a for

Heart Laura
BY ROBERT KIENER

Four hours to go and the little girls heart transplant was missing only one thing

It is just past midnight in central London. In a

small fourth-floor guest flat, directly across the road from Great Ormond Street Hospital, Andrew and Julia Whitworth are sleeping fitfully. A full midsummer moon shines softly through the couples lacecurtained windows. Suddenly, Julia is jolted awake by her mobile phone. Is this Julia Whitworth? Yes, it is. We have a heart. Julias hand tightens around the
PHOTOGRAPHED BY CRAIG STENNETT

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phone as she hears the voice of the hospitals transplant coordinator. We have a heart for Laura.

Feisty. A fighter. From the minute she was born Laura Whitworth was a handful. Take away her baby bottle before she had finished and shed let out an indignant cry. If she was lonely shed howl until picked up. By her first birthday it was clear to Andy and Julia Whitworth that their beautiful green-eyed daughter was, as Andy often said, one tough little cookie. So both were a bit surprised when she wasnt able to fight off an infection that kept her coughing, then wheezing, through the night when she was just 14 months old. At first their doctor said it was a cold. But the coughing got worse. Andy and Julia would take turns holding Laura at night as coughing fits racked her tiny body. Another doctor diagnosed gastroenteritis. But Andy, a no-nonsense Yorkshire builder, was convinced it was something more serious. Finally doctors ordered a chest X-ray. Im afraid Laura has a problem with her heart, a cardiologist told them. Andy squeezed Julias hand so tight she winced as the doctor said, Its dilated cardiomyopathy. This condition caused the heart to become enlarged and was often irreversible, he told them. Lauras heart could get weaker and weaker. Early last year when she was two and a half, Laura was already gulping 60 breaths a minutewith her heart unable to pump properly, her lungs filled with fluid, leaving her gasping for air. Shes like a little steam engine, Andy
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told Julia as he carried her upstairs one night. She was so weak she couldnt walk. She weighed only 22 pounds; she was skin and bones. Their little fighter was losing her battle for life. In April doctors placed Laura on the heart transplant list. But could the toddler survive until a heart was available? While there was still time, Andy and Julia decided to take Laura and her baby sister Lucy to Blackpool, where Laura had loved riding the donkeys. But Laura was so weak she could barely get out of her stroller. As they drove home, they were lost in their own thoughts. Then Julia suddenly said: What if she leaves us? Should we scatter her ashes in the sea off Blackpool? Andy, his eyes filling with tears, couldnt answer.

colour has returned to her cheeks. Best of all, shes feisty again, quick to argue with a nurse or her parents if she doesnt get her way. Andy and Laura look down at her, yearning to pick her up and hug her. Holding back her tears, Julia leans close and says softly: Laurie, youre going to get your new heart today.

Julia tucks Lauras nu nu, her tiny

blue security blanket festooned with white hearts, underneath her. I want that to be the first thing she sees when she comes out of surgery, she thinks. Laura cries when a doctor slips a needle into her and takes a blood sample. Dont worry, Laurie, says her mother with a nervous smile. Mummy will bash him if he does that again. Lorraines phone rings with the news that the heart is airborne and should arrive at Londons Stansted airport in

In her office, transplant coordinator

Lorraine Priestley-Barnham phones doctors, technicians and specialist

The donor heart must be transplanted within

The early morning call in the hospital flat has woken Andy too. Is it a heart? he asks Julia. She nods. My God, he says, and wraps his wife in his arms. For three weeks the tiny flat has been their home as they have waited for news of a donor heart. Across the street in the hospital, Laura lies tethered to a Berlin Heart, an external mechanical device that helps her damaged heart pump blood throughout her body. The cardiac critical care unit is dominated by the persistent thock thock thock of the air-driven, computerised heart pump connected by clear plastic tubes to Lauras chest. The pump has saved Lauras life; it has given her the time to wait for a donor heart. She has been eating and putting on weight; the
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fvehours

nurses who are on standby. Timing is crucial. A donor heart begins deteriorating the minute it is removed from a body. To gain precious time, surgeons will have to remove Lauras heart even before the new one arrives. Lorraine alerts a transport team to be ready to collect the organ and fly it to London. Lorraines phone rings just after 5.30am. A surgeon at the donor hospital tells her, Cross clamp is in place and the heart looks good. Within minutes, the heart is immersed in a sterile solution, sealed in a plastic bag and set into a cooler chest filled with ice for its flight to London. Even so it must be used within five hours to be viable. The transplant clock is ticking.
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20 minutes. Lorraine ticks off another entry on her checklist.

