Cardiac survivor follows his heart

Randy Evans ran dozens of miles every week through Atlanta for years, trying to deny the risk inside him: a weak heart, just like his dad’s.

In 2000, the chest pains didn’t stop, and he awoke in Room 2118 at Emory Crawford Long Hospital, recovering from a successful bypass operation —- the surgery that had ruined his father’s life.

He was 51, and life stretched out in bonus time. Where to run to, after running away for so long?

The answer would send Evans, a writer of corporate newsletters, back to basic science classes in which he was older than his professors. He would master an elite, excruciating training program that weeded out even the young and strong.

He would give up his job, his beautiful home and half his income.

And, at age 58, he would return to Room 2118.

Part I: Reality and denial

There was no Room 2118, or any modern cardiac recovery floor, when Randy Evans was born at Crawford Long in 1949.

He was a ringer for his dad, Frank O. Evans. Both were strong, stubborn, short-tempered. They were twins with the same hearts —- the tangible beating one, the abstract one that stores a man’s greatest passions.

Frank O. had begun his career as a baggage handler at Eastern Airlines before World War II. Oddly enough, he hated plane travel and dreamed of RV-ing the country once he retired. But he never got to hit the road. His own parents, a brother and two sisters had died of strokes or heart disease. In 1980, after 40 years at Eastern, he had a stroke during bypass surgery.

For the next dozen years, his death was slow and excruciating as his damaged heart gave out little by little. His muscle tissue began to blacken from the lack of oxygen. He was in a wheelchair until he died in 1992 at age 72.

Randy’s greatest desire was to avoid a fate like his father’s. And his heart was ruled by fear. He was terrified of seeking out a doctor. So he turned to his wife, Maria Mackas. They had shared first an office cubicle, then wedding vows. They created a plan to strengthen their hearts.

Every other weekend, they ran races —- 10Ks such as The Atlanta Journal-Constitution Peachtree Road Race, or even longer tests. For a dozen years, Randy ran 40 miles a week, minimum.

He and his wife were business partners, too, and their corporate communications business took off, boosted by contracts with health care organizations. Evans even posed for a photo showing off a cardiac catheterization lab, with electrical leads on his chest.

He’d never submit to any sort of real test. Most nights he fell asleep wondering whether he would wake up.

In spite of his stubbornness, there were positive signs that his heart, the metaphorical one, could be reborn to new possibilities.

The Evanses spent a decade trying to get pregnant, “even though his heart wasn’t in it,” Maria said. “He had to fake it when we had the [pre-adoption] home visits.”

He was 45 when they adopted a baby girl, Marra (the name a combination of Maria and Randy), from Guatemala. He loved her from the minute he saw her picture, from the first diaper he changed on the floor of the American Embassy in Guatemala City.

Within a year of her arrival in 1992, his chest pains began.

An avid gardener, he soon could not mow the lawn without pausing for breath after every length of yard. He started taking afternoon naps.

What he called his “secret life” went on for five years.

Moving to a new beat

Evans was rushed into surgery eight years ago this month, in relentless pain from four blocked arteries to the heart. A surgical team repaired these with blood vessels harvested from his legs.

“He had a great engine with pretty bad fuel lines,” said Dr. John D. Puskas, his surgeon. “They were plugged up, but the engine wasn’t badly damaged.” All that running had saved his life.

When he awoke to find out he had avoided his father’s fate, Evans was euphoric, free from fear. Four months after surgery, he hiked eight miles in North Georgia. The next year, he and his wife built their dream cabin on 4 acres near Lake Burton. ” ‘One of these days’ may never come,” they agreed.

There were other changes. He became more emotional. The kids on his daughter’s school bus made him a get-well card, and he couldn’t stop crying. He had setbacks, including a chest infection that forced a second surgery.

But overall, he was energetic and healthier than he’d ever been. His recovery would be, in many respects, the opposite of most patients, who awake to the depressing reality check that life isn’t forever.

“It’s the word —- heart —-that is from literature and religion, the center of a lot of things,” said Dr. Randy Patterson, Evans’ cardiologist. “There is both the feeling and knowledge that a problem with your heart can be suddenly fatal, and that reminds you of your own mortality.”

A successful open-heart surgery, doctors hope, will force figurative changes of heart. The person often must embrace a new diet, exercise and attitude. But sometimes a hardened heart sabotages the recovery.

“Why not change when your life is at stake? Aha, that’s a great question,” Patterson said. “It’s harder than you think, even with that motivation. Some people still will not do it.

“Often the people who have been through [cardiac surgery] are more effective at helping, just like Alcoholics Anonymous is more successful in helping a person quit drinking than someone preaching from the outside.”

Patterson suggested Evans join Mended Hearts, a group of volunteers who have had heart surgery and who reach out to new patients at Crawford Long.

