“Good morning, Mr. Garcia, Your new heart just arrived in the hospital. It looks great. We’ll get started soon.”
Sandra, Erica, and I were watching The Voice and spending a nice shelter-in-place evening together. We had just started to enjoy a small scoop of vanilla ice cream when my cell phone began to buzz. It was around 9:30 PM. The number was from my cardiologist’s office. The three of us looked at each other intuitively knowing why the doctor was calling so late.
Our instincts were confirmed. She called to tell me that Stanford identified a donor heart that was a “great” match for me. She advised that I should expect a call from Stanford within the hour. After spending 45 minutes of nervous anticipation, Stanford called with instructions on when and how to report to the hospital.
I quietly gathered my things and put them into a backpack, took a shower, and dressed for the drive to Stanford. Few words were exchanged between me, Sandra and Erica during the nerve-wracking 35 minute trip to the hospital. Because COVID restrictions didn’t allow visitors in the hospital, Sandra dropped me off at the curb.
After a few hugs and kisses with two of the three loves of my life, I walked into my future. The healthcare team that greeted me at the door was friendly. Going into the new Stanford hospital was like entering a 5-star resort. The lobby was spacious and welcoming. I wasn’t nervous or anxious anymore. I could feel God walking with me as security escorted me to the cardiac unit.
Shortly after midnight, a cardiac nurse started preoperative preparations. This included taking vital signs, drawing blood, and briefing me on the surgery. I asked if the donor heart was at Stanford or en route. She confirmed that it was still at the donor hospital. The prep process was completed around 3:00 AM.
The nurse gave me some light sedatives to help me relax and I fell asleep. It was a whirlwind night and early morning. In the haze of the call from my cardiologist, the hectic activities, and relaxation medicine, I heard that the donor heart was from Idaho. That hasn’t been confirmed. Nonetheless, I decided to nickname my new heart, “Idaho.”
At about 9:00 AM, almost 12 hours after the call from my cardiologist, hospital staff woke me to roll the gurney with me on it into the operating room. Once in the OR, nurses and the anesthesiologist made final preparations for surgery and gave me some more medicine to relax. We waited as I fell into and out of sleep.
All of a sudden, a young and charismatic surgeon came into view. “Good morning, Mr. Garcia, Your new heart just arrived in the hospital. It looks great. We’ll get started soon.” I was in a fog, not sure that I understood what the doctor was telling me. I shortly fell into a deep sleep.
The surgical team began by placing a breathing tube into my throat extending into the lungs to provide oxygen from a ventilator. The first part of the procedure was removing the defibrillator inserted under the skin below my left collarbone. For 9 years, the defib performed heroically saving my life on at least 2 occasions.
The surgeon then cut an incision from just under my throat to several inches above the belly button and proceeded to saw the breastbone in half to open the ribcage. With the ribcage held open by a metal clamp, the team placed tubes into the chest cavity to drain excess fluid and blood. Doctors then connected a Cardiopulmonary Bypass Machine to a major artery to pump blood. This ensured that blood still circulated though my body during surgery.
The surgeon proceeded to cut the remaining arteries that connected my heart and lungs. Once that was complete, he severed the electrical wire that connected the LVAD to the external equipment I carried in a satchel for 17 months. Once all the clipping was done, he removed my diseased heart from the chest cavity.
Idaho patiently waited in an ice chest next to my slumbering body. The surgeon carefully removed it from the container, rubbed the donor heart gently to warm it up, and placed it in its new home. With precision dexterity, his experienced hands meticulously sewed the arteries to reconnect the heart to the lungs. The surgeon administered a quick shock of electricity and Idaho came to life.
The process in the OR took about 10 hours. Sandra and Erica waited in the parking lot throughout the surgery. For me, it was much less time. What seemed like a few seconds after telling me he was about to begin, the doctor came back to see me. Everything was blurry.
