When we first discovered he had a blocked heart valve, we assessed that the chances of his having a successful transplant were still very good.
We had only one fact to go on.
To win a large university job, you need to have connections. Having been a graduate of McGill’s business school in the early 1980s, he probably knew the right people. If he lived in a city other than Toronto, he could also get into the right hospitals that are highly specialized. He had already impressed his employer, so they wanted him to stay. We thought a network worth an extra couple of million dollars would probably mean he could get medical treatment he wouldn’t be able to get elsewhere. And the network came in handy.
The disease he had was small, although far from easy to cure. He’d had an ultrasound when he was 20, and had discovered he had a heart valve that wasn’t working well. At that time, the treatment for heart disease was relatively new and simply slowing it down was a good way to keep it under control.
The conventional wisdom seemed to be that time was going to heal his symptoms. Years passed and suddenly, in 2005, he got the news that he might need surgery to have his valve replaced.
His doctors were willing to perform the operation at an hour’s drive from his house. Then they told him his heart had stopped.
The procedure was successful, but afterwards his body was profoundly affected. His immune system went into a defensive position. Before he had surgery he had been relatively free of infections, but as soon as the procedure was done, everything became awful for him. In effect, he became “reborn,” like a stray dog whose flesh was ripped cleanly away from him by the limbless leg and hurled across a front lawn.
But in his case, the good luck ran out. Though all the antibiotics worked, some parasites also came back.
We took him to a specialist. That specialist told us that transplant recipients have antibodies that reduce their risk of infections. The suggestion was that our patient could tolerate his medication, but it might take time for his body to recover to an acceptable level, and that he shouldn’t tolerate his medication as long as possible, which it did. He was a very smart guy, and also someone who liked to finish his sentences, which made it very hard for him to interrupt someone who was talking on the phone.
Finally, his blood condition got so bad that he couldn’t get a transplant, so we decided to give him chemotherapy. That medication is considered so much more efficient than transplant surgery that a large majority of people with heart disease who are ready for a transplant don’t actually get one.
After a few months of treatment, there was no heart valve that had disappeared. His immune system was still in a defensive posture, meaning it was attacking everything.
With everything in the world going in his favor, this was somehow not a good thing.
But it seemed that we were wrong, so we wrote him a new appeal, the best of which would get him a second opinion at the Leerink Clinic in Chicago. We went in with our man because he had a big network of contacts and some of our best doctors in Canada.
Almost immediately after his second opinion, he got clearance to have a cardiac transplant. We were close to congratulating ourselves on the success of the surgery — when we had the patients make the hospital beds in case they were supposed to come in.
At 8:30 that morning on June 8, the decision was made to have him transferred, because his body was more than ready for transplants. And this time, our man was lucky enough to get one.
This article originally appeared in The Toronto Star