Deep in the Sweet Melancholy

In the movie Elizabethtown, the character Drew Baylor stands in his aunt’s kitchen with a group of new-to-him relatives following his father’s viewing. While visiting estranged family in Kentucky, Drew’s father had passed away from a heart attack and Drew was sent by his mother and sister from Oregon to take care of the funeral and bring his father’s remains home. Chaos ensues. In this particular scene, the night is warm, the light is low, they’re obviously tired both physically and emotionally, yet they’re smiling as they revel in a sweet melancholy that often follows traumatic life events. 

I love this scene. It calls to mind a difficult-to-describe sentimentality that you have to experience to understand. It is this almost peaceful longing, a reverent recall of difficult times. As if the slow let down  that happens following the adrenaline rush and fear, provides its own serotonin release, cementing a beautiful nostalgia all its own.

This is what my family experienced in the month following my heart transplant.

As you recall, my miracle phone call happened on December 14th 2023, with surgery taking place in the wee hours of the morning of December 15th–just in time for the holidays. I had a record recovery and left the hospital eight days after surgery—it would have been seven but I begged for one more day to learn how to manage my medications and get a hold on my blood sugars. Nevertheless, I was released from the hospital on December 23rd—just in time to celebrate Christmas with my family.

Coming home from the hospital felt a lot like bringing home a newborn infant. For me it meant a whole new way of life. While I had gone through a lot of training on medications and things to watch for, I felt unprepared and scared. My body did not feel like my own. I was weak and sore and dependent on everyone around me—something I wasn’t used to. Even showering was a new experience with procedures and regimens that needed following and for which I needed assistance. It was bewildering. 

As I was so fresh from transplant, I basically had no immune system. My transplant team asked us to keep visitors to a minimum. We decided to basically act like it was the 2020 pandemic again and go on lockdown. Our married daughter came back home with her husband, our college-age sons moved back in (it was winter break anyway), and we hunkered down. Even though surgery had gone well and my recovery was, for all intents and purposes, on track, we were still taking things day by day. 

We fell into a rhythm of sorts: wake up, take medicine, check all my vital signs, make our way to the family room, take medicine, eat cheese (seriously, we ate six pounds of cheese), take medicine, assemble legos, take medicine, share a meal, take medicine, make the strenuous journey up the stairs to my room and take all of my vitals again, take medicine, make our way to bed for a restless night of worry and night sweats (oh, the joyous transplant medication side effects).

There were the inevitable excursions out to the lab, the pharmacy, or to the hospital for right heart caths and biopsies. I hated those times. Those days were long for me. I could barely walk across a room, let alone last an entire day navigating the halls of the University of Utah hospital. I was expected to arrive, fasting, at the hospital usually before 7:45 a.m. for my then weekly biopsies to check the progress of my heart’s healing and monitor any signs of rejection, and we wouldn’t arrive back home before 5:00 p.m. Thankfully, neighbors and friends often provided dinner for our little tribe on those harrowing days. 

For me, just the like the early weeks of motherhood, the days were simple but hard.

The holidays came and went and we existed in our own little bubble. 

No Christmas Eve parties. No family Christmas dinners. No Sunday services. No New Year’s Eve party. Just the seven of us gathered around the six-pound block of Muenster and the Titanic lego set.

The thing is, however, when we each think back on that Christmas and holiday season we each remember it with this deep, sweet nostalgia for the melancholy of that time. And though this is just my retelling of that season, we talk about it in a similar way. While we’re all grateful to have moved on and healed from that winter of 2023-24 we all express a longing, if you will, for those simple-but-hard days.

There can be a pulling together, a unifying in times like these. Where difficult events often force change—change in our lives and changes in ourselves—nostalgia pulls us back together. Whether it arises through grief brought on by loss or through the emotional release that takes place following periods of great stress, this sense of exhausted tranquility helps us process intense feelings into something–well, transcendent.

Call it a coping mechanism, call it delusion—call it what you will—but I call this experience a blessing for enduring well the hardships life throws our way.

I can recall one other time when I felt deep in this sweet melancholy before. It was after the passing of my brother. At the end of a long, emotional day of funeral planning we had gathered in the office of his home to go through some papers and photos. It was a warm summer night, not unlike that scene from Elizabethtown. We ended up crying and laughing, laughing and crying into the night, remembering better, easier, more innocent times. Recalling times when laughter came without tears, when memories were either good or bad, when we were uninformed on the nuances and complexities of adult relationships, and we simply would not have been able to fathom a world where joy and sorrow could exist side by side, and the understanding that we are all better for it. 

A world before we knew the longing for simple-but-hard times—and the joy of a six-pound block of cheese.

But I Didn’t Like My Face

I’m no Pollyanna, but I wouldn’t consider myself a pessimist either. In any situation, given time to think, I feel I have the ability to see both the good and the bad. When I was listed for transplant, Aaron gave me this cute little trinket—a cloud-shaped tchotchke engraved with the words Always find the silver lining. And that has become a mantra of sorts.

I decided early on that I was going to use the opportunity of receiving a heart transplant as a chance to improve myself—to truly have a change of heart. I often fantasized about waking up from surgery, or at least coming through recovery, with this grand new perspective that granted me wisdom, patience, kindness, and the ability to find a well of joy in life that was so often more difficult to find before. Receiving this second chance at life, this priceless gift, would make me a better person. And I tried—I really tried.

But it’s an uphill battle.

