Man's salvation may be only a heartbeat away

When she leaves her Redbank, N.J. home each day for work as a Chevrolet service manager, Kay Girling always checks to make sure she's got her beeper. But every day, as if broken, it makes no sound from the time she gets to work until she returns home at around six o'clock in the evening. The silence is maddening. And yet, every day -- wherever she is -- Kay Girling tries to hold fast to all of the optimism she can muster. She says she is driven by her longing for the day when the beeper's squawking finally rips through the quiet. When that day comes, she will know that a new heart has been found for Bob Girling, her husband of almost 25 years, whose own heart is slowly dying. "You're walking around like you're on a powder keg," she said last week. "You think, 'Is it today?' It's constantly on your mind, no matter what you're doing." Bob Girling is a 61-year-old former car salesman. His life story rings of classic middle America: he spent his life working hard to support his family, earning just enough to do a little extra, like buying a boat for fishing in the Atlantic. But those days are gone for now. Girling has spent the past two months in the Coronary Intermediate Care Unit of the Hospital of the University of Pennsylvania, and he is in bad shape. He suffers from cardiomyopathy -- a debilitating disease of the heart muscle -- and has had two heart attacks in the past two years. Doctors first tried to stabilize him with medicine, but in his words, "I just kept going down and down and down." By April, it was clear that Girling needed a new heart in order to survive. Too ill to remain at home, he was brought to the CICU in April, where doctors put him on intravenous medication and began to monitor his condition closely. Since then, he has been a man in waiting. After a lifetime of doing "pretty much" what he wanted, the tables turned: Girling now must wait for a heart, powerless to do anything but keep his spirits up and hope for the best. He is not waiting alone. About 80 people in the area await heart transplants, according to the Delaware Valley Transplant Program, which coordinates organ transplants of hearts, kidneys, livers and other organs in the tri-state area. Potential donor recipients are ranked according to a variety of factors, including time spent on the waiting list and the condition of their heart. How soon they receive a transplant also depends on their blood type and physical traits such as weight. Girling says he is currently fourth in line in the area for patients with an O-type heart. But because people with other blood types, such as A or B, can use an O heart, he will not necessarily receive the fourth O heart that is donated. Last year, 31 people in the area died before a donor heart was found, according to DVTP. Those deaths occurred despite extraordinary efforts by DVTP to take care of all potential recipients. Besides coordinating the program with over 180 hospitals in the area, the program keeps in close contact with transplant agencies across the country. Becky Mull, a transplant coordinator at HUP, said HUP has travelled as far as Miami and the Mississippi River to retrieve a heart from donors, in some cases using a Lear Jet. In fact, she said, the limiting factor is not distance but time: a heart can remain out of a donor's body for only three to five hours prior to the transplant. Even the growing awareness of organ transplants in recent years has not reduced the wait. The number of patients needing a transplant has grown faster than additional organs have become available. Howard Eisen, a HUP transplant cardiologist who is caring for Girling, said that while about 170 heart transplants are performed nationwide each month, an additional 300 people are added to the list during that time. Bob Girling knows all too well how long the wait has grown. Once he receives a new heart, he says he would like to spend some time promoting awareness of transplant programs. But don't bother him with talk of the wait and the personal fears that often accompany the uncertainty. When asked if the proverbial ticking of the clock scared him, he waxed slightly philosophical. "No, no," he said slowly, shaking his head. "Hey look, I'm 61 years old. I've lived a full life, I've touched all the bases, done pretty much what I wanted to do. From here on in, it's a plus, a bonus." "The wait can get to you, but I dismiss it from my mind," he said with a wave of his hand. "I mean, you can't wrap yourself up in knots with the eternal wait. When it's going to be, it's going to be." He says he has lost 40 pounds recently, and he complains that his sleeping pattern is out of synch: wakeful nights, sleepy days. But he receives regular visits from family members and praises the hospital staff's treatment of him. Since the first successful heart transplant in 1967, more than 8,000 heart transplants have been performed in the United States. Last year surgeons performed 81 heart transplants in the Delaware Valley region alone. At HUP, which has done heart transplants for the past 5 years, surgeons performed 16 of the $140,000 operations in 1991, which are often paid for by private insurance. And on Tuesday, while Girling continued to wait, the hospital added two more to this year's list. Kay Girling, noting that both her father and her husband's father died from heart problems in their mid-40's, said her husband is fortunate that modern technology has given him an additional chance at survival. "You can't walk around like it's doom and gloom," she said. "At least this way if something happens -- if a heart doesn't come along in time -- at least we know we took every option we had." "But one will."

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