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Sarah - Heart Transplant

For 11-year-old Sarah McPharlin, a last-minute heart transplant at Children’s Hospital would mean the difference between life and death
By Tom Nugent

It began around eight o’clock, on a muggy July evening in 2001, when an 11-year-old girl named Sarah McPharlin dove underwater at her neighborhood swimming pool.

“Mom, I’ve got a bad headache,” Sarah had told her mother moments before. “I’m gonna stick my head under and cool it off!”

Dianne McPharlin smiled and nodded. “Okay, honey, I hope that helps.”

A moment later, the frisky child was paddling through waist-high water toward the bottom of the community swimming pool, located in the Detroit suburb of Grosse Point Woods.

But then she suddenly went limp. Her body sagged and a stream of bright silver bubbles began to flow from her nose and mouth. Puzzled, the child’s mother watched her drift aimlessly through the water.

Ten seconds passed. Then twenty. She’s clowning around, Dianne thought with a flash of irritation. She’s being silly. Hurriedly, she groped for her daughter’s arm. Grasped it. Pulled the limp and motionless sixth-grader back toward the surface of the pool.

“Sarah . . . cut it out. This isn’t funny; you’re scaring me!”

No response.

“Sarah, I’m not kidding around. . . .”

Then Dianne saw the water gushing from her child’s nose – a flood of water that just kept on coming. Alarmed, she pulled her daughter closer. Shook her.

Nothing.

Sarah was unconscious. She was out cold. Her throat and lungs were full of water; in fact, she had been in the early stages of drowning, down there at the bottom of the pool.

My God, thought Dianne McPharlin, a special education teacher at the Maire Elementary School in Grosse Pointe. Oh, my God.

Then she began to shout for help. Within a matter of seconds, two lifeguards were pulling Sarah from her mother’s anguished grasp. Then, while one of them dialed 911, the other stretched the child out on the pool deck and began to administer CPR.

Numb with horror, Dianne stood helpless above the scene. Was this really happening to her child? Only moments before, the healthy and sports-loving Sarah – a star player for the Dragons travel team in the Grosse Pointe Soccer Association – had been frolicking happily in the turquoise-hued waters of the crowded and laughter-filled Lakefront Park Pool. And now the lifeguards were struggling to save her life.

Stunned and stricken, Dianne listened to the wailing singsong of the approaching sirens. Hurry, she commanded them inwardly, again and again, as the lifeguards worked frantically to revive the ashen-faced child on the deck. For God’s sake, please hurry!

A Life-And-Death Struggle

While Dianne rode in the ambulance with her stricken child, Sarah’s 18-year-old older sister Katie – one of the lifeguards who’d been on duty at the pool during the incident – was frantically telephoning her father.

Jim McPharlin, then a 45-year-old business analyst in the Product Development Department at Chrysler, listened to his oldest daughter with amazement, before hanging up and racing toward the hospital. For the moment, a family friend would have to look after three-year-old Emily, the baby of the McPharlin family.

At the hospital, a team of emergency room physicians and nurses managed to bring Sarah back to consciousness, and then stabilize her erratically beating heart.

“They told us she was down to 35 beats a minute,” says Jim today, “and we asked ourselves: Only 35? How can she possibly survive like that? And what’s wrong with her heart, anyway?”

The doctors shook their heads. After running half a dozen different tests, they could be certain of only one thing: something in the complicated electrical system in Sarah’s heart had gone disastrously awry. Somehow, the nerve-circuits that controlled her heartbeat had become snarled, producing a chaotically irregular rhythm that now threatened her life.

“They finally got her stabilized,” Jim recalls today, “and then they recommended that we transfer her over to Children’s Hospital in Detroit, where a team of pediatric heart specialists could evaluate her condition in detail.”