I had been warned about the nasty-but-necessary steroid prednisone. The one that makes you angry, tearful, sleepless, hungry, jittery, giggly, ravenous, and basically causes you to climb the walls. And for me, it did all of those things. I hallucinated (ask my family about the jelly-headed aliens and the Christmas light parade); I stayed up all night writing and rehearsing my TED Talks—plural; I broke down in tears in front of the poor cafeteria worker when I was reminded the quesadilla didn’t work with my dietary restrictions, just to name a few of my adventures on prednisone.

And then, one month post-transplant, I had my first rejection episode—a condition where the immune system attacks the transplanted organ. I was called back to the hospital for an extra blast of IV Solu-Medrol, an intense steroid. After a three-day stay, I left the hospital and waited for the inevitable… moon face.

I would place a picture here, but I don’t want to. Just Google an image of Alec Baldwin.

I tried everything to take the swelling down: gua sha, red-light therapy, lymphatic drainage, depuffing masks—you name it, I’ve dropped dimes on it. To no avail.

I was so sad at what my life looked like, I cried, “I am a monster!” Aaron hugged me and assured me, just like everyone else had, that it would go away soon.

It took about a year for the swelling in my face to go down—at least in my opinion. It took just long enough for me to have a recurrence of thyroid cancer that required surgery, which threw me back into rejection—again. Another blast of steroids, this time outpatient, led to another, albeit slighter, moon-face period.

You don’t even have to wonder—I’ll save you the energy and volunteer that I am, indeed, vain. I’ll admit it. I like to look nice. The first thing I do in the morning is put on makeup. Well, actually, I brush my teeth first, but makeup comes before I leave my room. Even so, I tried finding the silver lining: “Look how the prednisone puffiness has almost erased my fine lines and wrinkles. Maybe I’ve found the fountain of youth!”

Aaron would say, “You’re still beautiful to me, and you don’t look anything like Alec Baldwin.”

Friends kindly told me they didn’t even see a difference. Yeah, right.

And, of course, I heard the inevitable: “It could always be worse.”

Never—I repeat, NEVER—say these words to anyone, especially a transplant patient.

It got worse.

In June, I bit my lip. Who hasn’t? It seemed innocuous at first. But over the passing days, that bite turned into a canker. I’m no stranger to cankers—especially since transplant and being put on the immunosuppressant sirolimus. I didn’t think much of it and just steered clear of the right side of my mouth while eating for a while. But things got worse—in a big way.

Two weeks later, we flew to Ohio to help our daughter move from Cleveland back home to Utah. She met us at a hotel with her car loaded with boxes, and we began driving across the country. My canker hurt, and I was mainly eating soft foods and shakes to avoid injuring it more. Nevertheless, while stopped for the night in Nebraska, I woke up in excruciating pain. I went into the bathroom of our hotel room to inspect my lip. It was so swollen I thought the skin might actually split. The canker itself was about the size of a corn kernel, but the lip was hugely swollen, and I began to worry.

Here I was, literally in the middle of nowhere Nebraska, far from a hospital, a full day’s travel from my transplant team, and I didn’t know if I had some kind of rare, raging infection or what. I kept ice on it the next day as we made our way home, where I got myself to Urgent Care as quickly as I could.

Over the next few days, I went back and forth to Urgent Care and back and forth on the phone with my transplant team, trying to figure out what was going on with this mouth ulcer—until I found myself in the hospital with the world’s worst canker sore, which I had begun calling Lippy. It was so big it deserved a name.

Again, I would place a picture here, but I don’t want to. It makes me sad. But you can find it on my Instagram. Just imagine a gnarly mouth sore about the size of a large gumball, with swelling into the cheek.

I was in and out of the hospital over the course of two weeks as Lippy got worse and worse. I couldn’t eat due to the intense pain it caused—anything I consumed had to go through a straw. I couldn’t talk, and I frequently drooled. At the same time, I was struggling with terrible migraines. And every professional and specialist at the University of Utah looked at me with pity and said, “I have no idea what this is, but it sure looks bad.”

These are words nobody should ever hear.

I was tested for a myriad of infectious diseases, parasites, amoebas, autoimmune diseases, even multiple forms of cancer. I gave blood samples, stool samples, tissue samples and biopsies, and had a CT scan. But in the end, the doctors were split: it was either a bad reaction to sirolimus or a reactivation of Epstein-Barr virus. Either way, the treatment was time to heal and—yes, you guessed it—more steroids.

I was struggling.

My heart transplant had been nothing short of a miracle—I was truly grateful. And in the grand scheme of things, I’d been blessed with a fairly easy time and few setbacks with regard to transplant. Others really did have it worse. I knew this to be true.

But I didn’t like my face.

And I hated myself for it. I wanted to like myself, inside and out. I wanted to be 100 percent happy and grateful all the time post-transplant. But here I was, regretting everything. If life post-transplant meant constantly worrying about cancer, infections, rejection, and hating what I looked like, maybe I’d made the wrong choice when I accepted this heart. Ouch—that hurts to admit.

At the end of the day, the only choice I had was to sit it out and wait. Wait for Lippy to heal and for, eventually—hopefully—the swelling in my face to go away. And after two months, Lippy did pretty much go away, except for the scar tissue left behind. The puffy face, well, that may just be my new normal, at least in part.

I think it’s fair to say that two contrasting things can be true at the same time. I am finding that I can be grateful for my transplant and also be upset about some of the hardships it brings to my life. I can find joy in celebrating life’s milestones I get to witness—like my son’s wedding and the birth of my first grandchild—and still bemoan the chronic condition I now live with. I can be grateful for life and still not love my puffy face.

