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The gift

The climb was over.

Kelly Perkins stood on the summit of Mount Fuji, a freezing wind whipping through her short blonde hair, a mix of tears and rain streaming down her cheeks.In her hand she held the photo of a person she had never met, never spoken to, never seen.

She knew only a few things about this woman.

She knew that the woman was about 40 years old when she was thrown from a horse and had died somewhere in Southern California 21/2 years previously.

Kelly knew these things because she now carries that woman's heart in her chest. And as she stood on the rim of Mount Fuji's volcanic crater, she also carried the ashes of this woman, whose death saved her life.

In November 1995, Kelly Perkins was at the UCLA Medical Center dying of viral cardiomyopathy. Three years earlier, a virus had somehow infected her heart, done its damage and vanished.

She first noticed the problem one night when her heart began to race. Her family doctor found nothing wrong. He suspected stress.

Kelly knew that wasn't it.

"I knew something was up," she said. "And I knew it wasn't in my head."

Before going on a backpacking trip, she had herself checked again. This time, tests showed her heart was running amok. She was taken to a nearby hospital for a more advanced test, which showed the left ventricle was scarred and swollen to about four times normal size.

A device was implanted in her side to shock her heart into the proper rhythm.

For two years, she learned to live with the problem and a very unpleasant side effect: The device tended to shock her when she laughed. So she learned not to.

But a change in medication put an end to even that modicum of stability she had found in life.

To switch, she had to stay off her old medication for a full day. Without it, however, she was unable to function. Her heart ran wild, she collapsed. She was admitted to the medical center at UCLA and put at the top of their list for a heart transplant.

Somewhere, not too far away, a 40-year-old woman was thrown from her horse.

Kelly got her new heart in November 1995 and recovered so well that within a few months she was able to return to a favorite hobby - hiking in the mountains.

She and Craig, real estate appraisers both aged 36, started out on the gentler slopes near their home in Laguna Niguel, California. Soon they were making more serious climbs.

Just 10 months after her transplant, Kelly climbed Yosemite's Half Dome. The 17-mile hike to the 4,100-foot summit took her 111/2 hours.

Next came Mount Whitney.

At 14,494 feet, Whitney is the highest U.S. peak outside Alaska. Kelly had done it before, with her old heart. "I wanted to prove that I could do it with my new heart," she said, "to prove that to myself."

With Craig and a four-person support team, she made the three-day, 22-mile round-trip last September.

It put her in the national spotlight.

Kelly was the first heart transplant recipient known to have climbed Whitney. She was sought out for interviews. She appeared on "Good Morning America."

Among the millions of people who read Kelly's story, one was particularly touched.

"The donor's daughter read an Associated Press story about Kelly and put two and two together," Craig said. "She found our number through information and called our home."

"It was totally unexpected; I was totally taken aback," he said of the message recorded on his answering machine.

While Kelly was making her Whitney climb, a debate over transplants raged in Japan.

For years, the Japanese medical community had urged the recognition of brain death, the condition that makes heart, lung and liver transplants possible.

But opposition was intense.

Critics claimed doctors shouldn't be trusted to make such a judgment, that transplant advocates would rush to harvest organs instead of struggling to save a dying patient. Others simply felt uncomfortable with the idea, for reasons of religion or superstition.

Now, after being repeatedly shot down in Parliament, a bill recognizing brain death was about to become law.

Even so, Japan had virtually no infrastructure for actually carrying out transplants. Legal obstacles threatened to make harvesting organs extremely difficult and potential donors were few.

For many Japanese in need of a transplant, going abroad remained the only real option.

"I had seen little Japanese kids at UCLA waiting for a transplant," Kelly said. "It's heartbreaking."

So, after Whitney, she decided to climb Mount Fuji. Maybe, she thought, her climb could change the way some people in Japan felt about transplants.

The ascent was split into two legs.

It began at station 5, a little base camp 8,250 feet up, complete with restaurants, lodges and a post office.

From there Kelly, who is 5 feet 3 inches and weighs 95 pounds, hiked for four hours with her husband and a personal trainer to station 8. There they rested and acclimatized for several hours.

Mount Fuji, Japan's highest peak at 12,388 feet, is an almost perfect cone. The volcano is a symbol of beauty in Japan and has been worshipped for centuries.

Seeing sunrise from the summit is considered by many to be a sacred experience.

The four-hour final trek began just after midnight under a full moon.

The climb is not technically challenging. Pilgrims need no mountain-climbing skills. But Fuji's slopes are covered with a muscle-grinding mixture of ash and loose stone.

That was a problem for Kelly.

Because its nerves were severed for her transplant, Kelly's heart does not "know" immediately when to start beating faster to match the exertion of her body. Adrenaline kicks in after a few minutes, but until then she must endure an oppressive feeling of fatigue.

And, unlike her previous climbs, the trail up Fuji offers virtually no level ground.

"I'd heard people climbed it in sandals," she said. "But it's a hard climb."

After the call from the daughter, Craig had kept most of his dealings with the donor's family to himself. (He and Kelly do not want the family's name published).

Kelly had spoken to her donor's daughter on the phone, but it was a rather brief conversation, and they had never met.

Fear was part of the reason.

"I had mixed feelings. When you need a transplant, you think of it sort of like a pill. It's the medicine that will make you well," Kelly said. "It's not until everything is OK for you that you can start grieving for the donor. It's hard."

"It isn't just a pill that saved her life anymore," her husband added.

"When you have a family associated with it," he said, "it becomes more than a medication, it becomes a gift.

"It's a real gift."

Before going to Japan, Craig told the donor's daughter about the trip. She asked if he and Kelly would take her mother's ashes and picture to the summit.

He agreed.

But he didn't tell his wife until they had reached their goal.

Just after sunrise, crouching on Fuji's rugged rim, they opened the small leather pouch.

Clutching the photo and weeping, Kelly watched the gray remains of the woman who gave her her heart swirl from the pouch and disperse over Japan's sacred volcano, vanishing into the alpine storm.

"It's almost like seeing an angel," she said. "She has been a kind of mysterious figure in my life for so long. But now it's real."