I mentioned some of the things I had done in the past year, Geltman just shook his head and said I had been lucky. “Very lucky,” he added. Mary and I also talked with social worker Darlene Judd, who was to become a personal friend. When I described my early embarrassment at needing the operation, she said the feeling of being a freak was common among heart transplant patients. Connie Cance, a 31-year-old Duke University graduate, was the transplant team’s master traffic controller, keeping track of all logistics and timetables, making sure everything was running on schedule. I asked why she had chosen heart transplants over other work. Her answer, echoed by many of her colleagues over the next several months, was that in transplant work, unlike most other areas of medicine, “you get a chance to see quick and good results. You feel like you’re really helping. And you want to help because these patients show particular courage for going through what they do. They do it by choice. They can always say no. But instead they put trust in the team.” Another early friend was Dr. Randy Genton. Tall, athletic and good-looking, he was the team’s 29-year-old transplant cardiologist. He explained the continued absence of the doctor in charge of the transplant program, a star surgeon with the 16-cylinder name of R. Morton Bolman III. Bolman, 40, wouldn’t be seeing me for several days because he was in Utah, looking over the Jarvik artificial heart as a possible temporary replacement heart for patients awaiting a real one. Hardworking and widely published in surgical journals, “Chip” Bolman had been recruited from the University of Minnesota in late 1984 to start up the heart transplant program at Barnes. To date he has performed 100 transplants and is among the most active heart surgeons in the world. Toward the end of the evaluation, I was given a 27-page booklet explaining how it all would work. It was so horrifying that I wondered if it hadn’t been given to me as a test of my resolve. The booklet included a list of major medicines the patient must take after discharge and some possible temporary side effects, including such charmers as: tremors of hands and arms; increased hair growth on the face and arms and, to keep you off balance, hair loss on the top of the head; hypertension; lumps in the breast; increased appetite; “moonface,” or increased fat deposits, mostly in the face, neck and abdomen; fungal growth in the mouth; acne; muscle weakness and cramps; eye problems; sweating and hot flashes. None of it worried me. What I wanted was to get on the list for a transplant. After all these tests, I still hadn’t heard what my chances were, and I had yet to meet Bolman, which annoyed me greatly. The guy could have at least come in and said hello. When he finally did, Mary was sort of stunned because he looked like a movie star. MARY: The Man walked in today and he didn’t look like someone who had already done 100 of these procedures. I expected somebody gray, bent and ready to keel over. He wasn’t, and he told David, with little preamble, “You’ve been evaluated and found to be in the end stage” of heart disease. It was a death sentence in a way, but it meant David had made the list! Everything except his heart was okay, so he qualified. He was accepted. Following the formal acceptance, Bolman left, and Mary and I had a relaxed half-hour conference with his team. Cance said that among the criteria, social support was given very high priority. “You need a person in the background who cares. People with less support have less reason to care, and motivation to succeed is the biggest factor for survival.” Spouses, for better or worse, were very important. Each endures far more stress than either spouse or patient realizes before the transplant. “Afterward,” said Cance, “it will never be the same. These operations press home the point that none of us has a guarantee on life. Tragedy can hit swiftly and without reason. It is like punishment for a crime never committed. Then there are the intense financial pressures. And extra duties. When the patient goes home, the spouse becomes the nurse. I would say that, overall, the relationship is as it was before the surgery except it becomes more intense,” said Cance. “Where the marriage was happy, it stays happy because of the second chance at life. Where there is a problem with the marriage beforehand, things get worse. In those cases, time after time we’ve seen the wife—it’s usually the wife—give strong support to her husband while he’s in the hospital. She stays with him because of guilt and really because she doesn’t expect him to survive. She thinks he’ll die in the hospital and she’ll be free. Instead, when he comes back, she sees she is stuck with this demanding bozo for the next 20 years.” Genton warned: “Don’t expect it to be like a movie. You don’t return to being a boy of 21. You’ll return to being a 50-year-old with a healthy heart and you’ll be able to climb those Colorado mountains.” The conference ended. I took a small apartment nearby, and I was given a beeper with a 40-mile range and told to stay near a phone. Mainly, though, my job was to take it easy and wait for a heart. To stay alive in the meantime, I was given prescriptions for eight different daily medicines. After the team left, while we were waiting for hospital papers to clear, Mary and I discussed the need for her to go back to Colorado during my waiting period. MARY: I didn’t want to go. Several times the social worker Darlene Judd had given me guilt-inducing speeches about staying with David. She didn’t seem to accept that we lacked the finances for that. I didn’t want to go home alone to a cold, dark house, then to leave the mountains, find an easier place to live in Denver and to supervise a move and all that goes with it. Then to keep the PEOPLE magazine work going and resume my new job at the Rocky Mountain News. Plus worry about David 900 miles away. The answer, I knew—and David kept telling me—was not to think of all the problems at once. After all, I didn’t have to face what David was facing. The necessity, unfortunately, was that Mary had to earn us a living while I was incapacitated. Sitting on the hospital bed, she began to cry for the first time in my presence since Denver. I reminded her how dark it had all seemed in early January, how hopeless. “And look at us now. We’re over the hump, kid.” She moved closer and we held each other for a long while. Her crying stopped. Then she lifted her head and smiled. She is a champion woman. I had been told by the medical team and