Kathy Ritvo, thoroughbred trainer, watched the 2008 Kentucky Derby from her hospital bed in the cardiac critical care unit of Miami’s Jackson Memorial Hospital, where she was in need of a heart transplant.
Before the race, “My Old Kentucky Home” mingling with the rhythmic beating of her heart monitor, she turned to her cardiologist, Joseph Bauerlein, who was watching with her, and made what would have been a bold statement for any trainer, let alone a 39-year-old whose whose heart was failing after years of struggle with cardiomyopathy, a degenerative disease that weakens the heart muscle.
“When I take a horse to the Derby, you have to come,” Ritvo remembers telling him. “I don’t know why I said it, or what made me say it. It’s not like something I would say. But I told him.”
This week, that longshot hunch is coming home.
Ritvo, who received a heart transplant in November of 2008, will saddle Mucho Macho Man in Kentucky Derby 137, and if they gave a garland of roses for the race’s biggest feel-good story, Ritvo would be walking on petals.
Outside of Mucho Macho Man’s Barn No. 41 on the Churchill Downs backside, the colt’s connections have put out bottled water and snacks for reporters in anticipation of a media blitz. They should’ve put out some tissues, too. It’s not unusual to see tears when Ritvo starts telling her story.
“There were a lot of nights when she went to sleep that I wasn’t sure she’d be waking up in the morning,” said Ritvo’s husband, Tim Ritvo, also a thoroughbred trainer who now is the vice president for racing at Gulfstream Park in Hallandale Beach, Fla. “But she is as strong as anyone I know.”
You can measure heart function. You can hook up electrodes and perform ultrasounds and echocardiograms. You can have all the results there in black and white. But you cannot measure heart. Ask Bauerlein, Ritvo’s cardiologist. He’ll tell you.
“She would come into the clinic before her transplant, and I would know what her echocardiogram showed — she had just very poor heart function,” Bauerlein said. “But just looking at her, with her attitude, it would be hard for most people to tell she was as sick as she was.”
Ritvo said she started suffering from fatigue as early as 1998, but it wasn’t until she became sick during a pregnancy in 2000 that the heart problem was discovered. After that, she began a long period of life in and out of the hospital and heavy regimens of medication.
By the time she watched Big Brown win the Derby in 2008, Ritvo was, for the most part, confined to the hospital and hooked up to machinery that administered her medication, though she did manage to get released for short periods. She was waiting for a donor and trying not to think of the worst, though it was impossible not to.
“I lost a brother to the same disease when he was 38 years old,” said Ritvo, a mother of two who began training horses at age 18. “And I was very determined that my mother would not have to go through losing another child.”
You can look through all the heart tests and you won’t find the resolve it took to actually make all this happen.
She fought for normalcy. When her regular doctors were on vacation, she’d pester the staff until they’d let her go home, hauling a large piece of equipment to administer her medicine. It was restrictive, but at least allowed her to be in the house when the kids came home from school, to remember that she had a life outside the wires and monitors of the hospital.
It was while she was at home, watching a Style Network show called, “Clean House,” that the phone rang and an answered prayer was on the other end. It was Nov. 12, 2008. A donor heart had been found. Kathy and Tim Ritvo exhaled, then walked upstairs to pray with their two teenage children.
Some impressive fractions: Ritvo’s surgery lasted six hours, but she spent only seven days in the hospital before going home. Her surgeon, Dr. Si Pham, director of the Heart/Lung Transplant and Artificial Heart programs at Jackson Memorial, called that recovery, “record time.”
He also acknowledged time had been running out when the transplant was done.
“She didn’t have much longer,” he said. “When the heart becomes so weak, other organs fail — the kidneys, the liver — and the weaker you are, the more difficult the recovery is. So for her, we were very lucky to get a donor.”
Pham talked about some factors that have made her transplant a success – that she is a relatively small person who was in good physical condition, that she is disciplined and lives a healthy lifestyle. But the things that sustained her the most in the years leading up to the transplant aren’t there in her medical records.
“I wanted so badly to be there for my kids,” Ritvo said. “I didn’t want to leave Tim with the job of raising them alone. I was preparing myself for the worst, but I was determined to fight.”
