George Dickson never had many choices in life. His damaged heart wouldn't permit them.
After rheumatic fever struck at age 8, he couldn't play tag or race friends down the street. He sat on the sidelines during high school sports events. His heart weakened further with age, and by the time his daughter Shannon was born, just climbing steps was a struggle.
Dickson had grown used to his limitations by then, but depriving his daughter caused him fresh pain. I'm sorry, but I can't play catch with you, he said when she approached with her child-size baseball glove. I can't take you on the roller coaster, he said when a carnival arrived near their Kent Island home. I'm sorry, Shannon, I can't swim with you in the ocean.
As sick as it was, though, Dickson's heart outlasted his doctors' predictions. They'd said it would fail by his 21st birthday, but he was a graying man of 53 when congestive heart failure landed him in the University of Maryland Medical Center.
Once there, doctors encouraged him: A healthy heart could be transplanted from a donor, and finally he could experience everything he had been denied. He could dance with his wife, Jan. He could take Shannon on any ride she wanted. All he needed was patience -- to wait for a heart compatible with his type O blood and 6-foot, 235-pound body.
He entered the hospital on Oct. 10, 1997, confined to the Critical Care Unit because the medicine dripping from his IV forced his exhausted heart to squeeze, but it also increased the chance of a heart attack.
From his third- floor room, though, he could hear a sound that carried hope: The soft whup-whup of approaching medical helicopters. From his window, he watched them land on the roof of Shock Trauma next door and wondered: Was his new heart on board?
Fall eased into winter. Spring dragged by, then summer arrived. Other heart transplant patients came and went -- one received his heart in just two weeks -- but Dickson's turn never arrived. The donor hearts were always the wrong blood type, or too small.
The waiting got harder. Being cooped up in his small, sterile room made him feel like exploding. And his medicine was losing its effectiveness, leaving him so weak that he clutched the sink and gasped while shaving.
But the worst part was losing the one thing his heart had never before denied him: time with his family. His wife and daughter drove the two hours round-trip to see him several times a week. But he had missed Christmas, his wedding anniversary, Shannon's 19th birthday. He hadn't been there to fix things, like the waterbed that leaked and ruined the carpet. He hadn't been there when Shannon just needed to talk.
As October approached, his nurses compared notes. No patient in recent memory had waited so long. Surely a heart would come before Dickson's one-year anniversary at the hospital.
Dickson felt he could endure it if he knew for sure a heart would arrive. But statistics told him his fate was uncertain: One out of five transplant patients died waiting. Since he had entered the hospital, four other patients had received new hearts and gone home. After all this time, would he be the unlucky one?
The decision came to him with a swift certainty: On Oct. 10, 1998, he would leave the hospital, ready to rush back the moment a matching heart was found, if one was found. For now, he wanted to breathe fresh air again. If his time was limited, he wanted to spend it with Jan and Shannon.
Dr. Ronald Freudenberger, director of the heart transplant program, was strongly disapproving. Dickson couldn't survive without his powerful but risky medicine; at home, there would be no monitor to alert nurses if a heart attack struck. The danger was too great.
The doctor urged him to hold on a little longer. He knew Dickson was slipping; even talking was an effort for him now. But if a perfect heart didn't come soon, they could try to buy time other ways. The doctor knew, however that he couldn't force his patient to stay.
George Dickson, a man unaccustomed to choices, finally had a crucial one to make.
He'd arrived at the hospital with such hope. A few months and he'd be home again, a new man. He'd filled the days with elaborate jigsaw puzzles and "The Price is Right." He'd traded e-mail with colleagues at the Annapolis Capital newspaper, where he worked in the composing room.
To the bulletin board by his bed, he had tacked a photo of Shannon proudly holding up a fish. Years earlier, he'd been able to teach his daughter to fish, and some of their best times together were spent aboard his tiny boat. The photo was a reminder of the past, and a promise of the future.
When had his hope started to dim?
In February, maybe. February had been a bleak month.
It happened around Valentine's Day. A ringing phone made Shannon sit upright in bed in the middle of the night. It was her father: They had a heart for him at last. Shannon and Jan sped down the highway, too excited to talk.