Taking Heart

I never thought about death. 

While I mourned the loss of loved ones and understood that, sometimes, life is cruel in the ones it takes, for me, death was never a concern. I had always lived a healthy life so there was never a reason to think about something so morbid. What I’ve learned, though, is that life is fragile. It can change in any given second. When I was 19 years old, the entire life I knew came crashing down.

Four months before everything changed, I was setting up my dorm room and beginning my sophomore year of college. I was living with my best friends and loving my classes. I was walking to class one day when I started to realize something was wrong. A short walk felt like climbing the world’s tallest mountain. A short flight of stairs? My greatest obstacle. At first, I thought it was a vitamin deficiency and doctors agreed. Eventually it got so bad that getting out of bed felt like a high intensity workout. 

I was forced to withdraw from my favorite place. It was unfair and I couldn’t understand why this was happening to me. I didn’t realize I was about to begin the craziest journey of my life. I was losing weight in the blink of an eye. I had no energy. I visited doctors all across Long Island. No one could figure out what was happening to me — a formerly very healthy and active college student. 

In December of 2015, doctors discovered right before it was too late that it was my heart. At the time of my diagnosis, my heart was operating at 5% and there wasn’t much time left to act. I was immediately placed on an Extracorporeal Membrane Oxygenation Machine (ECMO), which essentially pumps and oxygenates blood outside of the body to allow the organs to rest. My family was told by doctors that I would need a transplant to survive, and within hours I was airlifted to the nearest transplant center where a team of nurses, doctors and surgeons would take on my case. Several days after arriving, I underwent surgery to have a Left Ventricular Assist Device (LVAD) implanted — a high-tech, battery-operated mechanical pump that helps the left ventricle of the heart pump blood to the rest of the body. The device is worn like a cross body purse and is bulky and heavy to carry. 

The next clear memory I have is being in a hospital, with an array of sounds and people shuffling around. I remember my family calming me down and telling me that everything was going to be okay. I remember kind medical professionals — who would later feel like family — explaining that I needed a new heart, but I was going to be alright. 

Clarke is active in the donor comunity, helping people sign up to become organ donors that could save someone’s life.

The next five months were hard. I was to remain in the hospital until a donor heart became available. Because my body had endured such trauma, I had to learn how to do basic tasks again like walking, standing up and even holding a toothbrush. It was hard to adjust to this new normal, all while trying to grasp that at any second, a call could come in and I would be rushed into immediate surgery. My daily routine revolved around hourly medication, IVs, getting bandages changed and trying not to look too far into the future.  

On April 19 2016, the news was delivered that a perfect and healthy heart was available and ready for me. Suddenly, I was being prepped for surgery and family members were pouring in and out of the room, showing their love and support. I was weirdly calm but eager. I was ready. The next morning, I was wheeled down toward the bright, open operating room where I kissed my parents goodbye. The automatic doors opened and the nurses calmly guided me through. Thus began the rest of my life. 

It’s been three and a half years since my surgery. I am doing better than ever before and have been blessed beyond belief to have had no complications post-transplant. It’s definitely some kind of miracle, the fact that my body was able to bounce back so quickly and respond well to any and all treatment. I returned from my long five-month stay in the hospital just 12 days after my surgery and was able to return back to my normal life. Every six months I visit my transplant center for a biopsy, where my cardiologist will test pieces of my heart’s muscle tissue. My results have been perfect — shocking for anyone who knows just how sick I once was. 

Doctors may never know why this happened to me or what exactly caused my heart to fail. They believe it was something that I was born with that started to show signs later in life. For so long I wanted to know. I was so angry that my body would betray me like that and put me through such a traumatic series of events. But as time passed, I became grateful. I am grateful for my scars, each and every one of them. I am grateful for the support I had along the way. I am grateful now that I can use my story to educate and inspire others about the tragic beauty behind organ donation. But most of all, I am grateful for the gift that is modern medicine. It’s the reason I’m alive today and it’s the reason I now have my whole life ahead of me. 

From flatline to full life

Photographer Laurence Salzmann was saved by Becker’s cooling technique after his cardiacarrest in 2009. This photo is from his 1974 series, entitled “La Baie / Bath Scenes.”

Dr. Lance Becker is an international leader in bringing the dead back to life. 

Becker, chair of emergency medicine at Northwell Health, has devoted much of his career to advancing the science of resuscitation. 

Becker was one of the first doctors to pioneer the use of automatic external defibrillators (AED) in emergency medicine and saw the need for this kind of life-saving technology in public spaces. An automatic external defibrillator  is a device that uses electrodes to generate an echocardiogram, a visual representation of a person’s heartbeat, which it then interprets in order to deliver an electric shock that can ultimately save a life. 

Today, millions of AEDs can be found in a variety of public settings such as airports and schools. The effects of the use of this technology can be seen in emergency rooms all across the country and in the homes of the patients and families they’ve helped to save.

“I remember when we put the automatic external defibrillators into the airports of Chicago. I got a note, written in crayon by a 4-year-old that said, ‘My grandpa is alive because you put a box in the airport, and I wanted to thank you.’ Becker recalled the note fondly, “…for a very long time I kept that note. That was one of my early attempts to change the way we did things.”

Inspired by the innovation already around him, Becker began re-examining and redefining the limits of medical technology. “I’ve been doing this for many years and so I saw the remarkable, life-saving change that automatic external defibrillators brought to people,” Becker said.

Becker set out to improve resuscitation in other ways. Until the last decade, a person who suffered cardiac arrest could only be revived after five or 10 minutes of no blood flow. But all too frequently, the patient was considered brain-dead and beyond saving. Becker and his colleagues are developing a new technique that promises to extend that window of time of 20 to 30 minutes. The new therapy is personalized and can be molded to fit the needs of different patients. It involves using a number of interventions at once, including cooling techniques, drug cocktails and extracorporeal membrane oxygenation machines, which stand in for the functions of both the lungs and heart, all combined to restore life. 

Becker’s methods are focused on two goals, which include protecting the brain and restoring the heart. “As part of the therapy, we lower the temperature of the blood to around 33 degrees (91.4 F) from around 37 degrees (98.6 F),” said Becker. “People have found that is very, very protective for the brain and we use that as part of this therapy.” 

“Cooling,” as Becker calls it, in combination with a drug cocktail, is used to preserve the brain as life begins to dwindle. Preservation of both the brain and heart are essential to not only restoring life but reducing the impact that medical trauma can impose on the quality of life.

While all this is happening, the extracorporeal membrane oxygenation machine acts as an artificial heart and pair of lungs. The same kind of machine is used every day for cardiothoracic surgery all over the world.

About ten years ago Becker’s technology helped to save the life of Laurence Salzmann, a photographer and  filmmaker who has walked very closely at death’s door. Salzmann, who suffered a cardiac arrest, was placed under an induced coma and cooled, or as he described, “put on ice.”

“Any event where you have a major health crisis makes you extremely aware of just how fragile and how momentary our lives are,” Salzmann said. With the help of  Becker’s cooling methods Salzmann beat the odds and went from his flatline back to his full life.

Becker’s drug cocktail is still in its preliminary stages, but he and a team of Northwell Health doctors and scientists are working to perfect it.

In the meantime Becker’s cooling technique is being implemented in hospitals all over the world helping to save lives that he will never personally touch. But receiving credit doesn’t matter much to Becker. He is driven by a  genuine passion to save lives.

“Truthfully, the cases that keep me up at night are the ones that don’t have a happy ending,” said Becker, “and I think about those a lot.”