A Heart Reborn: Faiyaz Elahi on Survival, Systems, and Purpose

Welcome to the Reimagine Podcast, where we explore the intersection of science and compassion to reimagine what's possible, starting with healthcare, organization and transplantation, for reaching far beyond. I'm Gabe Schnickle, Transplant Surgeon and founder of the Reimagine Center at UCC in Diego. This show is about bold ideas, difficult questions, and what becomes possible when we challenge the assumptions that shape our systems and ourselves. This month is Donate Life Month, a time when we reflect on the extraordinary gift of organ donation and the lives it transforms. Today's conversation is a powerful expression of that transformation. I'm joined by Fiaza Lahi, a heart transplant recipient whose journey began abruptly going from a seemingly healthy life into a multi-system organ failure, prolonged ICU stays in a path that ultimately led to transplant. What makes this conversation so compelling is not only what Fiaza went through, but what he has done with it. As a technologist, he brings a unique lens to the transplant experience. As a patient, he lived every moment of it, and now he's working to rethink how the system itself can better serve patients, clinicians and families. This is a conversation about survival, about fear, and acceptance, about compassion and medicine, and what becomes possible when lived experience meets purpose. So let's get started. Alright, Fiaza Lahi, welcome to the Reimagined podcast, and really pleased to have you here. It's a pleasure to be here Dr. Snickle, very humble to be here during the special month of giving and organ donation, so thank you for the opportunity. I want to start with kind of a little bit of your background, your heart transplant recipient, but perhaps we could start back before everything started with your heart issues. Tell us about your life at that point, and then kind of lead into when you first began to realize there was a problem. Well, I was a normal 50-year-old having a mid-life crisis. I was looking at sports cars and trying to figure out whether I need to change my wardrobe. I work with Boeing financial, as a technologist, director of product management, and I was quite happy with my performance at work, married man with one child, quite happy with all things considered with my personal matters and my marriage. So nothing really out of the ordinary, however, there seemed to be some concerns around my sugar management, and there was some swelling that I saw in my ankles at times. There was some heavy pain during the night time that caused concerns. So I went and saw a physician for that purpose, but nothing that was directly related to congestive heart failure or transplant for that matter that didn't really cross my mind. So that's where I was when I first encountered the word transplant. So that seems like a dramatic step from some leg swelling and having to get up in the middle of the night, which is not unusual for someone hitting 50 despite your youthful looks, bias. Like how did that path begin? What was the conversation with your doctors? I assume you started with your PCP and then led to what? Well, it was actually a flight back from Wages that started at all. I was at a tech convention in Las Vegas during that time. I think it was August, so 22. I came back on a red eye. My wife was already asleep and she said, "Hey, there's a sandwich on the counter. If you're hungry," what she didn't realize was that I had already downed a big stake and was, you know, partying. I came back and kind of settled into the home. It was dark. It was quiet. Happy to be home. But then I started feeling weird. And the weirdness was different this time. It was not the normal pain or numbness. It was just something I've never experienced before. It was enough for me to wake up my spouse and to say, "You know, I don't feel good." And I think I need to be seen at the emergency room because this is not something I felt ever before. So she being a good partner drove me to the ER where I was plugged in in all shapes of form. And the diagnosis was that I had two blocked arteries. There were 100 percent blocked. And the third one was 70. I think 70 percent blocked. A walking, talking time bomb from what I understand. And the physician on call was quite urgent regarding me being taken into the cat lab. And for us to follow those procedures to open up these arteries, otherwise, I probably wouldn't make the weekend or maybe even the day or maybe even the night. It was that urgent. After that, I don't remember anything for 22 days. I was taken into the cat lab from what I understand. They tried to do some procedures there. But then things kind of went south where I started to experience acute kidney injury. And so I went into a K.I. And I kind of know these labels and these terminologies. I speak like an MD now. But I really am still emotionally psychologically traumatized when I recall these things because it happened to me. And this was not supposed to happen to me. I was a healthy man. I was a normal man. I mean, how can I have a K.I. How can I have congestive heart failure? This is impossible. So I came around after about 22 days. I was plugged into an impeller. Five five, I believe, at Hogue Hospital Providence. Providence in Mission Yehoo. And also dialysis had been initiated. Well, that's like getting hit over the head with a sledgehammer. So