After learning that Children’s has the largest and most experienced group of dedicated pediatric heart specialists in Michigan, the McPharlins didn’t hesitate. Within a few hours, they had arrived on the campus of the Detroit Medical Center, the home of Michigan’s only freestanding hospital devoted exclusively to pediatric care.

Although the specialists at CHM quickly got Sarah’s heartbeat under firm control, it took them several weeks of exhaustive testing to uncover the underlying cause of her near-drowning at the pool. “They explained to us that she’d caught this strange virus,” says Jim, “a thing called Echo. Most of the time, Echo will move harmlessly through your body: There are often no health effects at all.

“But every once in a while – nobody knows why – this virus will attack the heart. And that’s usually very bad, because it can destroy the electrical system and even destroy the heart muscle itself.”

Unfortunately, this was the case with Sarah. For several months before the swimming incident, the Echovirus had been gnawing silently at the vital tissues controlling her heartbeat. In medical parlance, she had developed “giant cell myocarditis,” and the life-threatening damage had been done.

For the next three months – and during a series of endless and agonizing transfers between Children’s and her home in Grosse Pointe Woods – the stricken child would hover in a twilight world where death often seemed near. Placed on two different blood-pumping machines, she would fight bravely for her life, while doing her best to hang onto her sense of humor.

“I named the second blood-pump Herman,” she would recall later, “because it was a machine made of metal and glass, and I didn’t know if it was a boy or a girl.” (In fact, the machine was a “Left Ventricular Assist Device,” or “LVAD,” designed to boost the pumping ability of Sarah’s weakened heart.)

While Herman pumped away, Sarah hung on. But the weeks were passing, as August melted into September, and she was growing a little weaker each day. How much longer could her devastated heart keep on beating?

“We prayed,” remembers Dianne. “We prayed, and our neighbors prayed, and our friends all prayed. And I was angry at God. I struggled; we all did.”

By late summer, their lives had become a blur of exhaustion, punctuated by bursts of terror, as the child’s frayed heart began to give out. On five different occasions, it simply stopped beating. Each time, the skilled and swiftly moving team at CHM’s Intensive Care Unit managed to bring it back.

Enter Dr. Walters: “We Need A Heart.”

The heart surgeon in charge of Sarah’s care was named Henry L. Walters III (“Hal” to his colleagues and friends), and by the late summer of 2001, he had seen enough. The medicines and the blood-pumping machines were slowly losing their effectiveness, and the brave child was beginning to fade on them because of progressive weakness of the right side of her heart. Increasingly, Dr. Walters – the longtime chief of cardiovascular surgery at Children’s – had become convinced that Sarah’s own heart was not going to recover and that only one strategy remained: Sarah needed a heart transplant.

Hal Walters was fine with that, of course (he and his CHM colleagues have performed more than 50 successful heart transplants in recent years) . . . but the process of obtaining a healthy, adequately working heart that “matches” the one it will replace can be lengthy and difficult.

Again and again, Dr. Walters and his team of transplant specialists came close. But one potential donor had used cocaine: a disqualifier. Another was the wrong blood type. The weeks were passing, and Sarah was sliding toward the edge.

Jim and Dianne were virtually living in Sarah’s hospital room now. And they were still praying . . . still begging God for a heart. Meanwhile, Jim had earlier contacted one of his colleagues at Chrysler – Vice President for Purchasing Gary Valade – and had asked him a crucially important question: If we can find a heart out there, will you loan us the corporate jet, so we can pick it up in a hurry?

Valade’s answer: “Of course we will, Jim. Just give our phone number to the doctors at Children’s – and have them call us the minute they find that heart!”

But it was late October now, and their hopes had dimmed to a few dwindling sparks, after 68 days of breathless waiting.

And then on the 22nd of October, the phone rang. It was CHM heart transplant coordinator Joanne Dupuis, with good news from Dr. Walters at the hospital: “We think we have a heart for Sarah.” Dupuis then called Chrysler and asked for the use of the corporate jet.

