The young man handed her a stethoscope, opened his shirt, and pointed to where she should place it. Hesitantly, she reached forward, pressed it to his skin, and broke into tears.
The heart Elisabeth Tilly heard inside the chest of a 25-year-old stranger was the same that once beat inside her son. Christopher, age 8, was killed more than two decades ago, by a truck barreling through a crosswalk in front of his elementary school. But the memory of her grievously injured son lying in a Salt Lake City hospital is still raw.
A few doors down from Christopher, 4-year-old Jon Hochstein was fighting for his life. His heart had enlarged, damaged beyond repair, perhaps by a passing virus, or just bad luck. His family wasn’t sure he would make it through the night.
Tilly didn’t want to donate Christopher’s organs. He’d need them in heaven, she thought. But then she saw Hochstein’s tiny legs poking out from under the sheets.
She decided that this little boy needed Christopher’s heart more than he did.
Over the years, though both families thought about each other often, they never connected.
The Hochsteins soon moved to Northern Virginia, so Jon’s dad, David, could take a new job.
Tilly, divorced from Christopher’s father, quickly relocated to avoid the pain of seeing the places where her son had played ball and gone to school. She never knew whether the little boy who received her son’s heart had lived or died.
Jon Hochstein might very well have died — twice more, in fact.
Around second grade, he suddenly stopped gaining weight. A sports-crazy kid, he started tiring easily. He spiked fevers of 105. Doctors discovered he had Hodgkin’s lymphoma; the drugs that kept his immune system from attacking his donated heart had left him vulnerable to cancer. A six-month regimen of chemotherapy brought it under control, and his parents decided to skip radiation, which might hurt his brain. It was considered a risky decision at the time, but is now the standard.
Then, in fifth grade, Hochstein ran a 1-mile race, coming in eighth in the class. A few weeks later, he struggled to make it around the track. A friend told his mom with pride that he’d run faster than Jon! The astute mom called Hochstein’s mother and doctors began a battery of tests. His body was rejecting the transplant. He was quickly hospitalized to treat the rejection.
He’s been remarkably healthy ever since, he said, except for an appendicitis, and a few sinus infections.
Hochstein grew up wanting to play in the NFL and then become a doctor. He had seen more than his share of doctors. He lived like any other child, even playing football in high school. “Some people have their kids live in a bubble,” his mother, Barbara, said. But that’s not what she wanted for her son, not why she put him through the trauma of a heart transplant.
He got top grades in college and was accepted into Stanford Medical School, Johns Hopkins Medical School, and Harvard Medical School. His mom lobbied for the closer school, saying that traveling across the country was an unnecessary risk. He listened. Now, he’s in his second year of medical school at Harvard.
Hochstein worries that he might need another heart someday. And a new kidney. Immunosuppressive drugs do terrible things to kidneys, and half of kidney transplant recipients need a second transplant within 15 years. But his heart is still going strong, and long-term data on transplant recipients his age are sparse.
“Anything could happen to anyone. We’re all on a balance beam. Mine’s just a little more narrow,” Hochstein said. “This heart could last me a normal life expectancy. … This might go on forever, who knows. That’s my attitude. Otherwise it would be very depressing.”
His mother worries about him being around sick people all the time. “She wants me to be a surgeon, because it’s more sterile,” he said. “I’m definitely not going into infectious diseases. that would be a little bit — not a little bit, a lot — challenging.”
He hasn’t made up his mind, but at this point, he wants to be a pediatric transplant surgeon, helping save kids like himself.
April Hough was 17 years old when her brother Christopher was killed. The siblings had been close, despite their age difference. Hough had been a regular babysitter and a confidante.
“He was wild. He was full of life and 100% boy,” she said.
He always thought about others, she said. Once, on a phone call, he told her he had gotten a bag of candy, but saved her all the purple ones, because he thought she would like them more than he did.
Hough had battled through a tough childhood by the time her brother died. She had spent her teenage years in foster care, and had a 2-year-old of her own to care for. Her mother, who was already living in a neighboring state, moved away within a year.
Now 37, she has two grown children and two still in the house, lives in upstate New York, and works for a nonprofit that supports teens so they can avoid foster care.