let me backtrack a little bit and feel like cover a few of these terms that you're talking about. Explain what an impeller is and what the significance of that is. I know you're not an MD. Fiaz, but you certainly talk like one and having an impeller implanted in you. You probably know a lot about it. Well, it's a mechanical. I believe it's called an MCD, a mechanical circulatory device that is assisting or maybe even replacing the function of the left ventricle of the heart, which from my layman understanding is pushing blood out to the remainder of the rest of the body and to the vital organs. And so my heart in failure of that function, which is CHF, as you know, was not able to push blood out to the other organs. Therefore, there was shutdown and there was compromise in those organs, including kidney and possibly liver function compromise. And so the impeller five five was keeping me alive at that time. It was a small machine. I was a knob on it and there was some metrics on the screen. But from what I understand, it was the most important machine in the room. So you went from eating steaks and Las Vegas to being in an ICU with two system organ failure, your heart and your kidneys. For you, it seems like that was immediate from one to the other because you don't really remember the intervening days. So you must have awoken and being connected to all these machines and wires in quite a state of mental shock. And I'm sure there's a lot of trauma associated with that. What were you going through emotionally at that time as you're hearing about the current state of your health and your the tenuous nature of your survival? Well, when I came around when I started to visualize things in the room, there was not a coherent conversation that connected the last 22 days and the devices around me and my condition to give me a clear understanding as to what was happening and why it was happening. The way that I am repeating back to you, what happened to me is my understanding that has come to me in the last two years following Heart Transplant that I've been able to piece together those gaps and those lapses of time. But when I came around, my first instance was Mania. It was confusion. It was mass confusion and it was confusion that I cannot really describe, but it was enough for me to be jerking my head around so violently that they had to tie it down. Also my instinctive, or maybe some kind of physiological reaction, but my hand keep going to my neck because I was intubated and I wanted to take this thing out. It was hurting me. I didn't understand why I had this device or this alien instrument inside my body and for what purpose and so they had to tie my hands down. And so I was lying in bed with my head stationary, tied down to the bed with my hands tied to the side, almost like a prisoner of war, in my own head trying to figure out what is happening to me. And why is it happening? The only sense of calm that I got from the scenario was that I had loved ones whose faces I saw, but I could not understand why these loved ones were allowing this to happen to me, because it didn't feel therapeutic or medically necessary. It felt obstructive or maybe an undue force that was trying to keep me in bed, because I didn't understand why these things were in place. So that's the feeling that I got mania, confusion, there was involuntary jerks that were happening. But mainly my right hand going to my throat or to my nose or to pull these things out and my head jerking left and right in utter confusion. So tell us, Fias, when did you first become aware of transplant and the need for a hard transplant? Well, the first episode commenced in like I said in August 2022, and I was hospitalized for an extended period of time. So I was released on December 31st. So as you can imagine, there was a quite a long stay in the hospital. So going from all levels of care down to the very cardiac rehab level, which was in the basement of the hospital and spending three weeks there prior to getting released. My ejection fraction had been compromised down to about 30% of that time, and was continuously decreasing. It was not holding my main concern because I had ventilation assistance, I had nursing assistance, I had respiratory as well as cardiac function assistance. My concern was, well, can I take these home with me because I won't survive without them. And of course, I can't take these devices home with me. So my concern was, how am I going to survive without these things? I don't want to leave the hospital. So that fear was quite engulfing. And it was very dominating more so than anything else that I can remember during that time of release. I was released from the hospital and then I spent the next few months in intensive outpatient therapy and trying to get my muscle function back and my bodily function back. I was in dialysis for six months, which was quite a horrid experience for me to be receiving dialysis three times a week through a portal. And feeling very weak and very, very deflated after a session. I went back to work part time in March, never back to work full time in April, but I was not functioning properly. I was losing consciousness on video calls. My ejection fraction dropped to about 20% and 22%. And then I remember coding twice. I had one code, I believe it was that whole hospital in LA. And because they did not have advanced care to deal with that, I