After 30 years, it was time to let her doctor in on a little secret.
Eva Baisey had been going stir crazy. She’d spent weeks in isolation, unable to see her two small children, allowed to see her mom only from a distance for a few minutes a day. The risk of infection was simply too great, her immune system too compromised from the surgery.
Nurse Deirdre Carolan worried about her patient’s mental health and received permission to take her for a quick drive off campus. But they never told Edward Lefrak, Baisey’s doctor, where they went that day.
Three decades later, the nurse, the surgeon and the patient stood together in the lobby of the Inova Heart and Vascular Institute in Fairfax, Va. Carolan wrapped her arms affectionately around Baisey. They laughed as they told Lefrak that weeks after he’d performed the first-ever heart transplant in the Washington area, his patient went to McDonald’s for a cheeseburger and fries.
All Lefrak could do was shake his head with mock disapproval. What could he say? Baisey had beat all the odds.
Just days after Christmas, in the predawn hours of Dec. 28, 1986, Lefrak sliced the heart out of a 19-year-old man who had died that previous morning. The surgeon wheeled the healthy heart several feet to the operating room next door, where Baisey, the 20-year-old mother of two, lay waiting. He removed her weak, engorged heart exactly as he’d practiced doing dozens of times on bodies in the morgue and stared into the gaping hole in her chest. He then sewed in the donor’s heart and waited.
It was quiet except for some country music playing on a radio in the background.
Then the electrocardiogram monitor started to beep. Her new heart was beating.
Earlier that year, Baisey was in and out of the hospital, complaining of shortness of breath, little appetite and extreme fatigue. After months with no explanation, doctors determined that her heart was failing, diagnosing her with idiopathic cardiomyopathy, a disease whose cause is typically unknown. Without a new heart, it was unlikely that Baisey would live more than a few months.
Meanwhile, Lefrak, then a 43-year-old cardiac surgeon at Fairfax Hospital, had spent the better part of three years learning the techniques of heart transplants. In between his operations, he would slip into the morgue to practice, until the act of removing a heart and replacing it with another became almost second nature.
U.S. surgeons had been performing successful heart transplants since 1968, but in the mid-1980s, the closest options for a D.C. area resident needing a new heart were Johns Hopkins University in Baltimore or the Medical College of Virginia/Virginia Commonwealth University School of Medicine in Richmond. Lefrak felt it was a terrible burden on patients and families to travel so far for a procedure that would require weeks, if not months, of inpatient recovery and then regular follow-ups to monitor the body’s acceptance of the new organ.
At that time, heart transplants were no longer novel, but they still weren’t common. There had been 1,787 performed between 1968 and 1985, according to The Washington Post. Today, about 2,000 are performed a year.
There was a political dispute about whether smaller hospitals should be in the business of organ transplants. When Lefrak first took his case to the local Northern Virginia health agency for approval to bring a program to the D.C. area, he was denied. He appealed to the state, bringing along Christiaan Barnard, the celebrated South African doctor who performed the world’s first heart transplant, to help him lobby, a power move described then by The Washington Post as “having the air of Hank Aaron dropping by a neighborhood baseball sandlot.”
Lefrak won approval in March 1986. Then he had to find the perfect patient. Eight months later, after one patient died waiting and another was deemed too ill to undergo the operation, Baisey was transferred to Fairfax Hospital in dire need of a new heart.
Weeks later, a man who matched her blood type and chest size died. A murder-suicide, she’d find out later. At just 20 years old and gravely sick, she also didn’t fully realize that Lefrak and his team had never performed a heart transplant on a living person before. That they had no experience keeping a person alive after the heart was replaced.
As she listened to him now describe how he taught himself and practiced between shifts in the morgue, her eyes grew wide.
“Oh, wow, thanks,” she said, laughing. “That’s his secret. I didn’t know.”
Nearly every Dec. 28, Baisey receives at least two phone calls. One from Carolan. The other from Lefrak. She is their miracle as much as they are hers.
Living 30 years with a new heart is extremely rare. Lefrak has tried to track down the exact statistics, and most experts have told him that there are probably no more than six people in the United States who have lived as long as Baisey after such a transplant. In 2012, Johns Hopkins University did a study looking at the survival rate of heart transplant patients between 1987, the year after Baisey received her transplant, and 1999. Of the 22,000, just about half lived a decade, but those who received a new heart before age 55 were 24 percent more likely to live longer than 10 years.
“It’s a bigger deal than I even realized,” Lefrak said. He pats Baisey on the back, “She’s pretty special.”
“Eva’s going to set the record,” he said.
“I think I am,” she said, reaching down to knock on wood.
Lefrak is now retired. Carolan teaches nursing at Catholic University. Baisey is a nurse in Reston, Va. She was just starting schooling when she got sick, and it took years for her to finish and then for her immune system to be strong enough for Lefrak to allow her to be around sick patients.
Which may be why Baisey doesn’t complain about her two-hour commute from Maryland: driving to the subway, taking the train, transferring to a bus and then walking about half a mile to work.
The three, joined by Mary Dellinger, the operating room nurse by Lefrak’s side during Baisey’s surgery, sat together in a room in Inova last week, which was the first time they were all together in many years. They reminisced about the hard times, especially that first year after the transplant when it was still tenuous whether Baisey’s body would accept the heart; when she’d find herself back in the hospital in isolation for days or weeks at a time; when she couldn’t live with her small children because of the risk of infection.
She doesn’t think about the donor much. In the early days of transplants, there were rumors that a transplant recipient would adopt mannerisms or personality traits from the donor. Baisey said she does look for them. She plays with her eyebrows a lot, and she never did that before. She said, “I always wonder, is that a habit of his?”
Today, Baisey is all infectious spunk and joy. Lefrak said that “the positive attitude she exudes” has played a significant role in her survival. Carolan is working part time now as a nurse, but she always tries to be there when Baisey comes in for her annual checkup.
Baisey considers Carolan one of her best friends.
But her real best friends are her children. It’s not lost on her what she would have missed if not for Lefrak, Carolan and the others who cared for her.
“I always prayed – let me see them be old enough to take care of themselves, 18 or 21, and I’d be happy and He gave me more than that,” she said, her eyes misty for a moment. “Even if I went away today or tomorrow, I’m blessed. I’m very happy.”
(c) 2016, The Washington Post · Colby Itkowitz