All Bob Rust wants in the new year is a new heart.
The 57-year-old heart transplant candidate is waiting in LDS Hospital in Salt Lake City for a donor. If the right-size and blood-type heart doesn't become available soon, Rust may not live to see the next decade begin."My doctor told me this summer that without a transplant, I have a 50-50 chance of living a year and that he was lying about those odds," said Rust, undersheriff of Teton County, Wyo. "Doctors have told me repeatedly that they don't know why I'm still alive, that with my heart condition, I should have been dead five years ago. I decided to go for it."
It took him 10 years to make that decision.
In February 1978, Rust went to Tucson, Ariz., on business. He started having chest pains in the hotel one night, which he attributed to a hiatal hernia diagnosed the week before. When the pain had not subsided at 6 a.m., he called his doctor in Jackson, who recommended he go to the hospital immediately because his symptoms indicated heart failure.
"I spent the next eight weeks in the hospital in Tucson," Rust said. "While I was in CCU (cardiac care unit), I had eight massive heart attacks. The doctors told me my anterior descending artery was totally dead."
He searched for a doctor who would perform bypass surgery on him, and in November 1978 he had five bypasses in one operation.
While in Stanford University Hospital in California, he met transplant recipients and observed their restricted lifestyle - living in the hospital, wearing masks, not kissing or hugging or even touching other people.
"That wasn't living; that was being kept alive," he said. "That was not acceptable to me. It resolidified my feeling that I would not have a transplant - that I would live the life given to me and when it was over, it was over."
For the next five years he was OK, and then his condition began to worsen again. In 1983 a doctor told him his bypass surgery never worked, and he suffered several more heart attacks and severe angina, which is a brief attack of chest pain caused by lack of oxygen in the heart muscles.
In May of this year, he began feeling lousy, and then after a traffic accident in Jackson he went to LDS Hospital in Salt Lake for more tests.
"Through an echocardiogram he (the doctor) discovered a blood clot in my heart. He said I still was an excellent candidate for a transplant, even though I'm two years past the usual maximum age, since the rest of my body is in extremely good shape."
Explaining that post-transplant lifestyles and life expectancies have improved drastically in the past five years, the doctor arranged for Rust to meet with six heart recipients. Three had been on life-support systems, one had been released from the hospital the day before, and one had been training and riding horses for two years.
"I learned that, in a matter of months, a recipient can expect a lifestyle as good as or better than prior to the transplant," Rust said. "I went from `No, they're not doing that to me,' to wondering, `When can they do it?' There was no particular turning point. I just changed my mind."
United Transplant Affiliated Hospitals Cardiac Transplant Program's success rate also reassured Rust. In three years, UTAH surgeons have performed 197 transplants with a 95 percent success rate - the second highest in the nation.
Since UTAH is a cooperative effort among three hospitals - LDS, University of Utah and the Veteran's Administration - its surgeons perform more transplants than any other facility in the country, and its patients aren't in competition with each other for donor hearts.
Rust said that at first he had "a little problem about where the new heart would come from, but then I realized that person is dead, and wanted to be a donor."
He is equally composed about the possibility of not getting a new heart in time, or not surviving after surgery.
"If I don't make it off the table, I won't know it," Rust said. "That would be better than another heart attack anyway."
What Rust faces with less composure is the waiting. He has been living in Salt Lake City for seven weeks, and, if his waiting period matches the average, has at least another five weeks to go.