A Daughter’s Last Gift

The gift of life is never meant to be returned, especially not wrapped in plastic, packed in ice and enclosed in a small Igloo cooler. But that is precisely the transaction that occurred last week at William Beaumont Hospital in Royal Oak, Michigan, where doctors took the heart of a 22-year-old who died following a car crash and sewed it inside the body of her father.

Chester Szuber, a retired Christmas-tree-farm owner, had been tormented by heart disease for 20 years. He had endured three open-heart surgeries and two operations to clear his arteries. Four years ago, he was put on a waiting list for a transplant. But early in the morning of Aug. 18, he was bumped to the front of the line. His daughter Patti — a nursing student who carried an organ-donor card, had communicated to her family her wish to be a donor and even drove a car with a bumper sticker promoting donations — had been thrown from a car when it hit a rock wall on the Tennessee side of Great Smoky Mountains National Park. The vacation, said her brother Bob, was to have been her “last hurrah before starting school” in the fall. Instead she ended up at the University of Tennessee Medical Center in Knoxville, brain dead.

Every organ donation brings with it wrenching questions for the families involved, all of which have to be answered within hours of the death of a loved one. Would the donor really have wanted the organ to leave her body? Would the operation put the life of the recipient at greater risk? In this case, the two families were the same, but there was a deeper implication that was particularly discomforting: Can you take your own child’s heart, to feel and hear it beat day after day?

Patti’s mother Jeanne initially balked, fearful that having lost her daughter, she would now lose her husband during surgery. But the patient himself insisted, saying, “It would be a joy to have Patti’s heart.” The rest of the family agreed. “That was what Patti would have wanted, beyond a shadow of a doubt,” said Bob. It would “make Patti the happiest little angel in heaven.” In less than six hours last Monday, her heart was removed, surrounded with ice, flown 600 miles to Michigan and deposited in her father, where it began beating again. Szuber is listed in good condition and is expected to be released within two weeks. His daughter, the youngest of his six children, was buried last Friday.

While some 2,000 hearts are transplanted each year, last week’s operation was apparently unique. “I’m not aware of any cases in which a heart was transplanted from one family member to another,” says Joel Newman, spokesman for the United Network for Organ Sharing in Richmond, Virginia, which maintains a nationwide registry of 35,000 requests for organ donations, about 3,000 of them for hearts. “While the odds of this occurring are extremely slim, this puts a human face on a real problem for thousands of people awaiting organs. You can save lives by donating.”

That is a judgment of supply and demand. Emotionally, the transplant touched more ambiguous chords. “My ethical meter says this is O.K. and should be done. My gut-feeling meter says, ‘Wow, this is very troubling.’ It’s in the Ripley’s ‘Believe It or Not’ category,” says Arthur Caplan, who directs the Center for Bioethics at the University of Pennsylvania. “The heart is the most symbolic of organs. Had they moved a lung or a pancreas, it just wouldn’t have the same emotional impact.” But a child’s heart? Surely no parent could bear such a burden. Unless, perhaps, as in the case of the Szubers, the only alternative was another death in the family.