needed ECMO transition. They transferred me over to UCLA. At UCLA, I was on an ECMO machine and I'm happy I believe I came around after that event again, mass confusion. What happened? Why did it happen? Seeing this, you know, circulatory apparatus stitched into my lap, it was very, very traumatizing to say the least. And visually these machines are very disturbing, even though they're the ones saving your life. Very, very visually disturbing to a person who's a layman and who's not from the medical community. All those things we end off and then UCLA started some preparation for me to be listed. They did a pet test, I believe it's called a pet PET to see if the myocardium or I don't know if my cardium can be infused or whatnot. That was the purpose of the test, not successful because there was a lot of scar tissue from the two events. They had a stroke several strokes as a matter of fact, but they were not serious enough to affect brain function, but they did appear on the scans and they were concerning. I had pneumonia twice during that time. And then some insurance concerns came into play where UCLA was instructed that if he used to be listed and to be prepared for surgery, then he must be transferred over to UCSD. I'm not sure, but apparently there's some protocols and there are some policies that need to be followed with insurance. I just wanted to live, I didn't care which hospital which doctor I just wanted life. And so I said, okay, put me on an ambulance at 2 a.m. in the morning with all my apparatus and two technicians and three nurses and whatnot. And I made the trip down to UCSD and I think that was the time when doctors started visiting with advanced therapy recommendations. They started informing and educating me that intermediate therapies were no longer viable. And therefore advanced therapies such as an LVAD as a bridge or a hot transplant organ transplant where the go to therapies, which in itself was quite traumatizing to hear. And I can speak more about that, but that was the first time I started hearing about transplant. Wow, that's a lot. So the trip you made through Hogue and then UCLA, those multiple hospitals was your second time around going through this traumatic when you say you coded. That means you had a cardiac arrest and they had to. Twice. Yeah. So they had to resuscitate you. And you can mean CPR, it can mean cardio version with getting shocked, which are all dramatic and traumatic. And it sounds like clearly let me the lasting impression on you emotionally. You know, we can I can really see you living through this again and I'm sure there is some, you know, post traumatic stress from having endured these multiple episodes that where your life was on the line and you had to have these invasive procedures that must have been really hard on you and your family. Yes, my journey to transplant was not an easy one. And sometimes I hear fellow transplant recipients talk about their journeys and they're not as generous and they're not as hectic as mine was. I don't know if I was. I was just a little bit more, um, recipient of a special prayer or maybe a special blessing, but I was in doubt with this kind of journey. But I am also grateful that being a man of faith and being a family man, I was in doubt with. I was blessed with strong faith and I was blessed with strong family structure and support. And so the struggles as they came, I was able to navigate along with the resources around me for which I'm truly grateful. Now in San Diego and you're now starting to hear for the first time about the need for hard transplant as the really the primary option for long term survival. How does that, how did was that sinking in with you and how are you discussing that with your with your physicians and with your family. I was resisting it. It wasn't sinking in at all. I was deflecting it and resisting it because I think the visual in my mind of my chest being pride open wide and a vital organ, the most vital organ of the body being taken out and replaced with another from somebody else's body. It was all very surreal and I could not get my head wrapped around that visual. It was very traumatizing. I also could not get my head wrapped around LVAD because I had requested to meet with a living breathing LVAD recipient at UCSD's that I could assess for myself what the quality of life and what the. I was banned with a functionality in that particular individual was following receiving an LVAD wonderful individual I met that person at UCSD. They were quite happy with the solution that was given to them. This was probably a destination solution for them. It was not a bridge and they were quite happy with it. They were functioning according to their expectations, but it was not according to my expectation. visual of varying. that battery pack and that apparatus and having to watch for infections and having to avoid certain behaviors or actions in daily life not to either inject voluntary or involuntary distress into the scenario. It just didn't jive with me. I just could not fathom being assisted by a circulatory device. And so what was my option? Well, organ transplant and that was my biggest fear. So I had to get my head wrapped around that. I remember having a Zoom call with my extended family in Chicago and Texas, of course, my family in San Diego in Orange County. And it was like about 12, 14 people, like eight of them were physicians