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Second Glance: Tin Toys, Oct. 24, 2021 - The Washington Post

Find the 12 differences between the original photograph, top, and the altered photograph, center. Answers at bottom. For more Second Glance puzzles, <a href="https://www.washingtonpost.com/lifestyle/magazine/second-glance/">click here</a>.

Randy Mays

In addition to her work at the Post, Seiss writes fiction and music. 

Daniele Seiss

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Second Glance

Second Glance runs in The Washington Post Magazine.

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Second Glance: Tin Toys, Oct. 24, 2021

The Beating Heart

A terrible crime, a patient waiting for a transplant: The tragic, redemptive journey of one heart - The Washington Post

<span class="ent-dropcap-first-letter">I</span> stared disconsolately at three crumpled slips of loose-leaf paper. Separately, they had been drawn out of an old green fedora by three strangers in a restaurant, and together they created an ordinary day chosen at random: “December,” “28” and “1986.” That was the date I was going to be researching for the next six years. It was for a book to be titled “One Day,” which would explore whether, in the insistent gyre of human experience, there even <i>is </i>such a thing as “an ordinary day.”

The date seemed intuitively problematic: It was a Sunday, infamous among journalists for being the sleepiest news day of the week, and it was the week between Christmas and New Year’s, infamous among journalists for being the sleepiest news week of the year. And it was a year that didn’t seem all that historically memorable. Bad day, bad week, bad year.

One of my first discoveries involved an event that occurred in the early morning of that day, in suburban Washington. A woman received a new heart in a transplant performed by a surgical team that had never tried that operation before: It had worked only on corpses, in macabre rehearsals in a hospital morgue.

<span class="ent-dropcap-first-letter">A</span>lan Speir hadn’t had a drop to drink. The reason for this was on the phone.

The call came at 12:01 a.m. He’d just fallen asleep in the guest bedroom of his sister’s home in Charlottesville, Va. Speir and his family were visiting for the Christmas holidays, and now his brother-in-law was waking him, phone in hand.

Speir didn’t have to be told who the midnight caller was or why he was calling, or that the next few hours would be eventful. Okay, thrilling.

Speir wasn’t famous in his field yet. A quarter-century later, he’d be part of the team that would sew a new heart into Dick Cheney’s chest. But in 1986 he was a reasonably obscure cardiovascular surgeon in a busy hospital in suburban Washington. His name had not been in the newspapers. That was about to change, for better or worse.

The midnight caller, as he’d assumed, was his surgical colleague, Edward Lefrak. The terse message, as he expected, was that there was a donor. Speir was now fully awake. Within three-quarters of an hour he was dressed and in his car, beginning the two-hour drive north to Fairfax, Va., going through a heart surgeon’s mental checklist, which included, somewhere around step five, keeping your own heart steady.

Lefrak had made a few more calls himself; others, he delegated. By 3 a.m., the whole team had assembled. There were four doctors, 11 nurses, a physician assistant and two medical-instrument operators, gathered in two rooms.

In operating room 12 a body lay supine on the table, butterflied. This is an adjective no one who was there would have used — the terminology of transplantation is determinedly dignified — but that is what it was. A man of small to medium stature, well muscled, had been sliced open from the neck straight down to the crotch, and then cranked apart by retractors, for better access to the organs. There wasn’t much talking. The loudest sound was the insistent <i>whoosh</i><i>-gasp</i> of a ventilator.

The man’s head was behind a vertical drape, not visible to the surgeons, which was just as well. A single .22-caliber rifle had been fired point-blank into the center of the forehead, crossing the midline of the brain, tearing through both hemispheres. Such wounds — “insults,” in the curiously mannered lexicon of medicine — are almost invariably fatal, as this one had been. But they sometimes leave the heart beating, as this one did, so paramedics in the ambulance had eased a tube down the dying man’s trachea and hand-pumped a bag to keep the body breathing, which was why it was here, in operating room 12 in Fairfax Hospital, butterflied.

An exposed, beating human heart looks frantic and angry. Clench and release, clench and release. Because it is sheathed in a protective layer of fat, it’s more yellow than red. It’s only the size of a big man’s fist, but it will dominate any operating room. You can’t look away.