But her only brother is never far from her thoughts. “Christopher has always been a huge part of my life,” Hough said. She made sure her children grew up knowing about him. The family remembers him on his birthday and Christmas. “Christopher has always lived on as part of who we are.”
It didn’t sit right with Hough that her brother’s grave in Ely, Nev., remained unmarked. She’s not sure why no one ever bought a headstone. Maybe because the driver who hit her brother had been ordered to pay only $1,000 in restitution, which didn’t cover the cost. Or because her mother moved away so soon. Or because it was all just too difficult to manage.
Hough started a GoFundMe page to collect the $1,500 to pay for the stone. She had no idea what else it would bring.
A few years into his tenure at the Pentagon Federal Credit Union, Hochstein’s dad, David, was bumping up against the company’s $1 million cap on health insurance spending. He thought he’d have to leave the company to start a new tab somewhere else, relocating the family again. But the credit union, moved by the family’s story, increased the cap to continue covering Hochstein’s care.
Then last year, David was waiting for an elevator at his office when the the company’s CEO walked up. Hochstein thanked him for all he’d done for the family.
“We had the resources. It would have bankrupted the employee,” CEO James Schenck said in an interview, explaining the credit union’s generosity. “You never want a medical emergency for any employee to become a financial crisis.”
After the elevator conversation, Schenck suggested featuring the family in a company social media program. He’d hired a video team to make short films — “to share powerful stories and spread good news of hope and kindness,” Schenck said. “Within every firm there are so many amazing stories. That’s what makes strong community is sharing these stories.”
David agreed to allow his family to be featured. Andrea McCarren, a former investigative reporter and now a vice president and chief content officer for the credit union, visited David and Barbara and then flew up to Boston to interview Jon. In describing his story, Hochstein mentioned that he wished he could meet his donor family, to thank them for the gift of a heart.
The Hochsteins always thought that Jon’s heart had come from the 8-year-old boy who had been hit by a truck just before his transplant. They’d saved an article from a local paper describing the incident. But the transplant agency had been unable to locate the donor’s family. Christopher’s father, the only one named in the article, had died. His mother has a different last name, and lives mostly off the social media grid.
McCarren, only a year past her investigative reporting career, got the Hochstein’s permission to do some digging. Within 24 hours of checking records, calling sources, and conducting genealogy searches, and with help from her 40,000 Facebook followers, she had located Hough and her GoFundMe page.
She arranged for the two families to meet in January at Hough’s New York home. The credit union paid for Tilly’s flight to visit her daughter and finally meet her son’s heart recipient. McCarren texted Schenck from the living room, mentioning the headstone. He immediately agreed to pick up the tab.
A video shot by McCarren’s team shows Tilly nervously awaiting the Hochsteins’ arrival, and laughing at herself for being surprised that the little boy whose tiny legs she remembered under the sheets was now a 25-year-old man.
And then he walked in with the stethoscope he’d learned to use in medical school.
Hough said meeting the Hochsteins has rewritten her brother’s story, and turned her into a dedicated advocate for organ donation. And it’s given her peace to know that her brother’s heart has been put to such good use.
When you donate an organ, you don’t get to pick who gets it. “But I know that if we got to choose, we’d choose Jon over and over and over again. Wow,” she said. “To think that Christopher got to be a part of such an incredible legacy is unbelievable still.”
The Hochsteins are equally thankful. “There is not a Christmas that doesn’t go by when we are grateful that Jon is there, but realize that there’s another family with a missing spot,” his mother, Barbara, said.
Jon Hochstein said that he feels like Tilly and Hough are part of his family now. “There’s this massive special connection,” he said. “She had to make this crazy decision amidst this tragedy in her life to let someone else use her son’s heart and other organs. I was really grateful that she got to listen to Christopher’s heart in my chest. That was really powerful.”
The families now keep in regular touch on Facebook. David sends text messages. Tilly sent Jon a card for his birthday last month.
Hough said she doesn’t want to intrude on Hochstein’s life. “But if I could occasionally peek in and watch Jon live, that’s enough,” she said, choking up. “If I can just see him live, it’s enough.”