Shortly after Nathan Ruhland arrived at Mayo Clinic, Marty Unruh, DNP, showed his patient — a fellow dog lover — a picture of his dog dressed in scrubs, with a stethoscope around his neck. Dr. Ervin, the goldendoodle, would come to play an important role in young Nathan's time at Mayo.

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When Marty Unruh, DNP,  arrived for his shift at Mayo Clinic one night in January, a colleague approached him with a request.

Could he locate a dog-tor, STAT?

"One of our patients found out he was getting a heart transplant the next day and was pretty anxious," Unruh, a nurse practitioner in Cardiovascular Surgery, says. "He had asked if we had any dogs that could visit him."

It was too late to call in one of Mayo's Caring Canines. But Unruh had the next best thing: his goldendoodle, a very good boy named Ervin. After getting permission from his supervisor, Unruh had his wife drop Ervin off for a visit with 15-year-old Nathan Ruhland.

"Ervin read the room perfectly, recognizing Nathan's illness," Unruh says. "He laid on the ground and just let Nathan rub his belly. I snuck into Nathan's room later, after Ervin had left, and Nathan was sleeping without a care in the world. That's the power of a dog."

Furry connection continued

That night wasn't the first time Nathan had seen Ervin. Shortly after Nathan arrived at Mayo Clinic, Unruh learned he was a fellow dog lover and showed Nathan a picture of Ervin dressed in scrubs, with a stethoscope around his neck.

"Nathan's eyes lit up when I showed him that picture," Unruh says. "He said, 'I need him to be my doctor. I need that picture, right there on the wall.'" So Unruh printed the photo, and Dr. Ervin watched over Nathan throughout his stay.

Pets are one of Unruh's go-to topics when he's talking with patients.

"I've learned pets are a way into most people's hearts," he says. "I write down the name of their pets and ask them for pictures and updates each day that I take care of them. It connects them to home and life outside the hospital."

That was a life Nathan, who was born with aortic stenosis, was missing. He'd already had four open-heart surgeries and countless other heart procedures in his 15 years. Then, in May 2021, he learned he'd need a heart transplant. That December, he was admitted to Mayo Clinic Hospital in Rochester to be monitored until a heart became available.

While he waited, Nathan kept up with his classes online. He took walks, played board games and X-Box, and watched TV and movies. But his favorite activity was getting a visit from one of Mayo's Caring Canines. (He even came up with a term for the visits, Code Dog, that often brought Unruh to his room.)

On Christmas morning, Unruh stopped at the hospital to give Nathan some gifts, including a book with pictures of dogs living in New York.

"I just wanted to try to spread a little cheer to this boy who had to be in the hospital on Christmas," Unruh says.

We've been at three different hospitals, and they've been good, better and best. Mayo is by far the best.

Brian Ruhland

Then, Nathan said something that touched Unruh deeply.

"He was quite sick, so I doubt he even remembers this little side conversation, but it changed my entire Christmas season," Unruh says. "Nathan's voice became quiet and thoughtful, and he said, 'Dr. Marty, I've been thinking. I think I want to get my Christmas miracle tonight instead of early in the day, so whoever ends up giving their heart to me gets to be with their family all day.'"

Unruh said goodbye and quickly left the room so Nathan wouldn't see the tears falling from his eyes.

"I honestly think Nathan, with his beautiful, kind spirit, just simply outgrew his heart," Unruh says.

New heart, new start

Nathan's miracle didn't come on Christmas. But just a few weeks later, on Jan. 13, he received a new heart.

In the days and weeks that followed, Nathan began the difficult work of recovery. He was poked and prodded throughout the day and night to monitor his body's reaction to his new organ and new medications. He soldiered through occupational therapy, physical therapy and cardiac rehabilitation. All while far from his home, his family and his friends.

And while Nathan was well-known around the hospital for his optimism, there were times his smiles "were few and far between," Unruh says.

He wanted to do something to lift Nathan's spirits during those tough times, and reached out to colleagues with a request: Could they send him photos of their dogs, with messages of encouragement for Nathan?

Of course they could.

Unruh collected the images and messages in a photo album, which he presented to Nathan on a tough day.

And while the gift was meant to encourage Nathan, Unruh and his colleagues got a boost as well.

"The book might have been more healing for staff than for Nathan," Unruh says. "He was with us for a long time and never far from any of our minds. It allowed us to write down our care and love for him."

It's gestures like that that make Mayo stand out says Nathan's dad, Brian Ruhland.

"We've been at three different hospitals, and they've been good, better and best," he says. "Mayo is by far the best."

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Editor's note: After 128 days, Nathan left Mayo Clinic and moved to Ronald McDonald House. Today, he's back home in Rockville, Minnesota. He's earned his driver's permit, gotten his first job, and started 10th grade. "He continues to amaze us," says Nathan's mom, Mary. To learn more about organ donation or register to become a donor, click here. And to see Nathan, Unruh and Ervin reunite, check out this "Kids With Courage" story.

If you have a furry friend who could bring joy to patients, you can learn more about volunteering at Mayo Clinic here. Mayo Clinic has Caring Canine programs in Arizona, Florida and Rochester, as well as at many Mayo Clinic Health System locations. Contact a location near you to learn about opportunities.