The Boy Who Gave His Heart Away Read online

  ‘Did he?’

  ‘Yeah. I’ve bought him a St Christopher necklace, to go in his coffin.’

  Sue and Nigel both struggled to take all this in, although Michelle seemed like a very nice girl. ‘She was lovely. We always wondered what kind of a girl he would bring home,’ remembers his mother, who would later find pictures of her on Martin’s computer at home. ‘Obviously there was something quite strong going on between them but we didn’t know, he didn’t let on. Every time he saw kissing on the television he would be like, “Agh! Sloppy bits!” So the last thing we expected was for Martin to have a girlfriend, but it was a pleasant shock. One of the only amusing things to come out of that day.’

  A nurse called Anna who seemed to have stayed on after her shift just to look after them pointed out with a smile how many young women had come to see him. ‘We’ve had a string of teenage girls through here, haven’t we?’

  She brought a fresh cup of tea every time there were tears, says Sue. ‘Anna was wonderful. I was waterlogged with tea by the end of the day.’

  Sue was worried that the doctors would come suddenly for Martin without warning, so she asked them to give her lots of notice. ‘We knew we were going to leave him then. So when he left that room and we left that room, that would be the last time we would see our son breathing.’

  She still could not think of him as dead, despite what she had said to all the kids.

  ‘It’s very hard to sit with someone who is pink and warm and not see them as alive. I was sitting there holding his hand, he was alive. In my mind, anyway.’

  Sue was offered the chance to go with Martin, walking alongside his bed right to the door of the operating theatre, but she said no. She would say goodbye here, privately, in his room. The transplant co-ordinator from the hospital said kindly that she would accompany him instead and promised: ‘We will treat him with as much care as if we were saving his life.’

  As Thursday evening came, Sue was aware that time was running out. The nurses said Martin would be leaving at 8 pm. ‘The last hour was probably the hardest. We had been through thirty-six hours of this at the hospital and although we agreed with what was happening, when it came up close it was much harder to cope with. I felt I could sit there forever with him. While I was sitting there, it wasn’t the end.’

  But it was the end. It had to be.

  Harish Vyas was there to say so, personally. As the nurses were checking the monitors for one last time, the consultant met Nigel in the doorway to the room. ‘Martin will be going to theatre for the removal of his organs very soon. I think we need to say goodbyes now.’

  A nurse was beginning to work the translucent blue bellows of the ventilator by hand, as she would have to do all the way to the theatre. The bed was being turned now and Martin was coming towards them slowly, head first.

  The consultant saw tears on Nigel’s face, but then he felt a touch on his shoulder as they were both standing in the doorway and heard unexpected, tender words.

  ‘Thank you. I didn’t know you guys cared.’

  Dr Vyas realised that he, too, was weeping.

  ‘The day I stop caring is the day I pack my bags and leave this place. I am so sorry for your loss,’ he told Martin’s father. ‘I wish we could have done more but there was nothing we could do. I am so sorry.’

  The porters who had come to remove Martin on Thursday night paused out of respect for Sue, who was still bending over the body. She couldn’t say goodbye. She just couldn’t, even when her dad took her arm. ‘We have to go now, love.’

  ‘Susan, it’s time,’ Nigel said tenderly, using her full name, but there was almost a scuffle. ‘We tried to get her out of the door of the unit and that was very hard. She just fought because she didn’t want to leave her son, she found it extremely difficult to do that. We had to more or less force her out. She was in tears and we were all very emotional. You can understand that.’

  Sue knew this was the moment to let go. She felt everyone around her watching. It was the sensible thing, but it was so hard. Too hard. ‘I felt I was leaving him. I know now that he had been dead for at least twenty-four hours already, but that was the moment that I felt it was the end, for me. Not the day before. So it was excruciatingly difficult. I wanted to stay there. I wanted Martin to stay there, so I could be with him. To walk out of that hospital was the hardest thing in the world.’