A tall, rangy man with weary eyes and a surgeon’s preternatural calm, Lefrak was there for that heart. If everything went right, it would go into the chest of a woman just down the hall in operating room 6. Alan Speir was there, opening her up.

This was to be both men’s first heart transplant, and the very first in the immediate Washington area. In 1986, no one taught this procedure in a classroom. Lefrak had been training himself for two years, practicing on corpses with a handpicked team of doctors, nurses and technicians, the same people who would surround him for the next few hours in what would be a significant gamble, both with Lefrak’s career and his hospital’s fortunes.

A second team — an abdominal surgeon and his assistant — was in the room as well, to harvest the kidneys. “Harvest” is another word that lay people use but transplant surgeons seldom do, because it sounds impersonal and opportunistic, which of course it is. Organs are precious and prized; organs from young, healthy bodies, especially so. The dead man on the table, whose name was Mark Willey, was just 19.

Sometimes surgeons with different organs to remove find themselves working in an awkward scrum, jostling for position like basketball players under the boards. That almost happened here. There was to have been a third surgical team to take the liver, but at the last minute the intended recipient became too sick to survive surgery, so the liver would be wasted — there was no time to find and qualify another patient. That’s the way it goes with organ transplants — they are dependent on speed and timing, but also on factors you cannot control.

That this was happening in the early hours of a Sunday was unsurprising. Young, healthy people are most likely to do life-threatening things late at night on Fridays and Saturdays, so organ transplants often occur at 1 or 2 a.m. on Sundays and Mondays. That’s because it takes roughly 24 hours of lab work and paper-pushing to set everything up; felicitously, 2 a.m. also happens to be when operating rooms are free of scheduled surgery.

The process also involves diplomacy, a task that had fallen to a fourth man in the room, standing away from the operating theater. James Cutler was the hospital’s transplant coordinator, a meticulous man with the commiserating demeanor of a mortician, which was an occupational asset. Among Cutler’s duties was to obtain consent from grieving next of kin, and this takes a subtle skill. He must be persuasive without seeming to persuade. The decision must be freely given, with no feel of pressure, even though, of course, at such times there is the extraordinary pressure of circumstance alone, the pressure of life and death.

Cutler had been the first in the hospital to learn of this death, from Fairfax police. As was his custom, he did not immediately alert the transplant team. Hospitals are careful about this; there must be no hint of collusion or ethical corner-cutting. A wall is maintained between the doctors who need the heart <i>now </i>and the team of people who must certify brain death (two opinions), test for blood-type compatibility, rule out certain diseases and blood-borne pathogens, and obtain unambiguous informed consent. Usually Cutler approached this last task through a gentle appeal to a greater good: Let something positive emerge from this tragedy, and so forth. Sometimes he had an added tool, one that he deployed delicately but without apology. He’d used it here.

You must understand, he’d said to the stricken parents of the dead man, that because of the circumstances, the medical examiner will be involved. There will have to be an autopsy, anyway. The body will be opened and organs removed, anyway. You cannot spare your son from that, anyway.

“Because of the circumstances” was enough to get a yes. He didn’t need to elaborate. What he meant was that there would be a police investigation, because the young man butterflied on the table had committed an abominable crime.

<div class="ent-pullquote">
<div class="ent-pullquote-text">Surgeon Edward Lefrak had been training for two years, practicing on corpses with the same team of doctors, nurses and technicians who would surround him for the next few hours.</div>
<div class="ent-pullquote-annot"></div>
</div>

<span class="ent-dropcap-first-letter">L</span>ater, much later, when she was going through her daughter’s belongings, Ursula Ermert found the two letters. They were handwritten on loose-leaf paper, undated, from Mark Willey to Karen Ermert. They were love letters, of a sort. In hindsight, they were ominous. In hindsight, many things were ominous.

Mark and Karen, also 19, had been going out for almost two years — students from different high schools who had met the way suburban kids often met in the mid-’80s, at a mall. Karen was effervescent, with a broad, intelligent face under feathered blond hair. (Her hairdresser once observed wryly that other clients paid extravagantly for what nature had casually dropped on Karen — multiple shades of blond in captivating layers.) She was conventionally attractive, and a slight chipmunky overbite added a dose of adorable. In the high school band she played high and sweet: the flute and piccolo. She was strong-willed, stubborn, mischievous, spontaneously funny. When she posed for a graduation photo beside her mother, she subverted the solemnity by dropping a stockinged leg into Ursula’s hand, a la Harpo Marx.