Outside a small office just off the runway at the airport Simon Moore, a driver with East Londons M&L Ambulance Service, waits in his response car. A dispatcher rings his mobile phone: The plane is ten miles out. Fifteen minutes later a twin-engine plane lands and taxis to a stop less than 100 feet from where Moore is waiting. Steps are lowered and a crew member climbs down with a blue-and-white sealed cooler chest. Moore carefully places it in the boot of his response car and double-straps it down. He notes the number on the plastic security tag that seals the container and calls in to
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Ambulance driver Simon Moore feared he wouldnt get the heart to the hospital on time

Can you take me to the nearest police station? Ive got a heart in here
Most morning rush-hour
drivers, alerted by his lights and siren, are moving out of Simon Moores way. Hes now about 20 minutes from the hospital. Then, as he zips down Forest Road in Walthamstow, a car pulls out from a side street directly in front of him. No! shouts Moore as he swerves to the right to avoid the car. He hears two loud bangs as his car smashes into a six-inchhigh central reservation. He leaps out and surveys the damage; both right-side tyres have burst. His car is undrivable.

Wearing his yellow striped emergency vest, Simon Moore boldly walks into oncoming traffic and points firmly at the driver of the white, four-door 1993 Volvo saloon that is approaching him. Margaret Rollinson, a local government employee on her way to work, thinks: A police safety check! Why me? Must be because of my old car. She steps on the brake and pulls over. Moore leans through the drivers window. Can you do me a favour? Ive had an accident. Can you take me to the nearest police station? Hes trying to sound professional and trustworthy but his stomach is in knots. Say yes! he thinks as he looks at the woman. Margaret has her doubtsbut nods. As a precaution she says, Just let me phone work and tell them Ill be late. While she dials, Moore fetches the heavy cooler and puts it on the back seat. As he climbs in he adds, I dont want to panic you but Ive got a heart in there. We need to get to the nearest police station as fast as possible. Margaret is speechless. She tells herself, Calm down. Concentrate. Inside its cooler, the heart deteriorates.

his dispatcher: Got it. I am mobile. He flips on the cars flashing blue lights and its two-toned sirenblues and twosand heads for central London.

Starved of blood inside the cooler,

the hearts delicate cells are already beginning to die. If too many do not survive the journey, the heart will not be able to be live again inside Laura.

Just before 7am, Dutch-born surgeon Carin van Doorn reviews the daunting operation with Julia and Andy. As Laura has had the Berlin Heart attached to her own heart, the procedure will be even more complex than a tra126

ditional heart transplant. After opening Lauras chest, van Doorn will hook Laura up to a heartlung machine. Next we will remove the Berlin Heart and Lauras damaged heart and then, when the donor heart arrives, well transplant it into Laura. Andy and Julia help push Laura down the hallway and into the lift to the anaesthetic room. Before the anaesthetist slips a strawberry-flavoured gas mask over Lauras mouth and nose, Julia bends over and whispers, Mummy and Daddy will be right here; waiting for you. As she turns to walk out of the room Julia sobs. Andy puts a gentle arm round her.
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As her operating team watches, Carin

van Doorn, dressed in blue scrubs, switches on the sternal saw, a jigsawlike instrument, and cracks open Lauras tiny breastbone; then she inserts retractors to open the ribcage and expose the interior of Lauras chest. After connecting Laura to a heart lung machine, van Doorn examines the toddlers heart. It looks very sick, the surgeon notesthe walls are thin. Then she begins to clamp it off and disconnect it from the tubes of the Berlin Heart.
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PHOTOGRAPHED BY BARRY MARSDEN

With the heartlung machine breathing for Laura and circulating her blood, Carin van Doorn clamps off Lauras 127

heart. Lets paralyse it now, she says and an assistant surgeon injects a chemical into the heart so van Doorn can work on it. It stops. Slowly, precisely, she severs the hearts major blood vessels and leaves a portion of the left atrium in place. The donor heart will be grafted on to this.

