Choosing life with a VAD (ventricular assist device)
Rain spilled, blurring my view of the state highway of Massachusetts. The rental car's wipers creak as they drag across the windshield. Although I was tempted to go back, I kept driving. The man with battery-operated heart has invited me to his home, and I do not want to be late.
I am a critical doctor. Throughout my training I have learned how to manage a ventilator, how to treat sepsis, how to sort out the causes of kidney failure. But what I did not learn was what came after for those who did not die, whose lives were extended by days, months, or even years as a result of cutting-edge care and invasive technology, which led me to Van Chauvin - a man with a heart that operated by battery - and his family's rainy Sunday afternoon.
I had met Van a few weeks earlier while he was wandering a heart failure clinic a vision in a camouflage vest to carry a battery, a control unit along his waist. His doctors had directed me to him. When I told Van that I wanted to learn more about life with a partial artificial heart (called a ventricular aid, or VAD), he smiled in disbelief and, with a small laugh, invited me to his home to see what was living with a VAD really like.
Later that day, I had spoken with Van's doctor. They explained to me that Van had initially undergone surgery to place VAD in the hope that the device would only be a step toward heart transplantation. But Van's lungs, weakened by years of smoking, got sicker as she waited for the transplant list - and shortly before we met, Van had learned that he was no longer a candidate for the heart. This tool, with all the ropes and sacrifices and possible complications, would be the way Van lived until he died. Choosing life with a VAD (ventricular assist device)
As I drove, I wondered what Van would tell me about what it was like to learn that he would not get a new heart. Perhaps he regretted the decision he made to get VAD, knowing now that he will never again be able to shower as he likes, or go fishing for a wet machine. I wonder if he will get angry, upset about his current reality. Choosing life with a VAD (ventricular assist device)
So I was surprised when I entered Van's house (I finally made it, despite the rain and some wrong turns) and found myself in the middle of what happened. feels like a family gathering in the living room. Van's sisters have stopped by, just like a nephew, one of her daughters with her chubby son, even his mother. They wanted to tell me about Van. I did not even recognize her at first, as she stepped out of the kitchen with a smile and a potato tray, spring onion, and sour cream she whisked for the company. "Take the plate!" He said, call me in. First we will eat, and then we will talk. Choosing life with a VAD (ventricular assist device)
During the afternoon and many phone calls followed, I came to understand that I had been wrong about Van. I met him because I wanted to learn what it is to live a life that I consider to be a limbo state. I think that a very clear reminder of life with a battery-operated device - carrying a battery pack and a sleeper plugged into a wall socket - may not be sustainable. But Van told me that he was not angry at all. Once he finds out that he is no longer a transplant candidate, he can accept his life as it is. And a big part of the adaptation process means finding ways to do the things that he enjoys, even if he needs to bend the rules. Choosing life with a VAD (ventricular assist device)
Summer after we meet, which will be the last summer of Van's life, he even stays on a boat to take in the lake near his home. Her voice was raised when she told me about the day she spent on the water, catching fish and enjoying the sunshine. In one of our last conversations, he invited me to come out with him. I smiled and thanked him, thinking maybe next summer, assuming there would be time. Although I will never fish with Van, I will remember the lessons he taught me. Van has priority besides surviving, besides living for as long as possible. And contrary to what I had expected, as long as Van could find a way to regain the free life his heart failure had taken from him, he could tolerate the rope that connected it to the wall every night. Instead of feeling tethered, as I had expected, Van found a way to be free. Choosing life with a VAD (ventricular assist device)
Learn more about Van, and read other stories about men and women who navigate life on medical borders, in the book Daniela Lamas,  You Can Stop Humming Now: A Doctor's Story of Life, Death, and In Between .
Choosing life with a VAD (ventricular assist device)Category: Health