“Then he is the lesser of all the evils,” said Boyd. “See if he will take me.”
Lamont called Cooley and described the case. Cooley said, “Send him down immediately.” It was the Thursday before Labor Day, 1968. Boyd had been sick for so many years and had been in and out of so many hospitals that Ilene had lost count. There was a last-minute snarl when no commercial airline would take Boyd because he required oxygen, and it was considered a peril to other passengers. Ilene discovered a private air ambulance would cost $1,350. She had that much saved up, but if she spent it, she would be penniless for the expected long stay in Houston. Their daughter Carolyn called a radio-TV station, which broadcast the need for money and/or a plane. Within ten minutes the money was donated. The flight took ten hours with two doctors on board to give Boyd medication and watch his heart rate.
Ilene and Boyd walked into St. Luke’s at 7 P.M. on a Saturday night. Leo thought there would be a committee to greet him, that a heart would be waiting for him. Instead a nurse showed him to Room 301, immediately beside two swinging doors to a foyer. “Every time the swinging door opened,” said Ilene, “Leo thought they were coming for him.”
He waited eleven weeks before they came for him.
Boyd was under oxygen for most of the eleven weeks. Ilene remembers lying awake night after night in her motel room across from the hospital, waiting for the ambulance cry that would mean a new heart was coming for her husband. One of the Canadian doctors had given him six months to live, and that sentence was used up. “Leo felt he was living on borrowed time,” said Ilene. “Every time he heard a siren, he would straighten his shoulders and say, ‘This must be it.’”
He was not the only one in such poignant suspense. The “waiters” formed an informal club to exchange news and rumors. A chief topic was the scarcity of donor hearts. By November 1, Cooley had done but two transplants since the middle of August. “It could be that people are tired of the idea of transplants,” said Cooley at the time, “that public opinion has swung against them. I certainly have not lost interest.” Cooley popped into the waiters’ room, if they were sick enough for hospitalization, about twice a week to assure them that the search was still on for usable hearts. Ilene remembered that several of the waiters grew tired of the ordeal, or ran out of money, and left the city. Some died in their beds when their hearts simply stopped. One Flushing, New York, woman was so depressed by the deaths of Everett Thomas and Louie Fierro that she changed her mind about wanting a transplant and returned to New York. “I’ll take my chances living with my family,” she said. “In Houston I cry all the time like a hysterical child. I didn’t fear the operation, but I was so lonely.”
“We gossiped together and prayed together,” said Ilene. “We were all here for the same thing. Nothing else was on anybody’s mind.”
When Cooley did transplants on November 5 and again on November 9, a wave of envy swept through the waiters. “We were all terribly jealous,” said Ilene.
On a Friday in mid-November, Boyd was depressed. He had heard through the grapevine that George DuBord, a San Antonio contractor, had rejected during the night and was back at the hospital. There was little that was secret about the new hearts. If one coughed, the echo was heard in every waiter’s room.
Ilene was leaving to attend a party in honor of the waiting wives. Boyd asked her to bring him a piece of cake. The next morning, Ilene entered the now familiar room with a paper napkin in her hand. Her husband looked strangely exhilarated, as if he were trying to keep a secret. “Hi, honey, here’s your cake,” Ilene began.
“I think you’d better eat it yourself if it won’t keep, because they aren’t letting me have any breakfast today.”
“Why?” Ilene tried to keep her voice calm.
“I think.…” Boyd would not finish the sentence, almost as an actor does not like to talk of a part before he gets it.
“Is there a donor, Leo?”
“There’s one coming in.…”
The rest of the Saturday was, as Ilene remembers it, “nerve ends.” Boyd was only one of three candidates being considered for the heart, if and when it arrived. It was being flown in from some Western state. Moreover, it was cloudy and rainy. Could planes even land? Cooley was rumored out of town. Would somebody else do the transplant? No, they said, Cooley had been located. He would come back if the heart looked good.…
The tension, Ilene said, was “unbearable.” Boyd was happy but jumpy, “more nervous of the possibility of not getting the heart than of getting it. Our kids had had their bags packed and ready to fly down ever since we came to Houston,” she said. “But I didn’t want to call them unless the transplant was really going to take place. We would not find out for sure until minutes before the operation. One of the doctors came in and I said, ‘Is it going to be Leo?’ He shook his head and said he was not positive. ‘Well,’ I said, ‘How positive are you?’ ‘About 95 percent. Give me five more minutes.’” Ilene rushed to the telephone to call her children. She barely had time to kiss Boyd good-bye before he went to surgery.