For two years, Evans spent almost every Wednesday morning in or around Room 2118, visiting with up to a dozen patients and their families.

Back home, he often spent hours on the phone fielding questions: Can I scrub my chest in the shower? Why do I have mood swings? How can I trust my heart again?

Evans saw how his story of denial, doubt and recovery helped them —- and their families. If there was any doubt, he could always show them his long chest scar.

“We met for lunch one Wednesday and Randy was crying,” his wife said. “He had talked with a guy who was prepping for surgery, who wanted to hear his wife’s voice one more time. Randy said, ‘I remember how that feels.’ “

Was there more he could do?

He watched the nurses, many of whom had helped him. Running around Emory University, he saw where many had been trained.

An idea took hold, one he knew was truly outrageous.

A heart’s desire

People who are half Evans’ age can’t handle the pace and stress of cardiac nursing.

“This is not acne we’re treating,” Puskas said. “The No. 1 killer of Americans is heart disease, and the level of vigilance and attention to detail is more demanding in this than any other nursing.”

“Randy’s age was my main concern,” said Laura Brown, a nurse, neighbor and occasional running partner. “He’d be right around 60 [when he finished], and he wanted to work as a nurse on the floor, and would they hire him for that? Don’t quit your job and have your family make this huge sacrifice for you if no one will hire you.”

School would mean the loss of income to their company, Mackas Evans Corporate Communications. Tuition costs of roughly $70,000 meant they would need to sell their home in Druid Hills and move to one half its size.

And perhaps biggest of all, Evans would have to take —- and ace —- a dozen undergraduate courses before he could even apply to Emory’s nursing school.

“The science classes I had had to take in high school and college, I had done poorly on,” said Evans, who has a master’s in journalism. “The thought of doing this was so far out of my comfort zone.”

At 53, Evans enrolled at Georgia Perimeter College to take anatomy, microbiology and other courses. His fellow students were half his age.

“What am I doing here?” he asked his wife by phone after leaving his first chemistry class.

He willed himself to be a different student this time around, often waking at 3 a.m. to study. The pride that had once kept him from seeking medical help now kept his far-fetched plan going.

“I could unlock this part of me that was locked,” Evans said. “I could do something that I had spent my entire life thinking I could not do. I could overcome a perception I had of myself.”

The day he turned 57, he started classes at Emory’s Nell Hodgson Woodruff School of Nursing.

His maturity meant that patients often mistook him for a doctor. But experience mostly helped him deal with even the toughest cases.

“Randy had a patient on his psych rotation who had tried to circumcise himself and was severely injured,” said Sally Lehr, a clinical associate professor. “Randy could have just really freaked out, but he just takes everything in stride. One patient was overheard thanking God that Randy was his nurse. That’s about as genuine a compliment as you can get.”

His drive inspired his fellow students, who dug his Gwen Stefani ringtone, too.

“He stood out because of how he told his story, not just his age,” said Madhava Kantor, 26, who became Evans’ best nursing school friend. “He tells it with heart and clarity. I thought it was very powerful. … I went into nursing to continue a sense of fulfilling something, but I wasn’t sure what. His story reassured me that I was doing something positive.”

Evans’ final rotation as a student nurse took him back to the same floor as 2118.

One night, four doors down, he recognized himself in a woman just out of surgery. “She was lying on her back, motionless, under the covers and staring straight up. I could tell she was absolutely frightened. I leaned over and told her who I was and that I would take care of her for the next four hours.”

She started crying and said, ‘I hurt so much, and I am so scared, and I just wonder if this is the end of my life.’ I told her, ‘I am going to get you some pain medication, and then I’m going to tell you why it’s not the end of your life,’ … and I saw a lot lift off her.”

In July, just shy of 59, he passed his board exam. He was now a nurse headed back to the room where he had been a patient.

Room 2118 revisited

His dream job comes with 12-hour shifts, a $40,000 salary (what he made 20 years ago writing) and a new fear.

A recent shift begins with a patient collapsing, and Evans pitches in with his on-the-job teacher, Gerry Wall, to keep him breathing; they hope none of their others will crash.

This is a rugged job for his heart, both emotionally and physically.

In his old room, Room 2118, he tends to Oscar N. de la Cruz, 71, of Stockbridge, a retiree who had triple bypass surgery three days before.

The medical chart tells Evans that de la Cruz hasn’t wanted to get moving. His eyes look out vacantly at the TV, and he barely acknowledges his caregiver.

Evans knows that what comes next is going to hurt bad.

He removes the tubes sticking out of de la Cruz’s chest. Evans’ heart thumps as he then hoists de la Cruz to standing.

Side by side, just outside Room 2118, patient and nurse gingerly take a few steps, and another heart begins to heal.