A Happy Ending for a Ukulele Song

Heart transplant patient Sean Tiwanak pulled on plenty of heartstrings when he plucked his ukulele and sang a duet in his Cedars-Sinai hospital room with Lily Stern, MD, two days before his life-saving surgery.

As Stern – wearing a face shield and mask as protection against COVID-19 -- stood at Tiwanak’s bedside, the two sang “Stand by Me,” and a 55-second video of the scene swiftly went viral. 

Tiwanak’s personal story has continued to hit happy notes. His heart transplant Aug. 8 went very well, and he is expected to be discharged from the hospital soon.

“I know what it is to be blessed now,” said Tiwanak, a gregarious 53-year-old from Honolulu. “Everything I do from here on out is a result of this wonderful gift.”

Throughout his journey, Tiwanak did have some spells of gloom – one of them on the day of the duet. Not only was Tiwanak physically weak, but he was lonely as well. Due to COVID-19 protocols, he explained, everyone who came into his room was “gowned up.” Tiwanak also wanted someone in the hospital to sing with him, but he hadn’t been able to persuade anyone.

Then Stern came by his bedside, he said, “and the first thing she did was hold my hand. And I think that connection really gave me a lot of comfort, and that's what I needed – the moral, human support that you don't necessarily get in a clinical environment.”

Tiwanak proposed the song “Stand By Me” and, “We just instantly started singing together. And when you do that, when you sing with somebody, you kind of create this little space that is sort of like a communion in a way. And it was awesome. And she's so talented and sings so well that it just raised my spirits.”

Stern, a second-year cardiology fellow at the Smidt Heart Institute who plans to be a heart transplant specialist, said she was uplifted by the extraordinary doctor-patient connection. “I was just riding so high. Leaving the room, I felt like, ‘This is why I went into medicine,’” she said.

As Stern recalls the leadup to the magical moment, it came as she was making nighttime intensive care unit rounds with residents. Stern--whose musical background includes playing piano and guitar, singing with bands and performing her own music--had learned that Tiwanak played his ukulele for doctors, nurses and hospital staff.

She stopped in the room to say hello, caught about 15 minutes of Tiwanak’s music, and resumed her rounds. Later that night, after mentioning to Tiwanak’s nurse that she loved playing music and singing, too, the nurse passed along word to Tiwanak, and they two came to a decision: Stern had to go back to sing a duet.

Stern agreed, the moment was videotaped, and tens of hundreds of thousands of people wound up viewing the impromptu performance on social media. It even made a newscast back in Tiwanak’s native Hawaii.

The connection with Tiwanak came easily for Stern. “It was almost as if I met him on the beach and we just started playing music together,” she said.

Yet the episode had far more than a fleeting impact. Stern said it made her think about how she “went into medicine to really help people and not just to save lives, but to also save the quality of life. And my hope would be that Sean can get back to his former quality of life, where he could really be fully performing and sharing his music and light with the world.”

 Tiwanak has struggled with heart disease for 15 years with viral cardiomyopathy, a disease of the heart muscle that makes it harder to pump blood to the rest of the body, and he recently became gravely ill. Due to his deteriorating condition, Tiwanak was listed as a high-priority on the transplant list, according to Fardad Esmailian, MD, Tiwanak’s transplant surgeon.

Fortunately, Esmaillian, a Cedars-Sinai professor of surgery and surgical director for Heart Transplantation and Mechanical Circulatory Support, said Tiwanak’s operation went “extremely well.” He credited Tiwanak’s “great attitude” for his speedy recovery.

As for Tiwanak’s viral duet, Esmailian said, “for somebody to be able to do that, before having a heart transplantation, and on the brink of basically dying -- iI's pretty remarkable.”

Although heart transplant patients often fully recover within two to three months, Tiwanak expects to remain in the Los Angeles area for at least a half-year before returning to Hawaii. He said the extended stay is largely to avoid a long trip amid the COVID-19 pandemic.

He has led a remarkably varied life, working as everything from a respiratory therapist and a pharmaceutical salesman to a wedding minister and a recording artist. Tiwanak describes music as the one constant in his life ever since he started playing his first instrument at the age of 5. He plans to finish a fourth album of his music – he’s considering naming it “Change of Heart” – and he said he will dedicate a song he previously recorded, “Angel,” to his heart donor and healthcare team.

Tiwanak also has another plan in mind for his musical career – to perform in a more “substantial” way with Stern again one day.

Stern likes the idea, too. “We both keep saying that when he gets better, we're going to play music together,” she said.