Scott Wallick paced the hospital lobby floor, back and forth between the double sliding glass doors and the red chairs clustered next to the windows that stretch three stories high.
He sat down next to his wife, Carla, looked out the windows and stood up again.
He was waiting for a heart.
Three months earlier, his son — who rarely complained about anything — had said his chest hurt, like someone was pressing on it from the inside out.
Brett had had a cold, but was 15 and healthy. It had been finals week; his step-mom thought maybe the pain was caused by stress, or that he was getting asthma.
A teenage boy's resting heart rate averages about 75 beats per minute. But at the doctor's office Dec. 20, Brett's heart sounded like a stampede: 140 beats a minute. An X-ray showed his heart was way bigger than it should have been.
The doctor sent Brett straight to Phoenix Children's Hospital.
Tests showed a virus was attacking Brett's heart. Someone on the medical staff said something about a transplant. Wallick pretended not to have heard.
"It was just ridiculous how fast it came on, and how quickly it deteriorated," he recalled.
Ten days later, doctors opened Brett's chest and put in a left ventricular assist device, or LVAD, a mechanical pump that would help his heart pump blood through his body. It would keep him alive until a donor heart became available.
And then the family from Peoria waited. They had already spent Christmas in Room 5112, with red and green decorations and presents, though Brett was so sick he wouldn't remember it later. After his surgery Dec. 30, Carla and Scott even forgot about New Year's Eve until Brett weakly piped up, "Happy New Year!"
His mother lives in the United Kingdom, and though his step-sister Jordan, 9, lives here, she couldn't visit because of hospital policy, so Brett talked to them both on the phone.
On Jan. 8, Brett turned 16, and the nurses decorated with balloons and streamers. There was cake, and enough cash in his birthday cards to buy three Xbox games.
Pediatric patients typically stay in the hospital until their transplants, but Brett was doing well enough that he was the first child ever allowed to leave Phoenix Children's Hospital with an LVAD. He went home on Jan. 22; he and his family would keep their vigil for a heart there.
Brett couldn't go to school, and couldn't be alone. He had to be near a power source, plugged into the wall or, if he went out, two battery packs.
Brett Wallick had a Left Ventricle Assist Device surgically implanted to help his heart pump while he waited for a transplant.
Brett could sometimes feel the pump in his chest. And if it was really quiet, he could hear the motor working inside him. It made his cat Simba skittish.
Each time Scott and Carla saw a story in the news about a serious accident, they looked at one another and then at Brett, thinking the same thought, though neither said it out loud: Could this be Brett's heart?
It felt morbid and wrong. They twisted inside, prayed for a match, and prayed for the future donor, whoever it might turn out to be.
"We knew someone had to pay the ultimate price to save our kid," Scott Wallick said.
Donor hearts would became available, but they wouldn't be perfect matches for Brett. The heart had to be the right blood type, the perfect size.
But three months later, they got word: There was a heart for Brett.
The surgical team had wheeled Brett into the operating room about 1:30 p.m., before the heart arrived.
His parents were allowed only as far as the door. Scott Wallick had told his son, "See you soon, buddy."
Wallick was used to saying goodbye — he was in the Air Force for 26 years and said it each time he deployed. This time was the hardest.
Now, he was pacing the lobby. The heart was on its way. He looked out the windows again.
Even with all he was feeling — excitement and worry, relief and anxiety — Scott wondered, again, about who had had to lose a loved one so his son could live.
'You just go'
AN URGENT FLIGHT, A MOMENT OF SILENCE, A CRUCIAL CALL
As Brett's parents waited and watched in the lobby, he lay upstairs on the fourth floor, under anesthesia, his chest open, the LVAD mechanical pump disconnected, his damaged heart cut out, a bypass machine keeping him alive.
He had been taken into the operating room at 1:30 that afternoon; a Phoenix Children's medical team had already left to get the new heart.
Donor hearts remain viable for only a few hours outside a body, so when one is matched with a recipient in another place, a carefully synchronized process begins in both locations.
As one surgical team travels to the hospital of the donor, surgically removes the heart and returns with it, a second team begins surgery on the recipient, opening the chest and preparing to attach the new heart.
Dr. Daniel Velez, a heart surgeon at Phoenix Children's Hospital, had been on duty the day Brett first came in, white-faced and hurting, his dad worried.
In the months since, the doctor had seen the boy regularly. Earlier on the day a heart became available, Velez and a couple of the other doctors had attended a spring training game – Giants vs. White Sox – with Brett and his family. They joked that if a call came in, they hoped it would at least come after the seventh inning.
