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Some days we wear our hearts on our sleeves, but at least they’re in the right place. We pour our hearts out to those we trust, spilling secrets in a beat. Our hearts bleed with compassion, or grow heavy with sorrow. When we’re serious, we get to the heart of things. When we skirt commitment, perhaps our heart wasn’t in it.
We break, cross and warm hearts, but many of us barely understand the actual organ. The Lily talked with women who do. For American Heart Month, we asked providers who work on heart transplants to send us the moments that shaped their careers. From diagnosing diseases to offering emotional support, these women each play a role in helping those who need new hearts survive and thrive.
A cardiothoracic surgeon operates on the heart, lungs and chest organs.
A cardiologist specializes in the treatment and study of heart diseases.
A child life specialist helps children and families navigate medical issues and offers emotional and psychological support.
The term “cardiac” refers to the heart, while “cardiothoracic” refers to the heart and chest.
“Myocardial” refers to the muscular tissue of the heart.
Maria Mountis, a cardiologist specializing in heart failure and heart transplant at the Cleveland Clinic
“I was born in Paris to parents who were Greek immigrants, and I moved to the United States at the age of 6. Throughout my childhood, my parents instilled in me a strong work ethic, sense of values and a belief that I could accomplish anything. However, it was my father’s own health crisis that inspired me to pursue cardiology, and moreover, transplant. When I was only 10, my father suffered a severe heart attack that left him with crippling heart failure. Throughout the years, he was hospitalized countless time for heart failure, heart rhythm problems and had several near-death experiences. Eventually, he was listed for a heart transplant. However, he became so sick that he needed a mechanical heart to survive until he could have a transplant.
Eighteen years ago, my last year of medical school, after a six-month hospitalization, he received the heart he had been waiting for. Watching the gift of life be given to my own father solidified my choice of profession — and I’ve been grateful to help my patients receive this gift as well. I was truly blessed that my father lived for 13 years after his transplant — time that allowed him to see me get married and two grandchildren be born. I believe my firsthand experience has helped me connect on a personal level with my patients as they go through this process that can be amazing, painful and stressful all at once. I still think about my father’s donor and hope that my work is a way of paying it forward, out of gratitude and respect for the donor family that selflessly donated and gave my father a second chance at life.”
Erin Connelly, a certified child life specialist in the cardiac unit at Boston Children’s Hospital
“Can you imagine a teenager telling you that the best two weeks of his summer were spent inpatient in the hospital? That happened to me. I’ve worked with children who struggle to engage in the same activities as their peers, because their heart is sick and they don’t have the endurance. These children are trying to process what a heart transplant is and why they need one. While these children are hospitalized we play Uno or video games and talk about the best and worst part about the hospital. We talk about waiting in the hospital for a long time until they receive a notification that they will get a new heart. We talk about the emotion(s) they might experience.
As a child life specialist, I strive to offer control and routine to children in an environment that reduces this ability. We create plans on how to reduce anxiety and sometimes that means having a dance party … with a karaoke machine, of course. These children are asked to process difficult information daily, but they remind me to celebrate the littlest moments, like their 100th day in the hospital! These children are wise beyond their years and it is an honor to observe their strength and excitement as they leave the hospital and return to being a kid.”
Michelle Kittleson, a cardiologist at the Smidt Heart Institute at Cedars-Sinai
“I don’t think you can witness a heart transplant and not believe in miracles. How amazing that one can remove a beating heart, maintain it in a state of suspended animation, implant it into another human being and bring it back to life. Yet it wasn’t a miracle that inspired me to become a transplant cardiologist. It was a tragedy. And it has stuck with me. Fifteen years later, I think of that patient every day.
Back when I was a cardiology fellow, I cared for a retired engineer. He was disciplined and organized, dragging his IV pole through the hospital halls for his daily walks and keeping track of his medications with a color-coded spreadsheet. He would have been a perfect heart transplant patient. But while on the heart transplant waiting list, my patient had a massive stroke. He was declared brain dead and his family honored his wishes to be an organ donor. My patient’s liver saved the life of another patient in the same intensive care unit. It is an honor and a privilege to witness firsthand the courage of my patients and their families as well as the generosity of their organ donors. With every transplant, I am newly impressed by the power of the human spirit to endure unspeakable hardship and grief with grace. With every triumph, and with every tragedy, I remain in awe of the mysterious miracle of transplantation.”
