Outside The Lines

Wednesday, September 11
Updated: September 10, 9:06 PM ET
Within a heartbeat of tragedy

By Greg Garber

FREEPORT, N.Y. -- Doug Goodwin Jr. is 6-foot and nearly 300 pounds, and 20 years old, but he's not too old to wrestle with his father.

They're messing around in the gathering dusk at Holy Trinity High School, where Doug Jr. graduated three years ago and Doug Sr. still helps coach the football team.

Doug Goodwin's son could come to his rescue by leaving college early for a career in the NFL.
"He's going to be a player," Doug Sr. says, wincing as his son leans into his chest. "Going to be a player."

The father was once a Buffalo Bills fullback, but this is the kind of strenuous horseplay that leaves cardiologists queasy. That's because the heart that beats within Doug Sr.'s massive chest is not the one he was born with. After 10 years of declining health, after seven near-death episodes, Goodwin's own heart was failing him. It was replaced with a mechanical device, which kept him alive for two weeks before a donor was found.

The 5-hour operation was performed on Sept. 11 and remains one of the few uplifting stories of that ominous day. And yet, as much as the new heart saved Goodwin's life, it also has created new worries. Next month, supplies of Goodwin's costly anti-rejection medications run out.

Since Doug's insurance covers only $500 of after-care annually and his wife Gwen's insurance was terminated when she was laid off in April, there is no money for the 11 pills he takes each day that cost nearly $3,000 a month. The Goodwins, who are both unemployed, say related medical bills have left them approximately $300,000 in debt.

"I'm looking at it hard, realistic, because they tell you in the hospital, you cannot miss your medication. You know what I mean?" said Goodwin, who is 60. "The medication is your lifeline. You take the medicine so the heart isn't rejected from the body.

"Without my medication, I'm dead. It's over with. Put it like that."

In a story marked by a succession of miracles, there seems to be one more in store. His name is Doug Goodwin Jr.

While Doug Sr. says his battle against heart disease has been motivated by a desire to watch his son play football, it's possible that his burgeoning skills may actually preserve his father's life.

A junior defensive tackle at Boston College, Doug Goodwin Jr. (98) has made his presence felt on the football field.
Doug Jr. is a junior defensive tackle at Boston College. He is considered to be among the best tackles in the nation, and B.C. coach Tom O'Brien insists Goodwin may wind up being one of the school's best ever.

"I think, definitely, he's a kid that will be drafted, a kid that will have an opportunity to play in the NFL," O'Brien said. "Then, hopefully, he will have enough money that his family won't have to worry about dollars down the road."

The Goodwin's party line is that earning a degree is the most important thing and that there is no pressure on Doug Jr. to leave school after his junior season. The reality is it would solve a situation that is rapidly becoming a crisis.

"Doug Sr. and I would both like for him to finish school," Gwen said, "but knowing our son the way we know him, if the ultimate is for him to leave school to give us the support financially that we need, I believe he would do that."

With a breakthrough season, Doug Jr. could vault into the NFL Draft's first three rounds. This is significant, because even a middle-to-late second round choice can command as much as a $1 million signing bonus. Even with a bonus spread over three or four years and diminished by taxes, it might be just enough to wipe out the family debt and pay for his father's expensive medications.

Doug Jr., it's worth noting, is an extremely dutiful son. During the summer he ran errands and performed the many tasks his parents requested. He has a deep, abiding Christian faith; as part of a youth choir, he met the Pope on a visit to the Vatican. Two weeks after his father's heart transplant, he responded with the best game of his life against Temple. He gives the overwhelming impression that a good season would give him the impetus to submit to the NFL draft.

"I mean, that'd be the cap to a good season," said Doug Jr. "I'm not going to lie, I would love to do that. If the opportunity arises, sure, I would take it."

Facing long odds
From the beginning, the numbers weren't good.

Some 4,000 Americans each year need a new heart to stay alive, but only about half will ultimately receive one. At New York's Columbia Presbyterian Medical Center, heart transplants are big business. The hospital averages about 100 life-giving operations a year -- the world's second-highest total.

When Goodwin was diagnosed with congestive heart failure last year, the odds against him were even longer for several reasons. First, his larger-than-average size: some 300 pounds.

"Unfortunately, it's good for football, but it's not so good for finding a donor heart," explained Dr. Linda Mancini, Goodwin's chief cardiologist. "Because there are not so many big people."

The anniversary of Sept. 11 is a day Doug Goodwin and his doctor look forward to. Fifty percent of heart transplant patients who survive their first year after surgery go on to life another 12 years.
The second factor was Goodwin's blood type, O-positive. This is the commonest of blood types -- known as the "universal donor" -- and it placed Goodwin in a larger pool of organ applicants. The third strike was Goodwin's precarious financial situation. While the $150,000-$200,000 cost of the operation itself was covered by his insurance, upward of $100,000 required for the subsequent year of after-care was not. Nor was the nearly $30,000 annual cost for anti-rejection medications.

This final sticking point prevented the hospital from placing Goodwin on the national transplant list.

