CHAPTER 13

“I went into the transplant program with great hope,” said Jim Nora when it was all over, and when he could look back with passion that had more or less cooled. Nora is a well-made man with hunched shoulders bent from the depth and breadth of his practice. He rose from a lower-class section of Chicago to attend both Harvard and Yale, then to Houston, where he became a prominent pediatric cardiologist with a sideline specialty in genetics, as well as one of the few political liberals in a city whose medical community was overwhelmingly conservative. In the beginning he had shared Cooley’s enthusiasm for the new procedure and had zestfully managed the transplants against rejection. “What more noble purpose could there be in medicine than to return dying people to useful life?” he asked himself. But less than five months into the transplant year there began growing a pain within him that he could not deny. “Before we were through,” he said, “I was to feel that it was a small-scale crime against humanity. It became a grotesque joke, a game, a game we cannot ever play again.”

The disenchantment set in with Cooley’s ninth transplant in the blazing August of 1968. He had by then done more transplants than any other surgeon in the world; the hospital had to install security guards to contain the press and keep them from forbidden areas. Jerry Strong had leaned over the operating table one day and said to Cooley during a valve case, “Tell me, Denton, who was the second man to fly the Atlantic solo?”

There appeared at St. Luke’s that August a beautiful dark-haired five-year-old girl whose heart muscle was so diseased that Cooley’s surgery could not repair it. Both she and her parents agreed to a transplant. Their wait was not long; an eight-year-old boy fell from a tree in a Midwestern state, hit his head, and destroyed his brain. He was the son of a college professor. Nora recalled what happened:

“The two sets of parents met in the lobby outside surgery and both were crying. The parents of the girl made plans to share her with the parents of the boy who was giving up his heart. We were readying the child for a transplant and I can remember saying to myself, ‘I must do something different, I must not affect her growth’—how naive this sounds now—‘I must be careful with the steroids so I will not affect her psyche.’ I wanted her to lead a normal life.”

Cooley performed a splendid operation and within 24 hours the child was sitting up in bed coloring. But the next day she rejected, and on the eighth day she was dead.

“The euphoria for me was gone,” said Nora. “Our first transplants had seemed so hopeful that we thought we had somehow overcome that basic biological rule: the body rejects to protect itself against foreign matter. But we had not overcome the rule. Not at all.”

Nora began urging both in his own hospital and in national medical meetings that only transplants of the very best tissue matches be attempted, but he was not heard. Tissue matches between donor and recipient were graded on a scale from A down to D. An A match would be possible only when an identical twin donated his heart to his twin. Of Cooley’s transplants, only one tissue match was graded a C-plus. Seven were graded C, four were C-minus, and eight were D. “Perhaps we should do only one or two transplants a year, but we could make sure that they had a better chance to work,” Nora said. Bob Leachman was a powerful senior voice against him. “If we’re going to be in this game,” said the older cardiologist, “then we’re going to need to do enough transplants to make the experiment valid, to determine if it is valid clinical therapy. If we only do five or six, we could get bombed either way. You could have six bad ones or six lucky ones and you’d never really know.”

When the pattern of rejection had become a familiar one, Nora, distraught, went to Cooley and in a dramatic confrontation begged him to stop. “At least wait until the matches become better,” he pleaded. The surgeon was preparing a new transplant. “This is not a good candidate,” said Nora.

“But I’ve promised the family,” Nora remembered Cooley saying. It seemed almost an evangelical laying-on-of-hands. It seemed almost God guiding a scalpel. If a borrowed heart could be kept in place by the surgeon’s skill—and by his faith in that skill—then none of Cooley’s people would have died.

Disenchantment spread. Don Rochelle was attending a medical meeting in New York when he received a telephone call from the hospital in Houston. After a long and moving struggle for life, one of the transplants had died. Rochelle put down the phone and was near tears. He told his wife, who, on hearing the news, became ill. Both had been especially close to the patient. Rochelle located Cooley at the meeting playing string bass with the Heartbeats, a band composed largely of Houston heart doctors, which is well known in the medical world. When the music was over, Rochelle whispered the saddening report. Cooley shook his head and excused himself to attend a reception. Rochelle had been invited to the same party but he was too overcome to attend.