in my family and they all had this face saying, this is your only option. And I'm thinking to myself, why the hell did I even try to connect with these people because they're telling me exactly what I don't want to do? The turning point, however, because I'm a technologist by training as well as by disposition, I could not understand, is there a roadmap? Is there some kind of like stages that we go through or some kind of something that I can grab my head wrapped around that, okay, this is the next step, this is the next step. And this is what I can expect because everything seemed to be very convoluted and confusing and scattered and very fragmented, which speaks to the technology systems of the health system as a whole. That's for Dr. Tran, congestive heart failure director came into my room one day was October 30th, I believe it was Halloween day October 31st. And he drew a very simple roadmap on a chalkboard with a marker. And he said, okay, well, this is week one, this is week two, this is week three. And here are the things that you can expect to see in week one, you can have some preparations, some pre-testing, some, you know, some prep, you can week two, you're going to have a lot of visits from a lot of clinicians and various disciplines, etc. Week three, you're going to be presented to a committee of sorts and where you're going to be debated and, you know, your case negotiated and for it to be listed at a certain category or not. And then the transplant and then a discharge and the fact that he wrote a discharge was very exciting to me. That was like, okay, now I see a roadmap, now I see a beginning and end. It's not some really up in the heavens kind of storyline. It's something I can grab I can understand. So that was a very, very important juncture of my journey that still informs my technological pursuits in health care. And then soon after an offer started getting negotiated, there was another very important visit that happened with Dr. Pretorius, Victor Pretorius who was the surgical director, who is now at Emory, I believe. He sat down with me and he really just talked to me like a human being, not a patient. He explained to me the organ that he was considering and he was negotiating. There was a concern about some patient history that he discussed with me to make sure he wasn't a religious conflict of sorts or anything of that nature. He explained to me how the operation would be commenced and what I could expect a short visit of maybe around 10, 15 minutes, but it was very informative. And from that point on, my hope started getting lifted up and I started a positive trajectory towards okay, there's an end in sight and there's a better life and there's more I can do in this life and not just think about okay, I'm just a patient forever. So that was a big turning point for me and then transplant 1119, 2023. A major birthday which I now celebrate, I don't celebrate my biological birthday anymore. I celebrate my transplant birthday which is a very pivotal and grateful event for me. So Fias, let me let me circle back on a couple of things. First to explain LVAD is that term a few times left and trickular assistive is essentially being connected to a machine that is assisting the left side of the heart to pump blood to your body and can be as you set a bridge to transplant to keep your body circulation going while you're waiting for transplant or can be as you said, destination therapy where that's going to be the patient's final treatment option and it sounds like you went through what a number of patients do when first learning that transplant is really the only pathway to a durable long-term survival solution is somewhat denial like that can't be and hard to imagine the idea of having you part of your body removed and someone else's body put in there because that is such a profound particularly probably around the heart which we all center as you know the seat almost the seat of the soul for some people right and our heart is going to be replaced by another is something that can be hard to grasp you know emotionally intellectually and it sounds like you had a real struggle and it took some time for that to sink in what is that fair to say it is absolutely accurate Dr. Michael the visual the psychology the emotions accompanying that psychology the unknowns the uncertainty and just the the brilliance and the majesty of transplant I mean to do this in today's world and it's being done to me not to that person 10 feet from me or maybe on CNN I am that person who's going to receive this this brilliant therapy it's just surreal and so first we have to the patient I believe like myself has to grasp the whole concept of this is happening to me and get over that denial and once we have accepted at least I accepted that reality I am enamored with just the whole process and I'm just kind of like are we really going to do this like we're really going to put somebody else's heart into me and I'm going to like have a brilliant life after that it's that it's that moment of realization it sounds like it was particularly helpful and really essential for you to go through that part with Dr. Tran howey Tran is a wonderful wonderful guy wonderful physician to explain what your life is going to be like in that short term right people can tell you all they want you know you'll be fine in you know a year or five years but you needed to know what