It is tempting to call Mark Willey a Lee Harvey Oswald type — insecure, nondescript, brooding. He worked as an auto mechanic and lived with his parents, in a sullen, silent standoff with an emotionally distant father. He was desperate for connection.

Ursula was in the high school bleachers with her daughter one day when she saw Mark walk onto the field below, his eyes searching the stands for Karen. Ursula remembers the exaggerated anxiety on his face, as though he felt existentially alone and hungered to belong. <i>A vulnerable person</i>, she thought.

Karen liked to fix things. Mark’s vulnerability was appealing, at first.

In 1986, there was no term in the psychiatric lexicon for the infatuation with which Mark Willey would smother Karen Ermert. Today it would be known as obsessive love, and Mark checks every box in the clinical description. “Attracted”? Check. “Anxious”? Check. “Controlling”? Check. The final square is “Destructive.”

Ursula Ermert was a 1960s German immigrant who had been widowed when Karen was 12, which led to mother and daughter becoming exceptionally close, which meant they could too easily hurt each other. The years of teenage rebellion had been particularly freighted for both. Once, at 15, Karen ginned up an argument over something trivial to undergird a foot-stampy, theatrical declaration that she was leaving home. Ursula was not about to loose a naive teenager on the streets. “If you find me so hard to live with,” she told her daughter, “I will be the one to leave.” And she did. She drove to the family’s business, a dental lab, and slept on a bed in the back room. Eventually Karen figured where she must be and phoned in the middle of the night. Crying, she asked her mother to come home.

Ursula was crying, too. She said no, she would stay there until morning: “This has to hurt us both so much it will never happen again.”

It didn’t. Not that it would matter, in the end.

After high school, Karen went off to college in Shepherdstown, W.Va., but soon dropped out because Mark Willey persuaded her to. He missed her too much, he’d said. When she got jobs — she was starting out as a clerk — Mark would show up at her workplaces, unannounced. He once crashed her office party. He didn’t like these places in which she spent her days. They contained men.

It was all there in the notes, the ones Ursula found after it was too late. They were filled with incapacitating jealousy and lovesick histrionics, and in particular a suffocating need for control. Mark had evidently been monitoring Karen’s movements, day and night, and found them wanting. He’d left each note for her when she had not been precisely where he’d expected her to be, precisely when he expected her to be there. The handwriting, corralled by blue horizontal lines, is neat but gallops to the right, as though he was racing to keep up with his emotions.

<i>I took a shower and dressed up and did everything I could maybe to look halfway as nice as all the gorgeous guys you see every day. I would just kill to look as good as them and be able to catch your eye. Karen, I’m really hurting, in fact, I’m starting to cry … Where are you? Did you go out to eat? I feel like a fool that has been stood up. I love you so much. If words could be put on paper to describe how much there wouldn’t be enough paper. I’m gonna call your house again. Karen, if you want to go out with some other guy, please tell me. It would hurt less if I found out that way. Love, Mark.</i>

<i>Karen, where are you? I am really worried. First thing I thought was that you stopped for dinner but I know you would have the courtesy to call me so I would not sit here and worry like this. I am always worried about you being in an accident because I would be the last to hear. God, if you aren’t okay, I’ll kill myself! You don’t know what you mean to me.</i>

