An Ailing Man Fears Breaking His Borrowed Heart

Dr. Charlie Kleinman got a heart transplant two years ago, but now he's dying of liver cancer. i i

Dr. Charlie Kleinman got a heart transplant two years ago. His new heart is that of 17-year-old Marc Dawson, who drowned. Kleinman says he struggled to find the courage to contact Marc's parents to thank them — and it only got harder when he was diagnosed with liver cancer. Greg Miller for NPR hide caption

itoggle caption Greg Miller for NPR
Dr. Charlie Kleinman got a heart transplant two years ago, but now he's dying of liver cancer.

Dr. Charlie Kleinman got a heart transplant two years ago. His new heart is that of 17-year-old Marc Dawson, who drowned. Kleinman says he struggled to find the courage to contact Marc's parents to thank them — and it only got harder when he was diagnosed with liver cancer.

Greg Miller for NPR

Two years ago, Dr. Charlie Kleinman was living with a heart that had been badly damaged by radiation therapy he received for cancer as a younger man. The pediatric cardiologist from Manhattan needed a transplant.

At the same time, in Huntington, N.Y., a 17-year-old boy was training vigorously at a local pool in the hopes of becoming a Navy SEAL — until a freak accident ended his short life.

Now, the heart of that teenager, Marc Dawson, beats in Kleinman's chest.

"I am ashamed to say that I haven't contacted his family yet," Kleinman told an audience last September. A crowd of doctors had gathered at Yale-New Haven Hospital to hear Kleinman talk about his heart transplant.

"I will be in touch with them," Kleinman continued. "I just don't have the courage to do it. I did write them a short note. I thought that once it hit 88 pages, I had to cut it back a little bit."

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Connected By A Heart

But Kleinman had recently gotten news that would make his struggle even harder: He was facing death yet again.

Whose Heart Do I Have?

Kleinman had never wanted to know where his transplanted heart came from, says his wife, Jessica.

But as soon as Kleinman came out of surgery, his plan fell apart.

"When I awoke — and I remember they pulled the tube out and Jessica was there, and then it came into my mind to ask her: 'I have the heart of a 17-year-old boy who drowned. What were the circumstances surrounding a drowning in the winter?' " Kleinman recalls.

Though he was unconscious during surgery, Kleinman had somehow overheard the doctors talking about Marc.

The 17-year-old had blacked out while swimming and, by the time lifeguards pulled him out of the pool, Marc had suffered severe brain damage.

Marc's father, Ray, recalls the moment when hospital officials first suggested organ donation.

"Our first response was, 'What? Are you kidding me? Get away from me,' " Ray says. "You know, that kind of thing: 'You're not going to touch my son's organs. My son's going to make it.' You know. 'He's going to be better.' "

Eventually, the Dawsons decided that by donating Marc's organs, at least something good would come from this tragedy. And it did. Kleinman lived. But he struggled with the knowledge of whose heart he had.

"Everyone was surrounding me, as if I was the center of the universe, but I couldn't help but think about this other poor family and this poor kid, and I started to have very strange dreams about it," he says.

In the dream, Marc arrives at the hospital and Kleinman, who is his doctor, botches his care so he can get the boy's heart.

"For me to even dream it, and dream being a part of something like that, was the worst nightmare that would wake me up, moaning and saying, 'No, no,' in a cold sweat," he says.

The Letters

It was around this time that Dianne Dawson decided to reach out to Kleinman.

"We hope you have regained your health and can enjoy your life with your family," her letter to him said. "Marc was a bright, smart, strong, healthy 17-year-old boy — and we hope part of him has made you the same in some way."

Kleinman reacted emotionally to the letter.

"It was really, really hard for him," says Kleinman's wife, Jessica. Jessica says she asked her husband if he felt up to responding to the Dawsons.

"And he said, 'I can't. I can't do it. I cannot do it,' " she says.

Dianne and Ray Dawson lost their 17-year-old son last year when he drowned. i i

Dianne and Ray Dawson have photos and mementos of their son Marc all over their home in Huntington, N.Y. They have left his room exactly the way it was when he died two years ago. "It's just my way of making me feel like he's here," Dianne says. Greg Miller for NPR hide caption

itoggle caption Greg Miller for NPR
Dianne and Ray Dawson lost their 17-year-old son last year when he drowned.

Dianne and Ray Dawson have photos and mementos of their son Marc all over their home in Huntington, N.Y. They have left his room exactly the way it was when he died two years ago. "It's just my way of making me feel like he's here," Dianne says.

Greg Miller for NPR

Kleinman tried writing the Dawsons back, but the right words always eluded him. Last summer, Kleinman says, he was finally getting ready to do it, when he received some devastating news: He had liver cancer.

In the midst of his chemotherapy treatments, he talked about how it felt to get his diagnosis.

"I have a sense, a very crazy sense, but a sense that I've let people down by developing this illness. I feel guilty in a way, that I have their son's heart and something else is going on in me that may limit the duration of this heart's existence," he said.

Kleinman grappled with what to tell the Dawsons.

"When I thank them, do I tell them the whole truth and nothing but the truth? Do I tell them that I now have a malignancy?" he said. "It was my intention to promise them that I would be a worthy keeper of the flame, if you will. How I would contact them and tell them, 'Thanks a lot, it's been a great year and a half, but I think it is going to be over in a few months.' Do I tell them those things? And I am just — I still have to work that out. But I can't — the one thing that I don't want to do is contact them and tell them a lie."

Meanwhile, the Dawsons continued to keep the memory of their son alive. Two years after his passing, Marc's room remains untouched — even his cereal dish, with his spoon in it, remains on his desk from the morning he died. Dianne says she likes it this way.

"It's just my way of making me feel like he's here," she says. "And I'll go in, and I'll just say, 'Hey, Marc, I told you to put these clothes away already. Come on. Just put them away. When are you going to do it?' I do stuff like that."

'They're Keeping Him Alive For Us'

Late last fall, Kleinman finally sat down to write the Dawsons. He said that he'd managed to get some perspective on the whole thing — on both his life and Marc's.

"I think my parents went to their graves proud," he says. "And hopefully I won't be there too soon, but if it is meant to be, I'll be proud. And thankful. Not only to my family, but now another set of people I consider in a way family. You know, I'm carrying their genetic code in me as well now."

A short while later, the letter from Kleinman arrived at the Dawsons' house. Dianne, who had been checking the mail every day for a response, didn't open it until Ray came home.

She reads it aloud: "I am so ashamed that it's taken me this long to muster the courage to put my words of thanks onto paper. You have not only allowed me to live, [but also] attend the marriage of my youngest son."

In the letter, Kleinman goes on to explain that he is now facing a serious health crisis once again. Despite this news, the Dawsons remain hopeful.

"Maybe my son can save him twice: save him from heart disease — but the strength that it gave him will maybe save him from liver disease, as well. We can only hope," Ray says. "I mean, they're keeping him alive for us. In some small way. In a big way. Even though my son is gone, there's parts of him out there that are still alive, and there's a heart beating in a chest somewhere, and that's Marc's heart."

Kleinman continues to undergo treatment, and the tumors in his liver have shrunk. He's weak but still working as a pediatric cardiologist, caring for the hearts of his young patients.

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