“Denton was disturbed by the deaths, sure,” said one member of his team, “but he didn’t lose much sleep over them. He gave them the most beautiful surgery in the world. It was not the surgeon’s fault that the patient died.”

Nora tried to point out that two of America’s most distinguished heart surgeons, John Kirklin of Alabama and Dwight McGoon of the Mayo Clinic did not attempt a single transplant. Jim Hardy of Mississippi did but one. Only two were attempted in Russia. Cooley remained convinced of the procedure’s validity.

For a time, Cooley even felt that variations on the theme were perhaps possible. One such departure from the norm—if indeed there was a norm to heart transplantation—turned into a bizarre and dark comedy.

When a donor heart could not be found for a dying patient who needed one, Cooley elected to take a ram’s heart and implant it. The animal heart shriveled and rejected immediately as the human lay on the operating table. In anticipation of possible trouble, a large pig had been brought to Animal House, a small metal-walled laboratory next door to the main hospital. A pig’s heart is similar in physiology to a human heart. Word was quickly telephoned to a surgical team standing by there to prepare the pig—the ram’s heart had failed. The unwilling animal was chased about the room, caught, and strapped to the table. He was given anesthesia. He went out, then woke up squealing, fighting to break the straps that contained him. An anesthesiologist was called to bring a more powerful drug. Meanwhile, on the third floor operating room of St. Luke’s, the Cooley team was trying to keep the human patient alive. Finally too much time passed and Cooley cancelled the procedure. He pronounced his human patient dead before the pig’s heart could be tried.

“A certain amount of naïveté can be forgiven,” said Nora, “because, after all, the transplantation business was so new, so unknown. But what destroyed it in my opinion was our continuing to do them after so many failures. It was an example of dehumanization by technology.”

Nora remembers thinking as he drove to the hospital in the middle of some night to cope with yet another new crisis, “This is symbolic of everything wrong in our world. Fill in the blank, fill in any abuse you want—pollution, Vietnam, bureaucracy—the mechanics of that abuse are comparable with what we are doing.”

“There should be a ‘Ballad of Leo Boyd,’” said one of the nurses who watched over him during the sixteen months of pain and crisis. “Few men have ever gone through what he did.” I saw Boyd only once. It was toward the end of his ordeal and he must have known it, or wished for it. He was sitting up in bed and his skin was the color of old ivory. He was a museum-piece man, his cheeks artificially puffed from the drugs. I did not speak to him except to nod encouragingly, and he returned my hope for him with an almost papal movement of his right hand, a benediction from a transplant.

Jim Nora could no longer bear to even enter his room and had asked Don Rochelle and the others to care for Boyd. “He came to us a magnificent-looking man with great arm muscles,” said Nora. “I could not bear to look at his face and see what we had done to this strong, proud man.…”

Boyd was born in the tiny Canadian village of Stratfordville in Ontario province. It had 500 people or so when Boyd was a child and most were involved in the harvesting and curing of bright leaf tobacco. Boyd’s parents and people were masons who built saw mills, silos, and factories for tobacco processing. Once in a baseball game with a rival village, Boyd’s father offered him a dollar for each home run. He hit four in four times at bat and collected four dollars from his proud but astonished father. Boyd had two brothers, both of whom were boisterous outdoor kids. One threw Boyd into a creek, where he hit his head on a stone and almost drowned. The other boxed with him and knocked him down so often that he became angry and learned the way of the gloves and began winning trophies by-the-time he was fourteen. Boyd became a strapping youth of six feet plus, with dark hair, hazel eyes, powerful arms and legs with muscles that rippled and veins that stood out like rope on a package. In the Canadian army during World War II, he took judo and after but a few lessons was taunted to climb into the ring with a burly teacher. Boyd slammed him to the mat and almost broke the man’s back.

Rather than the masonry trade of his family, Boyd chose railroading and in 26 years on the New York Central, advanced from brakeman to conductor to yardmaster. He was not a man to be kept indoors, for he had a quick temper that flared and died; it rarely flashed when he was hunting birds on the plains near his home or moose at North Bay or casting in the pools below Niagara Falls for perch, or bass, or—his lifelong hope—a muskie. At the age of 42 he took up bowling, became an expert, and scored over 200 in every match. He smoked a pack of Camels every day, and took but an occasional drink after bowling or at weddings. He had two daughters and seven granddaughters and a slender, pretty, hard-working wife named Ilene, who adored him.

