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With a gift of life, one doctor's new year started early.

Heart of the Matter

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Dr. James Wolf's new year began on March 8.

Four decades after he trained under the world's pioneers of organ transplantation, the 66-year-old retired surgeon received a new heart.

"Life has its ironies," Wolf says.

Wolf began his career in the mid '60s as a transplant surgeon at the Medical College of Virginia. A native of suburban Chicago, Wolf was a medical student considering a specialty in gastrointestinal surgery when he read research by Dr. David Hume, who performed the world's first kidney transplant and established MCV's organ-transplant program in the early 1960s.

Wolf became a transplant fellow at MCV and rubbed shoulders in the laboratory with Dr. Christiaan Barnard, the South African doctor who performed the world's first heart transplant. "Who would have thought at that time I would have been on the other end of it?" Wolf now wonders.

Certainly Wolf never intended to become a poster child for organ donation.

He left MCV in 1968 to become chief of surgery at McGuire Veterans Hospital, where he started a transplant program. In 1976, Wolf left Richmond to become professor of medicine at Northwestern University in Chicago. Wolf became involved in the creation of the United Network for Organ Sharing, the Richmond-based national clearinghouse for donor organs, and was its president in 1991 when he suffered his first, massive heart attack.

A pragmatist, Wolf wanted his heart repaired by surgeons who performed the most heart surgeries. So he rented an air ambulance and flew to the Texas Heart Institute in Houston. His heart required nine bypasses; his surgeon, whom he had known for 30 years, slept in his room overnight. His heart leaked, and the next morning he required more surgery. When all was said and done, he needed 25 units of blood.

Three years later, in 1994, Wolf retired as professor emeritus of medicine at Northwestern and returned to Richmond as medical director of UNOS. In May 2000, he had another heart attack. Doctors in Richmond and Houston told him it was clear his heart would not last much longer and that he needed a transplant.

Wolf and his wife of 43 years, Marjorie, had to make a decision: To stay in Richmond, or go to one of three top hospitals in the nation performing the most transplants. Wolf studied transplant data provided through UNOS. "I knew it would be a difficult operation to get the heart out, and I wanted a master to do it," Wolf says. "We were not putting Richmond down, but we were very blessed that we had the option and knew these people" who would perform the transplant. So the Wolfs decided to return to Houston.

Wolf faced two additional challenges: He was not sick enough to remain hospitalized while waiting for a donor heart. That meant he wasn't given an urgent status for a heart. Also, because he carries hepatitis C antibodies, Wolf needed a heart with the same qualities — what doctors call a hep-C heart. But those hearts, even when they become available, are rarely used in non-hepatitis C patients, Wolf says, and he feared organ donor organizations wouldn't flag a "hep C heart" for him.

Wolf and his wife moved to Houston, where they rented an apartment and dug in for a wait that would drag on for nine months as his heart became weaker. The father of four, grandfather of eight, wrote out instructions for a local funeral home. "We kind of said goodbye," Marjorie Wolf recalls. "All of the kids had been talked to, everybody was on board. It makes some people uncomfortable to talk about death, but it gave us great comfort."

James Wolf says, "There was an obvious irony: The problem has been the whole time in transplantation that there are not enough donors. … I could never figure out why people would not donate organs if it was possible — because not everybody can be a donor. But the biggest problem we have is that when a patient has suffered brain death and the family is asked about donation, in 50 percent of the cases the family says no." He adds, "We could immediately double the number of organs [available] if those people would just say yes."

While they waited, the Wolfs, who are deeply spiritual, were inundated with phone calls from friends and supporters. They started sending e-mail updates to family and a few friends. Soon, the list bloomed into more than 200 names of people across the country and at their own church in Richmond, St. Matthews Episcopal Church. Wolf heard from people he hadn't talked to in 50 years. Boys at a private school in Chicago prayed for him daily.

"We really learned a lot. We learned about trust, we learned about patience, we learned about love, we learned about joy," Wolf's wife says. "Toward the end, we realized we had become inconsequential, that God was using us for other people to grow in their prayer life, to believe, to care."

At 5 a.m. on March 8, Wolf learned his new heart, from a 42-year-old Alabama man who had died from a brain tumor, was on its way. Wolf spent three months recuperating in Houston and returned to Richmond in June.

This spring, he'll go back to Texas for a month of tests. Wolf says he faced the matter of his death 10 years ago after his first heart attack. "When I woke up from that, I was pleasantly surprised," he says. "I've seen over the years that no matter what things look like, some good will come out of it. You just have to look for the good and not worry about the bad. I could sit around and say, 'Why me?' or 'Poor me,' but there's no point in it. I know where I'm going, so I don't worry."

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