  There was no choice, though. It was just after 8 pm on Thursday 28 August. She held her child one last time, kissed his face and whispered in his ear.

  ‘Sleep tight. We’ll love you forever.’

  Thirteen

  Martin & Marc

  They gathered outside the operating theatre in Nottingham as that Thursday night wore on: a dozen doctors and nurses, anaesthetists and surgeons in their green scrubs and gowns, waiting to take turns to retrieve the organs from the still-warm body of Martin Burton. His heart was still beating, his body was still working, with the assistance of drugs and machines, even though his brain was dead and his life was legally over. A single, long sweep of the scalpel from his throat to his waistline opened Martin up and the long process began. The heart would be removed first, but not until the early hours of the morning. A specialist team from the Papworth, the world-famous transplant hospital in Cambridge, had come across the country to take charge of this part of the operation. They could see from the colour of the heart and the way it was beating that this was a healthy organ, one that could save a life.

  A heart like this is the size of a fist. It clenches – or beats – somewhere between sixty and a hundred and twenty times a minute, depending on how hard the body is having to work at the time. The clench happens when a chemical reaction in the blood creates a tiny pulse of natural electricity that causes the meaty muscle to contract, squeezing out the blood that has filled the hollow chambers inside the heart while it was relaxing between beats. Half the blood goes to the lungs for oxygen. The other half has already been there and is now pumped out into the rest of the body. The double thump you hear is the sound of valves opening and closing at the top and bottom of the heart to allow all this to happen.

  The heart beats and the blood moves on. We can’t live without it. There was a chance that Martin’s healthy young heart might work for Marc in a way that his own defeated, swollen heart no longer could.

  The retrieval team told the surgeon waiting up at the Freeman Hospital in Newcastle that all was well and he could start preparing his patient. They used a clamp to stop the flow of blood into the heart and injected a chilling solution of potassium to slow down the beat then make it stop, in much the same way as had been done for the first ever transplant back in 1967. Martin was already dead, legally speaking, but now his life also came to an end in the traditional sense, as his heart beat for the last time. The surgeons were focused on the next step, though. Their aim was to bring this one part of him back. They were going to remove and transport the heart then revive it inside the body of a complete stranger, in the hope of giving that person many more years – if they could just get it to Marc in time.

  The clock was ticking from the moment the heart was clamped. When the beating stopped, the four tubes carrying blood to and from the body were cut and the heart was disconnected, lifted out of the chest cavity and carried across the room carefully by a nurse in gloves and a mask, to be packed in salt water in a sterile bag inside another sterile bag inside a third sterile bag and packed with ice in a protective white plastic box with a carrier handle, marked in blue with the words ‘Human Tissue’.

  They had four hours to get the heart from Nottingham to Newcastle and into Marc before it began to deteriorate. After that it would quickly become useless.

  The body of Martin Burton was sewn up after the operation and brought back to the intensive care unit. A nurse bent over him there, cleaning the iodine from his bruised skin, washing his hair and tending for him as if he was still alive, before he went off to the Chapel of Rest. Harish Vyas finished his rounds, checking up on
all the children in his care, before he could allow himself to leave at three in the morning. He felt the loss of Martin and knew what was coming.

  ‘Usually I become silent when we lose a child. I go home and remain silent for a while, I don’t talk to anyone, not even to my own kids. That is probably me gradually grieving in my own way. I don’t communicate with anyone for a day or two and then I come out of it and back to my normal self.’

  Long after Martin Burton had gone to theatre to have his heart removed and prepared for the journey to Newcastle, the consultant drove home exhausted. He pulled over and stopped his car at the top of the hill overlooking his village, with the deep, peaceful darkness of the countryside stretching out ahead of him down below. He got out, stretched his back and took a deep breath, through his nose, filling his lungs with the first fresh air after the long days and nights inside the hospital.

