Heart 2 Heart

When her husband faced a life-threatening condition,

she didn't know she'd be next
The Landau Luck

All day, Sandra Landau felt uneasy as she went about her job selling
fine jewelry in an Orange County, California, department store. She
was worried about her husband Mark's doctor's appointment that
afternoon. After work that evening, she entered their bedroom and
found him sitting mutely in a rocking chair, his eyes welling up with
tears. "Well, what?" she shouted, panicked. "What did the doctor
say?"

"I need a heart transplant." Without it, he added bluntly, he would die.
He was 45 years old.

Sandra, normally shy and composed, burst into tears and crumpled
on the bed. Mark joined her, holding her in his arms. A transplant?
Even the word was traumatic. "It was like being stabbed with a
knife," Sandra says now.

Mark, a self-described pessimist, expected the worst. "All I could

see was everything ending," he says.

Later that evening, the Landaus shared the news with their 21-
year-old daughter Sarah, their 19-year-old son Larry, and Mark's
elderly mother. Larry was the first to unravel emotionally, which set
off everyone else. The group came to the conclusion that it was just
more of what they called the Landau luck.

"Throughout our lives, it sometimes seemed like everything we

touched fell apart," explains Mark. Like most families, the Landaus
had had their ups and downs, but, at least for a period, it did seem
that they took more than their share of hits.

Mark's dream since boyhood had been to operate his own business.
But when he met Sandra at a Memorial Day singles weekend in the
Catskills in 1972, he was a recently certified 22-year-old health
inspector for New York State. Sandra, a secretary for a precious
metals firm, was six years older. She says that she knew instantly
that she'd found the man she wanted to spend her life with. She
loved everything about him -- his personality, his humor, the way
he dressed. It took Mark a little longer -- six weeks -- to make up his
mind.

They were married the following January, on a day that started out
sunny, turned to rain by afternoon and ended in a snowstorm,
providing a sort of meteorological metaphor for the years ahead.
The two New Yorkers settled in an apartment in suburban White
Plains. Sarah was born the next year, and Larry, 15 months later.

In 1976 Mark, partnering with his dad, took over a variety store in
nearby Ardsley. Named The Big Top, the shop catered to commuters
riding in and out of Manhattan. The days at the store were long, but
Mark was a born workaholic, and everyone pitched in, including
Sandra, who often waited on customers at night and monitored the
greeting card inventory. For fun, the Landaus bought shares in two
horses, Wind song and Bad Baby, and took the kids to the harness
races in Monticello, packing pajamas for the late-night ride home.
Life was good.

It all collapsed without warning in the torrential spring floods that

hit Ardsley in 1984. The Landaus watched in horror as the Saw Mill
River, 20 feet behind The Big Top, rose ominously in the drenching
rains. "Suddenly," says Mark, "my store was a river with seven feet
of water ruining everything, destroying $250,000 worth of
merchandise." Insurance covered only half the loss.

Determined to reopen, Mark borrowed $40,000, and his dad

mortgaged the family home. Then, six months later, the
unthinkable happened. The Saw Mill flooded its banks again, this
time wiping out the Landaus for good.

The couple reluctantly declared bankruptcy and, for a time, were

forced to go on welfare, even to accept food stamps, a humiliation
that still rankles. "That is just not us," says Sandra, "but we had two
young children who had to eat."

Mark found employment with a friend in retail, but money was still
a worry -- and not their only one. After the first flood, Mark, who
says he had always been "healthy as a horse," was hospitalized
with a severe respiratory virus initially diagnosed as legionnaires'
disease. He believes the cause was river bacteria that had lodged
in his store's air ducts and surfaces. The virus triggered my o
carditis , a serious inflammation of the heart muscle.

In the raw winter months, Mark began suffering increasingly severe

bouts of bronchitis, and each illness triggered episodes of heart
failure. Three times, he almost died. A physician told him that he
 should move to a warmer climate. So in 1988, when a friend
offered a three-bedroom condo in Irvine at a modest rent, the
Landaus migrated to California.