With a broad confident smile, he told me, “Congratulations, Mr. Garcia. You have a new heart! It’s working great. You have a Ferrari in your chest.” It seemed like he wanted me to share in his excitement, but I was more confused than anything else. My next memory was being in the ICU. I was scared and anxious, not knowing where I was and wary of all the strangers who were probing and prodding me.
The cardiac healthcare team I’ve been working with for a decade was at Kaiser Santa Clara Medical Center. Sandra, the girls, and I developed trusting relationships with them. We considered the Kaiser cardiology team like family and they treated us in kind.
Until the moment I arrived in the cardiac unit on April 15th, I hadn’t met anyone from the Stanford team. It’s one of the most elite hospitals in the world, but it wasn’t home. It wasn’t Kaiser. And, in the Age of COVID, Sandra and the girls couldn’t be with me. I was alone and felt helpless.
During the next week in the ICU, Idaho was proving to be a perfect fit for me. All tests and analytics confirmed that it was strong and adjusting to my body. I was on heavy pain medication, so I wasn’t physically uncomfortable. My mental state was a different story. ICU delirium reared its ugly head as it did in 2010 and 2018.
Instead of weird hallucinations of me in strange places, this time the delirium was set in the Stanford ICU. I was in a state of fear and paranoia. I thought those strangers dressed in medical scrubs were trying to hurt me or trick me into something or other.
I saw familiar medical personnel walking by in the hallway. They were members of my Kaiser team. I would excitedly wave them over, but not one of them recognized me. When a couple of them came closer, I noticed their name tags identified them as people I didn’t know. Mentally, I was in a lonely place.
Daily FaceTime calls with Sandra and the girls were like an oasis in a desert of loneliness. Although God escorted me into the hospital and stood by me throughout preoperative prep and surgery, I felt like He abandoned me once the operation was complete. I later realized that the effects of pain meds caused me to abandon Him.
I spent 11 days in the ICU and another week in a regular room. I remember very little of the ICU other than events that may have actually happened or were a product of my delusions. The time in a regular cardiac room was a little more clear, but not by much. I dwelled on the circumstances that led to my situation and over-analyzed every bad decision I’ve made in life. I became depressed.
On Sandra’s advice, I asked to see the hospital chaplain. A woman wearing a headscarf identified herself as a non-denominational chaplain entered the room and sat by the bedside. With a warm smile and a soothing voice, she asked me to describe my feelings and thoughts about the transplant.
Feeling comfortable with her, I was completely open about my regrets. Starting with failing at my first try to college, I meticulously detailed the decisions I made to overcome that original shame. I recounted how I worked tirelessly to finish college and forge a career that would erase the stain of that failure.
I told her that all I wanted was to be a “good man” by working hard, taking care of my family, and providing long term financial stability for them. Unfortunately, I lamented, my zeal to free myself from past mistakes and ambition caused the heart attack that led to ultimate failure in achieving those goals.
With sincere empathy, the chaplain reminded me that I had in fact met that expectation. She suggested that dwelling on a skewed self-perception of the past and worrying about a future that doesn’t exist were barriers to being grateful and living in the moment. She encouraged me to allow God back into my life, continue exploring my spiritual existence, and use God’s gift of a new life to “just be.”
Uplifted by the experience, I spent the last few days in the hospital in better spirits. One morning the cardiologist assigned to me confirmed that all was working well and announced that I would be discharged later that day. When a security guard wheeled me out to the lobby, Idaho skipped a few strong beats when I saw Sandra driving up to the front of the hospital.
In the 2010 Silver Ford Explorer that has been on this journey with us from day one, Sandra and I embraced tightly, not wanting to let go. Minutes later, we were on our way home with Idaho happily beating in my chest. Sandra was visibly elated and grateful. I was tired, nervous, and thankful for the gift from God.
As the Ford Explorer leisurely made its way south on U.S. freeway 101, Sandra and I chatted about what I could remember and our plans for my recovery at home. Little did we know that the next 90 days or so would be one of the most challenging times in our nearly 30 years of marriage. We would need faith, hope, and love like never before.
To be continued soon…