The Beat of a Different Heart: Matthew Moshen '92

By Veronika Ruff '01

Most 20-something college students don’t concern themselves with the condition of their hearts. In fact, many do just the opposite by potentially damaging it during college years. Matthew Moshen ’92, however, didn’t have that option. In his junior year at Vassar, after feeling excessively fatigued during a routine lacrosse practice, he was diagnosed with cardiomyopathy — a severe form of heart disease. Ten years and a few miraculous months later, Matt has a new heart and a new cause.

\Though relatively rare, cardiomyopathy was nothing new to the Moshen family. When Matt was diagnosed, his father was in critical condition awaiting a heart transplant after being diagnosed with the same disease in 1990. Matt’s grandfather and a cousin also suffered from the genetic disease that causes the heart muscle to malfunction, improperly pumping blood and eventually causing congestive heart failure. In nearly all cases, cardiomyopathy requires strict long-term medical treatment, and usually, a complete heart transplant.

But when Matt found out about his own illness, he wasn’t thinking that far ahead. “Though I did know what [cardiomyopathy] was about because I was watching my own father go through it, it’s something that’s so overwhelming it certainly didn’t sink in,” he said. “And since I felt fine, I was mostly concerned with whether I could play lacrosse the next day.” Instead, Matt’s cardiologist at Poughkeepsie’s St. Francis Hospital told him he would never play competitive sports again and suggested that he take up golf and walking. “It was not death I feared at this point, but rather a life of physical boredom,” Matt said. The doctor also advised his transfer to Columbia Presbyterian Medical Center in New York for further testing. There, Matt came under the care of his father’s cardiologist, and the two were merely two doors apart. “It was awkward to be there, surrounded by so many tremendously sick, much-older patients, when I felt fine,” he said.

Armed with a massive regimen of medications and feeling somewhat like “damaged goods,” Matt quickly returned to life at Vassar. His father, meanwhile, had a difficult time harboring his new heart and died on March 15, 1991, when his body could not fight off a viral infection. Still, Matt was convinced he would never share his father’s fate. “[Being diagnosed much earlier in life,] I always had faith that somehow technology and consistent medical supervision would spare me,” he said.

Returning to Vassar proved to be pretty difficult. No more lacrosse, which really meant so much to him. Matt learned lacrosse by playing with classmates Frank Caropelo ’92, Tom Tobin ’92, and Seth Dallaire ’92. Also, no more intramural basketball; no more Hoop Squad of Death v. No Rhythm Required (a 1989 intramural championship classic for Davison House). No more water polo, indoor soccer. Prohibition from Vassar sports truly became a “black hole in my college life and psyche,” recalled Matt.

Matt continued leading a fairly normal life after graduation: he worked, traveled, completed business school at NYU, and began dating Alexandra Fano ’92. “I told Alex about my illness early on in our relationship,” said Matt. “But it was hard to believe,” added Alex. “He was very healthy looking and able to do things. It’s hard to imagine such a serious illness when someone is outwardly so healthy.” When the two started discussing marriage, Matt sat down with Alex’s parents to tell them about his condition. “It was a terrible piece of information to digest, and an extremely difficult and courageous decision to accept that their future son-in-law had a significant chance of dying from heart disease, leaving their daughter a widow at a young age,” Matt said. “My dad is a cardiologist,” Alex explained. “He made me more aware of the extent of Matt’s illness, that since his was a muscular disease, the only cure was an eventual transplant.”

Nevertheless, Matt and Alex married in 1998 with the strong support of their entire family. Over the next few years, however, Matt’s condition began to worsen considerably. It was small things at first — he could no longer play in the pick-up basketball games he loved, he could only handle doubles tennis, and even then, needing long breaks between points. But soon, it became clear that he could no longer manage the demanding travel schedule his job at KPMG Consulting in New York required. Matt became so weak that he had to buy a pull-cart to transport his laptop to work and alter his subway routes to avoid stations without escalators. Luckily, his firm was supportive, allowing him to avoid travel and begin telecommuting as often as possible.

During the summer of 2001, Matt rapidly declined. He had undergone several cardioversions to shock his irregular heartbeat into rhythm. (These procedures can hold up to one year, but that summer one lasted only a week, and soon, it became too dangerous to continue with the shock treatments.) In September, after a routine check-up, Matt’s cardiologist told him that medicine alone could no longer keep him alive — he needed a new heart. Matt was then “listed,” or added to the United Network for Organ Sharing (UNOS) transplant list, which made him eligible to receive a heart from state, regional, and national lists, depending on his medical priority.