"The weather was phenomenal, and it kept me alive," says Mark,

who landed a position managing a large paint store. He lost weight,
went to the pool and even flirted briefly with golf. Sandra took a job
at a nearby department store, and while money remained tight,
both kids eventually graduated from high school and entered
community college.

Then, in late 1995, Mark was hit with a bad case of the flu. His
cardiologist offered a grim diagnosis. Mark's enlarged heart was
failing to pump blood adequately. His condition -- idiopathic dilated
cardiomyopathy -- had reached a point where he needed a new
heart to survive. Without it, he would live only 15 months.

Mark was stunned. Referred to the heart transplant program at

Cedars-Sinai Medical Center, he underwent a battery of medical
and psychological tests and, on October 3, 1996, went on the
transplant list. Having had five uncles who had all died in their 40s
or 50s from heart disease, he says, "I never thought it would work
out."

The toughest part was the waiting. In 1996 more than 23,000 heart
transplants had been performed in the United States since Dr.
Christian Barnard pioneered the surgery 29 years earlier, but only
about half of those waiting for a donor heart received one within a
year. "That means many people passed away," notes Mark, who
fully expected to be one of them. His greatest worries were for
Sandra. He was the man of the family, the decision maker, the
leader. How would she possibly survive -- financially or emotionally?

Praying Hard
Cedars-Sinai gave Mark a pager that would give him two and a half hours to get to the
hospital if a heart became available. The first time it went off, he was at work and began
shaking so hard, a fellow employee had to dial the hospital. Wrong number. "I had to go
straight home after that," says Mark. "I was a wreck." It happened several more times.

He began calling funeral homes in the tenth month, getting comparative rates and making
arrangements so Sandra wouldn't have to.

At the beginning of the 16th month, with Mark getting weaker, Sandra was driving home
from work late one evening, worrying about her husband, when she put her foot on the
gas pedal instead of the brake. She plowed into the car ahead. Luckily, no one was
seriously hurt, though her Nissan Maxima was demolished.
Three days later, Cedars-Sinai called saying a heart was available. It was April 14, 1997.

Mark and Sandra held hands tightly as they were driven by friends up the San Diego
Freeway. They were still holding hands as Mark was wheeled into the operating room at
1 a.m. This could be the end, Mark thought. As Sandra kissed her husband goodbye, they
both cried.

Rather than sit in the waiting room alone, Sandra spent an hour in the hospital chapel.
Praying is a practice she's since made part of her daily life. "I hadn't prayed for years,"
she says, "but I prayed hard. Now I pray three times a day, every day."

When he woke hours later, Mark thought he had died. "I had tubes down my throat, and
everything was white. I thought I was in heaven." The worst was not over. On the fourth
day, his body began rejecting the heart. Pain medications made him hallucinate. He once
jumped out of bed, yanked out the tubes and collapsed naked on the floor.

Sandra refused to leave, asking for a pillow and blanket and preparing to settle on the
floor. Instead, the hospital provided her a room near Mark's where she could sleep. "It
was scary," she says, "but he was alive, and I believed he was going to go home."

More than three weeks later, he did, along with IV tubes, oxygen and a laundry basket
full of medication. Sandra, who had taken a leave from her job, became her husband's
nurse, administering pills, giving him sponge baths and washing his hair in the sink. She
supported him as he took his first steps, 15 feet in the beginning, then, after four weeks, a
mile and a half.

By the third month, Mark was begging to return to work, having read 23 books and
watched every show on the tube. "I had more energy than ever," he says. "Eight months
after the transplant, I was rocking and rolling." The downsides -- a weight gain of 75
pounds and extremely oily skin, both caused by the antirejection drugs -- seemed minor.

To his own astonishment, Mark metamorphosed into a person who was appreciative of
everything and everyone around him, but no one more than his wife. "I would fall back
on her optimism," he says.

