Praise From the Heart : Patient Defends His Transplant

Clutching his wife’s hand and occasionally breaking into tears, Dr. Norton Humphreys, Orange County’s second heart transplant patient, spoke of the future.

He joked about plans to drink beer and be with his dog as he prepared Thursday to leave Hoag Memorial Hospital Presbyterian for the first time in nearly two months.

Dressed in a sweat shirt and running pants, the former family practitioner and emergency room physician at Hoag, who had retired in 1980 because of a degenerative heart condition, strolled through the halls of the Newport Beach hospital looking like a man ready for a quick jog or a game of tennis.

“I feel better than I have in a year,” the 58-year-old Fountain Valley man told reporters Thursday, just three weeks and a day after receiving the heart of a 19-year-old Costa Mesa man who had been declared brain dead.

“At first I thought this would be like putting a new engine in an old car, but it hasn’t worked out that way.”

As for a game of tennis, or any strenuous sport, for that matter, he said, “I’ve never been a jock, and I don’t plan to start being one.”

Most immediate on Humphreys’ mind and that of his wife, Lori, was their 15th wedding anniversary, which they plan to celebrate today. Although Humphreys must stay on a low-sodium, low-fat and low-calorie diet, his wife said she hopes they can still enjoy this anniversary as they have others.

“We are going to check to see if we can pop a bottle of cham

pagne,” she said with a smile. Humphreys, on the other hand, said he would prefer a beer.

It was on the evening of April 20, during a five-hour surgery, that Humphreys received the heart of a man who was found lying unconscious on the sidewalk outside a Costa Mesa convenience store shortly before dawn on April 19.

After brain surgery at Hoag, authorities determined that the man later identified as Eleno Ullua Ramirez suffered a skull fracture and massive brain damage, probably from a heavy blow to the back of the head.

Meanwhile, Humphreys, who had been on the regional list to receive a donor heart since Jan. 9 and had been hospitalized at Hoag a month earlier, was in rapidly deteriorating health. Ullua’s identity was not known at that time, but hospital officials have said they made every possible effort to determine his identity and contact relatives for permission to conduct the organ transplant.

Although the circumstances under which the heart was taken were unusual, Hoag officials said the hospital complied with the state’s Uniform Anatomical Gift Act. Under the law, a hospital may authorize the donation of organs if no relatives are available after a “diligent search” of at least 24 hours is conducted.

As required, Hoag asked Costa Mesa police to aid in the search for the man’s identity and next of kin, while hospital staff members watched for relatives or friends to come forth. Ullua’s sister came forward to identify the body a day later.

Medical ethicists interviewed by The Times after the transplant were divided about whether removing an unidentified man’s heart was appropriate. Both Arthur Caplan, director of the Center for Biomedical Ethics at the University of Minnesota in Minneapolis, and Sister Corrinne Bayley, director of the Center for Bioethics at St. Joseph Health Systems in Orange, expressed concern that such decisions could undermine public trust.

One nurse at Hoag telephoned The Times to complain that she and other Hoag staffers were upset that the transplant had been rushed before the man could be identified.

But Father John Golenski, consulting ethicist at UC San Francisco Medical Center, and Vicki Michel, an associate professor at Loyola Law School in Los Angeles and a member of the Los Angeles County Bar Assn.’s bioethics committee, said that if there is no other expression of a person’s wish, they are generally assumed to have altruistic motives.

On Thursday, while answering questions about the procedure, Humphreys became very serious and adamantly defended the hospital’s actions in using the heart of an unidentified man.

“The controversy seems more media-created than existent by itself,” he said, adding that in his opinion, ethical questions were being raised by people ill-informed about the procedures used by the hospital to identify the donor.

“I have extremely intense feelings about this hospital,” Humphreys said, breaking into tears during a news conference in the hospital’s board room. “This hospital is far and away the finest hospital I’ve ever been in.”

Humphreys added that fears of his contracting AIDS from the transplant have been “laid to rest.”

Ullua’s blood initially was tested for AIDS antibodies prior to the surgery. But a more sophisticated--and accurate--AIDS antigen test was run after the operation when police informed hospital officials that Ullua frequented gay bars and that a former co-worker had said Ullua was a homosexual, and therefore at higher risk of contracting the deadly AIDS virus.

Both test were negative.

“It doesn’t bother me at all, particularly compared to the alternative” said Humphreys, adding that the first thing he will do when he gets home is “get reacquainted with my dog.”

Dr. Douglas R. Zusman, who performed the transplant with Dr. Aidan A. Raney, said Thursday that Humphreys has experienced “no episodes of rejections” and that he is doing “as (well) as can be expected.”