your life was going to be like in the next day three days one week two weeks and and so on and so really having that sketched out for you literally on a chalkboard as you said or a whiteboard having that visual was was critical is that right you bet is correct yes and that helped alleviate a lot of stress it also helped alleviate a lot of mental anxiety and a lot of uncertainty and so that is absolutely correct and then having a doctor notorious also really an amazing surgeon come in and explain the details of the procedure and the details of the the organ that was being offered to you very helpful in the moment I'm sure as you're trying to think through this decision and what must feel like your mind racing in a hundred different directions how was that moment when you learned that there was a heart being offered to you and that maybe this next step was finally happening I was surreal it was unreal because I didn't expect it to happen that fast the way that it did also I did not expect for the surgeon to come and sit down with me and to have a conversation that I am the one who's going to be prying open your chest and I'd like to talk to you that was a very connected and a very human based design that I would say that really helped me as the patient connect the dots but also to feel comfortable because usually you know we look at surgeons as laymen patients and we're like okay well these are these big giants and with these big credentials and you're one of them. I mean, you have this aura and this resume and these fellowships. And it's kind of unreachable. It's kind of like these people are only appearing in the operating room for a limited period of time. I'm probably going to be under. I'm never going to see them or talk to them. But there's like God-like creatures. And so especially if they are live giving, like the way that a heart transplant surgeon is, that we see them as live giving. And so for somebody like that to come and sit down and have a conversation face to face, two feet from my bed. And to, in very simple English terms, explain some of the complications, some of the concerns. And to give me some hope of a better life was very, very crucial in my pivot towards healing and my pivot towards positivity. So these two moments of really compassion, this physicians, these people having this human connection with you exhibiting this compassion towards you and your situation as you're in the midst of this struggle really made a big impact on you. I can see the lasting impact on you and was very moving and reassuring for you. Yes, and I take that feeling and that experience into my future endeavors and my future projects that will hopefully help transform the transplant journey for many patients to come. But it goes to show that treating the person as a whole and not as a number or as a, you know, just a wristband, a number, and treating them as a whole and treating them with emotions and thoughts and feelings brings about a better patient outcome. Whereas not doing that would probably not bring about a better patient outcome. So I would like to maybe put a plug here that building health systems based upon patient outcomes and working backwards or as patient satisfaction scores is much more effective. So with that in mind, Fias, you have really become motivated to be an advocate for transplantation, for transformation of, you know, and addressing what you see as challenges in the system. Tell me what sparked that in you. Were you always somebody that was focused like this or do you feel like there was a switch turned on or something that with this transplant, with this new heart and going through these, that challenge and that struggle has led you to this place of advocacy. Yeah. So I've always been a person of drive and of ambition. And so that came to me easy. I don't ever have any problems initiating conversations or projects or transformational endeavors or whatever the case might be. I needed a purpose. And so coming out of this very, very strenuous extended traumatic journey of many hospitalizations, extended hospitalizations, I mean, I had eight intubations, twice ECMO, twice, and fellow. I mean, it was kind of unreal. I mean, ejection fraction, 15%, less than probably 5% chance the survival one physician told me. And so I needed to know that all this was for something more. That if I were to survive, it wasn't just for me to walk out of the hospital and have breath and to go back to my previous life. It needed meaning. It needed to be for a higher purpose. It needed to connect to improving the human condition somehow with my own personal experiences. And so that drove the compass and the engine that you now see that manifests in many different areas, such as advocacy with the American Society of Transplant Surgeons, the STS. I'll be on Capitol Hill again with them in the month of April beating down their doors and having conversations about organ procurement and LDPA, Living Donor Protection Act, et cetera, et cetera. It also led me to engage with individuals who are currently on the wait list or have already received their organ and are doing well. And some actually not doing well. And so that individual advocacy, I have also taken on by social media connections and social media platforms and making myself available for those conversations and those engagements. And that has been very rewarding to say the least because nobody knows