The Landau luck, Mark and Sandra were convinced, had finally shifted. Sandra returned
to her department store job, and she and Mark were able to enjoy a period without heavy
financial pressures.

Then, during the holidays in 2001, Sandra suddenly fainted at work. For the few weeks
prior, she had been feeling a little sluggish, but nothing else. She was taken to an Irvine
hospital, where tests revealed that she was suffering from congestive heart failure and
hardening of the arteries, the result of heredity and diabetes. It also turned out that she'd
had a silent heart attack. A brutally honest doctor said that Sandra could drop dead at any
time.
Mark decided on the spot to take his wife to Cedars-Sinai. When his cardiologist spotted
Sandra in the waiting room, he said, "It's not time for Mark's biopsy." Sandra's heart, it
turned out, was twice as bad as Mark's had ever been; her coronary disease was so
advanced that she was not a candidate for bypass. "We couldn't believe it," says Mark.
The Cedars-Sinai doctors were equally dumbfounded. They had never heard of his-and-
hers heart transplants, but that's what they were looking at.

Sandra went on the list for a donor heart in June 2003. The Landaus were not optimistic.
Two hearts for one family? Sandra wondered. In August they decided to return to Maui,
where they'd honeymooned 30 years earlier. They cashed in a time-share they owned to
be able to vacation for almost a month. They visited museums and sugar farms, drove the
exotic Road to Hana and took pictures of the spectacular sunsets each night. "We knew
this could be the end and were determined to be happy," says Mark.

"We just wanted to be with each other," adds Sandra. "That was all that mattered." To
their amazement, a few weeks after they returned from Hawaii, the call came from
Cedars-Sinai. Mark drove his wife to Los Angeles "like a maniac," and saw the helicopter
with the donor heart arrive on the hospital roof. The surgery was over at five the next
morning.

Unlike Mark, Sandra had no rejection complications in the days after the transplant. "I
felt like a new person with a new life," she says, "and just wanted to get on with it." She
left the hospital after a week.

Mark had prepared to be his wife's nurse for as long as necessary, but
she rebounded so rapidly that he was able to return to work just
ten days after her surgery. Eighteen months later, Sandra took a
job as a cashier at the local Target. Last April 15 -- a day many
Americans dread -- the Landaus celebrated the tenth anniversary of
Mark's transplant. A week later, they attended a gathering of
Cedars-Sinai heart transplant patients in a park near the Hollywood
Bowl. As they entered, people pointed them out as the only
husband-and-wife heart transplant patients. Sitting on a bench
holding hands, they basked in the attention. "We've been up and
down, rich and poor," says Mark. "But only one thing really matters,
and it's that we're alive."

They continue to care for each other daily, sorting their

medications (Sandra takes 27 pills a day; Mark takes 32). While
Sandra did not gain weight following the surgery, she occasionally
suffers a tremor in her hands. If it happens during dinner, Mark
quietly leans over and cuts her meat for her.

Before Mark's transplant, Sandra received a call from a nurse

asking how long the Landaus had been married and if they really
loved each other. "Why are you asking all these questions?" Sandra
responded. "Because," the nurse told her, "the transplant
experience is so stressful that some couples split up."

It has been just the opposite for the Landaus. "It's a whole new
commitment," says Mark. "We're buddies."

"It's a new romance," Sandra adds.

"I used to be a yeller," Mark admits, "and everything had to be my

way. No longer. I'm mellow."

The once fragile and retiring Sandra is now a take-charge person,

scheduling their appointments, organizing their lives. "I totally
changed," she says. "I became very forceful."

"Now she doesn't take guff from anyone," says Mark with a smile.
"It's pretty cool."

At the end of a Saturday night meal at a local restaurant, Sandra

casually tosses her jacket over her arm. "Put it on," urges Mark.
"It's cold out there." With a sigh, Sandra buttons up, and Mark
wraps an arm around her. "That's the way it is," he says with a wink
as they head out into the windy night. "I keep her alive, and she
keeps me alive."