After the surgery, Ritvo said she felt immediately better, but her thoughts didn’t turn back to training for a while. She was – and still is – on a heavy medication regimen that includes 30 pills a day, anti-rejection medicine and vitamins. She takes immunosuppressants to prevent her body from rejecting the new heart, but that puts her at increased risk for picking up infection. And horse barns aren’t the most sterile of environments. Horses pick up infections, bacteria. There’s dust. Yet, Bauerlein said, the risk level is “acceptable.”
The stronger she got, the more she wanted to get back to the track. She grew up around racing. Her father, Peter Petro, owned horses. Two brothers were jockeys, including the one who died of cardiomyopathy while awaiting a transplant at age 38. Another brother still is a trainer on the east coast, and she had trained with her husband since they’d been together. The Petros thought their little girl might be the one child who followed another route. But they couldn’t keep her away from the horses.
Tim was hesitant when his wife wanted to go back to work, but she started helping around the barn, and then saddled a horse for him one day, and she was back. And he saw that it made her happy.
As the sun poked through the clouds at Churchill Downs last week she said, “I’m not a sick person here. I’m not a heart transplant patient here. I’m a trainer here.”
Mucho Macho Man’s owners would tell you she’s a good one. Dean Reeves, who bought majority interest in the colt last year, originally hired Tim Ritvo to train him, but did not hesitate to leave Kathy in charge when Tim took a job at a racetrack.
“She’s very hands-on, very old-school,” he said. “She seems to have a great feel for what the horse needs.”
Jim Culver of Dream Team Racing, the original buyer of the horse and still a minority owner, called her training style “maternal.”
Both men, by the way, have undergone heart procedures of their own.
Ritvo won 149 races from 1990 to ’98 and had a horse finish eighth in the Breeders’ Cup Juvenile Fillies, but has never had anything like this colt.
She said she doesn’t spend much time thinking about what it would be like to win the Kentucky Derby.
“I don’t do that because I feel like I’ve already won,” she said.
Lots of times in sports, we talk about “heart” when a player can pound out a few more yards while going off-tackle or dig in when the game gets into overtime. But there’s a measure of heart that gets beyond toughness and into the area of what a person gives.
For Ritvo in this Derby, there’s a goal beyond the finish line. Ritvo doesn’t know who donated the heart that saved her life. She has written a letter and given it to the hospital to be sent to the donor’s family members. They haven’t come forward. She hopes they will.
But this week, she’s hoping to use the attention she gets from her accomplishment to encourage people to become organ donors, and to encourage people who are waiting for donations, to show them that there is life and success to be found after the wait. At 42, her long-term prospects are good. A heart that isn’t rejected in an otherwise healthy person can last a little more than 20 years, when another transplant is a possibility.
“Lots of people go on to live good lives after heart transplant,” Bauerlein said. “But to train a Kentucky Derby horse, well, that’s extraordinary.”
Ritvo has taped a public service ad for organ donation in Kentucky and told her story to Sports Illustrated and USA Today.
“I just feel like I’ve been put in this position to tell my story as much as I can tell it, and hope that it can do whatever good it will do,” she said. “When you have been given this gift, you feel the need to do something with it.
“If just one person sees my story and takes some hope from it, or decides to take the time to become an organ donor, then that will make whatever happens worthwhile.”
The heartstrings that weave through this story even touch the horse.
When Mucho Macho Man was foaled – more than three weeks after his due date – in Ocala, Fla., on June 15, 2008, his heart was not beating. He lay on the ground lifeless, according to Carole Rio of Rose Grove Farm, while she and her husband Jeff and others prayed. She put her hands on the foal and rubbed him, then stopped and prayed some more.
“Then all of a sudden this sucker just jumped up and started running,” she said. “He didn’t just stand up, he jumped up and took off.”
On the farm, they called the strapping yearling “Lazarus.” On the track, he is a running example of what can come of a second chance at life.
If all of this seems to have a fairy tale quality about it, Ritvo would tell you that the fairy tale has already happened.
“The horse brought us here and everything has fallen into place for us to be here,” Ritvo said. “No matter what happens Saturday, it’s going to be meant to be. I am not worried. We’re going to get the right post and right track and right trip. Every bit of this is a gift.”