Unfortunately, placement on the list does not ensure immediate, or even eventual, renewed health. According to an April 23, 2002, article in the Atlanta Journal-Constitution, close to 80,000 Americans are on this waiting list, and 16 die every day waiting for a new organ. In 2001, only 12,522 people donated organs. Because there are so few organs to be had, not everybody who needs one goes on this list. There is a litany of criteria to meet: doctors checked for other organ damage, assessed Matt’s ability to take all the medications necessary for recovery, took into account his mental health status and network of support, and thoroughly analyzed his immune system to make sure the new organ would not be rejected. Matt passed all the tests, and since his blood type is A (rarer than the universal donor, type O) the list was shorter, and his wait was originally slated at six to twelve months. The wait ended up being much shorter when on a beautiful day in late October, after a quick walk to his neighborhood grocer, Matt crashed. His heart racing, huffing for air, and sweating profusely, Matt called his father-in-law, who immediately took him to the hospital.

Because of his decreasing heart function, Matt’s blood pressure was extremely low. At first, doctors thought he would be released the next day, but Matt didn’t respond to the IV fluids and was soon moved to Presbyterian’s Cardiac Care Unit, moving him up the UNOS list and hopefully shortening his wait from months to days. Matt’s deterioration continued, and his transplant status was changed to 1A. “Despite being at the top of the list, days passed without an available donor heart, bringing me much closer to death,” said Matt. “The pressure of waiting for a heart was immense. It’s essentially a race between a new heart and death.”

Matt Moshen
Matt Moshen
By Halloween — still no heart. Matt had spent days in the CCU, where there are no windows, constant beeping, very sick patients everywhere, and no way to differentiate between night and day. “That’s when I started to go cuckoo,” said Matt. When telling their story, Alex takes over at this point. In the CT-ICU, Matt began suffering from ICU-psychosis, a common result of spending too many days cooped up in care units that causes patients to slip in and out of consciousness, enduring severe delusions. Though Matt remembers little of what actually happened during this time, he recalls his nightmares perfectly — most centered on September 11 themes: fires, elevator shafts, people screaming for help. Matt often awoke convinced that Alex had been killed.

That Friday night, Matt’s doctors determined that if they didn’t do something soon, he would die. They decided to wait through the weekend. (“It’s morbid, I know,” said Alex. “But the organs come from somewhere, unfortunately, and there are more accidents on the weekends.”) But if no hearts came in, Matt would need a new Left Ventricle Assist Device (LVAD) by Monday. That weekend, two hearts did come in, but neither was Matt’s type. Early in the morning of November 11, Matt went into surgery to receive his LVAD implant, a device that attaches to the left ventricle to help pump blood to the heart. Given Matt’s fragile state, the seven-hour operation was extremely risky. And perhaps most upsetting, he would have to be removed from the UNOS list until he recovered.

Though the surgery was technically successful, he immediately developed a serious infection, accompanied by a dangerously high fever. Doctors tried different antibiotics for two weeks, to no avail. Throughout their desperate ordeal, Alex usually left the hospital around 11 p.m., returned home to Queens, called in to check on Matt at midnight, slept until 5:30 a.m. when she woke to check on Matt again. Then she spent mornings teaching her sixth-graders. “Though it was hard to be away from Matt at all, it was helpful to have something else to focus on for at least part of the day,” she said. When Alex called in the Saturday after Matt’s LVAD surgery, a nurse told her that Matt had had seizures during the night. Alex rushed to the hospital, but no one could tell her anything for hours. Finally, she received word that Matt had suffered from two strokes caused, most likely, by blood clots that traveled to his brain. Though LVADs have low incidences of leading to strokes, Matt’s disturbed heart rhythm increased that likelihood. “At first, no one knew what the neurological damage would be,” explained Alex. “He was clinging to one word and repeating it, he couldn’t recognize objects, he had no spatial sense, and he babbled a lot. But it was difficult to differentiate between what was caused by the strokes and what was part of the ICU-psychosis.”

This differentiation was an important one to make because if Matt’s neurological status proved questionable, he could be de-listed for no longer meeting the UNOS criteria. Doctors continued neurological tests while Matt’s infection and fever worsened. “He couldn’t keep the feeding tube down to eat, his white blood cell count increased, it seemed as if the doctors had tried every antibiotic possible — his body was giving up,” Alex said. “Thanksgiving was the worst, though,” she continued. “Matt was completely unresponsive to everything. It looked bleak…he was down to 130 pounds and looked very Frankensteinish with wires attached to his head and wax in his hair.” When Matt’s usually calm and optimistic doctor expressed serious concern, Alex was sent into a tailspin. “I wondered if he was ever going to come back. Would I ever be able to talk to him again?” A nurse told Alex to prepare — barring a miracle it would be a matter of days. Friday, Alex called friends and family she had been keeping at bay. “I had wanted to protect Matt, who wouldn’t have wanted them to see him like that, and [I was] also trying to protect them from seeing Matt in that state. But at that point, I thought I should give everyone the opportunity to say goodbye,” she said.

