“What is that?”

“This,” Morgan paused for emphasis, “is a valve.  I haven’t slept since we brought Isaac home.” Morgan continued more quickly and energetically, “My mind’s been racing, knowing there has to be a better solution, and after researching everything I could find on his condition, expecting there had to be an alternative, one night I woke with a start—and could see with perfect clarity exactly what he needed. In full color, three dimensions, I saw the very thing that would solve the problem, and I’ve spent the last four weeks ‘round the clock developing it.  This is it.”

The doctor took the device and examined it from all sides.  His mouth hung open slightly, as he considered the challenges that artificial valves had always been known to have, and with every turn of the object and every twist and bend of the fingers that held it, the realization washed over him that this inspired design avoided both the coagulation problems of the more durable mechanical devices, as well as the durability problems of their bioprosthetic counterparts.

The features were so advanced it seemed like science fiction. Dr Golward turned the valve over in his hands many times as he continued to examine the prosthetic device.  He muttered thoughtfully, “This porous element might actually promote a strong matrix bond between the heart tissue and valve, maximizing implant stability…”

Morgan interrupted his thoughts.  “The valves are made of a synthetic polymer that possesses the physical qualities of natural valves: elasticity for preventing deformation and adhesions, efficient opening and closing of valves, and compatibility with the natural healing process. So, no deformity, flow, clot or infection problems, essentially eliminating the need for multiple surgeries, heart failure, blood thinners…”

“Unbelievable, Morgan.” Dr. Golward examined it pensively one more time, then began to question, “But—”

Reading his thoughts, Morgan interrupted.  “Ray, get this.” Morgan brought out a notepad with his midnight scribbles on it. Enthusiastically he pulled his chair closer to Dr. Golward and spun the pad around on the desk to face them both.  “Look at this—with thousands of medical devices and a lab full of building blocks for everything my company makes, when I saw the vision for this, every solitary thing that needed to go into it was apparent as well.” Morgan chuckled, “I jotted it all down, wondering if it would still make sense in the morning.”

Dr. Golward pored over the notepad and eventually whispered, “This is a dream.” Looking up at Morgan, eyes wide, he continued, “Can this be for real?”

Morgan rattled on, “Thrombosis: not a problem. We take the DXio45 melding component, combine it with ROJ-62, overlay it onto the methyl methacrylate fiberflex and you have an ideal replication of the endothelium of the connecting heart chambers.”

Dr. Golward remained in a daze, and Morgan kept going. “With the new technology for fusion in cranioplasty, it seems the same process could bond this compound to the outer surface of the prosthesis, and voila! You’ve got built-in endocardium—the body won’t even know the valve is there.”  After a moment he burst out a chuckle and excitedly pointed to one part of his diagram, “Do you see how this combination could even lay the foundation for potential self-repair?”

Dr. Golward sat back and closed his eyes, looking for a hole in Morgan’s theory.  Finding none, he began with a sigh, “If this is truly what it seems to be, it’s revolutionary.  The world will know about this, Morgan!  It needs testing and mass development!”  Leaning in he continued, “You’ve got to submit this to the medical journals—it’ll save thousands of lives every year!  You always said you’d be saving lives in the trenches!”

Shaking his head, yet smiling, Morgan threw his head back and countered, “Oh sure, who would listen to me?  I’m no medical doctor; I’m just a parent who is obsessed with seeing my son, the only child I have, grow up. No, Ray, the world isn’t ready for this.  It’s for Isaac, and we don’t have time to wait for the medical community to accept it.”

Dr. Golward cautiously tempered his excitement.  With his thoughts racing faster than he could speak, he blurted, “What are you saying?  Wait—no. This can’t be for real. It’s—you—what about…” With his thoughts in a blur, he eventually reverted to a question that was at least possible to formulate. “Morgan, how in the world did you think of it?”

Morgan replied, “I couldn’t have designed it on my own if I tried, Ray.  I’m not that smart. It’s bigger than me, and so I’ve got to go with it, follow where it’s leading.”

Thoughtfully Dr. Golward tried to process this incomprehensible event.  He was witnessing the birth of a groundbreaking innovation, and had trouble digesting the significance of the moment.  Slowly muttering out loud, he finally concluded, “You’re right, you’re not smart enough to come up with this on your own; somehow this passion of yours has become your portal to genius!”

“That’s about all I’ve got, Ray.  I feel the passion in my veins.  It keeps me awake at night. There’s nothing more I want than to know Isaac will give me grandchildren to carry on the family name. I want people—family—a hundred years from now to know and care that I lived.”  By now, Morgan’s eyes were misty.  One tear eventually fell, and looking embarrassed, he quickly wiped his face dry.  “I need my son live a full life, without the constant threat of another operation, and I believe this will do it.”  Morgan took a deep breath, and mustered the courage to say, “That’s why I need you to perform the surgery.”