In the surgical waiting room during the transplant operation, Ilene brushed past a weary, unshaven doctor from Yuma, Arizona. She did not learn for several days the incredible story of how this man had brought Boyd a new heart.
Maria Acosta was seven months’ pregnant when she fell unconscious in her home in the small town of San Luis, Mexico, near the Arizona border. She was rushed across the border to Yuma’s Parkview Baptist Methodist, where an obstetrician, Dr. Gerold Gordon, measured massive brain hemorrhage. The EEG waves were flat, her eyes did not respond. While she was being examined, her heart arrested. She could not have been more dead.
Gordon delivered Maria of the new life growing within her, and the baby had a slim chance at survival. The doctor felt that Maria had still more life to give—her heart, provided he could win permission to use it. She had a common-law husband who was told through an interpreter what Gordon proposed. Confused, frightened, the man refused in tears. Gordon then learned that Maria’s mother and a grown daughter lived but 25 miles on the other side of the Mexican border and, blood kin being more binding than common law, their signature would probably be more legal. The doctor raced his car across the border and into the small town. With a passionate speech about the highest gift of all, the gift of life, Gordon waited for it to be translated. The mother and daughter hesitated. He promised that if the heart could not be used, he would bury Maria as soon as it stopped beating. Permission was won; the mother signed the hastily dictated form with an “X,” witnessed by the older daughter. Gordon thanked them deeply and said there would be no hospital bill or doctor’s fee for Maria.
Maria Acosta’s heart was still beating, the ventilator breathing for her and drugs keeping her pressure at a satisfactory level. In his absence, Gordon’s nurse had run tests and discovered that Maria’s blood type was O, universal, her Rh factor was plus, there was a lack of oxygen in the heart but no massive damage. It was a promising heart for transplantation.
Gordon called Houston and asked for Cooley. He was not there; Grady Hallman took the telephone. The heart sounded highly usable but could Gordon get it to Houston? He would try. For six hours Gordon battled military red tape before he finally got someone to produce a Navy jet trainer. It took off at 9:30 P.M. with Gordon, his nurse, and the stretcher containing Maria wedged into the tiny compartment. Gordon told Phoenix journalist Earl Zarbin of the trip: The stretcher had to be placed on top of the oxygen tank, the respirator leaned against another tank, the intravenous bottles hung like clothes on a washline. The high-altitude flight in the nonpressurized craft interfered with the intravenous drip and the nurse had to hold the bottles in her hand and force the fluids into Maria’s arm. When the plane approached Houston, Gordon was horrified to learn that the coastal city was covered with fog and landing was impossible. The pilot made arrangements to put down in San Antonio, 200 miles away, and radioed ahead for an ambulance.
An Air Force ambulance scr
eamed through the dawn fog toward Houston at speeds from 80 to 100 miles per hour. The respirator breathing for Maria was coming apart and Gordon held it together with his hands. Oxygen tanks had come loose and were banging about like barn doors in a storm, bruising everyone they hit. Bottles broke and sloshed liquids. Maria’s thoracic cavity was filling with fluid, her heart was skipping beats. Gordon fantasized it would collapse and stop in grotesque irony on the very doorsteps of the hospital. When the ambulance entered the city, no one in it knew where St. Luke’s Hospital was nor did any of the people they stopped. Somehow an escort from the police materialized and led them through the fog to the hospital. The emergency flight that had begun at 9:30 the night before was over at 8 A.M.
Someone asked Gordon about the legality of bringing a Mexican national across state lines to Houston for an operation to remove her heart and give it to a man from Canada.