When the sun rose Saturday morning, Alex felt like a miracle had happened. Matt was listening to people reading the newspaper to him, even pointing to the sports section. His fever waned and doctors finally found an antibiotic that worked. Doctors were able to determine that the strokes had left no serious neurological damage, allowing Matt to be re-listed on November 26. Matt was once again placed on the top of the list because he had developed pericardial effusion, a condition caused by fluids collecting around the sac surrounding the heart that further limited the time he could continue surviving with his own heart. Around 5 a.m. the next morning, they received “the call.” A man from Stony Brook, New York, in his early 40s had died. The man’s family donated his heart, liver, and kidneys, and the heart was a match for Matt.

Before going into surgery later that day, Alex asked Matt if he had any last words before getting his new heart. “Surprisingly,” recalled Matt, “I spoke to the old heart: ‘F*ck you, f*ck you for not letting me play lacrosse, f*ck you for not letting me play intramural basketball.’ I guess I could have said something a bit more profound, but it’s a sentiment that had lingered since my Vassar years,” Matt said. The nine-hour surgery was a success, and the next day, Matt was off the feeding tubes, with his head up and able to take in “thick liquids.” His memory began to come back at that point, and his recovery began. Initially, sitting up was hard, but soon he stood, and eventually paced the halls with a walker. “Matt was very motivated. He did all of his exercises, and whenever people came to visit he made them take a lap around the nurses’ station with him. He recovered much more quickly than anybody imagined,” Alex said. “I was literally given a new life, and my body and mind quickly accepted and appreciated the great new opportunities,” Matt said. The Moshens finally left the hospital just before Christmas.

Today, Matt wears a special watch with six alarms reminding him exactly when to take the 50 to 60 pills required to regulate his immune system, protect him from infection, and provide nutrients. Though he walks on his treadmill and goes out to dinner with Alex, he has to wear a surgical mask in enclosed public spaces, such as subways and movie theaters, which garners annoying stares but protects Matt from potentially life-threatening infections. Matt takes his temperature and blood pressure every morning, and goes in for periodic biopsies to check heart pressures. His doctors introduce him to other transplant patients, to give them hope. While Matt is not ready to return to work yet, he hopes to return to KPMG Consulting as soon as possible.

In April, Matt began riding his bicycle again and hitting tennis balls with Alex at the West Side Tennis Club. Months later, he’s ridden all around Queens, Manhattan, and Brooklyn, and regularly plays some relaxed doubles matches. Next summer, Matt plans to play tennis in the U.S. Transplant Games, to be held in Atlanta.

Though the Moshens don’t know any further details about the man whose heart now resides inside a healthy Matt, they were able to send his family a letter of thanks through an organ donation counselor. “It’s so appreciated. When people donate their family members’ organs, they save lives,” Alex said. “It’s the most generous thing one can do.”

Unfortunately, not all families are as generous. Why? According to the Coalition on Donation, it mainly stems from misinformation about organ donation. Though most Americans do favor donation, one’s next of kin must consent to the donation. And since most cases in which organs are transplantable are tragic, unexpected deaths (rather than those caused by long illnesses that usually damage organs), family members are oftentimes unable to clearly make such a difficult decision in the face of incredible shock and anguish.

Both Matt and Alex urge people to speak with their loved ones about their own wishes regarding organ donation. “All of the things that were his biggest problems — the LVAD, which saved his life but also endangered it, the high fever, the strokes — could have been avoided if Matt had gotten a heart when he first needed one,” Alex said. “Thousands needlessly die every year, waiting.”

Matt, though, is among the lucky few. “My recovery has been fantastic, and according to my doctors there’s no reason to think that I won’t live a perfectly long and healthy life,” he said. “I will keep myself as fit as possible, continue to take my medications, make regular appointments with my cardiologists, and keep a positive attitude. Alex and I deal with my condition as a transplant recipient every day, either with worry about infections, where we are allowed to travel, or when we can have children, but we know we have been given a new opportunity to live fulfilling, fruitful lives, and we won’t squander it.”

For more information on organ donation, visit: