Lies and truths in affairs of the heart
“A Stranger’s Heart”: Hallmark Channel, May 5, at 9 p.m.
The premise: Suffering from severe heart failure, Callie Morgan (Samantha Mathis) is admitted to the transplant unit at University Central Hospital in Los Angeles, where she awaits a new heart.
Another patient in the ward, Jasper Kates (Peter Dobson), reassures her that she will soon have a heart because type A blood is easier to match. Jasper, a big man who loves to dance, says he has been waiting three months because large hearts are more difficult to find.
Ultimately, they receive their hearts around the same time. Callie recovers quickly, complaining only of bleeding gums and some emotional difficulties, but Jasper develops a life-threatening infection, a risk of the immuno-suppressive therapy (cyclosporine).
It turns out that Callie and Jasper have received their hearts from a married couple who died in a car accident, and when they are drawn to each other and to the couple’s surviving daughter, Callie calls it “cell memory.”
The medical questions: Can patients with severe heart failure dance and move freely without becoming acutely short of breath? Are patients who are awaiting heart transplants hospitalized together, and do they routinely require intravenous medication? Is it easier to find a match for patients who have type A blood and smaller hearts?
Is cyclosporine a cause of bleeding gums and life-threatening infections? Is there such a thing as cell memory?
The reality: Patients with severe heart failure have compromised breathing because of excess fluid that has backed up into the lungs. They cannot breathe easily, and they cannot dance.
Although 90,000 people are currently awaiting an organ transplant, and transplant units are common, the units are not holding pens where prospective recipients wait for months. Intravenous-only medications, such as dobutamine (an inotropic agent that helps a failing heart contract more strongly), are generally used intermittently, as extended use has not been shown to prolong survival.
Commonly used diuretics such as furosemide, and anti-arrythmics such as amiodarone may be administered orally. Transplant hopefuls need to stay in town, in case a heart becomes available, but not in the hospital. On the other hand, the movie is correct that heart compatibility is chosen in part on blood type and the size of the heart.
According to Strong Health, a network of doctors and nurses in Rochester, N.Y., the recovery from heart transplant can be rapid, with some patients being discharged from the hospital within 10 days, and returning to normal activity in six to eight weeks, as the film suggests.
Cyclosporine suppresses the immune system to prevent organ rejection, which can lead to infection, and it’s associated with excess gum growth, which can lead to bleeding.
Finally, though cells are genetically programmed to recall their functions even after transplant, there is no evidence that they recall or convey the emotions or memories of the donor. This is elaborate fiction.
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Dr. Marc Siegel is an associate professor of medicine at New York University’s School of Medicine. He can be reached at marc@doctorsiegel.com.