And so the race began. Within 80 minutes, the Chrysler pilot was thundering down a runway in Pontiac. In Detroit, the plane would land briefly to pick up CHM pediatric cardiologist Ralph Delius, M.D., and then lift off again to pick up the heart in Atlanta.

Now the jet streaked toward Georgia at nearly 600 miles an hour.

They had about five hours in which to accomplish the transplant, before the donated heart would begin to die.

Once on the ground in Georgia, Dr. Delius confirmed that the donated heart was “viable” . . . and Hal Walters gave his surgical team a green light. It was time to begin “prepping” Sarah for the potentially life-saving transplant.

Dr. Walters, a graduate of the highly regarded Baylor College of Medicine in Texas, has performed dozens of heart transplants since signing on as a pediatric surgeon at CHM 16 years ago. And none of those operations would be any tougher – or last any longer – than this one.

It took Dr. Walters and the other two attending surgeons more than 13 hours to accomplish the transplant and stabilize their young patient.

“It was a long, long surgery, and it was difficult at times,” says the surgeon today. “Removing Sarah’s diseased heart and her pacemaker was difficult because of all of the scar tissue around the heart and after the transplant there was massive bleeding. Getting that bleeding stopped was extremely difficult; it took a long time.”

But Hal Walters didn’t falter. “We’ve got a highly skilled transplant team at Children’s,” he will tell you with a smile of quiet pride. “Our staff – the doctors, the nurses, the technicians, all of them – has a great deal of experience, after doing so many of these transplants.

“We’re really glad we have the transplant program at Children’s, so that when things are at their worst for a patient, we can still have a backup medical strategy to offer them.”

A Red Rose From Dr. Walters

Sarah survived.

As a matter of fact, she has positively thrived.

Today she’s a senior at Grosse Pointe North High School. She’s also an enthusiastic runner on the school’s cross country team – where her dedicated coach Scott Cooper last fall created a special “modified” course for her to complete, so that she could earn a varsity letter in the sport. She did. And she also nailed down a gold medal in tennis at the annual Transplant Games in Louisville, Ky., during the summer of 2006.

Now 18 years old, Sarah McPharlin was recently admitted to Michigan State University, and plans to enroll there this fall. Her current goal: to become a pediatric nurse or medical technician, so that she can help in the treatment of children who are as sick as she once was.

“They treated me like family at Children’s,” she says today. “They did my nails at times, they even gave me beauty treatments right in my room. They treated me like a normal girl. And they let our family cat – Guinness – visit my room, so I could say hello. And Dr. Walters gave me a red rose on my birthday. He was like my uncle . . . like a member of my family.”

Says Jim McPharlin, six years after the CHM heart transplant offered his daughter a new chance at life: “On the day of Sarah’s surgery, Dr. Walters came into her room and sat down at the foot of her bed. He held her hand and he said: ‘I will take care of you.’ He and his team were amazingly dedicated to helping her.

“The hospital totally rallied to her. The entire hospital staff got involved – including the cleaning ladies! And they couldn’t do enough. I remember this one sunny afternoon in October . . . Sarah was in the hospital, and her perfusion specialist called me in her room. He told me that it was such a nice day – he wanted to take her for a ride around the hospital in her wheelchair.

“After I gave him permission and thanked him, he drove down to Children’s – on his day off and safely disconnected Sarah from the large LVAD and connected her to a portable unit – and spent an hour and a half pushing her all around the DMC campus.

“What can I say? There’s a goodness to people, that’s all. Every day of my life, I say: Thank God for the [heart] donor family, and for the folks at Chrysler who gave us the jet. And of course, we’re also grateful for the continuing care Sarah will be getting from Children’s – because Dr. Walters and Dr. Thomas L’Ecuyer and their teams have already assured us that they’ll be closely monitoring her progress at Michigan State.

“Thank God for the doctors and nurses at Children’s Hospital of Michigan. They gave us our daughter back.”


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