about it. Only my family knows about it. But it's the most rewarding and the most the biggest highlight of my day, sometimes, to have that conversation. And then thirdly, I came in contact with-- I've been a fixture, I guess, of sorts with Dr. Tran at the heart failure symposium. I've spoken as a guest for two years, consecutive, not sure how that happened. But maybe it was the nice hair or my speaking ability. But I was very humbled and grateful to be invited back with Dr. Greenfield and Greenberg, Dr. Greenberg and Dr. Tran. And so being able to have that platform to impart details of my journey and to share those experiences has been another humbling pivot. So, Fahean, tell me a little bit more about when you started feeling this inspiration towards advocacy, towards making change. Clearly, I can see that-- well, at least I've only known you post-transplant. But I would imagine that even as a little boy, you had a lot of drive and you were always moving forward and getting into probably some mischief. We'll have to check with your mom. But when did you start to feel the emotional connection to push you towards helping people in the transplant world, helping people that were about to go that challenging journey that you had survived? What was that like? And when did that really start to take hold? And when did that really that idea concretize into something that you could see and you knew what you were going to do? There was a collection of data points and a collection of milestones in my own journey. And so something as simple as, OK, no drink and food for the next morning or the next day, because I have a procedure, right? The procedure somehow gets postponed. But now I'm still hungry and I'm still thirsty. And that's been extended because now, if I eat and drink, that procedure will have to be rescheduled. It's already rescheduled for the next day. And so now the patient is this guinea pig that is breathing, living, and trying to survive without water and without food. Now one day, OK, I can handle that. Two days are extraching it, but I can handle that. But when it turns into three or four days, it becomes devastating. And especially if you are on mechanical devices that are assisting you to live. And especially if you are immobile, especially if you are limited in your ability to function as a normal human being, hunger can be very, very traumatizing. And thirst can be very traumatizing when you're pumping down all these drugs. And you have these sponges that you're trying to keep your mouth moist with that is not really doing the job. Those are the moments that collect into several milestones that say, OK, what if we had a AI assisted platform that took that destruction of a appointment being rescheduled and took the nuances of that appointment being scheduled off the now the patient is still having to live without food and drink and water and whatnot. And to be able to somehow map together and aggregate the data in a manner where we can improve the quality of that patient's experience and still keep that appointment scheduled and still have the outcomes to the physician. How can we do that? Well, sometimes that is very difficult to do from a human standpoint. But it is easier to do when you have something like artificial intelligence assisting you in aggregating these variables and putting together a solution. Another point of aha moment was, okay, when I learned that the surgeon is negotiating several organs at a time and they have to pull together into their negotiation framework to disposition this offer, whether to accept or decline, they have to pull together a variety of data sets from a variety of different perspectives and systems and aggregate all this data, provide a solution to themselves to say, okay, this organ is a yes and this organ is a no and this is and then they're dealing with the ischemic time clock running down on them and they're dealing with geographical variables and they're dealing with proximity to the hospital and they're dealing with whether the patient is in the hospital and so all these variables, they're very hard for a single surgeon to disposition. What if we were to provide them with a platform where we can use something like artificial intelligence or maybe generational intelligence or maybe machine learning to help them make these decisions faster, more efficient with less error so that they can be more rested in a better emotional disposition to perform the surgery which is the most important component of that journey, at least to me as a patient, right? And so these things combined together, they all came together for me in more of a, we need to have a better process in place, we need to have a better digital process in place because that's what makes things easier and we need to have a connectivity between the digital and the human and working together and in harmony to provide that lift to the human experience in being fantastic and stellar versus just it's okay we're making do with it. So those are the things that kind of collect together to help me move this needle forward. So you're taking your FIES the technologist and FIES the heart transplant recipient and bringing the two together to try and create a better system. You're a system guy, yes? Yeah, so better process, a better system, a better use of data because we have data, surgeon you know you have a lot of data around you that is