Erika D. Feller, medical director of the heart transplant program at the University of Maryland Medical Center
“I was just starting my pre-med studies in New York City at Columbia University. To pay for my classes and books, I tutored the undergraduates and worked as a lab technician at the Rockefeller University. In our lab, we studied the complexity of the human immune system. One of my friends at Columbia — we tutored together — was finishing his law degree. We commonly jogged together and played tennis in Riverside Park on weekends. He could never keep up. We always started walking. He complained of his long hours studying, inability to sleep, fatigue. He was always pale and bloated. Law school was hard, with many late nights snacking on junk food. One average day, he didn’t show up to his class. Later that day, he was found dead in his apartment.
He had a known dilated cardiomyopathy and died of sudden cardiac death. His heart was so weak, it was failing to deliver blood to his organs. His heart developed a deadly arrhythmia that quickly killed him. It was a shock. I had a lot of questions about how he died. Why did he die? In hindsight, he had symptoms, but he did not seem sick. Now I have answers to many of those questions I had. But many people still die from dilated cardiomyopathy and sudden cardiac death. Through medical school, residency and a cardiology fellowship, I was able to take my experience with the immune system and my interest in cardiomyopathy and develop a career in heart transplant and diagnosis and treatment for all causes of cardiomyopathy.”
Betsy Blume, medical director of the heart transplant program at Boston Children’s Hospital
“As a pediatric cardiology fellow in training, I was called to the emergency department to see a toddler with breathing issues and a big heart on chest X-ray. Her parents were scared, she was in distress. We diagnosed her with dilated cardiomyopathy and once she was on her medications, this tired, ill-appearing child was playing and running around the next week. Over the next year, she initially thrived, but then got a cold that another child would tolerate well. She got much sicker, and it was clear that she would need a new heart in order to survive. She eventually required a heart-lung machine called ECMO to keep her alive, until her new heart finally was found.
Being part of the team helping her and her family through that life-and-death experience, and watching her thrive over the next few years solidified my decision to continue to take care of patients and families like her, and to research better devices to bridge patients waiting for transplant. Every day I get to partner with patients and families walking through this complicated journey together. Organ donation is clearly the gift of life.
As for that toddler, last month, I got the ‘save the date’ invitation to her wedding.”
Sarah O’Leary, a nurse in the intermediate intensive care unit at Stanford Health Care
“One of the heart transplant patients I cared for has inspired me to continue this work. She is someone who had to fight fiercely for her life. During her pregnancy with her little girl, her heart muscle weakened during the pregnancy stress and physical changes, resulting in severe cardiomyopathy. My team and I got to know her and her family very well, as she spent a long time on our unit recovering from her pregnancy and stabilizing. She was implanted with a left ventricular assist device (LVAD) initially to improve her cardiac output and overall health. However, her health continued to suffer.
Only a few months later, she got the phone call that there was a new healthy heart that matched for her at Stanford and she needed to come in ASAP. Just a few days later, she returned to our step-down unit with her new heart. She was beaming. It gives me goose bumps to think about the incredible gift of life given to her. Now she can be with her daughter as she grows, enjoy time with her parents and build a beautiful life with her husband. About a year later, after one of her clinic visits, she returned to the nursing unit with treats for us all, holding hands with her daughter. As a nurse, this is one of the best moments of our careers — to see a patient who was so ill come walking into your unit healthy and strong. We hardly recognized her! She thanked us all for our care, but we reminded her we were just doing our jobs, and that she is one of the many awe-inspiring patients that motivates and drives us and brings so much joy to our career.”
Erin Iannacone, cardiothoracic surgeon at Weill Cornell Medicine and NewYork-Presbyterian
“Just as complications can occur during even the most ‘routine’ cardiac surgeries, some of our patients with formidable risks reward us with unexpected success.
One such patient presented to me recently in one of the more dreaded scenarios from a cardiac surgical standpoint. She was a rescue transfer from an outside hospital with a tear in her ascending aorta — a true surgical emergency. She was so unstable that instead of coming through our emergency room or intensive care unit (ICU), she was wheeled by the paramedics directly to our operating room in extremis. The anesthesiologist flew into action to attempt to stabilize her so I could at least have a chance to make the initial incision. I did not have access to her complete records, nor did I have time to call family to gather information. I knew that she was an octogenarian, she had compromised cardiac function at her baseline, and she was actively crashing.