Velez was scheduled to take his family on vacation the next day. But when the call came late on March 22 that there was a potential heart, he postponed the trip.
"I'll go get the heart," Velez told April Colón, the pediatric cardiac transplant coordinator.
With Velez were registered nurse Kayla Taylor and Jordan Brimhall, a medical perfusionist who would operate the heart-lung machine.
The team knew the drill: a drive to the airport in an SUV dressed up like an ambulance, lights on top; a chartered plane to the donor's location; a delicate surgery; the return flight; and then back into the SUV and back to the hospital. Velez had done it hundreds of times.
He is cautious to not give specific details about what time his team left, or how long it took to get there. The identities of organ donors are kept private.
As soon as the team arrived, Velez met with the transplant coordinator there to review the donor's medical records. He doublechecked blood type, test results and consent forms.
But included in this donor's paperwork was something Velez had not seen before, not in the 12 years he had been doing this. He read the paper, paused, then tucked it back into the binder.
It could wait. What he needed to do couldn't.
Velez and his team entered the operating room. The surgeon confirmed for himself that the donor was brain dead, being kept alive by machines to preserve organs for donation.
Other surgical teams were arriving and lining up; there is an order to how donor organs and tissue are removed.
The heart comes out first.
In some hospitals, there is a moment of silence for the donor. Velez likes that. In some cases, the same doctors and nurses who worked to save the donor may be helping with the organ donation.
Velez opened the donor's chest and watched the heart. It was in fine shape, the color good, beating steadily. He made a call to Dr. John Nigro, the surgeon in the operating room with Brett.
"It's a good heart," Velez said, and hung up.
"It's a good heart," Dr. John Nigro repeated as he hung up the phone.
Nigro is the division chief of cardiothoracic surgery and director of the hospital's heart transplant program.
Nigro had been the surgeon who opened Brett's chest the first time, and implanted the LVAD to help pump blood through his body while he waited for a heart. The device had bought Brett time — time to get stronger, time to find the perfect heart.
Brett likely could have lived with the LVAD, Nigro says. But it would not have been a normal existence for a teenage boy with plans for the future, including studying medicine.
So when the call came that a heart was ready, Nigro had taken Brett into surgery and opened his chest again.
The two surgical teams — one at Phoenix Children's, the other on the move — would be in constant contact, with calls every step of the way.
Nigro had been waiting to completely remove the LVAD device and Brett's heart until he got the word from Velez.
"It's always a dilemma," Nigro said. "We want to know the heart is good before we do anything we can't undo."
Proceeding even after that call is risky, since something could go wrong for the team en route with the heart. It was a risk Nigro would take.
Taking the heart out now would mean he would need less time to put the new heart in once it arrives. And the quicker that heart gets into a human body, the better its chances of working.
Nigro went to work. He began to take out the LVAD and the damaged heart, too.
In the operating room with the donor, Velez injected the heart with a cold solution that flushed out the blood and slowly stopped it from beating. Velez then carefully removed the now-still heart.
It went into a plastic bag filled with the same cold solution, which would nourish the heart during the journey. That bag went into a second bag filled with ice, which went into a third bag filled with ice, and then into a hard plastic container with a lid that sealed. Finally, the container was nestled deep in the cooler and covered with more ice.
"And then you boogie. You just go," he said.
This is the point in any transplant where time is at its most critical. The team had four hours — at most — to get the heart on the plane, into the air, back to the hospital in Phoenix and into Brett's chest.
So many things can go wrong, and Velez worries about them all, every time: mechanical problems with the ground transportation or the plane, inclement weather, an accident.
But this return trip went smoothly, and from the hospital lobby at 6 p.m., Carla spotted the white SUV with the words "Organ Recovery" in black letters on the side even before it turned in off Thomas Road. The SUV pulled up to the curb, and Velez and his team spilled out.
"That's our heart!" Scott Wallick cried.
The phone in Nigro's operating room rang again when Velez's plane landed in Phoenix.
The team watched Brett closely, monitoring his vital signs. A heart bypass machine filled in until the new heart arrived.
Another call came when the SUV got close.
And then, someone called out, "They're bringing it up."
The sliding glass doors to the lobby opened with a whoosh, and Velez came through first, wearing blue scrubs, pulling the cooler and grinning.
"Thank you! Thank you!" Carla and Scott called. They carefully stayed out of the way to give the team a straight shot to the elevators and up to their son.
Nurse Taylor carried the donor's paperwork in a binder. Also inside was a piece of paper, the same one Velez had read at the donor's hospital.