  The next day he stayed at home alone, as was his custom after losing a patient. He was very quiet, even when the children came home. They found him kneading dough and rolling it out for home-made pizzas, with fresh tomato and mozzarella ready, and they all knew what that meant. ‘In my silent phase, I make pizzas. I feed my family. It is a way of finishing the day by at least doing something for my children, overcoming the grief by showing there is still life. They have got to know after a while that if I make pizzas and I am quiet, something dastardly has happened at work.’

  The ritual was so familiar that Harish Vyas sometimes had to take steps to avoid making his children become alarmed at the sight of a home-made thin-crust pepperoni. ‘Occasionally I make pizzas without any dastardly things happening. I have to do that, so they don’t get scared every time they see me rolling out the dough.’

  The blood supply to Martin’s heart was cut off with the clamp at two-thirty in the morning on Friday 29 August, but it took time to remove and prepare the heart, which did not leave the hospital until just after three-thirty. Now there were only three hours left to reach Marc. That wasn’t quite enough. The journey from Nottingham to Newcastle by road would take three hours even with the blue lights flashing and no traffic all the way up the A1. They were cutting it too fine.

  Lynne Holt had already anticipated this and been in touch with a private transport company to book a plane – so the driver of the car carrying the heart turned south first, against instinct, and sped through the early hours of the morning to East Midlands Airport, a dozen miles away. There he took the back road, fast-tracked by airport security to the south apron, where a light aircraft was waiting with a pair of turbo-driven propellers already turning.

  Once the box had been lifted from the car to the back of the plane and secured with just the two members of the aircraft crew for company, the pilot opened the throttle and began to taxi for take-off. The wind was picking up that night as fiercely cold air came in from the Arctic to blow the summer away, so it took longer than expected to fly up the spine of the country, with the shadowed contours of the Yorkshire Moors down on the left and the North York Moors on the right. This was a short flight, but nothing was guaranteed. Planes do crash. A whole transplant team died a few years ago when an air ambulance for a heart patient came down and exploded in Nevada. A Cessna carrying a liver from Belfast to Birmingham crash-landed in autumn fog more recently and caught fire with the pilot inside. The fireman who pulled him out also rescued the white transplant box, so the operation could go ahead and another life was saved. ‘I’ve gone over it and over it and over it, waking up at night and thinking about it,’ he said later. ‘Luckily for us, everything went well.’

  The surgeons in Newcastle would not begin to remove Marc’s heart until they knew the plane carrying the new one had touched down and was safely on the ground.

  ‘The weather does keep the adrenaline going,’ says Lynne, the lead transplant co-ordinator, who was walking back and forth between the operating theatre and her office in scrubs, taking calls and letting the surgeon know what was going on. Timing was everything. The switch of hearts had to be done as quickly as possible to avoid a disaster. ‘The surgeon was waiting for that heart to come through the door.’

  The box was carried down the steps from the plane and put into an ambulance waiting on the tarmac at Newcastle International Airport, a mile from the terminal, where commuters in suits were already waiting for the Friday red-eye shuttle to London and tourists in shorts and straw hats were arriving dazed from sunnier places.

  The time was a quarter to six in the morning. There were now only forty-five minutes left to get the heart into Marc. The hospital was seven miles away by road. That would take half an hour in normal traffic, twenty minutes with a police escort. Marc’s mother and father had been awake there all night. So had Lynne. ‘There was a lot of stress, all totally understandable. Families in a situation like that haven’t slept for days, they’re not eating, they’re not drinking, so just trying to get some toast and tea into them is as much as we can hope for. I try and explain that we need them to be fit for when their son wakes up after the operation, but they never think of themselves, all they think of is him.’

  There was no way Linda was going to sleep while her son was in surgery. ‘I had been pacing the corridors all night, I was actually outside the theatre just standing there, staring at the doors for a while. I couldn’t see anything, but there was this urge to be near him.’

  She asked if she could go in to watch the operation. The staff said no, in the nicest possible way, so Linda kept pacing and ran into Norrie, who was doing the same thing. They went outside together for a smoke and were standing by the front entrance to the hospital in the dawn light when familiar flickers of blue suddenly appeared on the glass of the windows and shelters around them, reflecting the lights of the police car that was pulling up, almost silently, with an ambulance behind.

