The Transplant Surgeon
Gets a New Heart
by Eve Jacobs
n the body of physician David Laskow beats the heart of a 51-year-old woman — and beyond the joy he feels every day just to be alive is his gratitude for the opportunity to continue his life’s work in the operating room. There are no available statistics for the number of transplant surgeons who become transplant recipients, but common sense suggests that it is a rare situation indeed.
If you assumed that a chronic disease, like diabetes, inspired Laskow’s choice of career, and then rendered his kidneys and pancreas ineffectual, you’re dead wrong. A nonsmoker and a self-described life-long jock, health conscious and healthy, he rarely let a day go by without jogging outdoors or running on his treadmill, and had “a drink” at tops maybe five or six times a year for special occasions. His energy level was high, his health complaints negligible.
Laskow — director of kidney and pancreas transplant surgery at UMDNJ-Robert Wood Johnson Medical School — says he’s always been a high energy guy. He does recall feeling a little more tired, perhaps the slightest bit less energetic, in the months leading up to the heart attack that almost killed him on December 10, 2005. But like most 50-year-olds, he attributed those small changes in stamina to the effects of mounting years and creeping weight gain, in Laskow’s case an extra 10 pounds he had put on his 5 foot 11 inch former-wrestler’s frame.
Looking back, he says that perhaps the fact that he had started napping (not something he had ever felt inclined to do before) should have set off a few alarm bells in his brain. But he went jogging just the day before; and running up the stairs, which he does often, posed no problem.
So the events of that fateful December morning truly came out of left field. He was showered and dressed, ready to go to Atlantic City with his neighbor as planned, when he was almost bowled over by severe chest pain. Was it a heart attack? He certainly considered it, but not all that seriously since he knew he didn’t fit the high-risk profile. “If I start sweating,” he said to himself, “then I’ll think heart attack.” That’s when he broke out in a sweat, immediately telephoned his neighbor and his wife (who was at work) and passed out. He didn’t stay conscious long enough to call 911. Lucky for him, his neighbor made that call and hurried next door. That was the start of a long rollercoaster ride that threatened to put an early end to the life and times of David Laskow.
Maybe we need to backtrack and fill in some of the details of Laskow’s life prior to his near-death. A 1977 graduate of Rutgers University’s Livingston College in Piscataway with a BS in biology and psychology, his dream was to become a high school biology teacher. But based on his stellar academic track record, his advisor and wrestling coach urged him to apply to medical school — and he entered Rutgers Medical School (now UMDNJ-Robert Wood Johnson Medical School) that fall.
Despite being somewhat anxious at the start, Laskow discovered that he was well-prepared for the challenge and that medical school was “relatively easy” for him. After a general surgery rotation at Princeton Hospital and a fourth-year trauma elective at Cooper University Hospital in Camden, he realized that a career in surgery was where he was heading. A five-year general surgery residency at Beth Israel Medical Center in New York was his next step, and again his accomplishments earned him recognition, this time in the form of an invitation to develop a transplantation program there after further training.
Why transplant surgery? Not only does it require you to be highly skilled, says Laskow, but “it was the cutting-edge, appealing intellectually as well.”
Completing a two-year fellowship in his future specialty — at the University of Alabama at Birmingham (UAB) — put the icing on the cake, so to speak, and he had two competing offers for jobs. UAB wanted him to stay, and he did — for a total of nine years — despite ribbing from his New York friends about choosing to live in the deep South. Laskow points out that the UAB healthcare system was infused with funds after the death from cancer of Lurleen Wallace in 1968. For those whose recollection of Alabama history is foggy, she was the first wife of Governor George Wallace and served as his “surrogate” governor when he could not run for successive terms in office. She was forced to go out of state for her cancer treatment because of the inadequacy of Alabama’s medical facilities at the time.
With generous state funding, Laskow says UAB attracted some big names, among them heart surgeon John Kirklin and surgeon Arnold G. Diethelm, who founded the transplant program. UAB now does more kidney transplants than anywhere else in the U.S. — 360 a year, he says, of which he himself was responsible for 120 annually, and also became director of pancreas transplant.
In 1995, Laskow was ready to move on and did a short stint at Hahnemann before coming to RWJMS, which had no transplant program at the time. After getting appropriate approvals, educating staff, purchasing equipment and drugs, he and his team did 36 kidneys that first year — with just the one transplant surgeon. On that platform was built the current transplant group at Robert Wood Johnson University Hospital (RWJUH), which includes five transplant surgeons and is highly reputed in heart, kidney and pancreas transplant.
Again, lucky for Laskow that the program was up and running when he needed it. Taken by ambulance to a local hospital on that December morning, his heart function was so “out of control” that “they couldn’t even get a blood pressure” — and things were looking very bad for him. He was too sick to be moved to another facility.
Enter stage left three RWJ transplant docs, who stabilized their dying teammate, making it possible to safely transfer him by ambulance to RWJUH in New Brunswick, where he arrived at 10 that night and was promptly attached to a left ventricular assist device (LVAD). Suffice it to say, the LVAD — a mechanical pump that helps when the heart is too weak to circulate blood through the body — is most often used to keep a patient alive until a replacement heart can be found and implanted.
The very sick doctor-patient had “lots of complications,” including an allergy to heparin (used to prevent blood clots from forming on medical devices) that allowed clots to attach to his stent, blood pressure so low that his kidneys and liver were failing, and lungs that critically weakened during those first 24 hours. He was placed on dialysis, pumped full of blood pressure medication, attached to the LVAD and still barely hung on. The search for a replacement heart widened beyond the state — and one was found in Delaware, slightly too small for his body but usable, given the dire conditions. Hearts are allocated to the sickest patient, explains Laskow, which he clearly was. But there was not clear sailing ahead.
His recovery was long and also filled with crises. He contracted a very serious Klebsiella infection, which again shut down his kidneys, and dialysis became a necessity once more. On Christmas Day, he hovered near death again, and so critical was his condition that Mark Anderson, MD, the surgeon who had transplanted the new heart, spent 24 hours by his bedside.
But the patient managed to pull through. “It makes you believe in God,” he says.
During his battle to stay alive, Laskow went from 190 to 130 pounds and lost a great deal of muscle mass, leaving him unable to stand or lift his arms. On February 16, 2006, he left the hospital, and despite predictions of a one-year recuperation period, he was back at work in June. But, he admits, it took a full year to feel “semi-normal” again.
Fifteen months later, Laskow says he feels good, although his stamina and strength are not the same as they were. He works out with weights every day and does a daily routine on his treadmill. Twenty pills daily are part of this new schedule — nine in the morning, four at lunch, three at 5PM and five at 8 PM — but he’s not complaining.
Has his life changed in other ways? “I was always compassionate,” he says, “but now my patients relate better to me and I to them — things are much easier to discuss. And my younger daughter is pre-med because she saw firsthand the power of medicine.”
He himself is awed by the power of organ donation. “Just think,” he says, “this donor not only saved my life, but made a difference to all of the people I touch through my work, and all of the people they touch.”
It has taken Laskow a long time to regain some of his weight and he still gets short of breath running, but he’s finally reached 160 “fighting” pounds. Life is good.
And despite the smaller size of the heart that now beats in his chest, he’s ready to take on the world. “After 50, everyone should want a woman’s heart — not a man’s,” he concludes with a smile.