The Heart of the Matter

"I had a vision of a young man ... for twelve years, that's been with me all the time, every day."
"I can even be alone, and I'm not alone. I feel the presence with me."
"You have to know that this is not yours ... you're borrowing it. It's mine, but it's also the person's that died. It's like you're in a little partnership."
Eunice Barriga, 65, Vancouver

"I got a little concerned, I don't know why, and was wondering 'What about this [organ donor]? Maybe I don't even want to accept this heart. It was a very strange feeling."
"I found that I hadn't grieved. And that was the ticket; you need to grieve that part you've let go of. That brought me great relief."
Sister Jean Higgins, Roman Catholic nun, Sisters of Providence of St.Vincent de Paul, Kingston

"We believe it is a significant issue for some patients. Many people actually had distress. It was very common."
"If your goal is to have optimum outcomes after transplant, you have to take a holistic approach. If I'm trying to get the best quality of life for my patients ... and there is more distress than we realized, I need to try to do something to better prepare, better support and be more sensitive."
"In Western culture ... we do ascribe so much to the heart. You wear your heart on your sleeve. You say, 'He broke my heart'. You don't say, 'He broke my liver'."
Dr. Heather Ross, Toronto cardiologist, head, University Health Network (UHN)

AP Photo/The Seattle Times, Steve Ringman  The transplant world typically has viewed the procedure in “Cartesian” terms, as a bio-mechanical exchange of spare parts, one doctor notes.

Eunice Barriga who had a heart transplant in 2002, discovered that the donor had been a 20-year-old man. She envisions him constantly. She is deeply grateful for the opportunity given her to receive a healthy heart enabling her to live more years than would have been possible with her enlarged heart, but she has the emotional feeling that the heart beating in her chest represents a loan from a family to whom she is eternally grateful.

Suffering from cardiomyopathy, a weakness in the heart muscles, without a transplant Sister Higgins, now 71, had doubts about the procedure, the very thought that she would be dependent for her own life on the heart of someone else whom misfortune had deprived of the usefulness of their heart. A new study of patients at a Toronto hospital published in the journal Health, looked at the psychological, emotional results of that particular transplant surgery.

For the study, interviews were conducted with 25 heart recipients, many of whom experienced crises of various intensities reflecting their questions about their identity and whether it had been altered in the aftermath of receiving someone else's heart to enable them to continue living. Some had the impression that a stranger had entered their persona. And others felt an emotional bond to the donor.

"For a while, I felt as if there was an alien in my body ... a foreign identity", one heart recipient stated, as reported in the UHN paper. A 20-year-old teacher informed researchers she felt alienated from her friends whom she could not expect to understand "my mood swings and understand the strangeness that is me". Another, a 70-year-old retiree, felt the donor had been a better person than himself.

A 38-year-old recipient wanted to know nothing about the donor fearing that if he learned who that person was: "all I'm going to do is see a ghost at my bed". Another transplant recipient described going "kind of crazy", once she had given her new heart a name, and for some reason grew angry with the ghost she had named behind the heart.

Dr. Ross, head of the UHN's cardiac transplant program felt compelled to study the philosophy of being and the ideas of phenomenology which holds that body and consciousness are closely linked, and that "we are in a never-ending process of becoming". Research that spanned five years appears to affirm that ever-advancin evolution, validating the belief that receiving someone else's heart has greater meaning than merely the mechanics of transferring an 'engine' from one body to another.

The University Health Network, through its study of the mind-body pairing, attempts to prepare patients pre-surgery for the psychological/emotional feelings that may confront them post-surgery, providing support in helping them to write letters to donor families, for example, as well as how to fare in coming to terms with the emotional after-effects of their new realities.

The aim is to provide peace of mind for those who have undergone that radical transplantation procedure and for many reasons, not the least of which on the evidence is that transplant recipients' emotional well-being can have a telling effect on their physical condition. If a patient is well adjusted rather than agitated psychologically, problems like organ rejection or infection are less likely to occur.

Coming to a place of emotional peace is a requisite for the healing of mind and body. Where patients may display emotions that seem out of whack with context like "sobbing and incongruous laughter"; where nine of those interviewed felt that somehow the dead donor lived on within the heart now beating in the chest of the recipient. One patient felt as though he was imbued with someone else's "spirit", another felt nostalgic for his old heart, replaced by an "alien thing".

Clearly, the human imagination can be a self-defeating force, and it can also be a means by which we can be guided toward a better understanding of ourselves and the world we face.