  ‘There’s another poor soul,’ said Norrie, wearily. Linda heard the wheeze of the hospital’s automatic doors behind her and a transplant nurse came out in her surgical gown, straight from theatre: ‘Linda, here comes Marc’s new heart.’

  Marc’s mother’s legs gave way suddenly and she found herself on the pavement, on her knees, being helped up, unable to quite comprehend what she was looking at. ‘It was in a box like you would take on a picnic with your sandwiches and cold cans in.’

  Then it was gone.

  Five past six. They had just twenty-five minutes to get the heart to theatre and connect it up, which was very tight timing indeed. Lynne Holt took the heart from the driver and was tempted to run, but she walked very briskly instead so as not to drop the box and ruin everything at the last moment. ‘I put the box onto a trolley and just pulled it through the hospital on wheels, that was the easy part.’

  The surgeon and his team had also been up all night, preparing for an operation that was going to take all day. Even if their hands were sure and swift, even if the organ was undamaged by the journey, even if the body did not reject the heart, Marc might still not be strong enough to survive. After all this effort by so many people, he might yet die on the operating table.

  Linda did not know what was going on behind the closed doors and there was nothing she could do about it. All her nervous energy had to go somewhere, so she fretted about the donor and his family. All she knew was they were from the Midlands. ‘I was thinking about this wee boy of sixteen and his mum and dad have just lost him and they’ve let his heart go to somebody they don’t even know. How can they be doing this? They don’t even know who we are, what kind of people we are. What better gift can you give people than life? I just felt so humble. I was grieving for them as well, but worrying for Marc. We weren’t out of the woods.’

  Fourteen

  Marc

  The surgeon stood to the right of Marc’s body with his gloved hands in the air, ready to begin. This would be a tricky operation, but Leslie Hamilton was used to that. The handsome fifty-something Northern Irishman with a super-calm manner and soothing voice was one of the best heart surgeons in the country, and pe
rhaps the very best at carrying out transplants for children. Heart surgeons are the rock stars of medicine, but he has a way of laughing that off. ‘We’re plumbers. We just connect the pipes.’ Plumbers can turn the water off before they start to work, though. The water isn’t blood. The house isn’t a living human being who will die if they get it wrong.

  Mr Hamilton had done a full day’s work at the Freeman on Thursday before popping home for tea and coming back about midnight. Marc had gone into theatre at that time to be examined and prepared as the surgical team got everything ready, then waited for the word from Nottingham that the heart was coming. Now it was definitely on its way. The surgeon wore loose-fitting green surgical scrubs and cap, a face mask and heavy, black-rimmed glasses with curious magnifying lenses that appeared to have been cut off a pair of binoculars. A headlight strapped to his forehead would help him see the way into the heart. There were half a dozen others in the room, including a perfusionist to check the blood supply going through the heart-lung machine that would keep Marc McCay alive while his own heart was removed and another stitched in.

  Mr Hamilton looked around at his team.

  ‘Shall we make a start?’

  He was used to pressure. There are few sharper ways to learn how to stay calm than working in casualty in Belfast at the height of the Troubles as Leslie Hamilton did. Bombs, guns, beatings and kneecappings, the victims all came to the hospital on the Falls Road where he helped out as a medical student in his youth. Loyalists, Republicans, gunmen or innocent bystanders, they all ended up at the same hospital. There, among the blood and guts, he realised that the attitude of the best medics was always the same: ‘Faced with a difficult situation, you analyse it and deal with it first. Reflect on it later.’

  The first time he opened a human body up to fix a problem inside the chest, he knew this was his thing. ‘“Wow,” I thought. “This is what I want to do.” The excitement of it all, the drama of the patient deteriorating rapidly, you’ve got to make decisions fast and if you do the right thing it works.’