What I’m learning is that change is a choice that comes only by consistently showing up with gratitude. That new perspective and change of heart I hoped for with my transplant is up to me—and that it’s also perfectly acceptable to see the clouds along with the silver lining.

In Good Hands

Sit with me for a minute, will you, and let me tell you about a dream I had that wasn’t really just a dream at all.

First, a little backstory. We were driving through Salt Lake City when Aaron’s phone rang. It was a friend from work who had a connection to a PA working with an electrophysiologist—a cardiologist who specializes in heart rhythm disorders—who could fit me in for an appointment quickly. Desperate, we accepted the next available opening.

Unbeknownst to us, we had agreed to see the very doctor who had treated me 25 years earlier. I hadn’t liked him then—let’s just say his bedside manner was lacking—and sadly, we did not like him now either. Nevertheless, within a month, he diagnosed me with ARVC, placed an ICD, and referred me to an interventional cardiologist for follow-up care. Over the next two months, Aaron and I both had misgivings; we woke up in the middle of the night feeling I needed a change of providers.

At that time, I was receiving care at IMC in Murray, Utah. Our insurance covered most services, but some things required referrals elsewhere—a frustrating hassle. There were other issues, too: a hospital admission where my doctors could not be reached, test results that never came, and a general sense of lack of urgency regarding my care. Eventually, we made the switch to the University of Utah—a decision that pleased our insurance but left us uncertain.

That’s when I had the dream.

I was in an empty banquet hall with windows overlooking the city. It was just my family and me when in walked Russell M. Nelson, then president of the LDS Church and a former renowned heart surgeon and researcher, and his wife. He sat next to me on a padded window seat, placed his hand on my knee, and said, “We are aware of what’s going on, and you are in good hands.”

That was it. That was the entirety of the dream. Yet I woke feeling warmly comforted.

Fast forward a few months and several traumatic events, and I found myself waiting for a heart transplant. At the University of Utah, three surgeons performed heart transplants, and the surgeon on the day of surgery was the “luck of the draw.” Patients are encouraged to consult with one or more surgeons while waiting. I met Dr. Selzman during a particularly grueling two-week admission following a VT storm—an episode of uncontrolled ventricular tachycardia. I was informed I would be listed for a transplant and then bombarded with the pre-listing battery of tests. I met countless specialists, residents, med students, fellows, technicians, social workers, and nurses—their faces blurred together, and Dr. Selzman’s was just another among many.

I met another surgeon, Dr. Goodwin, during the following 18 months of my waiting. He was friendly, quiet, confident, and passionate about his work. Aaron and I felt reassured that we were in good hands.

Then, on December 14, 2023, the call finally came: “Fiauna, we have a heart for you. Are you ready?”

Nothing can prepare you for that call. No matter how many times you rehearse it in your head, checklists you’ve crossed off, bags packed, or prayers said, when it comes, you are struck speechless. We made phone calls, gathered our family, had a small Christmas gift exchange—because we had no idea what life might look like on the other side of this day—and headed to the hospital.

During pre-op, scheduled in the early hours of December 15, the staff repeatedly told us how lucky we were because Dr. Selzman was on call. Their words barely registered. I felt dizzy, nauseous, and weak. Anxiety consumed me. Soon, a surgeon I had barely met would cut into my chest and remove my most vital organ. And if things didn’t go well…

I was acutely aware that somewhere, for some family, this was the worst night of their lives.

As the anesthesia team inserted an arterial line into my arm, my blood pressure plummeted. I felt myself losing consciousness and prayed silently: “Heavenly Father, please hold me.”

I have no recollection of what happened next, but Aaron says Dr. Selzman walked in calmly, said, “Oh, I know how to fix this,” and wheeled me to the operating room.

Later, after recovery, while walking the cardiology unit, I saw a plaque on the wall bearing a picture of President Russell M. Nelson embracing Dr. Craig H. Selzman.

Remember my dream, where President Russell M. Nelson told me I was in good hands? Had it been just a dream, or did President Nelson somehow know I truly would be?

In 2018—five years before my transplant—the University of Utah created the Dr. Russell M. Nelson and Dantzel W. Nelson Presidential Chair in Cardiothoracic Surgery, a professorship awarded to Dr. Selzman. Five years later, President Nelson donated his professional journals to the University. In a meeting with dignitaries from around the world, Dr. Selzman shared what he had learned from President Nelson. Then, in the October 2025 General Conference of the Church of Jesus Christ of Latter-day Saints, Elder Dale G. Renlund, also a retired heart surgeon, shared a story about Dr. Selzman:

“Dr. Selzman recounted that, four days before being appointed to the professorship, after a long day in the OR, he learned that a patient needed to return to surgery. Fatigued and disappointed, he resolved to act differently. President Nelson had been known for his composure, respect, and patience, and Dr. Selzman determined that his actions in the operating room would emulate those qualities. Though already considerate, he chose to be even better, mindful of the impact on his team.”

Almost two years have passed since my transplant, and over a year and a half since my last follow-up with Dr. Selzman. There is a strange intimacy in trusting someone with your life, someone who has held your heart in their hands. Yet, the day-to-day of a surgeon’s life moves on, leaving behind a subtle emptiness for the patient.

Healthcare often makes us feel like a number, not a human being, and our stories can feel invisible. This is not uncommon. I know firsthand the long hours, low wages, and lack of support in the healthcare profession. But feeling unseen can make self-advocacy difficult, and self-advocacy is vital to good outcomes. Feeling safe and valued matters.