In Walthamstow, Margaret Rollinson waits for a break in the dense traffic so she can pull back on to the road. Simon Moore feels beads of sweat breaking on his brow. Even with blues and twos theyre still 20 minutes from Great Ormond Street. What chance does he have of making it on time with an unmarked car and no siren? As if in answer, the traffic lights ahead of them turn red. In the operating theatre van Doorn pauses as an assistant suctions blood from Lauras chest cavity, OK, she says, that looks good. She finishes cutting away most of Lauras heart, then grips it with the forceps, pulls it away from the chest and places it in a stainless steel kidney dish. Its a critical moment. As she had explained to Andy and Julia, the transplant team is now at the point of no return. The medical team has no idea that the heart has been in a traffic accident. Although the light is turning red Margaret Rollinson sees a small gap coming up in the cross-traffic. Now! She glances repeatedly to both sides and decides to take a chance. Holding her breath, she accelerates into the oncoming traffic. 128

Once through she speeds away. She sees the police station ahead and tells Moore, Its not much further! As Margaret pulls up at Walthamstow Police Station, Moore jumps out with the cooler, bounds up the steps and announces to the receptionist: I have a heart in here and need a police car to drive me to Great Ormond Street Hospital. Now! Please! Three minutes later he hears a police siren screaming down Forest Road towards him. As Simon is whisked away, Margaret pulls into a lay-by just past the police station. Once her heart stops racing she dials her husband, Colin. You will never believe what just happened.

With their lights flashing and sirens wailing, Moore, Police Sergeant Dean Reid and Inspector Pipper Mills make headway through the traffic. Reid, a qualified response driver, and 12-year veteran, weaves in and out of traffic as Moore calls out directions from his satnav. Take a right at the next light, says Moore. Then straight on for three blocks. His left arm cradling the cooler in the back seat Moore calls in to his dispatcher, Were five minutes from Great Ormond Street Hospital. In their flat across from the hospital, Andy Whitworth hears sirens, rushes to the window and sees a police car speeding down Great Ormond Street. It could be Lauras heart! he tells Julia. In the hospital lobby the transplant coordinator is already waiting and leads Moore and Reid to the first floor lift. Come on! Simon shouts as the
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lift doors refuse to open. Come on! They give up on the lift and rush up the stairs with the cooler. As he hands it over in the operating theatre, Moore nearly collapses from exhaustion. It will be hours before he knows if his race has been successful. In the theatre Carin van Doorn gently lifts the heart in its plastic bag from the chipped ice pack. She examines it and wraps it in white cotton swabs to keep it cool. Then she begins trimming it to fit Lauras chest, readying it for suturing to Lauras major blood vessels. Unable to relax in the flat, Andy and Julia return to the hospital, have a coffee and try to watch television in the waiting room. An hour drags past. They buy Laura a Get Well Soon balloon from the gift shop. Julia nervously flicks through a magazine. Van Doorn and her team now have the donor heart sewn tightly in place. Next they will remove the clamps and let Lauras new heart fill with blood. If it has not been out of a body for too long, it should kick into life on its own. Van Doorn, peering through threepower magnifying glasses, removes a stainless steel clamp from the aorta. Rich blood flows into Lauras new heart and the team waits expectantly. Nothing happens. As a last resort, the tiny

organ may need to be shocked into life. But then, almost imperceptibly, the heart starts to beat. The cells, starved of nourishment for hours, start to revive as blood courses over, through and around them. Poppoppop, the cardiac monitor echoes each beat. Van Doorn removes the clamps from the other blood vessels and more blood rushes in. Lauras heart begins beating even more stronglyjust as it will 100,000 times each day for the rest of her life.

Two days after the operation Andy

and Julia visited Laura and began kidding her, Laurie, wheres that Berlin Heart pump youve been using? She looked her mother straight in the eye and announced loudly, Its gone. I dont need it any more! Why not? asked Andy. Ive got a new heart, she replied. And its better! Her parents now describe Laura as the picture of health. Shes put on weight and suffered no complications from her surgery. The family has met and thanked many of the people responsible for getting the organ to Great Ormond Street in time. Theyve also sent a thank you letter to the family who so generously donated Lauras new heart.

Three hundred and ninety-five Croatians painted themselves blue to beat the world most Smurfs in one place recordonly to discover that the mark was 450. The group, who assembled in a park in Komin, had read on the Internet that the record was 291. They learned the truth when they phoned to register their achievement.
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