Biding his time for a heart, and another chance to live

November 21, 1999|By MICHAEL OLESKER

THE TELEPHONE rang in Howard Golden's home Wednesday night, and the woman on the other end of the line, calling from Johns Hopkins Hospital, keeping a professional grip on her composure, said, "They may have a heart for you."

"Oh, my God," said Golden.

The words arrived at the end of 16 months of anticipation. Golden awaits a heart transplant. He is 57 years old and chief judge of the Orphans' Court for Baltimore City. He has suffered two heart attacks in the last 15 years and knows what it is to contemplate his own demise.

He is already carrying someone else's heart. Six years ago, on Oct. 19, 1993, he underwent a heart transplant at Hopkins. The surgery was splendid, but the aftermath was not. In the last five years, his arteries have done about 30 years' worth of clogging. It is not an uncommon pattern after such procedures. So in July 1998, his doctors said he must undergo another transplant or face the end of his life.

And, once again, the familiar waiting commenced: not only for a heart, but one that would fit into Golden's chest -- he's about 5 feet 6 inches, 135 pounds -- and a heart that would arrive while there is still time, when he's not only still living but still healthy enough to be considered likely to survive such a traumatic operation.

So when the call arrived last week, after so much waiting, Golden reacted with a mix of delight and dread. The surgery is rough -- but it is his last hope.

"I almost had a heart attack hearing her words," he was saying at week's end. He meant Sharon O'Neill, the Hopkins transplant coordinator who called that night.

"You know," he said, "I've been through this before. I've been anticipating this one for 16 months and yet, with all that waiting, when the call came, I went into absolute emotional panic and flat-out fear."

"We've been offered a heart, and maybe it's suitable for you, or for another patient," Golden remembers O'Neill saying.

"Well, I'm feeling fine," Golden said. "I'm not sure how long it's gonna last, but if the other person is much sicker than I am, and more critical, then the right thing for me to do is decline the offer and let him have it."

He was making the grand gesture -- but, it developed, an irrelevant one.

Last May, there was a similar telephone call: They thought they had a heart. Don't eat anything, he was told, these things move very quickly. Two hours later, he was told to report to the Hopkins emergency room. He sat there for a couple of hours, and then came the news: The donor heart had deteriorated, and Golden should just go home.

"It was deflating," he said last week, "but I told myself, OK, my waiting must be over. I must be at the top of the list for hearts now. Maybe I'll get called next week."

Instead, he waited six months -- until last week. And last week became an echo of last May. He hung up the phone with O'Neill and, in a frenzy, called his son, his daughter, his ex-wife. He wanted everyone to know the moment had arrived once more.

Only, it hadn't. Ten minutes after the first call from Hopkins, there came another: The donor heart was too large for Golden.

"So I'm waiting again," he says.

And he is wondering why the waiting has to be so long, and so traumatic, for so many organ recipients. Two years ago, in fact, Golden testified before the state legislature's Task Force on Organ and Tissue Donation.

He told them about his own transplant -- the first one, not yet knowing he would need a second. Six years ago, he'd been waiting only 25 days when his doctor called.

"How would you like to get a new heart tonight?" the doctor asked.

Golden was sitting in a room with his mother, Rose. The two of them wept. Over the next few hours, his family gathered.

"I thought I might be saying goodbye," he remembers. "I hadn't even had time to get scared yet. I promised myself I would, but they called so fast, they blindsided me."

He awoke from surgery and refused to believe it was over. He imagined his heart troubles had been a terrible dream. When it hit him, two days later, he sat up in bed and began singing out loud.

"No more waiting, and I'm fine," he thought. "My troubles are over."

But they were not. And now, like so many others, he waits. Two years ago, in his speech to the legislature, Golden talked about interviewing "reliable sources from every aspect of the transplant world" and finding troubles he hadn't imagined.

For example, a person signs up to donate organs upon his death. It's a noble gesture. But in the emotional aftermath of the donor's death, the family balks. Never mind what the deceased wanted, the family declares: No way. Golden asks, why should the next of kin have the right to nullify the wishes of the dearly departed?

"This is not just my case we're talking about," Golden says. "We're talking about tremendous numbers of people who can be kept alive, and who wait indefinitely, and the organs become available. But people die."

In his speech to the legislature, Golden said, "This undermines the sanctity of the right we all have to decide on the disposition of our earthly remains. Should our Orphans' Courts be permitted to overturn other testamentary gifts where the next of kin objects?"

Golden would like the legislature to take another look at transplant issues this session. Last week, he remembered 15 years ago when he was rushed from the Clarence M. Mitchell Jr. Courthouse to Mercy Hospital and was told he was having a heart attack.

"I don't have the time," Golden said. "I have to go back to court."

"You're not going any place," he was told.

"Fifteen minutes later," he remembered last week, "I'm sitting there making a deal with God. My kids were 3 and 7. `Just let me live long enough to see them.' "

Fifteen years later, his voice breaks at the memory. The children are grown, and Howard Golden hopes for another extension of his life. And he waits and waits.

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