Enter Dr. Ulrich Jorde, a cardiologist at Columbia Presbyterian. When he discovered that it might be another nine months before alternative insurance could be arranged to pay for the after-care, Jorde met with Goodwin to explore some options.

"We were concerned that if we waited nine months, he might be dead," Jorde said. "So I went back to Doug and explained this to him, not knowing how prominent a football player he had been. Once we got talking a little bit, I thought that maybe there may be some help with the Buffalo Bills."

Actually, Goodwin hadn't been a "prominent" player at all. He had been a late-round draft choice of the Bills in 1965 and was a marginal contributor during the team's AFL Championship season. In his two injury-marred seasons in Buffalo, Goodwin never carried the ball.

All of which makes what happened next even more remarkable.

Jorde contacted the Bills in March of 2001 with a letter and a phone call to explain Goodwin's difficult circumstances. The Bills' alumni office responded by sending out a fax to former players and, the very next day, Jack Kemp, the former U.S. Congressman and a Vice Presidential candidate in 1996, called Jorde at the hospital. Kemp, the quarterback and captain of that championship team, hadn't played with Goodwin in 35 years, but here he was, offering to pay for everything.

"I told him I thought it might be a lot," Jorde said. "At the end of the conversation, I told him how wonderful it was that Doug's team comrades came through after such a long time. He was slightly insulted and told me that he was his captain. He didn't say it was his duty, but he made it sound like that."

Kemp, who had been the president of the AFL players union, said he felt a moral obligation to help. "It captured my imagination," Kemp said. "It touched my heartstrings."

At the same time, Bills owners Ralph Wilson, along with several NFL and players' organizations and former teammates, pledged some $40,000 to Goodwin's cause.

"They came, they played for us," Wilson said. "He was part of the Bills franchise, and whenever we can step forward and help in some sort of way, I think it's a privilege to do it."

Almost immediately, Goodwin was placed on the national transplant list.

The harvest run
Seven months later, Goodwin -- a mechanical pump in his chest -- was still waiting for a donor.

He had just finished watching the Broncos-Giants on Monday Night Football from his hospital room, when he was approached by two doctors. It was Sept. 10.

"I looked at them and said, 'What's up?' They looked at me and started laughing. They said, 'Your heart is on the way.' I said, 'Whoa, mine?' They said, 'Yeah.' ''

A donor heart had been located in Boston a few hours earlier. Resident doctors Mauricio Garrido and David Rabkin were heading home after a long day -- they had harvested the heart from a donor in Atlanta and flown it back to Columbia Presbyterian -- when their pagers went off. They returned to the hospital and prepared for another run.

Charlie Hart picked up the doctors in his black Excursion ambulance at 2:25 a.m. and drove "hot" -- with sirens flashing -- across the George Washington Bridge to Teterboro Airport in northern New Jersey. There they met Manfred Herrmann, the pilot of the King Air C90 that would take them to Boston.

"It was a beautiful night, typical, beautiful fall clear sky, not a bump in sight," Hermann remembered.

After a 3:05 a.m. takeoff, the turbo prop plane landed 50 minutes later at Boston's Logan Airport, where Garrido and Rabkin were rushed by ambulance to a Boston hospital. (Donor confidentiality protocol prevents the hospital's identity from being revealed.)

The doctors executed a sternotomy and studied the heart, which had been kept beating by a mechanical pump. They called the transplant coordinator at Columbia Presbyterian, who relayed the information to Dr. Yoshifumi Naka, who would perform the transplant -- the heart looked good, the operation was a go.

Meanwhile, Mohamed Atta was clearing security at Portland International Jetport in Maine before boarding a flight to Boston.

At 6:30, the heart was explanted from the donor, suspended in a preservation solution, wrapped in plastic and nestled in a bed of ice. The heart's shelf-life: four hours, five at the outside.

After the doctors returned to Logan, they were stopped by security. They were told the ambulance couldn't proceed to the tarmac and the awaiting plane without an escort.

"They wanted all this paperwork, all these things," Garrido remembered. "I basically explained the situation to him. I said, 'I have a heart that is in the ambulance that's cold.' I gave him my name and moved on."

At 7:40, Herrmann started the twin engines and began the long taxi from the North Terminal to the runway. At the same time, two Boeing 767s ultimately bound for New York -- American Flight 11 and United Airlines Flight 175 -- both scheduled to depart for Los Angeles -- were making final preparations for departure.

"American Airlines is not too far from the North Terminal," Herrmann said. "We taxied right close enough to the two 767s, one of which was being pushed back at the time. And I even remarked to my co-pilot, 'Isn't that a gorgeous airplane?' ''

Later, Dr. Jorde remarked, "In two of the planes you have people determined to kill thousands of people, to commit an act of terror. And in the other plane you have two surgeons trying to rush this heart home to save one life."

Herrmann's plane took off at 7:50. Nine minutes later, American Flight 11 followed. Another 15 minutes, United Flight 175 had cleared Logan.

It was 8:35 when the doctors touched down at Teterboro. It was one of the last planes allowed to land there that morning.

