The Biker With A Big Heart

It took several drafts to get the letters right. To dis-till her boy’s life into the two dimensionality of words on paper. To paint a picture of someone full of energy and love, so that the beneficiaries of his death—the recipients of his organs— would know just how lucky they were.

Three weeks earlier, the thread that held Christine Cheers’s world together had been ripped away. On 21 February 2018, someone on the other end of the phone had said the words that bring parents to their knees: “There’s been an accident.”

Her son, James Mazzuchelli, 32, a flight surgeon with the United States Navy, had been injured in a helicopter training mission at a military base in California. If she wanted to see him while he was still alive, she needed to get on the next flight from Florida—and she needed to pray.

James was still breathing when Christine and James’s stepfather,David Cheers, arrived at Scripps Memorial Hospital in La Jolla, California, the next morning. Machines were keeping him alive, and the doctors told Christine that what she was seeing was likely his future—that her scuba-diving, very worst day a stranger’s best one.

Christine instructed the hospital to begin the organ donation process.These few words, as hard as they were to say, would soon ripple outwards, allowing a man to return to work, a military veteran to regain his health and an ailing cyclist to get back on his bike.

Mike Cohen was just 18 when he’d been diagnosed with an aggressive form of leukaemia in 2004. Doctors warned him that the treatment protocol could cause lasting damage to his heart. At the time, surviving cancer seemed like the more pressing concern. He took his treatment seriously, doing the radiation and chemotherapy and even moving from New York to San Diego,California, for his last year of chemo because his oncologist felt that mild weather would be easier on his body.The risk had paid off—two years after his diagnosis, he was cancer-free. And the move had been a good fit, too. As soon as he was healthy enough to get outside, he was hiking or riding his bike. A casual cyclist as a kid, Mike became bike-obsessed.

To celebrate his sixth year without cancer, Mike decided to ride his bike cross-country to New York. From the start, it was a grind.

What he didn’t know during that ride was that his heart was beginning to fail, and in the years that followed,his health continued to deteriorate.Even on days he didn’t ride his bike, he always felt tired. Then one evening 2017, he started having chest pains.

His brother, Dan, rushed him to the emergency room, where doctors discovered a clot the size of a golf ball lodged in his left ventricle. They tried blood thinners, but the clot wouldn’t budge. Soon hospital staff were preparing him for open-heart surgery to install a left ventricular assist device(LVAD), which would do the pumping that his heart couldn’t accomplish.

The implanted LVAD required constant access to an electrical outlet,which meant Mike was literally tethered to the indoors by a cord that ran out of his abdomen. Even with an emergency backup battery pack, “You couldn’t go out in public because you couldn’t trust that someone wouldn’t knock into the cord,” he says. His old active life seemed like a thousand lifetimes ago.

Doctors had told him the device could work for eight months or eight years. Six months later, though, Mike was in a San Diego hospital with another clot. His heart was failing. He would need a new one.Heart transplant priority lists are tricky. You have to be sick enough to truly need the new organ but not so sick you can’t withstand the lengthy surgery or the immunosuppressant drugs heart transplant patients take to sustain the new organ. Mike fit those parameters and was at the top of the list. Now he just had to hope he survived the wait for a new heart.

Mike setting out on his cross-country journey.

On the plus side, Mike’s bloodwork showed the clot had dissolved enough that he could safely go home.As he packed his bag on 24 February,a nurse walked in. “I have good news and bad news,” she said. Mike asked for the bad news first. “You’re not going home today,” she said. The good news? They’d found him a heart.

The next morning, Mike woke up in a hospital bed with a new heart beating in his chest. His energy seemed to improve immediately: He took his first steps around his hospital room just five days later and was walking the hallways shortly after. “The old heart was like a two. With the LVAD my energy was like a five,” he says. “This heart is a 10.”

After two weeks, he was sent home with instructions to report to cardiac rehabilitation, where he was limited for the first few days to slow walking on a treadmill. Across the room he spied a stationary bike. He knew he wasn’t ready yet, but it became a beacon. And two weeks later, with his doctor's permission, he threw a leg over and soft-pedalled.

Christine Cheers wasn’t leaving the hospital until every last one of her son's organs left the building.She and David watched hospital employees carry coolers from the operating room: his kidneys, pancreas and liver went to various recipients.His corneas went to an eye bank; tissue and bone went to tissue and bone banks. That left his heart. 

“That was the one I cared about most,” Christine says. As a serviceman and physician, James embodied the ideals of bravery and altruism. “James had such an amazing heart,” she says.When a hospital representative delivered the news that James’s heart was headed out of the hospital, David and Christine watched as the cooler was taken away.

James Mazzuchelli loved adventure, serving in the Navy, and helping others.

In the ensuing weeks, Christine descended into a grief so deep that climbing out seemed impossible. Her lone consolation, she knew, would be to find out that James’s organs had helped people. That the recipients were doing all right. So she wrote each recipient, at least the four she knew of, a letter.The part Christine wanted to get right was the one about what organ donation had meant to her son. How glad he would be that his heart and kidneys and tissue were helping others. She didn’t want the recipients to feel guilty about the heft and gravitas of the gift they'd gotten. On 19 March,Christine put the final copies of her letters in the mail.

Two months after his surgery,Mike Cohen got a call from the organization that had coordinated the transplant. There was a letter for him. When he got it, he unfolded the typewritten pages and took a breath.

Christine described her son’s love for serving his country and the fact that he considered everyone a friend and never judged a soul. He was selfless, she wrote, had a quirky sense of humour and was a brilliant and gifted doctor. She described his love for scuba diving, snowboarding and motorcycles.