Hours later, after I had replaced her aorta where it had torn, she miraculously separated from the heart-lung machine despite her baseline comorbidities. By the time she transferred from the operating room to the ICU, it was the middle of the night — too late to call her cardiologist for an update, as is my routine. After seeing her a few hours later on morning rounds, alert and requiring minimal medical support, I made the call, grateful to have good news to share. He answered the phone and spoke without hesitation, knowing about the transfer but not its outcome, ‘She didn’t make it, did she? Thanks so much for trying.’”
Esther Vorovich, medical director of the shock team at Northwestern Memorial Hospital
“I was an intern in the cardiac intensive care unit when a man came in who was in his 50s. He worked at a local college and had a massive heart attack one day while walking across campus. He was really sick; he was on a breathing machine and another machine called a balloon pump that inflates and deflates the heart to stabilize it.
He did okay for a little bit and came off the machines but it was clear that his heart was so badly damaged from the heart attack he would need a transplant or a mechanical pump called a VAD (ventricular assist device). Usually it takes patients and their families time to wrap their heads around this news. We had started the conversation about this and he told us, ‘I’ve thought about it, I want to live and I want to go for the transplant.’ He then said, ‘I don’t feel well’ and went into cardiac arrest.
We did CPR and ended up putting him on ECMO, a heart-lung bypass machine, to stabilize him for a BiVAD, a mechanical pump supporting both sides of his heart. He spent six months in the hospital before getting discharged. He went through rehab and got his transplant. He invited me to the one-year party his family had on the anniversary of his transplant, and sent me a photo of him — during that year — walking his daughter down the aisle at her wedding. I haven’t thought about this in a long time because there are so many gut-wrenching stories. This was the first time where I thought, oh my gosh, this is amazing, we took someone who was on death’s door and now he is walking his daughter down the aisle. I remember being like, this is the coolest job in the world. I still think that to this day.”
Jane Wilcox, director of myocardial recovery at Northwestern Memorial Hospital
“My father was actually listed for a heart transplant for a few months after he became acutely ill in his mid-50s, while I was in college. It was a really scary time, his diagnosis of heart failure was overwhelming, and I knew at that moment I wanted to be a doctor, with the goal of getting patients safely to transplant or helping their heart recover. That experience motivated me to enter the field of advanced heart failure.
During medical school and now as a practicing advanced heart failure physician, every day I see my own experience in other families; the experience of daughters wanting their fathers to make it to their wedding or the birth of their children. I got to see a young mother receive a transplant and watch her toddler grow up. We are able to help allow family members to have five or 10 or 20 or more years with each other. It’s really a new lease on life and an awesome experience. I love my job.
My dad ended up not needing a transplant as his heart muscle function recovered for many years. However, at age 75, he is now living with a mechanical heart pump, which is a testament to rapidly advancing technology of heart care, and the world we live in — people can live with a mechanical pump as a bridge to transplant or to keep them alive to watch their grandchildren grow. For me, it is about giving people extra moments of time with their family.”
Angela Velleca, clinical cardiothoracic transplant coordinator at Cedars-Sinai’s Smidt Heart Institute
“I have met so many wonderful patients and learned something from all of them. Not many areas in medicine allow you to follow a patient so closely for many years. You get to know them well and to know their families. I had the chance to take care of a very special lady for 15 years. At the time of her transplant, her two daughters were very young. She waited for many weeks in the intensive care unit for a heart transplant. I saw her every day. We were all overjoyed when her transplant day finally came. She did well, and after her transplant, she gave so much back to other transplant patients who were waiting for their new hearts and our friendship grew over the years. Her daughters grew too, and one even became a nurse. My patient was always thankful for the special gift of life that she received.
After 15 years, my patient developed complications and eventually passed away. I was sad because we had lost a kind and lovely patient and I had lost a friend. I realized then that being a transplant coordinator is a unique experience. We are with the patient in their most vulnerable moments for the most important conversations. I’m humbled every day by the gracious way our patients and donor families face life’s most difficult challenges. It’s a privilege to witness this miracle.”