Dr. Golward’s face fell.  “You want me to do what?”

“I need you to give him this device.  Put it in there.  I can’t do it myself, or you know I would.”

“It’s too experimental—too infantile!  Where’s the lab testing?  Years of experimentation?  This is your son, for crying out loud, not a laboratory rat!  Have you gone mad?”

“You said it yourself, doc: this is genius; I didn’t come up with it on my own.  I’ve been given a solution to save my son.  Who am I to reject it?”

“How will you pay for this?  The hospital, equipment, medications, the physicians?  No insurance company would ever touch this.”

“I’ve already cashed in my entire portfolio.  Much of the equipment can come from my own company, and—since on paper it can be considered product development and testing—I can utilize company funds, to an extent. I’m prepared to cover the facility, medications, and most of what your team would require, but I’m hoping you’ll do your part—as a favor.” Morgan searched the doctor’s face, which held back any sign of cooperation. “Let me try to simplify the idea. This proposition is not really that difficult, Ray.  The procedure is routine, just with a different device—same contact points, same procedure.  Only this time, no complications.”

“Do you have any idea how much red tape there is to go through?  This sort of thing takes paperwork, releases, and legalities. I’m not sure Isaac has that kind of time, Morgan.”

“You can push it through, can’t you?  I’m on my knees, Ray. I don’t know what else to do. He won’t always be a candidate.  I’m afraid we’ll lose Isaac if we don’t do this.”

“You could lose Isaac if we do, Morgan.”

“Just tell me this.  Is it possible?  Can you use a device that has only been tested in the research and development lab at the plant?  Can you get a team to do it?”

“It’s complicated. I can get the facility and a team, but this is a Class III device, so without approval from the Food and Drug Administration, we need an investigational device exemption—an IDE—and even with that we can’t do anything for at least 30 days, probably more.”

“But if you recommend it, and I consent—I’ll sign anything you need me to sign—then what does it matter to the FDA?”

Even though Dr. Golward could see the feasibility and genius of the invention, there was a part of him that had a hard time not seeing the gadget as home made, and the thought of being responsible for its performance to any degree terrified him.  There was comfort to be had if they would just slow down long enough to allow the federal agency to either lend support or shut it down entirely according to their judgment.  Apparently, Morgan didn’t care what the FDA thought, and Dr. Golward desperately wished that he did.

The doctor was certain that questioning the suitability of the gadget further would fall on deaf ears, so he tried another argument: “Well, here’s the thing, Morgan.  What if it works?  What if you’ve created something that would help others?  Naturally I’d want this for your son, but you can’t expect me to approach this with the same indifference as if I were helping you fix your car. For another thing, if you’re asking me to do a favor like this, ethically, I’d need to take this on with the ultimate intention of letting it help humanity on the whole, not just Isaac.  That requires an IDE to treat him as part of an approved clinical study.”

“So under those terms, how long before he’d get the surgery?”

“Honestly, I’m not sure he ever would.  Before approving the study, they have to review all the documentation from prior studies—laboratory, animal, other human tests—a proposal for how we’ll run the study, consent documents. We have none of that. If by some miracle they approve the request anyway, then there’s a good chance they’ll impose some serious restrictions.”

“There’s got to be another way, Ray.”  Morgan paused awkwardly and then continued, “You know what? Let’s not talk about this now. You’d probably like some time to digest it. Come to our house tonight.  You’ve always relied on Rita to keep my head on straight. The three of us can talk about it at home.”

