This is a story all about heart: the big heart of a man who has had more challenges thrown at him than one person should have to bear, and the heart of the medicos who would not give up on him.
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Sam Atkins has stared death in the face more than once.
Each time, he has been pulled back from the brink by a miracle.
The latest time, in November last year, it was a team of surgeons in the cardiac unit at Hobart Hospital who stepped in and gave him the ultimate gift of continuing life, and he will be forever grateful.
Sam, 46, of Launceston, has had a series of serious health crises that could have seen him crash out of life three or four times in the past 20 years.
At the age of 23, he collapsed in his backyard while practising martial arts - his heart valve was failing due to a previously undiscovered congenital condition.
Emergency surgery, an artificial valve, a stint in rehab and he was off and kicking again.
A few years later, a rare melanoma was discovered on his face.
It required the removal of a section of the bottom lip and chin, the two sides being stretched across and rejoined.
The books said people rarely survived this type of melanoma for more than seven years.
No one told Sam.
Sam married, and had children.
Five years after the melanoma, a bomb hit Sam's life.
While holidaying on the north-east coast, he felt severe chest pains and drove himself to Bridport, from where he was immediately taken by ambulance to Launceston.
It looked as though his aorta might be tearing, and he was flown to Melbourne for emergency surgery at the Austin Hospital.
As they opened up his chest the aorta burst apart: he bled out and died on the operating table but was resuscitated and after many hours of surgery by an incredible cardiac team he lay in ICU, close to death but still hanging on.
For his family - his wife and parents who flew across from Tasmania, and his brothers back home - it was beyond stressful.
It was numbing.
But Sam survived.
However his loss of blood caused catastrophic damage.
"He's the sickest man in Australia," the surgeon and head of cardiology at the Austin, Professor Siven Seevanayagam (widely referred to simply as Siven), told his family.
Sam was on life support.
As well, one leg had to be amputated below the knee because of damage to the muscle.
His lower spine was damaged and while it transpired that some slight feeling remained, he could not move his legs - he was now paraplegic.
His vocal chords also sustained damage.
After a few days, Sam's devastated mother quietly asked if they should be preparing themselves to let him go.
"We're not ready to give up yet," Siven told her.
And neither was Sam.
After a month in ICU and two in the spinal unit, he had improved enough to be transferred back to Launceston to continue management at home through the LGH under cardiologist Dr Rohit Barthwal and clinical nurse consultant in cardiology John Aitken.
Sam's marriage ultimately did not survive but he pushed on, sharing the care of his children, becoming a familiar figure on his son's cricket field coaching the young team from his wheelchair, albeit able to speak only in a loud whisper.
There were, of course, times when he felt crushing despair - how could there not be?
But he drew on an extraordinary inner well of resilience and while life was tough, he made life good.
Fast-forward another 12 years to 2022 and the artificial valve in Sam's heart began to fail, along with other issues around his heart.
Over several months his body progressively weakened and eventually he was no longer able to move his wheelchair about, or do anything much for himself.
After a flurry of medical tests and an emergency air ambulance trip to see Prof Siven in Melbourne, finally the brutal truth - the complexities of Sam's condition, which included scar tissue problems around his heart from the previous surgeries, meant that his was an incredibly problematic case and his body would likely not survive another open-heart surgery.
Not a third one.
That was it.
At 45, Sam Atkins was dying.
The prognosis was three to four months at most.
But in a subsequent discussion with Sam, the Melbourne surgeon uttered, with a vehemence that Sam had not heard from him before, "You can't die, Sam.
"We have to do something."
But aside from the immense difficulties Sam's case itself presented, this was now the post-pandemic world of hospital waiting lists that were crippled with the weight of delayed surgeries and staff shortages.
The Austin had a multitude of urgent surgeries backed up.
Professor Siven Seevanayagam is a determined man.
He conferred with a former colleague and the head of cardiothoracic surgery at the Royal Hobart Hospital, Dr Ashutosh Hardiker, as well as with various specialists around the country, and Dr Hardiker agreed to take the case on with his team in Hobart.
Dr Hardiker developed a complex plan for replacement of the valve as well as bypass surgery to get around the scar tissue problems.
A race against time then ensued to coordinate all the doctors and ancillary medical team required, theatre staff, theatre time, and to ensure Sam was in as good a physical condition as possible before scheduling surgery.
The odds for Sam were not good, everyone knew that, Sam most of all.
He was just a fraction off the risk ratio at which doctors will not operate because they know the patient will not survive.
Sam had total confidence in Dr Hardiker.
But he was also a realist, and over the next two months, as he waited and hoped that the stars would align for him, he turned over and over in his mind whether going ahead with the surgery was the right thing.
Ultimately he felt had no choice.
With it, he may die immediately, but his life could be significantly extended.
Without it, he would be dead within a couple of months anyway.
He owed it to his children to try.
In November last year Dr Hardiker and his team including cardiac specialist Dr Rajiv Sharma, staff specialist Dr Jee Leong, head of clinical perfusion services Carmel Fenton, and specialist anaesthetist Peter Peres, stepped into the surgery to begin the expected 12-hour surgery.
They completed it in eight hours.
And Sam woke up.
And now, four months later, as he continues his recovery at home in Launceston and gradually builds up his strength again, Sam knows that he owes his life to the surgical team at Hobart Hospital and is inexpressibly grateful.
Dr Hardiker plans to write up Sam's incredible history for a medical journal.
Sam would like to shout from the rooftops about the doctors who have delivered him another miracle.
So this is also a story about gratitude: public hospitals cop a lot of flak, Hobart as much as any, but there will be many people who, like Sam Atkins, have everything to be grateful to those hospitals for, and this is their shout from the rooftops.
Pip Butler is a former Melbourne journalist. She is a relative of Sam's.