On an early autumn morning in 1965 Boyd slept late because he was on the 11 A.M. to 7 P.M. shift. He rose, washed his hair, had coffee, and dressed for work. He went to the garage of their home in Niagara Falls, Canada, and Ilene remembers hearing some muffled noises. The ensuing silence worried her. She walked down the long hall of the house and saw her husband sitting on their bed, his face a purple color.

“I’ve got the worst pains in my chest,” he said. “Must be indigestion.”

“But you didn’t eat any breakfast and nothing special last night. Leo, lay down.”

He obeyed and fell backward, rubbing his left arm.

“Leo, honey, have you got pains in your arm?”

“Yes. All up and down.”

Ilene started to back hurriedly out of the room. “I’m calling the doctor,” she said.

“Oh, don’t do that, hon. It’ll pass. I’m due at work.”

“Leo, I’m scared.” A neighbor had suffered similar pains in his arms while sitting in a lawn chair. He had died before he reached the hospital.

Ilene called for an ambulance, which delivered Boyd to Niagara Falls General Hospital. He had suffered a whopping infarct and was hospitalized for seven weeks. “It was a frightening experience for him,” remembered Ilene. “He didn’t understand why it had happened to him. But he was a good patient.… He would always be a good patient.”

Boyd asked his doctor why he had suffered a heart attack. The doctor drew a picture of a pipe rusting inside with little particles flaking off and building up until the pipe occludes and when the fluids can no longer pass through the pipe, it ruptures.

For the first time in his active life, Boyd had to stay indoors and grouch for six months of semi-invalidity. He was a prisoner of blood thinners and digitalis and nitro tablets. He won permission to return to work and seemed restored to a normal life except for rare flashes of anginal pain. In September, 1966, Boyd and Ilene drove to Kentucky for the funeral of a relative and upon arriving back in Niagara Falls, Boyd crumpled to the floor with a second heart attack. Another seven weeks in the hospital, followed by months of terrible pains in his back, neck and head. “I’m going out of my mind with this pain,” he told Ilene. He would stuff himself with tranquilizers and pain pills and prowl the house at night. Once he fell asleep in a certain chair and became fond of it. The family dachshund, Gretel, was not allowed near that chair. When Boyd discovered her in it one day he picked up the squealing animal and yelled that he was going to kill her. Ilene smuggled the dog out of the house, gave it away, and interested Boyd in tending to tropical fish, more obedient pets.

On an evening in 1966, Boyd went to sleep after Ilene had given him a shot of Demerol, as she had learned to do. “When they first told me I would have to learn to give the shots,” remembered Ilene, “I said I couldn’t possibly do that … but one learns.”

Ilene herself was stricken with pneumonia and on this night she lay beside her drugged husband. When the Demerol wore off, Boyd roused himself and begged for another shot. Ilene refused. He began to rage for more pain killer. Ilene insisted she had to follow the regimen laid down by the doctors. Boyd got up and said he was going to walk about the house and try to make the pain go away.

He was gone such a long time that Ilene got up and began to search for him. She discovered him on the couch in the living room, rolling on it, tossing his body from one end to another, crying out, his face contorted in agony. Then he rolled off the couch and onto the floor. “I had never seen a man in such pain before,” said Ilene. She called a doctor, who came and, after a rapid examination, said it might be a gall stone. “I don’t think it is another heart attack,” he said. But at the hospital, the EKG showed a third infarction had destroyed part of Boyd’s heart. It was, in fact, his most severe heart attack to date, and during the night his heart arrested. A team resuscitated him, and Ilene was called at home and told to be at the hospital by eight the next morning and to make up some excuse so as not to worry her husband. He was, they said, desperately ill.

Boyd was in an oxygen tent and frowned at seeing his wife so early. “What are you doing here at this hour?”

“I was going downtown shopping,” Ilene lied. “They have sales on and I wanted to be there when they opened the doors.… So I thought I’d come here first.”