unused, there's human generated data, there's machine generated data, there's structured data, there's unstructured data, there is big data that involves pictures, texts, visuals that are not necessarily textual in nature. And so how do we aggregate all this together into building a system that can help the surgeon in their component that can ultimately help the patient in their component to have a better transplant experience. So yes, I'm bringing my skillset from the corporate world and I'm combining it together with my lived experience to produce something that I believe has not been done before. So FIES I'm thinking about this lived experience that you've been through. The idea that Wilman is an island right that there is this wovenness to our humanity and you I would imagine feel that every single day as you feel that heart beat in your chest as you feel your pulse, you know, in your wrist that every day you feel that connection, how does that inform your desire to bring about change to change what you see as you know is something that needs to be fixed. Yeah, great question. I think first and foremost I have to take responsibility and take ownership of the heart that has been given to me and to take care of it because I cannot be a role model or an example or a good ambassador of heart transplant if I'm blowing it as a heart transplant recipient gaining weight, not having sugar management, not taking my immunosuppressants or anti-rejection drugs on time, how can I be an advocate for heart transplant. So first and foremost I have in the last two and a half, two years that I have been post transplant been very serious about my exercise regimen. I learned five, five miles a day at the beach without fail. And just saying that gives me tremors because at 15% injection fraction, I could not walk five feet without falling down and now I'm running five miles without breaking the sweat, right? And so it's amazing. It's an outcome. I also have to take responsibility for my diet and for my intake of what I eat and what I put inside the body because the compass that is guiding me is that I've been given a gift. And this gift needs to be taken care of and this gift needs to be cherished and needs to be guarded with everything I've got because there is no other heart transplant waiting for me, right? There is no L-Wat solution after this. This is it. And then why should there be anything else? If this is the ultimate gift, then I should take care of it. And so first and foremost, I have to take responsibility as an individual and as a patient. Secondly, now I'm able to move forward and I'm able to focus outwards and I'm able to say, okay, now that I'm a role model and now that I can speak confidently at the podium with Dr. Trans Art Filiers symposium as a role model, as an example, I'm now able to bring forth ideas that can improve the human experience during, before, during and after transplant. I have started to connect the pain points. I've started to connect the experiences of joy, of success, of failure, of disappointments, of all those things that are normal heart transplant recipients are even an organ transplant recipient for that matter will experience and putting it together in the context of a journey. And to see end to end, some similarities, let's say in kidney transplant and liver transplant and heart transplant because I wish to tackle the issue of multi-modality transplant in the near future versus just heart transplant. And so I'm starting to notice that the patient experience has a lot of commonalities and has a lot of similarities in the way that patients approach transplant journey, go through it and come out of it and sometimes don't. So these are all the things that are really guiding me and really encouraging me. But first and foremost, my faith has always been very prevalent that the higher power that I ascribe to, which is I call God, has provided me with the opportunity to now turn around and pay it forward. And so I take that as a big responsibility. Secondly, the team at UCSD, the nursing team, I visit them every week when I go to CVICU, just to say hi, five or whatever, they know me by first name, you know, bothering you guys on text, you know, our emails or what not. I mean, I just find that I need to really keep that energy alive in the transplant community because I'm no longer afraid of upsetting someone with too much information or being too forward. I just don't have a lot of time. I need to get things done. And so let's get it over with, you know, so that's my my moral compass. And thirdly, I just feel that the skills that I have accumulated in the technology and the digital world up to this point, I really truly believe that I was prepared. I was prepared for a moment where I would pivot and I would pivot in a way where I would be now more concerned with improving the human condition and the human experience versus making money or versus climbing a corporate ladder. I get a sense from you this this feeling of urgency to have an impact that drive in. I imagine that going through this journey that you've been through. So, Strenuous, I'm sure terrifying at times your life is hanging in the balance. And to come through that on the other side, do you feel a I guess a power from that having endured like that nothing like nothing to be afraid of now that you've gone through all of this this this challenge and you have this new