Ten months ago Leonard Pattnett, a healthy 10-year-old who loved playing ball and going camping, had no inkling that he was about to undergo two heart transplants in desperate attempts to save his life.
But by spring, doctors at Childrens Hospital of Los Angeles decided Leonard had just one chance to live anything near a normal functional life: a heart transplant. On May 14, in surgery at Stanford Medical Center at Palo Alto, he received a donor heart. A few weeks later his body rejected it.
On July 1 the Stanford doctors tried again, transplanting a second heart they hoped might be better matched to Leonard in size, age and tissue. All seemed well and his mother, Earline Carr, was looking forward to bringing Leonard home to Los Angeles.
Then he was found to be rejecting the new heart, too.
"We were ready to come home when all of a sudden the doctors found the second heart was rejecting," Carr said from Palo Alto. "He was readmitted Aug. 31 and given medication, the same medication he had received just before his surgery, for three days. Then they put him on another medication and they seem to have found one that is working now.
'Coming Home Soon'
"His biopsy is clear. He is still on medication, but we should be coming home soon, the end of September or before."
With Leonard's release Sept. 13 from Stanford Children's, that dream seems to be coming true, although he remains in Palo Alto so doctors can monitor his progress.
That's good news to Leonard and his family, which includes two sisters, a brother and his grandfather, in addition to his mother--and to the team of professionals at Childrens Hospital of Los Angeles that has cared for the boy and become a sort of Leonard Pattnett cheering section.
On his return Leonard will see Dr. Barry Marcus, a cardiologist at Childrens of Los Angeles, where Leonard was hospitalized the beginning of last February.
In an interview in May, Marcus explained that Leonard never recovered fully from a bout late last November with what appeared to be the flu. Some such viruses can lead to heart problems for a minuscule few--"a fraction of a fraction of a fraction of patients," the physician said.
A biopsy of the internal lining of the heart confirmed the diagnosis that Leonard had a dilated heart and cardiomyopathy that failed to respond to medication: "The damage to the heart was permanent," Marcus said.
Doctors recommended a heart transplant. "A transplant was his last chance for a functionally normal existence," Marcus said.
Since heart transplants are not performed at Childrens Hospital, Earline Carr chose to take her son to Stanford University Medical Center, where Leonard became the 392nd heart transplant recipient and the third of four child patients to undergo such surgeries there this year. She praised Dr. Vaughn Starnes, chief of transplant service and a cardiovascular surgeon at Stanford Children's Hospital, as "a quite human" person for his care of Leonard, as well as the nursing staff in the heart care unit.
Shy, Retiring Child
But she will be glad to have Leonard back under the care of Marcus and the cardiac nurses at Childrens of Los Angeles. A shy, retiring child ("He doesn't talk until he gets to know people," Carr said), Leonard is more comfortable among those he knows, and the cardiology staff at Childrens have become his friends.
Barry Marcus, too, said he'll be delighted to see Leonard again.
"He is a very mature young man for his age, kind of shy," Marcus said. "But our nursing staff was phenomenal with him, an example of how nursing care is just that, nursing care. Two nurses especially, Lori Stern and Wendy Morse, became his special friends and took him to the zoo on their afternoons off and went to his birthday party (for which he was allowed to go home briefly) when he turned 11."
Much of the Leonard Pattnett story centers around the team effort to save his life.
Obvious, of course, are the medically skilled cardiologists, surgeons and nurses who labored desperately to diagnose and treat him.
But others are deeply concerned, notably Beverly Daley, a Childrens Hospital social worker who helped Carr with the gamut of problems that arise when a family member becomes seriously ill and who has stayed in touch with her during Leonard's months at Stanford.
Daley explained that Leonard's family includes Heidi, 18, and Houston Carr, 15, his mother's children by a previous marriage, and a sister, Denise Pattnett, 8. Carr's father, the children's grandfather, also is especially close to Leonard. They are a loving and supportive family, a key element, Marcus said, in the decision for a heart transplant.
"The network of family support is superb," Marcus said. "That is important. All patients have an emotional response that interacts with the physical."