“I see.…” He was suspicious.

“How are things?” she asked.

“Something bad is wrong.…” Boyd was so gray and weakened from the attack that Ilene had to rush from the room. Outside, the doctor said, “Leo cannot possibly live until night. I think you should gather your family to the hospital.”

An hour later his heart went into fibrillation but the electric paddles jolted it with current enough to send it back to a fairly normal rhythm. When Ilene saw him later that afternoon, there were burn marks on his chest. But he was alive.

Boyd’s life became a grotesque carousel spinning from hospitals to home to doctors’ offices, from new drugs to old ones, to increased dosages, to EKG machines, to sentences of doom, to scenes of horror in the living room when he would shriek his fury at Ilene because she would not quiet him with the medication she kept hidden. One doctor suggested that he go to Toronto General, where a bold surgeon might attempt an open-heart procedure. Boyd was elated at the possibility. But the EKGS and cardiograms were far too pessimistic for surgery. “From your studies, we feel you would not have one chance in a million,” they said. “A man with a weaker body than yours would already be dead. There is nothing we can do surgically. We’re going to put you on medication and, hopefully, strengthen your heart. Come back in six months and we will examine it again.”

Boyd’s hopes crumpled. He felt he was beyond hope. He went home in despair with thirteen new drugs to take every day. Ilene chattered gaily beside him, but in her mind was ringing the surgeon’s report: one branch of Boyd’s left coronary artery was 90 percent blocked, a second branch, 30 percent, and the right, 70 percent.

He would yell at Ilene for more Demerol. “What’s the difference in giving it to me now or in an hour and a half from now?… Woman, I’m dying from pain!” The scenes became such that Ilene felt her sanity was leaving her. She tried to work at a drugstore and slip away in the afternoon to nurse Boyd and he would be, more likely than not, half-conscious and delirious. “It was in and out of the hospital, in and out of the hospital.… One Saturday morning we brought him home, and took him back the same night.… I called Toronto and said that even though the six months were not up, couldn’t we come back and see if anything could be done? The surgeon there agreed. Leo went in for six weeks of tests. I was trying to save money so I was staying with my sister 85 miles from the hospital and commuting to Toronto with Leo’s railroad pass.… One night he called me and fairly shouted with happiness, ‘Come early tomorrow morning! Come extra early! They’re going to operate!’”

Ilene rushed to the hospital by dawn and into her husband’s room. She found him curled into a tight ball, facing the wall, his face streaked with tears. “They’re not going to do it,” he said. “They’re sending me home to die.”

They waited for death. Boyd took his medicine. Ilene drugged him to erase the pain and bring the sleep. Sometimes she would drive him to Niagara Falls and park and they would look at the happy, beautiful youngsters in yellow slickers, promenading about the mist. Leo Boyd was only 48, but he was an old man. And tired. And deathly sick.

When Boyd picked up the paper in early December, 1967, and read the headline from Capetown, South Africa, he cried for Ilene to come to his bed. “There may be hope for me,” he said, thrusting the paper at her. He followed the case hourly, by radio, by newspaper. Ilene was glad for something to occupy his interest. When Blaiberg was transplanted and seemed to be recovering, Boyd asked his doctor in Niagara Falls to explain the transplant procedure. “We may have to send you to South Africa, Leo,” said the doctor.

“I’m just about ready to go,” he replied.

A few weeks later, Ilene took Boyd to a larger hospital in London, Ontario. They sat in the waiting room for hours, Boyd’s breathing echoing through the room like an iron lung. A doctor finally examined him and said his heart would not last the night. “We have heard that so many times,” snapped Ilene. “He will not die if you can just find the time to take care of him.”

A general practitioner, a Dr. Lamont, came into Boyd’s room and said, “I think you should consider a transplant. What would you think of that?”

“There’s not much to think about,” said Boyd. “Where could I go?”

“Cooley is doing them in Houston, and Grondin in Montreal.”

“I’d rather go to Houston. Neither my wife nor me care much for French Canadians.”

“Then I take it you want to go for broke in Texas?”

“Is there another choice?”

“Cooley has done five or six. He appears to be the world leader.”

“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 screamed 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.…”