In December 1967 the first successful heart transplant was performed in Cape Town, South Africa. The dying man’s diseased heart was removed, and a healthy heart from a deceased donor was sewn in its place. Since then, over 75,000 heart transplants have been performed worldwide.
In each heart transplant recipient, the patient’s own body recognizes the new, lifesaving heart as “foreign” and begins to attack it. Left unchecked, the body’s natural response will reject the new heart, and the recipient will die. Medicines can suppress this natural response, but the medications must be taken daily and with exactness. Furthermore, the condition of the new heart must be monitored. Occasional heart biopsies are performed wherein small pieces of heart tissue are removed and then examined under a microscope. When signs of rejection are found, medications are adjusted. If the rejection process is detected early enough, death can be averted.
Surprisingly, some patients become casual with their transplanted hearts. They skip their medicines here and there and obtain the needed follow-up less frequently than they should. They think that because they feel good, all is well. Too often this shortsighted attitude puts the patients at risk and shortens their lives.
A heart transplant can prolong life for years for people who would otherwise die from heart failure. But it is not “the ultimate operation,” as Time magazine called it in 1967. 1 The ultimate operation is not a physical but a spiritual “mighty change” of heart. 2
Through the Atonement of Christ and by obedience to the laws and ordinances of the gospel, we undergo this ultimate operation, this spiritual change of heart. As a result of our transgressions, our spiritual hearts have become diseased and hardened, making us subject to spiritual death and separation from our Heavenly Father. The Lord explained the operation that we all need: “A new heart also will I give you, and a new spirit will I put within you: and I will take away the stony heart out of your flesh, and I will give you an heart of flesh.” 3
Just as with heart transplant patients, however, this mighty change of our spiritual hearts is just the beginning. Repentance, baptism, and confirmation are necessary but not sufficient. Indeed, equal, if not greater, care must be taken with a spiritually changed heart than with a physically transplanted heart if we are to endure to the end. Only by doing so can we be held guiltless at the time of judgment. 4
Enduring to the end can be challenging because the tendency of the natural man is to reject the spiritually changed heart and allow it to harden. No wonder the Lord cautioned to “even let those who are sanctified take heed.” 5
We all know of individuals who had this mighty change of heart but subsequently yielded to the natural man. They became casual in their worship and devotion to God, their hearts became hardened, and they thereby jeopardized their eternal salvation.
The lives of the people who were converted by the preaching of the sons of Mosiah offer some insights as to how one avoids rejecting the mightily changed spiritual heart. Of them, we read that “as many as were brought to the knowledge of the truth, through the preaching of Ammon and his brethren, … and were converted unto the Lord, never did fall away.” 6
How did they successfully endure to the end? We know that they were “distinguished for their zeal towards God, and also towards men; for they were perfectly honest and upright in all things; and they were firm in the faith of Christ, even unto the end.” 7
Their zeal towards God likely reflects an eagerness to please God and worship Him with fervor and passion. Their zeal towards men suggests an ardent interest in helping and serving others. Being perfectly upright and honest in all things suggests that they held their covenants firmly and did not rationalize their commitments to God or man. We further know that they taught their children the gospel in their homes. We know that they buried their weapons of war, distancing themselves from temptations.
They must have frequently assessed the condition of their spiritually changed hearts. They did not simply assume that all was well. By figuratively examining their changed hearts, they could identify any early hardening or rejection and treat it.
Alma the Younger poses a series of questions to contemporaries of the people of Ammon that figuratively biopsy spiritually changed hearts. Alma asks, “If ye have experienced a change of heart, and if ye have felt to sing the song of redeeming love, I would ask, can ye feel so now?” 8 He further asks if they have been sufficiently humble, free of pride and envy, and kind toward their fellowman. 9 By honestly answering questions like these, we can correct early deviations from the strait and narrow path and keep our covenants with exactness.
In 1980 we moved as a family across the street from the hospital where I trained and worked. I worked every day, including Sundays. If I finished my Sunday work by 2:00 p.m., I could join my wife and daughter and drive to church for meetings that began at 2:30.
One Sunday late in my first year of training, I knew that I would likely finish by 2:00. I realized, however, that if I stayed in the hospital just a little longer, my wife and daughter would depart without me. I could then walk home and take a needed nap. I regret to say that I did just that. I waited until 2:15, walked home slowly, and lay down on the couch, hoping to nap. But I could not fall asleep. I was disturbed and concerned. I had always loved going to church. I wondered why on this day the fire of testimony and the zeal that I had previously felt were missing.
I did not have to think long. Because of my schedule, I had become casual with my prayers and scripture study. I would get up one morning, say my prayers, and go to work. Often day blended into night and into day again before I would return home late the following evening. I would then be so tired that I would fall asleep before saying a prayer or reading the scriptures. The next morning the process began again. The problem was that I was not doing the basic things I needed to do to keep my mightily changed heart from turning to stone.
I got off the couch, got on my knees, and pleaded with God for forgiveness. I promised my Heavenly Father that I would change. The next day I brought a Book of Mormon to the hospital. On my to-do list that day, and every day since, were two items: praying at least morning and evening and reading in the scriptures. Sometimes midnight would come, and I would have to quickly find a private place to pray. Some days my scripture study was brief. I also promised Heavenly Father that I would always try to get to church, even if I missed part of the meeting. Over the course of a few weeks, the zeal returned and the fire of testimony burned fiercely again. I promised to never again fall into the spiritual death trap of being casual about these seemingly small actions and thereby jeopardizing things of an eternal nature, regardless of circumstances.
To endure to the end, we need to be eager to please God and worship Him with fervor and passion. This means that we maintain faith in Jesus Christ by praying, studying the scriptures, partaking of the sacrament each week, and having the Holy Ghost as our constant companion. We need to actively help and serve others and share the gospel with them. We need to be perfectly upright and honest in all things, never compromising our covenants with God or our commitments to men, regardless of circumstances. In our homes we need to talk of, rejoice in, and preach of Christ so that our children—and we ourselves—will desire to apply the Atonement in our lives. 10 We must identify temptations that easily beset us and put them out of reach—way out of reach. Finally, we need to frequently biopsy our mightily changed hearts and reverse any signs of early rejection.
Please consider the state of your changed heart. Do you detect any rejection setting in as a result of the tendency of the natural man to become casual? If so, find a place where you too can kneel. Remember, more than mortal years on this earth are at stake. Do not risk forfeiting the fruits of the ultimate operation: eternal salvation and exaltation.
I pray that we may press forward with steadfast faith in Christ and endure joyfully to the end, 11 in the name of Jesus Christ, amen.
“Surgery: The Ultimate Operation,” Time, Dec. 15, 1967, 64.
See 3 Nephi 27:16.
See Alma 5:27–30.
See 2 Nephi 25:26.
See Dieter F. Uchtdorf, “Have We Not Reason to Rejoice?” Liahona and Ensign, Nov. 2007, 18–21.