Dr. Golward was somewhat surprised by the suggestion because he knew Rita was too level headed for this, and he thought it odd for Morgan to suddenly shift from dogged assertion to being openly willing to bring her into the conversation.  It actually sounded like a safe and perfect way to bring this madness to a peaceful conclusion. “Great. I’ll get back to work and then,” shaking Morgan’s hand he promised, “I’ll swing by on my way home from the clinic.”

~~~~~~

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“Dr.—” Morgan stammered.

The doctor knew Morgan had never grown accustomed to calling him by such a formal title.  Because they had been close friends long before he received his license, it didn’t bother him when Morgan continued more informally using his first name instead.  “Ray, I don’t know what to do.”

“Morgan, he needs the procedure. Remember, your valve replacement was particularly hard because of the additional stresses:  Medical school, a new baby.  You made it through, even with all that, and I believe he will too.”

Morgan shook his head despairingly.  “Sure I made it through, but I had to drop out of school.  There’s got to be an alternative.”

Dr. Golward pursed his lips together then asked, “When did you say Rita would be back from her mother’s?”

“Tomorrow.”

Knowing Morgan’s wife would help him recognize what was medically necessary, he suggested, “Why don’t you talk to her about it then and give me a call.”

“I already have.  She can’t understand why I’m holding back.  I know. I know; there’s really no question.  We’ve just got to do it.”  After a halting pause, he nodded, “It’s okay.” Morgan sat quietly with the doctor for a moment, gathering his thoughts.  His brows furrowed slightly before asking directly, “But what if it doesn’t work?”

“Morgan, you’ve experienced this as a patient.  I don’t need to explain the risks; you know them as well as anyone.  But you’ve also seen it work, and Isaac really has no other choice.”

“I know; you’re right.”

“Just let me do my best, and pray for God’s hand in his full recovery.”

Morgan nodded, and took a deep breath.  “You know, if I’d been able to stay in medical school, you realize I might be the one performing this surgery?”

“No, Morgan. Everything happens for a reason.  It’s not your job to do this for your son.  And somehow, all that’s transpired will ultimately reveal a grander purpose for your life, and greater meaning to your challenges.”

Morgan lamented, “I never aspired to work for a medical devices company; I always thought I’d be in the trenches saving lives like you.”

“Well, we all play our part.  I couldn’t do what I do without the tools you provide.  And look at you now, succeeding magnificently right where you are.  Your interest in medicine making you uniquely equipped to bring passion and purpose to an industry often driven by profit alone.” Dr. Golward smiled. “No wonder you’ve done so well.  In your wildest dreams, did you ever think you’d so quickly end up as the company president?”

Morgan was too numb to respond.

After a reflective moment, Dr. Golward put his hands on Morgan’s shoulders and reiterated, “Now.  Let’s help your son.  That’s my passion and purpose; I want to see him grow up to play football for our old high school.  Deal?”

“Alright,” Morgan nodded, “I’ll trust you.”

“No, don’t trust me.  Trust God, Morgan.  I’m just an instrument; and like I said, all I can promise is to do my very best.  You know, my own heart is in this one.  I want him well.”

~~~~~~

Eight months later

“I’m so sorry, Morgan.”  Dr. Golward looked at his hands, wringing them as he prepared to deliver the devastating news.  Then, bravely making eye contact he stated, “It’s infective endocarditis.”

Morgan closed his eyes and Rita put her arms around him, hiding her face in his shoulder.  Questioningly, Morgan looked up, shaking his head to Dr. Golward: “Why Isaac? How can thousands of people come through without a hitch, and Isaac’s little body goes toxic? Can you explain that to me?”  Morgan was angry and Dr. Golward just listened. “This was supposed to work, Ray!”

It’s not that Morgan didn’t understand the medical terminology or anticipate the potential setbacks of his son’s condition.  He had spent hours at the hospital library learning everything he could about the aspects of cardiology that had impacted his family twice now, but Isaac’s situation wasn’t a story in a medical textbook. This wasn’t just “O” positive on a chart.  This was real blood, and not just any, but his own, coursing through the veins of his very sick, but cherished offspring.

In reality, this was his own flesh, under conditions beyond his control.  Powerlessness, helplessness—emotions not easily adjusted to by any grown man, but especially Morgan, who erroneously felt that if somehow he had been able to finish school, he would have had more power or knowledge to avert this tragedy in the first place.

Finally the doctor responded.  “The valve is compromised; the leaflets have seeded bacteria. We hope to get the infection under control with antibiotics, Morgan, but I’m afraid the valve is only temporary. The leaflets are damaged.”

Morgan’s anger melted away as he mustered some weak but hopeful determination. “So now what?”

“He’ll need another surgery. How soon? Not sure.  We’ll wait as long as we can, managing his condition with medication to delay the second procedure.”

“So what’s to keep this from happening again?”

The doctor silently pressed his lips together and then replied, “There are no guarantees. There are inherent disadvantages to both the mechanical prosthetic valves and the ones made from animal tissue. We do the best we can with what we have to work with.”

Unsatisfied with the doctor’s response, Morgan replied resolutely, “I believe in miracles, doctor. I still envision Isaac leading a normal life…”