Elder Renlund’s talk illuminated this for me. Before surgery, I had understood the professional significance of Dr. Selzman’s award. That was meaningful. But learning about the character lessons he drew from President Nelson—composure, respect, patience—transformed everything. I felt seen, I felt safe.

I realized then that my dream had not been solely about easing anxiety or reassuring me about my choice of surgeon. It was a whisper of love from a Father in Heaven who knows all things and prepares a way. From the start, I had been held in the very best of hands.

His hand is in all things. If you can’t see it, look for it. What you seek, you will find.

And that is the story of a dream that wasn’t just a dream after all.

Jars of Hearts and Fishing Line

Another day, another five-mile walk in the autumn sun. I’ve said it before, and I’ll say it again: what a privilege.

There was a time I would have taken that for granted—not just the walking, but the friendship and camaraderie that comes from spending miles in conversation with friends.

What seems like a lifetime ago, I was a runner. Running was solitary for me, exactly how I liked it. It gave me space for my thoughts. Pounding my burdens into the pavement became my therapy.

I began walking with friends after buying my first home and having a few kids. That’s when I discovered the joy of female companionship, and I learned that doing something hard together—especially something physically demanding like exercise—can strengthen relationships in ways words alone cannot.

But life grew noisy. The demands of motherhood and the endless “more important” tasks slowly edged out those near-daily walks with friends.

In 2012, I suffered a traumatizing miscarriage and fell into depression. Aaron gently suggested I find a hobby to help me recover. I decided to certify in group fitness and began teaching a Pilates-and-yoga-fusion class I called Mix Method. Later, I added High Fitness to reach a broader audience and bring a little cardio fun into the mix.

Putting myself out there wasn’t easy at first, but week by week, my class attendance grew. I had my regular ladies who came faithfully, and others who popped in when life allowed. We spent years sweating side by side, learning from one another, laughing, struggling, and celebrating our progress. I called them my friends, and I hoped they felt the same. Doing something difficult—especially something physical—has a way of bonding people.

But it all ended.

That cursed day in October 2021, my heart could take no more. With my ARVC diagnosis, it was no longer safe to teach fitness classes. I was a literal ticking time bomb. Teaching had been my social life, my way of connecting. Without it, I felt like I had no value outside providing classes.

At one point, I had to write an email to High Fitness to cancel my membership and close my instructor portal. I would never teach aerobics safely again; my heart was broken. I explained my situation—that I needed a heart transplant—and their response was, “That must be scary for you. Have fun in your next adventure!”

I wasn’t sure what response I had expected, but it certainly wasn’t that. I felt dropped like a wet brick by a community I thought I could rely on.

There have been times in the last four years when I felt deeply alone. That feeling is common for people who have gone through something as traumatic as a heart transplant—there are few who can relate, and some distance themselves out of discomfort or fear. I also noticed that my conversations often circled back to my health, which can be boring or isolating for others.

Almost exactly two years ago, I sat in my car, tucked inside the garage, feeling utterly destitute. My health was failing, and I knew my days of driving were coming to an end. That morning, while taking my daughter to school during a dizzy spell, I had driven directly into the path of a dump truck, narrowly avoiding disaster with the next turn. I had to admit: I was no longer safe behind the wheel. By that time, I had been waiting for a heart for more than a year. I realized that in order to get better, things were going to have to get so much worse. I needed a miracle. I cried. I prayed. I cried and prayed again.

And I felt so alone.

I asked God to send me someone, anyone, to help me—someone to ease my burden, to distract me from the crushing loneliness. The answer was clear: no.

Surprised? I was. It seemed like such a simple request. I wasn’t asking for an earth-shaking miracle. I wasn’t asking for the heart I needed. I was asking for someone to reach out and ease my loneliness.

The answer was no because I had lessons to learn—one of which was to notice and appreciate the ways people were already showing up, even in small ways.

This is one reason I collect heart-shaped rocks.

On my kitchen counter sits a jar of heart rocks. Most are collected from nature—small gifts from a loving Father in Heaven, reminders to see miracles every day. Some are gifts from people in my life, accompanied by notes that say, “I saw this rock and thought of you.”

My son, Aiden, served a mission in Ghana. Fishing is a big part of life there in Cape Coast. Fishermen take large nets from the beach and cast them into the ocean. At the end of the day, they pull the nets ashore to see what they’ve caught. The nets are huge, and they cannot be hauled in by one man alone—so others step in to help.

One day, Aiden and his companion came across such a scene. They began to help pull for an hour before two of the fishermen began arguing. To Aiden’s surprise, everyone else dropped the line and walked away. No fish were hauled in that day.

In life, we all have our own lines we’re pulling, our own responsibilities and messy challenges. At the same time, we are called to show up for others. We don’t have to haul in the nets alone.

Recognizing how people show up—big or small—makes a difference. A sincere, “How can I pray for you?” or “You’re in my prayers” goes a long way. Faith-filled prayer, followed by acting on promptings, is one of the most charitable things we can do. After all, in the final hours before His death, that is exactly what Christ did for all of us.

I am blessed to see these acts in my life: God’s angels taking up my line, helping me haul in my nets. Offering a prayer, silent or spoken. Noticing a heart-shaped rock, cloud, or even a Pringles chip. Sending a morning text: “Walk at 9?”—and then filling the miles with our words and laughter.

What a privilege.