<img class="unprocessed placeholder" data-hi-res-src="https://img.washingtonpost.com/wp-apps/imrs.php?src=http://www.washingtonpost.com/news/magazine/wp-content/uploads/sites/69/2019/09/heart_5.jpg&amp;w=1484" data-low-res-src="https://img.washingtonpost.com/wp-apps/imrs.php?src=http://www.washingtonpost.com/news/magazine/wp-content/uploads/sites/69/2019/09/heart_5.jpg&amp;w=480" data-raw-src="http://www.washingtonpost.com/news/magazine/wp-content/uploads/sites/69/2019/09/heart_5.jpg" src="https://img.washingtonpost.com/wp-apps/imrs.php?src=http://www.washingtonpost.com/news/magazine/wp-content/uploads/sites/69/2019/09/heart_5.jpg&amp;w=60"/><div class="ent-photo-grid-small-caption ent-photo-grid-2">Karen Ermert with her mother, Ursula, in July 1985. (Courtesy of Ursula Ermert Jones)</div><img class="unprocessed placeholder" data-hi-res-src="https://img.washingtonpost.com/wp-apps/imrs.php?src=http://www.washingtonpost.com/news/magazine/wp-content/uploads/sites/69/2019/09/heart_4.jpg&amp;w=1484" data-low-res-src="https://img.washingtonpost.com/wp-apps/imrs.php?src=http://www.washingtonpost.com/news/magazine/wp-content/uploads/sites/69/2019/09/heart_4.jpg&amp;w=480" data-raw-src="http://www.washingtonpost.com/news/magazine/wp-content/uploads/sites/69/2019/09/heart_4.jpg" src="https://img.washingtonpost.com/wp-apps/imrs.php?src=http://www.washingtonpost.com/news/magazine/wp-content/uploads/sites/69/2019/09/heart_4.jpg&amp;w=60"/><div class="ent-photo-grid-small-caption ent-photo-grid-2">Ermert’s boyfriend, Mark Willey, in an undated photograph. (The Fairfax Journal)</div>


Karen Ermert with her mother, Ursula, in July 1985. Ermert’s boyfriend, Mark Willey, in an undated photograph. (From left: courtesy of Ursula Ermert Jones; The Fairfax Journal)

<span class="ent-dropcap-first-letter">O</span>ne day near the end, Ursula drove her daughter to the emergency room to be treated for kidney stones. A nurse looked at Karen, did a double take and asked, “Weren’t you here two weeks ago with a head injury?”

Ursula waited for Karen to say the nurse must be confusing her with someone else. She didn’t.

“Mark hit me,” she said later. She had wanted to get out of the car, and Mark hadn’t wanted her to. The explanation was unnervingly matter-of-fact.

Imagine the dilemma facing Ursula Ermert in 1986, trying to decide what to do with a headstrong daughter who at 19 was living on her own and supporting herself because she treasured her independence. Karen would not be pushed to do things she did not want to do. In fact she might well stubbornly do the opposite, if nudged too hard. Should Ursula go to the police over Karen’s objections? And what exactly would she tell them? What did she really even know?

Mother and daughter argued about it more than once. On one occasion Ursula infuriated Karen by telephoning Mark’s parents, telling them that if Mark ever hurt Karen again, she would hold them responsible. Mark, it turned out, was listening on an extension and told her to butt out. What followed was a letter from Karen to Ursula; it was typical Karen — firm, but affectionate. It said in effect: <i>Stop complaining about my friends, and you and I can still love each other unconditionally.</i>

That was the dreadful state of affairs around Christmas 1986, when the tension lifted. Karen had decided she’d had enough. She told Ursula she was going to end the relationship, and she’d made the decision on her own. It wouldn’t be a breakup so much as an escape. All that was left was logistics.

Mother and daughter conspired and came up with a plan. Karen would tell Mark a tactfully laundered version of the truth: She had just gotten a new job working at Dulles International Airport for the German military. That was true. She would tell Mark that she’d be so busy studying German that she would no longer have time for any dating at all. That wasn’t exactly true — Karen was fluent in German. Mother and daughter reasoned that this story wouldn’t seem so much like a personal rejection, and with luck, the “no dating” would keep Mark’s jealousy at bay. But the answer would also have to seem final. For Christmas, he’d given her a table he had carpentered himself, and Karen was going to insist on returning it.

That was the plan. She was going to tell Mark on the phone on Friday, the night of the 26th.

Ursula waited by her phone. In early evening, Karen called.

“He said he’d kill me.” Karen was giggling. She’d felt enormous relief, and it tickled her. It overwhelmed everything else, including caution.

But Karen demurred. She hadn’t taken Mark’s threat literally. His love for her was septic, but still it was love — how could he kill her? She didn’t expect to hear from him again that night, but if there were problems, Karen promised, she’d call. Ursula slept with the phone next to her head.

<div class="ent-pullquote">
<div class="ent-pullquote-text">In 1986, there was no term in the psychiatric lexicon for the infatuation with which Mark Willey would smother Karen Ermert. Today it would be known as obsessive love.</div>
<div class="ent-pullquote-annot"></div>
</div>

Midnight passed without a call, but the phone rang around 2 a.m., or at least Ursula thinks it did. Her sleep had been fitful, and to this day she knows she may have anxiety-dreamed that ringing phone. In any case, by the time she worked the receiver to her ear, there was only a dial tone. So she phoned Karen.