heart. I would imagine that you feeling bold and then like why should you be afraid of what what judgment there might be or why would you be worried about you know any perceptions or ruffling feathers when you have something that you want to accomplish and a change that you want to see in the world. Well Dr. Schmickle, I mean for all intensive purposes technically or directly speaking I face death twice and I lived to telebarde and when I was facing that death and when I came around I wasn't thinking about all the people or the relationships that I've ruffled feathers or I've gone south or maybe didn't things didn't work out. I never thought about the opportunities that maybe I I didn't take or maybe I did not, I did take. I was simply just thinking about, it's very simple at the end. And it's just really the good that you do and the good that you leave behind. And we have a limited amount of time on this earth to do that. And me coming face to face with that reality, we all have that reality on a daily basis, but me coming face to face with it was an eye opener. And it took away all those hesitations and all those obstructions that psychologically, I mentally, I mostly block us from moving forward or maybe doing something. Those were removed. And so now if I'm a pest that I'm a pest, if I'm overwhelming that I'm overwhelming, if I'm, but I know what I need to accomplish. And yes, I'm learning along the way, and I'm yes, I'm learning to be more cordial and more professional at the same time. And maybe a little bit more considered of people's boundaries. But at the end of the day, I mean, when you're facing the end, that's not much there. It's only the good that you have done. And that's what you're going to take with you. And so that's what I would like to accomplish. - That's beautiful sentiment, Fias. It's the good that you do in the world. With that in mind, as we kind of come to the end of our conversation, as we mentioned right at the beginning, it's donate life month and April, as we're recording this, we are close to donate life month. What do you want people who are listening to know? - Education. Educate yourself, start looking at YouTube videos, talk to people, voluntarily contact transplant centers or talk to physicians, talk to your primary care physician. Education, I think there's a lot of misconceptions and a lot of misinterpreted and misguided messages regarding transplant, some are coming out of the religious community, some are coming out of personal experiences, some are coming out of maybe even family, but I think education is the best counter to that. And I'd encourage people to educate themselves and to give the gift of life and to give not blood, just blood, but also the gift of an organ because a healthy person can save up to eight people from what I understand in donation. And so when you're going to the DMB and you're registering for, and somebody asks you, do you want to be a donor? Yes, put that red dot on your driver's license and be a donor because at the end, that is really what stays behind. We're not gonna take anything with us anyways. And so I would really encourage people to get educated. I'd really encourage people to learn more about transplant and to embrace the brilliance and the majesty of transplant because the ester is fear, but with education, you can remove that fear and you can become an advocate. Thanks, Fayeza. I love your take on that. This has been a great conversation. Is there anything that you were hoping that we would talk about that we haven't gotten to? No, I think we've covered quite a bit of ground here, Dr. Snickle. And I do want to thank the genius of you and your staff that has wanted to spread the message and wanted to put this podcast together. I think it was a labor of love on your part for a while that has now materialized and you are now bringing on people with very important messages to disperse to the community. And so I want to applaud your efforts. I want to applaud the times where you felt like giving up or maybe not starting it and you're still pulling through because these are the moments that we're celebrating together that matter the most and you're doing it. So I congratulate you for that. Thank you for the kind words Fayeza and I appreciate you and your dedication and your perseverance and the message that you're giving out there and your advocacy on behalf of transplantation has really been powerful. So thank you for everything that you do and thank you for the support of Reimagined. We genuinely appreciate you. - My pleasure. - Fayeza's story is a powerful reminder that transplantation is not just a medical intervention. It is a deeply human experience shaped by fear, connection, compassion, and ultimately meaning. What stands out most is not only his survival, but what he has chosen to do with it. Bringing together lived experience and innovation to imagine a better system for those who will follow. So if this conversation resonated with you, I'd encourage you to learn more, get involved, and share this episode with someone who might need it. And as always, thanks for being part of this community. Our theme music was composed by Jeff Bowman and our producer is Leyla Adler. If you'd like to learn more about the Reimagined Center or support at work, you can find us at reimagined.ucsd.edu. Thanks for listening and until next time, this is the Reimagined podcast. [MUSIC]