Witness Marks

My husband loves old clocks. I’ll admit, it sounds romantic—but when he brought his first antique clock home, I was a little perplexed. The thing was beautiful: a mantel clock made of ebony hardwood, engraved with delicate filigree. Built around 1910, it required care in the form of weekly winding. He was instructed to turn two keys—one clockwise, the other counterclockwise. If he kept to a disciplined schedule, the clock kept remarkably good time and chimed faithfully on the hour. If he forgot to wind it, well… she sat uselessly on the piano where she was meant to mark the passage of time.

Aaron is disciplined, and he wound the clock regularly. On the rare occasions he forgot and the clock fell behind, he would patiently work the keys and gently move the hands back to where they belonged. One Sunday evening, Aaron went to wind the clock only to discover it was broken. The hands no longer responded to the turning of the keys. When we removed the back and exposed the inner workings, we found the problem: the coiled mainspring—an essential piece—had fractured. We had no idea how to fix it or where to find someone who could. Aaron was devastated. He was so proud of that clock and of the care he had taken to keep it running, and his disappointment made me deeply sad.

Eventually—by what means or after how long, I don’t know—Aaron found a repairman. The shop was tucked into a small, rust-colored brick building on a crowded corner of Main Street in Holiday, Utah. Inside, the space was filled with clocks of every kind: towering grandfather clocks, noisy cuckoo clocks, delicate pendulum clocks under fragile glass domes, and even a few whimsical Felix-the-Cat clocks with their tails swinging back and forth to keep time.

The clerk took our beautiful-but-broken mantel clock and warned us that repairs could take up to a year. “You have to understand,” she said, “we don’t have an owner’s manual for clocks this old. The clock will need to be completely taken apart and examined before we can even know what repairs it needs.”

Then she added, “And sometimes, we simply can’t find the parts. When that happens, the only option is to rebuild.”

In the art of clock repair, when instructions don’t exist, repairmen rely on what are called witness marks—tiny clues like faint scratches, screw holes, tool marks, or even missing pieces. Sometimes these marks are intentional, left by builders or previous repairmen. Other times they’re the result of damage. But to a trained eye, they tell a story. They guide the repair.

Through heart transplant surgery and thyroid cancer, surgeons have left plenty of visible witness marks on and within my body. Fifty years of living have left even more on my soul. I’ve been brought, many times, to what I believed were my breaking points. Life is full of them.

I don’t believe God gives us trials. I believe life is inherently hard—sometimes brutal, and for some, unspeakable. But I do believe that these hard, brutal, and unspeakable things can be used for good. They can become blessings.

In a recent conference talk by President Henry B. Eyring titled “Proved and Strengthened in Christ,” I was drawn to Philippians 4:13. Most of us know it by heart: “I can do all things through Christ who strengthens me.” What a beautiful promise.

But when I returned to the King James Version, I noticed something subtle yet profound:
“I can do all things through Christ which strengtheneth me.”

Which—not who.

That distinction matters.

I can’t count how many times I’ve felt so low, so devastated, that in the darkness I’ve wondered: Where is He now? If Christ is the one who strengthens me, why does He feel absent when I need Him most?

It is in those moments—when we feel alone—that we are given a choice: to turn away from Christ, or to turn toward Him. And in the act of turning, in the choice to believe, we find strength.

It is in the doing that faith is strengthened. It is believing still—choosing Christ again—that fortifies us. He is with us, always, inviting us: “Take my yoke upon you, for my yoke is easy and my burden is light.”

This is the great initiation. This is the school where we learn to consecrate what feels entirely unholy into something redemptive. In trial—when we are stripped bare, opened up, and taken apart—we can be strengthened. Our grief can be met with love and wisdom.

And when Christ has healed us, like a master clock repairman, He will have left His witness mark.

The Five Mile Trail

Today I walked five miles.

The sun was shining, and the air held that perfect autumn-day crispness. We had the trail mostly to ourselves—Christine, Millie, and me—and we talked freely, filling the miles with whatever drifted into our minds.

Five miles. What a privilege.

At one point, we passed a neighborhood friend, Megan. She commented on how fast we were—and we were, moving along at a pace of fifteen or sixteen minutes per mile. Without missing a beat, Millie and Christine both said, “Well, Fiauna has a new, young heart. It wants to go fast!”

I have a 21-year-old heart.

That’s a fact that still brings me to tears. My donor was only nineteen years old when her life ended and her heart was donated to extend mine.

After my transplant, while I was still in the hospital, the social worker came to my room during a rare moment of privacy and asked if I wanted to know what little information she was allowed to share about my donor. Surprisingly, I had to think about it.

Did I really want to know?

It seems like such an obvious question, but after everything I had been through, I had to ask myself how much I truly wanted to carry. That information felt sacred somehow. Holding any knowledge at all felt like a responsibility I wasn’t sure I was capable of bearing. It’s hard to explain exactly why. There are good things and hard things that come with knowing. We are all just human, after all, and sometimes the magic you hope and pray for can also break your heart.

While I was waiting for transplant, I heard all the anecdotes about organ transplants and personality changes—believe me. My father-in-law shared, more than once, a story about a man in his church who received a heart from a thirteen-year-old girl and went on to develop her personality traits, right down to an uncontrollable case of the giggles. While I understood there were logical explanations—medications, trauma, the body adjusting—it still colored how I felt in that moment when I was given the chance to learn about my donor.