“I imagine I must have broken six laws,” said Gordon, “But we’ll worry about that later.…”
Ilene went to the chapel, where she was surrounded by friends, chaplains, a waiter or two, a newspaper reporter. She prayed almost continuously for five hours. In the late afternoon Cooley came in with a tense face; he was still in his scrub suit and there were spots of blood on it. He had obviously hurried from surgery with the news. Ilene thought the world would turn upside down before he spoke. “Everything seems to be fine,” he said, bending his mouth into a smile. He seemed exceptionally worn. “The heart started on its own, it didn’t even require a shock. His pressure’s about 130. I think he’s already conscious. He seems to know us.…”
At 6 A.M. the next morning, Ilene and her daughters were permitted to enter the operating room still being used for recovery. Alice Nye had prepared the women for how Leo Boyd would look—the tubes, the bottles, the wires, the yellow-orange chest, the smell of mingling drugs. But it was still a shock to see the strong railroad man in such circumstances. Ilene bent forward and kissed him gently.
“I felt like the burden of the world had been lifted from me,” she said later that day. “Those eleven weeks here, those years in all the hospitals, the hell is over.…” Ilene spent the rest of the day praying her gratitude.
Because his recovery seemed so routine and because there was no hint of rejection, Boyd was moved into Alice’s transplant unit on the first postoperative day. On the second day he stood beside his bed. Ilene put on masks, gown, hat, and boots and went to her husband. They looked at each other for a few moments. Boyd became emotional and wept. Ilene’s mask could not hide her tears.
“Well, I finally got it, honey.…” Boyd gestured toward the enormous bandage at his breast.
“And you’re doing just fine.… Everything is going to be just fine, Leo. Just like you always knew it would.”
Boyd lived for sixteen months but he never left the hospital for more than a few hours. He never returned to his beloved Canada. No sooner was one crisis over than another took its place. The supreme technology and knowledge of the Cooley team kept him alive, but the life they sustained within him was a cruel one.
For three months he did well. He walked about his room, strolled masked down the corridors, proud of the circulation provided from the Mexican woman’s heart. He asked to go home, but Nora and Rochelle wanted him to stay in the hospital. They were alarmed at the sudden deaths of Thomas and Fierro and DuBord; Boyd was Cooley’s fifteenth transplant and only five were still alive.
Bursitis developed in Boyd’s right arm and shoulder. It became so painful that he could not lift his arm from the bed. One morning he told Ilene, “Honey, I think it’s crossing over to the left.” And that night he could lift neither arm. The previous night he had heard the emergency cart with the bottles clanging and clattering down the hall to the room of another transplant, and the transplant had died. It was, Boyd told his wife, like an executioner coming to get the condemned man. He begged Alice to let him sleep in another part of the hospital; he feared to be alone in the transplant unit with his arms useless beside him. Alice joked and made him laugh and he passed the night fitfully.
The bursitis went away and a rejection episode set in, the first. Boyd could not eat, then would not eat. He was nauseated continually but could not vomit. Ilene said, “I kept telling myself this wasn’t happening. I told Leo it was some little virus so often that I almost believed it myself. I don’t think he realized the heart was being rejected.”
After a month, when all the familiar symptoms of rejection would not go away, Rochelle took Ilene aside and said it would be best to gather the family. Ilene made up a story to fool her husband about the girls flying down to Houston, a pathetic story that they had saved their baby-sitting money and were coming to surprise him.
But he did not die. He did not die so many times that Ilene—and the doctors—began to feel he was somehow invincible. “He fought so hard,” said Ilene. “He obeyed all the orders, he took his blowing machine twice a day, he put on the mist mask, which a lot of the others refused. Leo used it every day of his new life.…”
He was just getting over his first rejection episode when he was stricken with meningitis. Rochelle explained to Ilene that every human being carries a little meningitis around in his body, but Boyd’s resistance from the immunosuppressive drugs was so low that he was unable to fight it. When a month of meningitis was over, he was starting to walk around his room again when one day, standing beside his bed, his knees buckled, he fell to the floor and cracked a vertebra. Bone softening is a common complication of long-term steroids. For six weeks he was bedridden with a back brace. A cyst coincidentally appeared behind his knee cap. The doctors drained fluid collected there and attached a leg brace in addition to the back brace.