patients that I was now in the most difficult period—waiting for the call that would tell me a heart had been found. I had brushed all these warnings aside with polite indifference. Having written three books in the past three years, I was looking forward to a rest. I envisioned sleeping late, morning walks in the park, thoroughly reading the papers, long lunches and hour-long soaks in the tub. It didn’t work out that way. The days were much busier than I wanted and the nights were downright rough. That’s when the thoughts came, particularly around midnight. As time passed, my anxiety grew. I despise people who feel sorry for themselves. It’s a sin. But it got so bad one night that I cried. It was only the second time that I let go since receiving the news. I had managed to keep a lid on everything, but damned if I didn’t start feeling sorry for myself. And this time I was alone; there were no nurses around to interrupt the flow. As the weeks passed, I became resigned to dying alone in the little apartment. MARY: The wait was terrible. I worried every second that something would happen to prevent the transplant. Then I would tell myself that it would happen, that David would survive. That we would have our Sundays with the papers and coffee, our road trips, our secret jokes and games. Bird watching. Fierce Scrabble competitions. Days in bed. All the things that made our life together so wonderful. At 4:50 p.m. on March 16, as I was nearing the end of the third month, the long-awaited phone call finally came. I was at my desk doing income taxes when Bolman’s office called. “Are you ready?” “For what?” It took me a second to grasp it. “We’ve found you a heart. Can you be here by 5:30?” I called Mary, then a photographer friend, Barry Staver, who had covered previous heart surgeries and had been on alert in Denver to shoot this one. While driving out to Barnes I kept thinking that this was it. No turning back. At the hospital, all was ready. The team was gathering and everyone was upbeat. I was a bit scared, but mostly I felt sheer excitement. It was only a matter of putting one foot after another and letting the team do the work. During the preparations, Mary phoned and I had to go out to the middle of the nurses’ station with my rear end hanging out of a surgical robe to take the call. I was accompanied by a laughing nurse holding intravenous tubes over my head and six people were watching me as I tried to figure out how to say, “I love you.” Barry arrived about a half-hour before the heart to find me unconscious on the operating table, with the tubes in place for the heart-lung machine that would take over for my heart when it was disconnected. BARRY: The heart arrived. It was inside a standard Playmate-type cooler. The top layer of ice was removed and a nurse lifted out a clear cylinder filled with fluid and the new heart. Another nurse said, “Let Dr. Bolman take it from here.” Bolman took the heart in his gloved hands and placed it in a basin of sterile saline solution. He then removed David’s “old” heart and, with assisting surgeon Dr. Mary Gregg, lowered the new heart into the gaping chest cavity. “Bingo!” Dr. Gregg exclaimed as the new heart began driving new blood and new life through David’s body. At 2:20 a.m., four hours after the operation began, the heart was beating on its own. According to the report, the last thing the team did before I left the operating room was to count the sponges. Twice. The entire operation took about six hours, ending around 4:30 in the morning. It was 21 hours after surgery before I began to come to. I went back to sleep almost at once and was awakened seven hours later. It was 8 in the morning of the second day and Mary had arrived. I was drugged and disoriented, but Lord, was I glad to see her. MARY: I should have been prepared for what I saw, yet it was still a shock. I haven’t seen that many dead bodies, but David could have been dead. His eyes were covered with gauze, there were wires and tubes in his chest. Seven computerized machines were delivering medicines through intravenous tubes. He was hooked up to a heart monitor, and a ventilator was helping him breathe through a tube in his throat. A nurse later told me that some people pass out when they see their spouses in that state. I talked to David, squeezed his hand, stayed about an hour. Back at his apartment, I laughed when I looked at what David had left behind in the refrigerator: a few beers, a bottle of Beaujolais, tapioca and butterscotch pudding, a lemon cream roll, chocolate milk, apple strudel. Not exactly health food. The dietician would have passed out. I came back later as he was beginning to shake off the anesthetic. It was painful to watch. I wondered if David were in pain, if he could feel the twitching that was going on from head to foot. He looked like a piece of bacon popping around in a frying pan. I went to the apartment and just had a good cry, a few glasses of wine, and then crashed into an incredibly deep sleep. On the third day after surgery, I took my first steps out of bed. Then, a week after the operation, it all seemed to come together. At 4 a.m. I woke up in my hospital bed suddenly thinking in terms of a second chance. Twenty-five more years. I lay there for at least 45 minutes just grooving. It was very quiet in the hospital. Of course, it’s quiet most places at 4 in the morning. Nine days after the operation, I left the hospital and returned to my apartment. Later Mary slipped over for a weekend and we went to a picnic and softball game thrown by the transplant group. There were lots of forbidden things on the menu at the picnic—Cokes, beer, hamburgers, cheeseburgers, hot dogs. Tactfully, the dietician stayed away. Mary rested in the shade while I took a few feeble swings and dribbled the ball back to the pitcher. She left the next day to return to Denver. Two weeks later I drove home. It had been only 130 days since I left the note on the door, “Gone to see the cardiologist….” Yet it had been a lifetime as well. The new heart has been in place for 2½ months now—pumping strongly. My stamina is 70 percent returned. I owe much to a lot of people, to medicine, to the skills of my doctors and nurses, to friends including those I thought I didn’t have. Perhaps to God. Not being religious, I had never put much confidence in that concept, even in the dark beginnings of the nightmare. But many, many people said they were praying for me. With genuine enthusiasm, I urged them to go ahead. What was there to lose? There was much to gain: nothing less than a new life.