When the social worker told me my donor was female and between the ages of eighteen and twenty-four, I couldn’t stop the immediate cascade—no, the deluge—of tears. My own children were that same age.

Who was I to take a heart? To take life, opportunity, learning, and growth from someone so young?

I still haven’t found an answer.

Nine months after my transplant, I wrote a letter and sent it to my social worker, hoping it would eventually reach my donor’s family. I didn’t need a response; I simply wanted to say thank you. It felt like the right thing to do.

Then, the following February—ironically, on the very day I learned my thyroid cancer had returned—I received a letter in return. It was from my donor’s mother.

My donor was Ella.

She was a medical assistant and a nursing student. A dancer. A lover of music. She and her mother were very close. Precious.

There’s something that happens when someone comes close to dying—or, in my case, receives a heart transplant. You feel a responsibility to live an extraordinary life, to somehow make the second chance, the gift of an organ, worth it. I’ve wrestled with this more than I care to admit.

I don’t want to go back to college and complete a nursing degree in her honor. I don’t feel healthy enough to run a marathon or climb a famous fourteen-thousand-foot peak. Maybe someday I’ll create a charitable trust or do something meaningful in the realm of organ donation.

But for now—for today—I will walk five miles.

I will breathe in the crisp autumn air and feel the steady rhythm of this 21-year-old heart. And that will be enough.

Mountains to Climb

If I’m being completely honest, I didn’t always like the person I became while I was waiting for a transplant.

In my defense, being told you need a heart transplant is a big deal. It’s not something you can immediately absorb or cope with. I needed every minute of my 18-month wait to begin adjusting. And even then—even now—it’s still a hard thing to wrap my mind around.

In April of 2022, I was sitting in church, pondering the words I was hearing. I don’t know whether it was spoken over the pulpit or whispered by the Spirit, but I distinctly heard this instruction: Ask the Lord what you need to strengthen, and He will tell you.

So that’s exactly what I did. As I sat in sacrament meeting that day, I prayed to know what I could work on—what I needed to improve.

The answer came clearly: patience and long-suffering.

A few short weeks later, those words would become something of a mantra—though often they felt more like a chastisement—as the transplant process truly began.

The transplant team, while hopeful and supportive of organ transplantation, was very clear about one thing: transplant is not a cure. It is, instead, a trade—one disease for another. At the time, I remember thinking, Well, it’s the only chance I’ve got, so let’s get on with it. I caught the enthusiasm quickly and felt anxious to move forward.

But nothing about this process was easy.

The wait ended up being far longer—and far harder—than I had hoped.

Though I thought of myself as a patient person, this trial taught me that the Lord truly knows us better than we know ourselves. Patience was something I deeply needed to develop. And as month after month passed, I felt myself becoming less patient and more self-pitying.

In December of 2022, while casually fixing my hair in the bathroom mirror, I noticed a new lump in my neck. I immediately suspected it was my thyroid. I took a picture and sent it to my sister, asking if she could see it or if I was being overly vigilant. She confirmed that she could definitely see the lump.

I didn’t waste any time trying to schedule an appointment with my primary care doctor—but she couldn’t see me until the end of January. Feeling that this was more urgent, I scheduled with another physician who had availability in early January. Even so, I still waited nearly a month to be seen.

To my dismay, that doctor dismissed my concern almost immediately. He didn’t perform a manual exam—he simply looked and said the lump was small. I explained that one of my medications was known to be toxic to the thyroid.

“Why would you say that?” he responded. “Surely if it were toxic, you wouldn’t be on it.”

I explained that both the prescribing physician and the pharmacist had warned me of its thyroid toxicity and advised frequent monitoring. In the end, I had to ask for labs and a thyroid ultrasound. I never returned to that doctor again.

In early February, I finally had the ultrasound. While my lab results were normal, the ultrasound was not. It revealed three nodules—one of which had concerning features and was classified as TIRADS 5, meaning highly suggestive of malignancy.

That same doctor emailed me the results and suggested I follow up in a year.

Do nothing and follow up in a year? Absolutely not.

When the transplant team learned of the findings, they expedited a referral to endocrinology. In March, I went to the Huntsman Cancer Institute to meet with a specialist. He explained that thyroid cancer is often slow-growing and highly treatable, and that the suspicious nodule was still small. He gave me the option to biopsy it—or not.

I explained that because I was on the transplant list, no transplant would happen if there was even a possibility of active cancer. We needed answers—and we needed them quickly.

Right there in the office, he performed a fine-needle aspiration. Under ultrasound guidance, he inserted a long needle through my neck and into the thyroid nodule, collecting several samples for pathology. All I received for pain was a shot of lidocaine.

Little did I know, this was something I would need to get used to as a heart transplant patient.

A week later, the doctor himself called me.

“I’m so sorry to have to tell you this,” he said, “but it is cancer.”

My transplant listing was immediately put on hold until the cancer could be successfully treated.

I cried—not because I was afraid of dying or even of cancer. Thyroid cancer, after all, is often referred to as “the good kind” because of its low mortality rate. I cried because I was exhausted. Because I was angry. Because this felt like one more blow on top of everything else.

I spiraled into the familiar Why me?

From where I stood, everyone else seemed to be living life on easy mode—vacations, goals, progress. Meanwhile, I was waiting for a heart transplant… and now dealing with cancer.

How was that fair?

And then I was reminded of the words in Ether 2:24:

“For behold, ye shall be as a whale in the midst of the sea; for the mountain waves shall dash upon you. Nevertheless, I will bring you up again out of the depths of the sea…”

Here was another opportunity for God to strengthen me. Another chance for Him to deliver me. Another moment to choose faith in the Savior.

