Saturday, February 11, 2012

The Heavy Wait

We received a call right before the holidays from Dr. Murillo's office. As of December, Patrick moved to the top of the transplant list, so the call could come literally any day now, at any time of the day or night, with the news that he is the winner of an all-expense paid trip to the lovely Research Hospital OR and ICU suites. The food is shit, but the door prize more than makes up for it: a gently-used but healthy kidney of his very own.

We have been on the list since August 2009. Is it really possible that two and a half years have already gone by? It seems so long ago. It seems like only yesterday.

For the most part, everyone we meet is supportive and optimistic, but there is a dark, inescapable reality associated with organ transplants. Somebody has to die in order for him to have a better quality of life. I am continuously amazed that some people seem to LOVE to point that fact out.

Healthcare workers develop a pretty macabre sense of humor to deal with the situations they face on a regular basis. The transplant and dialysis nurses become positively ghoulish about the whole thing, especially as we come into the winter months. They are fond of saying, with big, scary vampire grins, "Winter is car accident season!" And car accidents, of course, equal organ donors.

Naturally, this winter has been almost devoid of snow and ice. You don't want to pray for snow and ice. You don't want to pray for somebody else to perish so you can have their vital organs. But you can't help but look out and curse the bone-dry streets. You can't help but wonder, who's in the hospital now? What are their chances? If they don't have some sort of will or living directive, will their family make the right choice? You can't help but pray that someone who was young and healthy is on the verge of expiring from some non-kidney-damaging illness so your loved one can have the best transplant possible.



I go to New Orleans at the end of this month for an International English Honor Society conference. I'll be gone for four days. I'm petrified that the transplant will come while I'm out of town, that Patrick will go into that situation without me.

The nurses say that, in recovery, transplant patients are almost impossible to keep in bed. They feel so good, they don't want to lie down. They want to get out there and start making up for lost time. No more pain. No more nausea. No more trips to the emergency room. No more dialysis.

Sounds too good to be true.

I have these lines in my head, one from Nabokov, "And the last long lap is the hardest." The other, from a Walter de la Mare poem, "Oh, out of terror and dark to come/In sight of home." If I weren't a fatalistic person before, I would be now. The last two and a half years have been exhausting, a nightmare from which we keep hoping to awaken. Now that there's an end in sight, I keep thinking of the strange and almost mystical intersection of circumstances that will be required to provide the kidney donation-- the right person, the right place, the right time, the right death. Also, even though the past two and a half years have been so hard, I feel like we've both come out of this as better people. Does that make it all worth it? Would I trade who I am now for the person I was two and a half years ago if it meant none of this ever happened? There's no way to answer such questions.

And there's no way to address the deeper issues-- weighing your worthy qualities against your unworthy qualities. Wondering how you will ever be able to demonstrate sufficient gratitude to humanity and the universe at large for the gift you are about to be given. It's this weird twist on survivor's guilt, like that scene at the end of Saving Private Ryan, where the old man is wondering if he'd really deserved all those men sacrificing themselves to make sure he came home.

We heard from the transplant team last week-- two potential matches have already come up for Patrick, but the doctor rejected them. I don't know what the criteria is. Maybe the deceased weren't healthy enough, or young enough. A lot of the time, the doctors just go with their gut-- something tells them that the transplant wouldn't take. They want to be sure before they get Patrick on the operating table, which I both appreciate and understand, but does not assuage my impatience.

The transplant center hosts regular donor memorial services, so people who have received transplants can get together with the families of the deceased and honor their selflessness. We haven't been to one yet. But a long time ago, when I got my driver's license, I checked the organ donor box without hesitation. As someone who has a great deal of experience with medical problems, I also have a living directive on file at the hospital, so there is no ambiguity about what I want done with my earthly remains.

As the requiem says, "In the midst of life, we are in death."

For people waiting for organ transplants, there is a sense that life has been put on hold. Receiving a transplant means that it will be jump-started again.