The doctor cautiously assured, “I believe in miracles, too, Morgan.”  After a sympathetic pause, Dr. Golward smiled faintly, “I’m looking forward to the football game we’ll watch him play in about ten years.  Mark your calendar; we’ll eat nachos at halftime.”

~~~~~~

The doctor would never express such confidence to just any of his patients’ families, but he knew Morgan needed his buoyancy more than he needed a report of the apparent truth.  Their enduring friendship transcended the typical professional protocol, and he knew the friendship would endure, even if his words proved to be a lie.

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Ten years earlier, and
30 miles northwest of Great Bend, Kansas

Morgan’s heart pounded in his head as he frantically placed his suffering boy in the back seat of his car and threw the .22 caliber rifle in the trunk. As he raced to the main highway, he knew he might still be forty minutes away from anyone who could help, and his mind flooded with echoes of his last conversation with Rita:

“Hunting Jackrabbits? Honey, he’s only six! Can’t you wait until I get back from Mother’s so I can keep him out of the line of fire? I know how focused you can get and I know how spontaneous he can be. I just can’t help think he might race ahead of you, and you might not notice.”

“Rita, don’t worry, I’ll be careful. Nothing will happen to him.”

“Morgan Stillwater, you promise me he’ll be safe. It was too hard to get pregnant, and carry him full term in the first place to have anything happen to him now.” There had been a long pause until she softly asked, “Are you going to let him shoot?”

“Been thinking about it. I was six when Dad let me try the rifle.”

“Please don’t do it, at least—will you just—wait until I get back? Mother’s doing better; I can be home by dinnertime Thursday. What if you save it for next weekend, and we can all go together?”

“Honey, let me have this time with him. Ever since the day you told me you were finally pregnant, I’ve been dreaming of doing father-and-son things with him. No offense, but I just don’t think it would be the same with ‘Mom’ coming along to make sure we’re okay.”

Rita’s voice turned grave. “Promise me, Morgan. Promise me you’ll have your eyes on Isaac the whole time. I don’t care if you don’t come home with a single rabbit. All I care is that this family stays in tact. Got that?”

“Everything’s gonna be okay, Rita. It’s just a rabbit hunt.”

~~~~~~

Morgan glanced in the rear view mirror. Isaac was breathing faintly and his lips were darker than the last time he checked. Cursing the day he had to drop out before getting into medical school because of his failing health and mounting bills, Morgan hit the steering wheel hard with both hands. “I could have helped him! I might have known what to do!”

He picked up his cell phone, hoping that somehow it might have magically charged itself, even though it had died more than an hour previously. No luck, and no charger.

Suddenly the anguish overcame him and he began to sob uncontrollably. A weak, but restless movement from the back seat and the pallor of his son caused Morgan’s foot to press harder on the accelerator.

“Oh, Rita,” Morgan moaned through clenched teeth as his speed reached 95 miles an hour. The grasslands whooshed by in a blur under glowing clouds against an electric blue sky. “I was careful, I was so careful!”

Finally, the barren landscape gave way to an occasional silo and farmhouse. Do I stop and call for an ambulance, or do I just look for a hospital on my own? He didn’t know how serious Isaac’s condition was, or how much time he had to work with. He decided to press on.

After another five long minutes as he entered a small country town, Morgan heaved a sigh of relief to see a blue sign on the side of the road with the large capital “H” and an arrow, indicating there was, in fact, a hospital nearby.

Pulling in under the portico labeled “Emergency”, Morgan screeched to a halt and labored to carry his son through the automatic glass doors. The receptionist stood, responding to Morgan’s alarmed expression and she signaled a nurse from triage to come quickly.

Miraculously, there were no other patients waiting to be seen in this sleepy little town hospital he had stumbled upon. The nurse quickly provided a bed, called for a doctor, and began asking questions.

“Is this your son?”

“Yes, he is.” Morgan was in a daze.

The nurse checked Isaac’s vitals while asking, “What happened?”

“Uh—,” his voice cracked with a spontaneous whimper, but he quickly continued between anxious breaths, “we were hunting jackrabbits, and I spotted one, and I shot, and then I don’t know why, but Isaac collapsed, because he wasn’t even in my way, and I can’t find a wound anywhere. I don’t know what happened.”

“Has he been ill?”

“Uh, I don’t know, I mean, he’s been extra tired lately, but I just figured he’s been in a growth spurt, and today I thought it was because I woke him up so early.”

Just then the doctor arrived and Morgan watched intently as the two professionals quietly searched for an explanation. At length the doctor spoke. Addressing the nurse he instructed, “Darla, arrange transport. Mister, uh—”

“Stillwater. Morgan Stillwater.”

“Mister Stillwater, we’re a small facility; and we don’t specialize in pediatric cardiology. I’d like to have him transported to Wichita right away.”

“Cardiology?” Morgan fell back in his chair. Shaking his head he explained, “Doctor, I had a valve replaced five years ago. You think he might have the same condition?”

“These things can be hereditary. We’ll only know for sure after he’s seen in Wichita.”

Speaking to himself Morgan scoffed sadly, “So a bullet didn’t hit him.” Blindsided, he rubbed his face. Weakly, numbly he asked, “Could you contact Dr. Ray Golward at the Cypress Heart facility? He’s an old friend from high school who is also my cardiologist now. I’d trust his recommendations.”

“Certainly.” The doctor nodded and left the room.

With one horrific tumult put to rest, Morgan realized the real one had only just begun. “Oh, Rita. How am I going to tell you?”

(Let us know what you think about this NEW Chapter 1 before you proceed to Chapter 2…)