As he read Christine’s letter, Mike began to understand just how special his new heart was. Eager to know more about James, Mike googled him. Except for the fact that Mike shaved his head and had a beard—James had had a full head of hair and was clean-shaven—they had a lot in common. They were both athletic,and practically the same age. James was 32 when he died, while Mike had turned 33 on the very day of James's accident. 

Another thing he learnt about James:He was buried in Jacksonville, Florida.Back in rehab, Mike had hatched a plan to take another cross-country trip as soon as his doctor said it was okay. The end point of that ride now came into focus. He wanted to pay his respects in person. It seemed fitting to make the journey by bike—to show just how transformative his new heart was.

Left: Mike recovering from the operation. Right: Mike and Seton (left) on the road beside the RV that trailed them.

He took his time before responding to Christine: a week to process her letter and another week to compose his own. He wanted to get the tone just right, to accurately express how grateful he was for James’s heart and how determined he was to keep it beating for years to come. He communicated his desire to stay in touch with James’s family, if that what they wanted.

Of the four letters Christine had sent, she got a response to two. The first was from the man who got one of James's kidneys and his pancreas. He thanked her, saying how the organs had changed his life—that he could go back to work and provide for his family. But his letter subtly hinted that the thank-you note was all the contact he wished to have.

Mike’s letter was a balm for a wound that Christine felt would never heal.And so began the emails and texts, which proved comforting to her. She even began avidly following Mike ’s Instagram posts .“Knowing he was doing well really helped,” she says.By September 2018, Mike was back to riding and building up his mileage. His physicians were impressed by his progress and his cautious approach, so much so that they ultimately gave their blessing for the cross-country ride he was planning for the following year.

The trip would be slow in order to not overstress his heart and immune system: four hours of riding a day maximum, keeping his heart under 150 beats per minute—doctor’s orders.

Mike recruited Dan (who had become certified as a medical assistant so he could care for Mike after his first open-heart surgery) to tag along in an RV as support. Then Mike asked his friend Seton Edgerton to ride with him. They figured the trip,starting from the cardiac ward at the San Diego hospital that treated Mike and finishing at James’s grave, would take just under two months. They would bike most of the way and ride in the RV only on the busiest highways.

When Mike announced on social media that he was riding to his donor's grave site, the Cheers family decided they would meet him there.

It was only day one of a 2,300-kilometer bike trip, and, as with his first cross-country trip, his heart was not cooperating. Perhaps he hadn’t eaten enough or hydrated properly. Whatever the cause, it didn’t really matter. What mattered was that he had to keep his heart rate under 150 beats per minute, but the steep Cuyamaca Mountains east of San Diego were sending it sky-high.

Seton had rigged Mike’s heart-rate monitor so he could see the read-out on the computer attached to his bike's handlebars as they rode. He watched helplessly as the beats-per-minute number shot up. Both men were thinking to themselves: This is just the first day. Should we even be attempting this?

But on they rode. Across Arizona and then on to Texas, Mike and Seton rolled along in matching blue jerseys, the struggles of that arduous first day behind them as Mike’s heart rate settled down. Still, somewhere in the desert, they took a wrong turn and ended up slogging through deep sand.In the first 1,600 kilometres, they got a combined 24 flat tires.

From Florida, Christine and David followed along on social media, worrying about traffic and dogs and all the things that can befall a rider in the middle of nowhere. A few times, when Mike and Seton couldn’t find roads suitable for riding, they detoured on to an interstate highway, causing Christine to wince at the thought of trucks whizzing by those boys—and that heart. If it had been her son, she might have called him and scolded him. But Mike wasn’t her son; he was a stranger with her son’s heart.

“As cliché as it sounds, I wanted her to know that James’s heart was in a safe place,” says Mike, shown here with Christine.

On 20 November 2019, Mike and Seton pedalled the last few kilometres of their trip. All Mike could think about was what a gift it was to be healthy. He had doubted his body for so long, but now he finally felt that there could be a normal life ahead.

As he got closer to the cemetery,Mike grew nervous, unsure what kind of emotions may be attached to meeting strangers who had already come to mean so much to him. “It’s just such an intense moment to share with someone I’ve never met,” he says.

Christine and David Cheers got to the grave site early. They wanted sometime alone with their son before Mike arrived. It was a perfect day: sunny and warm. Then Mike and Seton coasted into the cemetery and rode towards the couple at James’s grave.

Mike got off his bike, handed it to Seton, and walked straight to Christine. At a loss for words, he managed a quiet “Hi.”

In that moment, Christine felt a deep sense of calm, as if she’d known Mike her entire life. They folded into a deep hug. Then came the tears. They weren’t tears of grief. They were tears of relief, from a mother who knew she’d done right by someone she’d deeply loved, and from a grateful man who’d been accepted by the family whose worst day was his best.

Together, the two then walked the few steps to James’s headstone.Mike squatted down and took a deep breath, feeling the strong pulse of James’s heart in his chest. Silently he told James how thankful he was for his sacrifice and how sorry he was they’d never get to be friends. He promised to take care of his heart.

Mike Cohen, left, with Christine and David Cheers.

Someone ran back to the RV to grab the stethoscope from Dan’s medical kit. Christine slid the cold metal head underneath Mike’s blue jersey and listened. She shifted the instrument up and then down and a little to the left.And there it was, loud and clear.The best part of her son, still very much alive.

From Bicycling Magazine (24 January 2020),Copyright © 2020 by Hearst Magazine Media, Inc.