I would get through this. I would climb this mountain too.

After all, you never shout for joy from the peak of a mountain you did not have to climb.

What Happened In June

Over the next several weeks, I returned to the emergency department multiple times, each visit marked by being stuck in a slow ventricular tachycardia rhythm. Each time, the team adjusted my ICD/pacemaker settings to pace me out of the arrhythmia—lowering the threshold again and again—until it finally settled at 111 beats per minute. That meant any heart rate above 111 bpm would trigger therapeutic pacing.

As a result, my activity had to be extremely limited until the issue could be resolved—either through healing, additional ablations, or transplant.

On June 14, 2022, we had completed all of the pre-transplant evaluation testing and received insurance approval. The only thing left was officially being listed. I messaged Sarah, my transplant coordinator at the time, asking if there was any update. Within hours, she called to tell me I was officially listed for transplant.

It was a surreal moment. At first, I felt a flicker of excitement—we were one step closer to closing this chapter, I thought. But that feeling was quickly eclipsed by fear. How does one prepare for something like a heart transplant? Death is woven into the equation—the death of the donor, and the possibility of one’s own.

We decided to put it out of our minds for the day and drove down to Utah County to enjoy the Utah Valley Parade of Homes. But before we even made it into our first house, my phone rang again. It was Sarah.

“Fiauna, are you ready to come into the hospital? We can have a room ready for you by the end of the day.”

I wasn’t expecting that call—not at all—and I wasn’t sure what it meant or how to respond. I didn’t want to go back into the hospital, especially not for an indeterminate stay while waiting for a donor heart. And yet, if this was part of the process, I didn’t want to risk missing my perfect match. I told her yes and listened as she explained the next steps. I had a few hours to prepare while they readied a room. Once it was available, admitting would call and tell me to come in.

We toured a few homes before heading back to pack and wait. I called some family members to let them know, expecting to feel something—excitement, urgency, clarity. Instead, something felt off. With every phone call, my confidence wavered. I began to second-guess everything.

Around 5:30 that evening, the call finally came. We finished dinner and quietly, nervously drove up to the hospital. I had a pit in my stomach the entire way. I couldn’t quite articulate it, but something felt deeply wrong.

What followed over the next five days was one of the most emotionally wrenching experiences of my life. I wish I could say something transformative happened during that stay, but it didn’t—at least not immediately. The lessons would take another eighteen months to fully surface and take shape.

That first night, Aaron and I sat in my hospital room—fully expecting to stay there until transplant—and called another transplant recipient, someone who had already walked this road and could offer advice. She was kind, generous, and informative. Still, when the call ended, I felt even less certain. Maybe I didn’t need a transplant. Maybe the doctors were wrong. I went to sleep confused and deeply conflicted.

The next morning, a group from the heart failure and electrophysiology teams came into my room and asked me bluntly, “Why are you here?”

I was stunned. What did they mean? I had been told to come—by them.

I was then informed that there was no chance I would receive a transplant at that point. The electrophysiology team suggested trying different medications before moving forward with transplant. Then they left the room without a clear plan, leaving me to question everything.

Later that day, while Aaron stepped out to get some work done, the discharge planner came in and asked—again—why I was there and when I hoped to go home.

“I’m here for a heart transplant,” I said, increasingly confused. “I didn’t expect to go home until after that.”

She responded, “I don’t even think we do heart transplants anymore—not since COVID. We don’t get many viable donor hearts, and the hospital across town has an entire floor full of people waiting.”

When she left, I fell apart.

Aaron returned to find me inconsolable—crying, angry, and ashamed. I couldn’t understand why this was happening. I had followed instructions. I had shown up when told. And yet I felt as though I’d done something wrong, though I had no idea what—or how to fix it. That night, the sun seemed to set on my spirit. I felt confused, betrayed, and unsure of whom to trust. Aaron and I prayed for peace and guidance.

The next morning, the doctors returned—this time separately. Dr. Shah from the heart failure team sat with us and explained clearly that the likelihood of transplant happening anytime soon was slim. He recommended that I go home as Status 6, acknowledging that transplant at that status is rare. We appreciated his honesty.

Later, the electrophysiology team presented a new medication option—one that might control the VT with fewer side effects. The drugs were high-risk, but the hope was that they could stabilize me long enough for a suitable heart to become available. Again, we appreciated the clarity. After careful consideration, we agreed to the plan.

I would remain hospitalized for the rest of the week so they could monitor me for dangerous side effects. If all went well, I would go home to wait for transplant as Status 6.

For the next three days, I stayed on telemetry and had an EKG every twelve hours. My heart tolerated the new medication regimen well. I wish I could say I felt better on it. I told the doctors that I did—partly because I was still wrestling with anger, regret, and an unexpected sense of shame—but physically, I didn’t feel much different.

What I did feel was peace.

This was the right course of action. I would wait at home with my family for the perfect heart to become available—no matter how long it took.

When the Path Became Clear

The journey toward a heart transplant began long before I realized what was happening.

I had started seeing a new heart failure specialist at the University of Utah, and he began ordering a series of specific tests. The first was an overnight pulse oximetry test. He explained that it would help determine whether my fatigue was caused by heart failure or possibly sleep apnea. I later learned that this test is just one of many routinely used in a transplant evaluation.

