Nahush Mokadam: Reflections of a heart transplant surgeon

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Dr. Mokadam
Credit:
Clare McLean
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I’m always amazed at what we can do in the operating room. We can stop an organ donor’s heart, remove it from their body, pack it in ice, transport it 1,500 miles, stitch it into someone else's body, and…it beats! It's truly awe-inspiring. I’ve seen observers and medical students get giddy, which is actually how we all feel,  but we have to be a little detached because we’ve got work to do and a patient to take care of.

I want to let the awe out when I talk about my work, but there’s no way to communicate it. It’s truly raw emotion. If you’ve never seen a heart start to beat again, or agonized over one that didn’t start, it’s impossible to describe.

It takes a village. This is assembling a group of people who share a common vision, have similar levels of enthusiasm, and can support each other in times of need, stress and overload. That’s how we did 75 transplants last year, third most in the country. Up and down the list — surgeons and cardiologists and anesthesiologists, nurses and nurse practitioners, physician assistants, OR staff, social workers, financial counselors, hospital administration, coordinators, colleagues in other departments and divisions — everybody is pulling their weight and opening up the doors to new ideas.

We’ve pushed the envelope for years. We once thought, ‘this heart is too far away.’ We have a solution for that now: heart-in-a-box. Or we’ll ask our infectious disease colleagues, is this heart really high-risk to transmit an infection?

We form immediate and powerful bonds with our patients and our families, and sometimes people pass away. That’s the hardest part of the job. Sometimes we lose. Really lose, and lose hard. If you did everything you could, if you used all the skills and resources you had, if you called for help when you needed it, you did the right thing. And you can sleep at night if you did the right thing.

The reward of doing transplants comes from two poignant moments. The first is when you go talk to the family while their loved one is still in the operating room, and you meet them in the waiting room and say, ‘The heart is working!’ The second: when the patient emerges from anesthesia and they say ‘thank you.’ 

Mokadam, his wife and twin sons
Mokadam with his wife of 20 years and their twin 14-year-old sons, at least one of whom won't be following their dad in the family biz (Mokadam's father and grandfather were both physicians). Credit: cutyerheartout Photography

My family time is so important to me.  We love to travel, hike, ski and spend time together. Because there is never enough of it, it is precious.

Many years ago I came up with an Xbox gamertag: cutyerheartout. I was going to be a heart transplant surgeon, so why not? I’m an avid amateur photographer, and I now use the name @cutyerheartout to showcase my photos online, on Facebook, on Instagram, and on Twitter.

I really don’t like to talk about work outside of work. People get intimidated by my title. I just want to be a person and walk around with my camera. 

Mokadam and a camera

Dr. Mokadam is surgical director of Heart Transplantation and Mechanical Circulatory Support at UW Medical Center.

As told to Jake Siegel

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