An unfamiliar man’s voice answered hello.

She apologized for having dialed a wrong number, hung up and called again.

“This is Ursula Ermert. Are you in my daughter’s apartment?”

So Ursula threw on clothes, ran to her car and drove the 15 minutes to Karen’s apartment, trying to make no assumptions. The truth was, she didn’t <i>know</i>. There were all <i>sorts</i> of scenarios, none of them benign but some less awful than others.

At the apartment, it fell to Detective Tommy Lee to confirm the worst.

Three decades later, Lee remembers the moment as the saddest thing he’d ever had to do as a police officer. He was 39. He had a 16-year-old daughter of his own at the time, and he was worried about the fast company she was keeping. Eventually he would lose her to a drug overdose. But on this day he was just someone’s father who had to break some terrible news to someone’s mother.

Ursula gasped, her knees buckled, and she collapsed into Lee’s arms.

<span class="ent-dropcap-first-letter">A</span>ll that time later, sitting in her house, in the study that had once been her daughter’s bedroom, with Karen’s ashes in a box high on the top shelf, Ursula remembered what happened next.

She’d asked the detective, “How is Mark? Where is he?” Lee told her that Mark had shot himself and wouldn’t survive, either.

It may have seemed like an oddly solicitous question, under the circumstances. It wasn’t. If Mark was not dead, Ursula was going to see to it that he became dead, right then and there, whatever it took.

Ursula smiles. “If I had,” this dainty woman says mildly, with a faintly Teutonic sibilance, “I would be getting out of prison right about now.”

<span class="ent-dropcap-first-letter">T</span>he call had come in as a shooting. Fairfax City patrol officer Ed Vaughan was among the first to arrive. He took Main Street toward Jermantown Road, alert for a car driving erratically, because that’s sometimes how you catch the guy in the immediate frenetic aftermath of a domestic. But the streets were almost empty.

The address Vaughan was headed for, 11100 Gainsborough Ct., was at the poor end of the city of Fairfax — a homely two-story, U-shaped apartment cluster surrounding an inner courtyard. The front door was locked, so Vaughan went out back to find Apartment 6, which was on the second floor. It had a balcony. He saw a downspout he could climb, and a tree.

Then Vaughan heard a single shot, and he flinched and looked for cover. He needn’t have. As it turned out, it was the final shot, the suicide.

Ursula had hated that tree beside the balcony; she thought it provided an excellent hiding spot for a peeping Tom or perfect access to someone intent on burglary or worse.

As police later reconstructed it, Mark Willey had shinnied up the tree with his rifle slung over his back. He’d stowed the weapon on the balcony and knocked to be let in. For reasons we will never know, Karen slid open the glass door. There was an argument. Voices were raised. Accusations were leveled. The finality of the breakup was confirmed. Mark stormed out. Seconds later, he was back, with the rifle.

That was the story line in the local newspapers on Sunday: Girlfriend breaks off relationship, returns Christmas present; enraged boyfriend commits murder and suicide.

As it happens, there was an added dimension, another stratum of pain, one that Ursula Ermert had not known about, one that never got into print. It’s there in the police report.

Rich Lieb is now 51. He had been casual friends with Mark Willey since elementary school. In 1985 and 1986, he’d double-dated with Mark and Karen a few times, until Rich didn’t have the stomach for it anymore. He didn’t like what Mark became when he was liquored up, how he’d treated Karen.

Rich didn’t know why such a feisty, self-possessed girl had accepted the abuse, but he had a theory. Early on, Karen had carried a few extra pounds, and maybe it affected her self-confidence. But by the end of 1986, she’d jettisoned the weight, looked great and gained moxie.

In the era of the long phone call, Karen was a letter writer; she considered it an old-fashioned virtue. In November, she wrote a letter to Rich. It was just a friendly hello out of the blue, an old friend remembering the good times they’d spent together. Because he was a 19-year-old guy with the requisite lunkheaded cluelessness about such things, Rich didn’t take the hint. He accepted the letter at face value and never responded. Weeks passed. Then, on Christmas evening 1986, Karen telephoned him to tell him she was lonely. Even a 19-year-old lunkhead could figure that one out.