There were good hours. There was a first anniversary (one year with his new heart) party with a red heart cake and a new suit, which Boyd happily got into to pose for pictures. There were always the newspaper reporters and he enjoyed answering their questions and clipping out his name. He spent a few weekends at Ilene’s apartment near the hospital, where she happily cooked him ham hocks and navy beans, his favorite dish. He even gamely answered the psychiatrist’s questions, normally replying, somewhat mischievously, “a naked woman,” when asked what a Rorschach ink blob looked like to him. There was but a brief two-day period of confusion and disorientation. Boyd insisted that he had won a Sweepstakes race and was upset that Ilene could not find the huge check in his dresser drawer. “I know it’s there, honey, keep looking!” he cried, as Ilene rummaged sadly through his things.
“Leo did not have the psychic problems that so many of the others did.” said Ilene. “Considering what happened to the others, I am grateful that his mind did not suffer.”
For Christmas, 1968, the children and grandchildren came from Canada and New York and there was, as Ilene remembers, a “muted family celebration.” A few days later, another rejection episode, a final rejection episode, struck his heart and destroyed his body. Pneumonia smothered him, his kidneys deteriorated, he was forced in the last two weeks of life to urinate through a catheter. Cooley came one night toward the end and took Boyd’s hand and gripped it. He studied the x-rays and EKGS and said, “we’re not licked yet.” Boyd was the last one alive, the last living model of the splendid operation, the ravaged testimony to the grace and daring—and ambition—of the surgeon’s hands. On the day before Easter, 1970, Boyd wanted something. He turned his head this way, then that way, he pleaded with his eyes for Ilene to help him. She held her husband in her arms and tried to reach for the Panic Button to bring doctors running. But her sister held her back. “Leo closed his eyes,” said Ilene, “Leo was gone.”
Rochelle broke. “He cried,” said Ilene, “more than I did.” Nora was devastated by the death. He wept for the man but he wept as well for the morality of the process. It had cost more than $160,000 to keep Boyd alive. “I couldn’t help but think what would happen if we had taken $160,000 and spent it in India on children with yaws,” said Nora. “I wondered just
what was moral anymore. This was a small corner of my life, I kept telling myself, not successfully, a not very major corner.…”
Cooley asked Ilene if she would permit a memorial service for Boyd the next day, Easter morning. None had been held for the other transplants, but then, none had so captured and held the hospital’s mind as had Boyd. Ilene agreed. The chapel next day was full. The service was brief, moving. The chaplain spoke of Boyd’s courage and of Ilene’s. Prayers were held to speed his resurrection on the Easter day. Alice Nye, for the first time since she had begun to nurse the transplanted hearts, cracked, and put her head in her strong hands and cried.
“Leo did it for me, and for the children,” said Ilene. “But he also did it for the doctors. He loved them all—Cooley, Rochelle, Nora, Bloodwell. They gave him sixteen months of new life—hard life, yes, but life! He saw a man walk on the moon and he saw his children and grandchildren grow older. Why, he met so many celebrities … the King and Queen of Belgium.… One day Cooley called and said ‘Dress Leo up, Christiaan Barnard wants to see him,’ and Leo was so happy and Barnard said, ‘You don’t even look sick enough to be in the hospital.’ … Leo’s autograph book was full of famous doctors’ names. Oh, I think he would go through it all again.… He was a man who laughed and joked until there was nothing more to laugh at.…”
CHAPTER 14
There was a conspicuous silence at Methodist Hospital in the immediate months after Christiaan Barnard performed his first transplant and startled the world. Mike DeBakey had made an immediate statement of congratulation to the South African surgeon. “He has broken the ice,” said DeBakey, when asked by a reporter for his reaction. “It is a real breakthrough in the whole field of heart replacement. It is a great achievement.” There were, DeBakey said, at least twenty medical centers in the world where there was skill and knowledge enough to perform transplants. “What we’ve all been waiting for,” he went on, “is the right circumstances—the right donor and the right recipient. Dr. Barnard had the right circumstances and he did it. They took the first step. We will do it, too.”
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