Sabrina | profile

Everything had to go well. No room for mistakes. Failure (the death of Sabrina M.) would bury the heart transplant program forever.

Should it depend on a miracle? Happiness? About the suitability of the group of people gathered and brought together under my leadership? Certainly from each of these mixed factors.

The operating room was ready. About twenty people were moving frantically, completing their tasks. Then, from my position on the operating table, on the right side of the already opened chest, with the patient’s body connected to the extracorporeal circuit, I saw Gerardo, one of my colleagues, transferring the heart to the operating table. He carried it in a container of ice. The instrument girl handed it to me and I picked it up. A strange feeling flooded my mind. In milliseconds I checked all my technical and surgical resources. He had operated on thousands of hearts, but he had never held back a cold, congested, limp heart that he had removed from a dead body a few hours ago in the hope that it would beat again so that another body could live on. Would I do it?

I placed it in the chest of Sabrina, our first patient. Now everything depended on the skill and speed with which we stitched the structures together; and for the heart that someone had donated and that had been stopped for resuscitation. Not a drop of blood should escape between one seam and the other of our seams.

In that moment, I didn’t think about whether it was easy or difficult, whether it was right or wrong that we had taken the heart from a brain-dead body and put it in Sabrina’s chest. Nor did I think about whether all this was done for the girls and boys of the public hospital so that they had access to such medical-therapeutic complexity. Or if he would do it for me, to show me that he could do it and that the polio I had suffered couldn’t stop me. There was even less time to decide whether this would be a miracle or not and ultimately whether it was a miracle if I believed in it. I didn’t think about that. To.

And he spoke loudly, as if to calm me down:

—Auricle to auricle, right?

“Yes, and that is the aorta,” Gerardo answered me. They fit perfectly… Now we have to put them together…

We placed the new heart so that the part that went deep into the chest, the edge of the left atrium, lined up with the edge of the same atrium that was left of Sabrina’s heart. An expected invader, foreign and unknown, summoned to restore blood circulation to every cell in your body.

There were more than twenty people in the operating room, but no one spoke. There was silence.

It was a sunny Sunday in October 2000. The National Central Single Ablation and Implant Coordinating Institute – Incucai, the government agency that manages organ donations – had offered us a young donor who was brain dead due to a massive intracranial hemorrhage resulting from the rupture of an arterial aneurysm. The girl was now in a sanatorium in the capital.

At lunchtime I called my closest and dearest colleague, Gerardo Naiman. I told him that the long-awaited and at the same time feared call of the Incucai had finally taken place. Together we called in the cardiologist of the team, who was to meet at the door of this place two hours later. We finished lunch (I almost couldn’t), I left my older daughters and then my wife at home with our youngest daughter and headed to the appointment. Gerardo, about four years older than me, is a very good surgeon, but also a great friend. Brother in life and profession. Colleague and friend with whom we tried to pave and consolidate our own path within a specialty, pediatric cardiovascular surgery, that was plagued with obstacles, not only because of its great complexity, but also because of those who were involved and held leadership positions. With strict intellectual and professional honesty, he was the companion without whom I would not have been able to realize many of my projects.

To consolidate the project to develop the transplant program, we selected the cardiologist who has long been dealing with heart diseases that would lead to transplantation in young patients without other alternative treatment. Over time, it also became more important in my professional interest and personal affection.

When we entered the sanatorium, we had to go through the waiting room on the way to the intensive care unit. There was a pediatrician from Garrahan, the hospital where I worked, and her husband, a renowned pediatric neurosurgeon from the other children’s hospital who we had known for many years. They got up and came towards us. We welcome each other. They asked me if my presence had anything to do with their niece, who suffered a brain hemorrhage while getting dressed for her graduation ceremony on Saturday evening. She graduated as a psychologist on Friday. I told them we were there to evaluate a dispenser offered by Incucai. That we didn’t know who it was.

*Author of El corazón en la mano, Sudamericana publishing house (fragment).