They spent the night together. It was electric. Part of that was the new intimacy, and part was simply a natural rapport — they liked each other. Permeating it was a sense of elation and relief, as though Karen’s eyes had just been opened to the possibilities of a relationship that didn’t hurt.

Rich felt that it was the start of a romance that would last a lifetime. He and Karen spent the next day together at the house he lived in with his parents. He was to leave on a ski trip at 3 a.m., so a little after midnight, Karen left to return to her apartment.

What happened next is evident, if some of the details are not. Mark had somehow found out about Karen’s new relationship. She may have told him when she broke up with him — she’d promised Rich that she was going to — or Mark may have discovered it on his own. But police are certain he knew, because before he arrived at Karen’s apartment, he telephoned. Karen hadn’t gotten home yet, but her roommate Christine was there, and Mark told the young woman of his anger, depression and feeling of betrayal. Karen arrived during the call and talked to Mark as well.

After she hung up, Karen took a bath. After he hung up, Mark wrote a bitter suicide note and left it on his bed. (It’s not in the police file, but Lee remembers it well: It was sick, sullen and self-pitying, he said.) Then Mark loaded his rifle and carried it to his car.

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<div class="ent-pullquote-text">Young, healthy people are most likely to do life-threatening things late at night on Fridays and Saturdays, so organ transplants often occur at 1 or 2 a.m. on Sundays and Mondays.</div>
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Madness, it is said, is a private religion — a set of values and beliefs that may seem irrational to others but is perfectly manifest to the madman, consistent within his delusional world. Obsessive love is not formally classified as a mental illness, but it is a disordered mental state with some of the same rhythms. To Mark, all his dark suspicions were confirmed.

He was a paranoiac, but he <i>had</i> been betrayed. Beyond that bitter truth was blind rage, unmodulated by logic. It would not have occurred to him that his treatment of Karen had extinguished any right to demand or expect her loyalty; or for that matter, that killing her was a wildly disproportionate reaction to a predictable if painful development. He’d become unhinged, a lethal player in a dark psychodrama.

Rich Lieb didn’t find out about the murder until he returned from his ski trip the following night to find his parents sitting up late, waiting for him, so he’d hear it from them first. For days afterward, he couldn’t drag himself out of bed.

He still lives in Virginia. He works in IT. He’s divorced and in a relationship. Asked to write down his memories of Karen Ermert, he took some time. The intensity of his response may seem incongruous for a romance that lasted, strictly speaking, 48 hours. But Lieb trusts his feelings, infused as they may be by anger and guilt and loss and, above all, a bedeviling regret.

“She made me want to move mountains for her,” he wrote, “and also made me feel like I could do it. She was everything I ever wanted and to this day is the standard against which I measure other women.”

When Mark Willey walked back from the balcony into that apartment, he was firing, and firing with precision. Christine, who had witnessed the confrontation, ran.

Karen took five bullets, three to the head and neck. The crime scene photos are difficult to look at. There is a Christmas tree, and beside it, a wall with four Christmas stockings, three big ones for the roommates and a smaller one for the dog. On the floor is a young woman in a powder-blue bathrobe and a white patterned nightgown. Karen’s hair is almost unmussed, but blood streams from her eyes and nose and mouth, soaking into a ratty rug and a dingy parquet-floored hallway near the dog’s bowl.

In the police file, in plastic bags, are a half-dozen misshapen, sharp-edged pieces of bullet that had tumbled through the brain. So much tissue was destroyed that Karen’s heart stopped.

Mark postponed the end as long as he dared, until there were police officers in the courtyard and officers banging on the front door. He backed away from Karen’s body, turned a corner, steadied the rifle against the floor, and reached a thumb for the trigger.

Christian Font is a Design Editor focused on storytelling in Investigative, Metro and The Washington Post Magazine. He has been at The Post since 2012. He previously worked in a variety of roles over 12 years at the Sun Sentinel in Fort Lauderdale, Fla.

Christian Font

Gene Weingarten is a Pulitzer Prize-winning journalist and writes "Below the Beltway," a weekly humor column that is nationally syndicated.

Gene Weingarten

Katherine Frey is a staff photographer for The Washington Post.

Daniele Seiss

Washington, D.C.

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