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A Change of Heart [Case Histories gathered by William Novak]

Thomas, who was in his forties, took on a completely new personality after the transplant. Before the operation, from all accounts, he had been shy and introverted. But when he joined our original support group a few months after his transplant, Thomas, who now wore a baseball cap all the time, had turned into a big, exuberant, talkative child, like a nine-year-old boy in a man's body. His wife would bring him to the meetings, and he was completely dependent on her. Fortunately, Thomas's extreme regression was only temporary, and during the course of our meetings he regained his old maturity as if he were growing up right in front of us.

Thomas had been told that his new heart came from a teenage boy who was killed in New York. From the start he assumed his donor had been black, although this was never confirmed.

Thomas had come from a prejudiced background, but after the transplant he became far more comfortable with black people.

He even became enamoured with one of the hospital nurses, who looked a little like Tina Turner - the first time he had ever been attracted to a black woman. He started identifying with blacks in general - not only African Americans, but Africans as well. Thomas was surprised to find himself affected by a news report about civil strife in Ethiopia.

"I read that blacks on both sides are shooting each other," he said. "They're even shooting at the people who are bringing in relief supplies to save other black people who are dying of starvation. Before the transplant I wouldn't have paid any attention to a story like this. But now it enrages me."

Thomas told us that his vocabulary had changed since the transplant, and that he had started swearing in front of his wife, which embarrassed him terribly. His language reminded him of his army days, when his speech had been full of vulgarities.

Given these changes, I was surprised that he didn't seem very interested in trying to learn more about his donor's identity.

"Sometimes I think about this person whose heart I have," he said, "but I have to put it out of my mind because it scares me. I sometimes picture the doctors standing over his body, waiting for that moment to take his heart, and a couple of hours later putting it in me.

"I won't go so far as to say that two people exist in me, but I have been changed. It might be different if I had received a new kidney, but the heart has spiritual, psychological, and emotional attachments. I believe my donor's spirit is still around, and in that sense he's still alive."