At one of my appointments, Aaron asked the doctor how often people with ARVC eventually need a heart transplant. I didn’t understand why he would even ask such a question. I wasn’t going to need a heart transplant—certainly not. I was relatively young. I was otherwise healthy. Right?

The doctor explained that the determining factor would be whether my arrhythmias could be controlled. If they couldn’t, transplant would become the necessary option. He then ordered a VO₂ max test and scheduled a follow-up appointment later that month.

Shortly after that follow-up, my heart “declared itself.”

I began experiencing difficult-to-control ventricular tachycardia. After one episode that lasted more than an hour, Aaron took me to the nearest emergency room. The ER physician quickly performed a cardioversion, but unlike the first time, my heart continued slipping back into VT. He called my doctor at the University of Utah, who requested I be transferred there for observation.

That night, I was transported by ambulance up to the U, where I would remain for 12 days—moving in and out of the ICU.

The next morning, I woke up in the cardiovascular medical unit. My doctor came into my room and said, “Remember when we talked about this in clinic? You’re having multiple episodes of VT. That means it’s time to talk about transplant.”

It was Saturday morning. He told me the earliest I might go home was the following Tuesday. But later that same morning, I went back into VT and had to be transferred to the ICU. There, the VT continued—coming and going despite being on multiple IV anti-arrhythmic medications.

That’s when I was told, plainly, that a heart transplant was the best option. With my consent, the team would use my inpatient stay to complete the full transplant evaluation. I would also undergo an epicardial ablation in hopes of locating and treating the source of the VT.

At my hospital—though I understand this can vary by transplant center—the transplant evaluation included:

  • Extensive blood work (more than 20 vials drawn in one sitting—torture)
  • Cardiac catheterization to evaluate coronary arteries, pressures, and overall heart health
  • Echocardiogram (ultrasound of the heart)
  • Stress echocardiogram
  • VO₂ max test
  • Chest X-ray
  • Pulmonary function testing
  • Abdominal ultrasound
  • Ankle-brachial index test to assess blood flow in the arms and legs
  • And one particularly strange test involving a large plastic bubble placed over my head to measure gas exchange while breathing

It was a whirlwind week in the ICU. Because the University of Utah is a teaching hospital, there was a constant stream of doctors, residents, fellows, nurses, student nurses, and pharmacists in and out of my room—a room with no bathroom.

There was no privacy. Every time I had to use the bedside commode, I found myself breaking down in tears. It was humiliating and overwhelming, and something I hope and pray I never have to experience again—though I know I will, post-transplant.

After eight days in the ICU, I was transferred back to the cardiovascular medical unit. The epicardial ablation was considered successful. The VT was controlled—at least for the moment. However, the procedure allowed my doctor to see just how severely scarred and damaged my right ventricle truly was. He told us that, given what he saw, heart transplant was the logical next step.

After a few more days in the CVMU—and twelve days total in the hospital—I was finally discharged.

But this was not the end.

I would be back.

The Months That Followed

Following news of my diagnosis, and after my first visit with a heart failure specialist, our next stop was back at the hospital to have an implantable cardioverter-defibrillator (ICD) placed. We returned to the same same-day surgery unit where I had undergone my ablation and, to our delight, were assigned the same nurse. Clo was absolutely wonderful, making sure we were comfortable and genuinely cared for.

That day, I received a single-lead ICD pacemaker and was sent home within hours, hoping and praying I would never need the device.

Two weeks later, I found myself back in the hospital with chest pain. I assumed it was my gallbladder, but testing revealed nothing. The pain was then presumed to be cardiac in nature, so I was admitted overnight for observation. A good dose of Toradol finally eased the pain, and I was discharged the next day without answers.

The only thing that incident clarified was that we needed new doctors. During my entire 24-hour hospital stay, neither of my cardiologists could be reached. A follow-up visit with my heart failure specialist confirmed that he hadn’t even been informed of my admission—despite Aaron having called his nurse to notify them. Shortly after, we received a referral to Dr. Bunch at the University of Utah.

Our first consultation with him took place over the phone. He had already reviewed my chart and immediately prescribed several medications—something my previous doctors had not done. From the start, we felt reassured that we were finally in capable hands.

Things went smoothly for a few months, until March 16. I was sitting at Keelie’s basketball game when I experienced a sudden wake-up call. I glanced at my watch and saw my heart rate was 152.

152?

I was just sitting on a bench watching the game. I wasn’t emotional or excited—and I didn’t feel anything unusual at all. Discreetly, I got up and went to the restroom to run an ECG on my watch. I recognized the tracing immediately: ventricular tachycardia.

I was shaken, scared, and confused. How was this happening? And why?

Once I got home, I sent a PDF of the tracing to Dr. Bunch’s office. A physician assistant called me back, advised me to increase my anti-arrhythmic medication (flecainide), and asked me to send a transmission from my ICD.

Normally, the ICD records VT episodes and automatically sends that data to the doctor’s office. I sent the transmission, but the PA told me she didn’t see any recorded events. While I was relieved I hadn’t received a shock that day, I was deeply confused. I knew I’d had several minutes of VT—and that is not insignificant.

They decided I should wear a heart monitor for 30 days.

I wore the monitor until mid-April, anxiously awaiting the results. But before my doctor could review the findings with me, my heart decided to escalate matters.

On April 29, after seven days of intermittent VT—culminating in an episode lasting several hours at a rate of 140–160 beats per minute—Aaron took me to the emergency room for cardioversion. What we thought would be a quick ER visit turned into a 12-day hospital stay, most of it spent in the ICU.