Hart helped Garrido and Rabkin load Goodwin's new heart into the ambulance and set off for Columbia Presbyterian in Manhattan. Meanwhile, back at the hospital, Naka began the process of removing Goodwin's mechanical heart.

As Doug Goodwin awaited his new heart, terrorists already had commandeered four passenger jets.
At 8:46, American Flight 11 slammed into the World Trade Center's North Tower.

At 9:03, United Flight 175 hit the World Trade Center's South Tower.

Twelve minutes later, the ambulance reached the George Washington Bridge. The doctors observed the dark cloud rising above the World Trade Center and turned on the radio and learned, for the first time, that the towers were under attack.

At 9:21, approximately three minutes after the ambulance crossed the bridge, the Port Authority of New York and New Jersey ordered all bridges and tunnels closed.

"Later we found out we were one of the last vehicles to cross the bridge before they shut it down," Hart said. "It was really pretty close."

At 10:05, the South Tower collapsed. Twenty-three minutes later, the North Tower followed.

By 3 p.m., Naka had closed Goodwin's chest. The operation, based on early returns, had been a success.

Later that afternoon, Jorde visited the sleeping Goodwin.

"Seeing Douglas after his transplant in the intensive care unit, on a breathing machine, still under the effects of anesthesia, [I was] thinking, 'He has no idea what happened. How are we going to tell him?' ''

'Very thin paper'
On Sept. 12, nearly 30 hours after he first had been anesthetized, Goodwin awoke in his sixth-floor room at noon, feeling wonderfully refreshed -- better than he had in more than a decade. Gone was the annoying sloshing of the mechanical heart, the invasive breathing tube, the vague choking sensation that had dogged him for weeks.

Goodwin couldn't believe what he was seeing on TV when he awoke after his surgery.
"I have no negative feelings at all," Goodwin remembered. "All I could see is the TV screen in front of me, and the TV is showing the World Trade (Center). I see this building, people jumping out, then I see the second plane coming around the first one and hit the next building. I looked at it and said, 'Oh man, that's a Godzilla movie.' "

Dr. Peter Shapiro, a psychiatrist in Columbia Presbyterian's transplant program, assured him that it was real.

"While you were having your heart transplant," Shapiro explained, "they attacked the World Trade Center."

And so, in retrospect, is the entire saga of Doug Goodwin.

The doctors, the pilot and the ambulance drivers that successfully harvested the heart and brought it home to Columbia Presbyterian were merely doing their job. Certainly, they had a sense of urgency about them, but no more than usual. It wasn't until the doctors first noticed the smoke over the World Trade Center that they began to realize Sept. 11 was not an ordinary day. A few hours later, it dawned on them: they had been lucky to land at Teterboro, lucky to get over the George Washington Bridge.

What if the donor heart had become available even minutes later? What if the terrorists had struck minutes earlier?

"If this heart had been held up at any point, at the airport, before the bridge, even not being able to leave Boston, then we don't know whether Douglas might have been transplanted," Jorde said. "He might have died."

Naka's expression, translated from Japanese, is thin paper.

"The timing is very thin paper," Naka said. "If the two planes had hit at the same time, probably the government would close the bridge and, then, he won't be here.

"He was just lucky, or we are just lucky."

This Sept. 11, at least for Goodwin and his family, will resonate with overwhelmingly positive feelings. The one-year anniversary is a significant one for heart transplant patients; 50 percent of those who reach that milestone live for another 12 years. With the proper medication -- and a means to pay for it -- Goodwin's doctors say his prognosis looks good.

Come season's end, Doug Goodwin Jr. could be weighing his options as pro prospect.
Doug Jr., who still has that difficult question of the NFL draft ahead of him, is happy his father will be able to watch him play football.

"You have all these thousands and thousands of people who had their lives impacted and changed for the rest of their lives, and the same goes for my father," Doug Jr. said. "You know, he will never be the same again.''

Dr. Linda Mancini, who still lectures Goodwin on the dangers of potato chips when he visits for checkups, noted that Goodwin is just one of the hospital's approximately 100 annual transplants.

"For every Doug Goodwin, there's a whole other list of patients that I can tell you about that have heart-wrenching stories that, fortunately, I can give happy endings to. They're all little miracles Doug is a big miracle."

Said Kemp: "The word heartwarming is a metaphor, but it is a wonderful one. I'm extremely conscious of the donor, the doctors, the nurses, the hospital, my teammates, the Bills, Mr. Wilson -- I think it's one of the greatest stories of my life.

"There are a lot of memorable moments in my life, of football games, of politics, but this stands out because it saved a human being's life."

Goodwin gets emotional when he thinks about all of the vectors that had to align themselves for his successful transplant.

"When I saw how people came together for this 9/11 thing, it brings tears to your eyes," he said. "When I see how the world came together for something like this, then you understand how beautiful life is, that the world has a heart.

"The world has a big heart."

Greg Garber is a senior writer for ESPN.com

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Former Buffalo Bills players respond to a call to help a teammate in need.
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