Artificial heart patient faces public

Posted: Wednesday, August 22, 2001

LOUISVILLE, Ky. -- His face gaunt and his voice just a whisper at times, the first person with a self-contained artificial heart stepped into the public eye Tuesday and said with a smile that the whirring sound takes some getting used to -- but he likes it because it ''makes me realize that I'm alive.''

Robert Tools, a 59-year-old former telephone company employee, was introduced at Jewish Hospital through a video link from his doctor's office.

It was his first public appearance since the titanium-and-plastic pump the size of a softball was put inside his chest July 2. Without the operation, he had been given just a month to live.

''I'm still getting used to it,'' he said. ''And the biggest thing is getting used to not having a heartbeat, except here I have a whirring sound and that makes me realize that I'm alive because I can hear it without a stethoscope.''

Tools, wearing a blue shirt, red tie and sneakers, walked into the room and sat upright in a chair as he fielded questions, peering through his glasses at the video camera. He kept his right hand over his throat to cover a hole left from a tracheotomy tube; his doctor said that helped Tools project his voice.

A diabetic with a history of heart problems, he chose to undergo the highly experimental operation after he had been deemed too ill to receive a transplant.

''I had a choice to stay home and die or come here and take a chance,'' he said. ''I decided to come here and take a chance.''

Jewish Hospital and Abiomed Inc., maker of the artificial heart, had kept Tools' identity a secret until this week, saying only that the patient was a diabetic man in his 50s with a history of heart problems.

His name had been so closely guarded that even the family pastor and people who live on the same street in Franklin, 140 miles south of Louisville, said they didn't know Tools had received the heart

Tools moved to Franklin from Colorado five years ago hoping to receive a heart transplant, but he grew so weak he could barely cross the street. He said he was on his ''last few days of life'' when his cardiologist told him about the artificial heart option.

''I realize that death is inevitable, but I also realize if there's an opportunity to extend it, you take it,'' Tools said.

Doctors had said they hoped the artificial heart would extend the lives of patients like Tools by a month. Tools has gone seven weeks since the operation, and doctors said they are pleased with his recovery.

Dr. Laman Gray Jr. said if Tools gains strength, a heart transplant could become an option in four to six months. Tools' liver and kidney, which were failing at the time of the surgery, are now functioning normally.

''We've taken someone who has been the sickest you can get and literally gotten him now back into a very healthy situation,'' Gray said.

Dr. Robert Dowling, who implanted the device with Gray, said their patient still needs to gain about 30 pounds and go through physical therapy. Should everything go well, Dowling said, Tools should be able to take long walks and resume fishing, one of his favorite hobbies.

The first recipient of an artificial heart, Barney Clark, a Seattle-area dentist, lived 112 days after receiving the bulky Jarvik-7 in 1982. William Schroeder of Jasper, Ind., lived longest with a complete artificial heart -- 620 days before he died in 1986.

Tools' heart, called the AbioCor, is self-contained, with an internal battery. Unlike the earlier mechanical hearts, it has no wires and tubes that stick out of the chest and connect to a power source.

Abiomed has received federal approval to perform at least five human experiments with the artificial heart. Tools is the first to receive it.

Tools said the device feels ''a little heavier than my regular heart.''

After the operation, he said, ''I was happy to wake up, to see people, to know that I was alive and to know that I had gotten that far.''

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