Change Of Heart

Recovery from his second transplant includes checkups on his heart (above) and regular workouts (below) to build his stamina.

From the day of his heart attack on, Compton's condition worsened, gradually at first, and then precipitously. On May 14, he was hospitalized for observation. Doctors began using Milrinone, which improved the functioning of the heart and also placed him in a more dire category, increasing his chances of receiving a transplant. "I was obviously scared at that point that I was going to get another heart attack," Compton says. There was no point in further medical procedures—the damage to the heart had been done. "They weren't going to go in there and do any more stents. They wanted to get me a heart quick," he says. He was fitted with a PIC line to dispense the Milrinone directly to his heart and was set to go home with a nurse to provide 24-hour care when Dr. Si Pham, his surgeon and a friend of the family, called. "He says, 'Oh, by the way, stay in the hospital because we found a heart for you,'" Compton says. The 14-hour operation was performed May 20.

One thing that can be said without fear of contradiction: Heart-transplant surgery is not non-invasive. It's about as invasive as it gets. The rib spreader operates like a stainless-steel window crank. Electrocautery seals bleeders in the chest cavity, filling the nostrils with an odor of burning flesh that lingers like a sour memory. The ailing heart is removed and placed in a pan, sometimes before the new heart is even in the room. It arrives in an Igloo cooler filled with ice. The heart is in a Lock & Lock container, the kind that advertises itself as absolutely air tight, floating in an icy saline solution. The nurses check the paperwork quickly. Even a heart leaves a paper trail.

The operation has three distinct stages. The first is a flurry of activity. Surgeons prepare the chest cavity, removing implanted pumps or other devices. The anesthesiologists take sets of blood tests and monitor a rack festooned with hanging medicine bags, tubes and syringes, too many to count. Someone runs the heart-and-lung bypass machine. Somebody else makes certain the patient's body temperature, lowered for the operation, remains constant. Nurses set out instruments and keep track of how far away the donor heart is. If you wanted to pick a time when bad cell-phone reception is its most aggravating, this would be it. If you wonder if the surgeon worries how long the donor heart has been outside the body, the answer is, only every second.

When the new heart is placed in the patient, the operating room becomes oddly quiet while the surgeons, often one on each side of the chest, reconnect the five major veins and arteries. The needles and the thread make the only sounds that matter. In an orderly progression oddly reminiscent of a pre-shot routine performed under the most severe pressure, everything is attached and tested before two paddles that look like spatulas made for flipping dollar pancakes are placed against the heart and it is jolted back to life. In a room dominated by green fabric, yellow antiseptic and crimson blood, the attached heart becomes a pink blossom. In a stroke of good fortune for us, it turns out the human heart just wants to beat. In the third stage of the operation, the flurry of activity resumes as the doctors crash to insert drainage tubes, get the meds just right, close the chest, shut down some machines, push them out of the room and start others in their place. At 14 hours, Compton's surgery took longer than usual because of trouble controlling the bleeding.

"They wheeled me in, and the next thing I remember was waking up in the ICU like two-and-a-half days later," Compton says. "I was thinking, 'Man, what have I done to myself?' I could feel the stress of just lying there, not being able to move. I was intubated. I felt like I couldn't breathe and I really was breathing. It's just a hopeless feeling. I had 17 IVs in me. I had seven chest tubes. I couldn't feel my leg, so I didn't know what was going on with that. And I had a lot of hallucinations and stuff."