A few months ago I received a letter from a transplant surgeon who helped put my dead son’s heart into the body of a boy who would have died without it . He is Dr. Stefano Marianeschi, now Director of the Pediatric Surgery Unit at Niguarda Ca’ Granda hospital in Milan, one of Italy’s foremost transplant hospitals. “We have never met in person but our lives crossed in 1994,” he wrote.
At the time, Dr. Marianeschi was a young cardiac surgery assistant at Rome’s famous children’s hospital, the Bambino Gesu (Baby Jesus) where one of his patients was “a bright boy” named Andrea, 15 years old, who suffered from a complex congenital disease of the heart for which he had already had three major operations, none of which had cured him. This time the diagnosis was terminal complications from the third operation, namely protein-losing enteropathy.
“When I met him he was struggling to survive, he was grossly undernourished, weighing only 27 kilos (60 lb.)and twice a week he had to be admitted to our hospital for albumin and calcium infusions. The only hope for him to get back to a normal life was a heart transplant.”
In those days organ donations in Italy were just about the lowest in Western Europe. “People were resistant to the idea of consenting to donate the organs of their loved ones. So every heart transplant brought challenges and great emotions at the same time,” Dr. Marianeschi wrote.
“I clearly remember the night of October 2. Andrea was in our ward and suddenly we were called because there was finally a heart for him. Dr Antonio Amodeo flew to Sicily to harvest the heart. I went to the hospital and gathered with all the surgeons assisting Professor Carlo Marcelletti to perform the transplant.
“Initially I did not know who the donor was. I was just happy for my patient to receive the transplant. But as I realized that it was Nicholas’ tragic loss that was the light at the end of a very dark tunnel it was with mixed emotions that we proceeded, trying to make the best of a bad situation. The operation went well and Andrea gradually recovered. Now he is 35 and we meet sometimes on the social media on the Internet. He is still bright like when he was a child.”
Just another medical miracle.
I remember that night too and the numbness that came with having made a decision that meant we had given up any last hope of holding on to Nicholas. But it never entered my mind, nor Maggie’s either, that this was anything other than the overwhelmingly right thing to do. And that is as true now as it was then.
P.S. I should add that the letter was mailed from Cambodia, where Dr. Marianeschi and other doctors from Niguarda hospital work several weeks of the year to make a dent in the huge backlog of medical problems in a country where a whole generation of physicians was blighted by civil war and repressive regimes and where even now medical resources are woefully inadequate.