A Child’s Legacy of Love

Recently I strolled through a park in Rome with Andrea Mongiardo, a 23-year-old Italian whose heart once belonged to my son.

My son, Nicholas, a magical little creature whose teacher said was the most giving child she’d ever met, was 7 when he was shot seven years ago in a botched robbery on the main highway south from Naples. Two young men, mistaking our rental car for one they thought was carrying jewelry to stores in southern Italy, fired on us, hitting Nicholas in the head. Two days later he was declared brain dead.

I can remember that sunlit hospital room, with the doctors standing in a group in the corner, leaving my wife, Maggie, and me alone to absorb their terrible news and the thought that came with it: “How will I ever get through the rest of my life without him?” Never to run my fingers through his hair again, never to tickle him or hear him say, “Goodnight, Daddy.”

We sat there numbly for a few more moments. Then one of us--we don’t remember which, but, knowing her, I’d guess Maggie--said, “Now that he’s gone, shouldn’t we donate the organs?” and the other said yes. And that was all there was to it.

Although we are not a gloomy family and still laugh a lot, every morning when I wake I know life will never have the sparkle it had when Nicholas was alive. But we have never had a moment’s regret about our decision--and if we had had any regrets they would have been banished by the first sight of the seven organ recipients, four of them teenagers, whom we met a few months later.

None of the four teens could have expected to live much longer, two of the adults were going blind and the third, a diabetic, was in pitiful shape, her whole central nervous system disintegrating, scarcely able to see, unable to walk without help.

Andrea was all too typical. Born with a severely deformed heart, he stopped growing when he was 7. He underwent a dangerous operation, which failed, then another, which also failed, then a third, a fourth and a fifth. None of them worked. His family was in despair.

He became so sick he could scarcely walk to the elevator in his apartment building. Every other day he went to the hospital for a transfusion of albumin, the protein that kept him alive. He was hollow-cheeked, a frightened look set on his face. At 15 years old, he knew he couldn’t last much longer.

The turning point came in March 1994 when the doctors at Rome’s Bambino Gesu (Baby Jesus) Hospital brought up the idea of a transplant. “Only a new heart can save him,” they told his parents. At first he said no. After five failed operations he was understandably reluctant to have another.

But he was persuaded to try. He was put on the transplant waiting list and began the long, cruel, double-edged wait that could only end successfully if someone else died.

Seeing him now, and knowing what would have happened to him, I know that if we had made a different decision and shrugged off his problems and those of the other recipients as none of our concern, neither Maggie nor I could ever have looked back without a deep sense of shame.

The operation was much more difficult than a normal transplant because of the acute deformation of his heart; he hung between life and death. At length, however, it was a resounding success. The new heart turned out to be a perfect match. “It might have been made for him,” Lidia, his mother, told me, a tear in her eye because, being a mother, she never forgets the little boy it came from.

Andrea has had his share of ups and downs as his body, like that of all transplant recipients, tries to reject the new organ. But, all in all, he is thriving. He plays soccer, works with an uncle who manages condominiums and finds deep satisfaction in the simple things of life. Looking at him in a crowd, you would never pick him out as the one who spent half his childhood in a hospital.

We would have done anything to keep Nicholas alive, of course. But that wasn’t an option. So standing next to Andrea in the park wasn’t horrifying or depressing or awkward. We’ve never thought of Nicholas living on in any literal way inside Andrea or the others, but as I put my arm around his shoulders, I did feel a kinship to Nicholas’ pure heart, beating steadily, and a flow of satisfaction, knowing that even in death he continued to give so fully.

We first met our recipients and their families just a few months after the shooting, when our grief was still agonizingly raw. But that meeting, which both of us had to steel ourselves to attend, was explosive. A door opened, and in came this mass of humanity, some smiling, some tearful, some ebullient, some bashful, a stunning demonstration of the momentous consequences the donations had.

We now think of them as an extended family. We’ve watched the children grow and leave school and get their driver’s licenses and the adults go back to work. One of them, 19-year-old Maria Pia Pedala, in a coma with liver failure on the day Nicholas died, bounced back to good health, married and has since had a baby boy. And, yes, they have called him Nicholas.

In Italy, schools, squares and the largest hospital have also been named for him. Better still, organ donation rates have almost tripled, yet they still fall far below the need.

I have a story I like to tell about Nicholas. On our way to Italy a few days before he was killed, we played a game in which he was a Roman soldier returning home, after years heroically guarding the frontiers. When you get to Rome, we told him, you’ll be famous. Poems will be written about you, streets will be named for you, you’ll get a gold medal.

It was only a game. But it all came true. With this difference: that Nicholas conquered not by the force of arms but by the power of love, and that, of course, is much stronger.

Reg Green lives with his family in Bodega Bay, Calif.

For information on organ and tissue donation, please go online to www.ni cholasgreen.org.