It was a photocopy of a letter, handwritten on standard lined paper.
TRYING TO FIND A WAY TO GIVE THANKS
The heart was pale and still, cold in Nigro's hand.
Nigro lowered it into place in Brett's chest, and then worked for the next hour to carefully reconnect it.
When he finished, he removed the clamps, allowing blood to flow into the new heart. Nigro watched it change color, growing brighter red. He waited for it to beat.
"It can be agonizing," he said.
A newly transplanted heart can start instantly, or take a few minutes, or a few hours, and in rare cases, even days. Most start beating within minutes.
This was Nigro's 29th heart transplant in four years. The surgical staff doesn't tend to cheer or holler when a transplanted heart begins to beat, but Nigro can always feel the relief and excitement.
"It is amazing," he said. "I don't think it will ever cease to amaze anyone."
The wait seemed long. But it was only a few minutes, and Brett's new heart began to beat.
Carla and Scott didn't see Brett until after midnight.
But when they did, they could see the pulse in Brett's neck. The thump- thump- thump of it was comforting.
And in the morning, Brett was awake and talking. Scott was so relieved and grateful that he began writing a letter to the donor's family.
Dear Donor Family,
From our family to yours, we want to start by saying we are so sorry for the loss of your loved one. We cannot imagine what your family is going through and we pray that you can find comfort in the good times and fond memories from the years.
He tapped it out on his iPhone, talking to Carla and Brett as he wrote.
No words seemed enough to convey the family's feelings, so they made a promise:
We hope your family can find some peace knowing that your gift saved Brett's life, and we promise that he will make the most of it.
At the end, they asked to know more:
We would like you (if/when you feel comfortable) to reach out to us. We would love to hear from you. We would certainly love to hear about your loved one.
Sincerely and thankfully, The Wallick Family (Scott, Carla, Brett, and Jordan)
Scott emailed the letter to Colón, the pediatric cardiac transplant coordinator. She was touched that the family had written so quickly. She forwards such letters to the Donor Network of Arizona, the federally designated, not-for-profit, organ procurement organization for the state.
Colón didn't expect a reply. Sometimes it is months or even a year before donor families respond. Some never do.
She didn't know she already had the answer right there on her desk.
A strong, healthy teenager's life turns on a dime after a virus attacks his heart starting a chain reaction that led to a heart transplant.
'You're not going to believe this'
A MESSAGE IN THEIR HANDS
After Colón forwarded the Wallicks' letter, she picked up the binder of information that had come with Brett's new heart, given to Velez at the hospital and carried back by the team.
Among the usual patient history, test results and consent forms was the piece of paper that had caused Velez to pause. It was a photocopy of a letter. In three years on the job, she'd never seen anything like it.
"I just sat there and cried," she said.
By the next day, she had confirmed with the donor network that the letter was real. Then she walked it to Brett's room.
"You're not going to believe this," Colón told the Wallicks.
Scott and Carla sat side-by-side, holding the letter between them, and read it together.
It was hand-written, no date or salutation. It simply started:
He was a son, a brother and a father.
Scott's eyes filled with tears. He looked at his boy in the hospital bed.
He was always a giving person. Always cared for others.
Oh, man, Scott thought. This could be describing Brett.
We as a family wish you the best. Live life to the max. Keep him in your prayers.
We as a family would like to know about you, one day, when you get better.
Know that our family member always wanted to help others.
Carla leaned into Scott. He rubbed his face and cleared his throat so he could read the letter to Brett.
Colón explained that the letter was a photocopy likely because the donor had given more than his heart.
Carla thinks about the donor's mother. "Her son's heart is keeping my son alive." She hugs the letter to her chest.
"I know it's not something the doctors look for in a match, but I do," Scott says. He knows the heart is a muscle, but when someone is caring or kind, people say, "He has a good heart."
Brett got a good heart to match his own.
Brett Wallick's message to others waiting for a donated organ: "Keep hoping... keep praying."Chad Bricks/12 News
Doctors expected Brett to stay in the hospital for at least two weeks after the transplant, but he was doing so well that they let him go home after nine days.
He said good-bye to the staff, and then pointed toward the elevator with both index fingers, raising his eyebrows at his parents: Can we go — now? He feels good, almost back to normal. His mother is coming to visit in July.
Brett will put the letter in a frame on his bedroom wall. If he gets to meet his donor's family, he will let them listen to his heart with a stethoscope.
"It will be nice for them to know that a part of him is living on in you," Scott says, his voice catching.
Brett had been able to feel the LVAD in his chest, but the new heart feels natural.
"It feels just like mine," he said.