The Heavenly Heart (20 page)

The Silver Lining
 

Without saying a word to Pete I leave to check on Garrett.

He’s at the University of Pittsburgh Medical Center. This is where a bunch of the world’s best transplant surgeons have been trained. Garrett’s in need of a liver transplant because he’s got viral hepatitis. Don’t ask me where he got this virus. It’s like asking where he caught the last case of flu he got. No telling.

Of course in the Silver Lining I’m still alive so Garrett doesn’t have my liver. I’m checking to see if he get’s someone else’s. I find out quickly he’s not here to receive a cadaver liver transplant, meaning an organ from a dead person. He’s getting a live person’s liver! Well, a piece of it. What happened is this college student read about him and agreed to donate part of his liver. Excuse Me? I didn’t even know that was possible. It’s called a living donor. At first, people who received living donor livers were almost always children. But because so many adults waiting on the transplant list started dying, and then there’s this shortage of organs to begin with, well, they now do these live type transplants, too. And these kinds of transplants have a much better chance of succeeding.

I watch as the doctors tell this college kid how serious it is to consider being a donor, but it doesn’t even phase him. It’s like—you need a piece of my liver? No problem. He’s really weird. Listen to what this guy’s willing to go through to give Garrett, who’s a total complete stranger, a chance for a normal life.

His name’s Dennis Frailey. He meets the preliminary requirements. He’s between the ages of eighteen and fifty-five—he’s twenty-three and in graduate school—he’s in good health and he has a blood type compatible with Garrett’s. There’s a bunch of other stuff they have to make sure of, too. Like they have to be sure that Garrett will benefit from the donor liver—that’s a no brainer—and they have to be sure the donor, meaning Mr. Frailey, is able to tolerate the surgery and be healthy after the operation, since they’re going to remove about sixty percent of his liver. I told you this guy’s weird.

Now for the difficult part—the testing of the donor begins. First they do a medical history and physical exam to make sure Dennis has no identifiable medical problems. He doesn’t. Next he has to sign these written forms describing the risks and possible complications that could result due to the donor surgery. The complications described would have most people immediately asking for the location of the nearest exit. Not Dennis; he’s fearless. Maybe he’s not weird. Maybe he’s some kind of saint.

A social worker, Ms. Gray visits with Dennis next and reviews plans for Dennis’s care when they discharge him from the hospital after the surgery. She’s got a long list of things: housing arrangements, medications, transportation to and from his postoperative appointments, support for his personal and emotional and his physical needs, whatever those are.  They cover everything with him. Then they do a psychiatric evaluation. This consists of an interview with a head doctor to ensure that Dennis’s able to handle the physical and emotional changes associated with the procedure.  The doctor talks about the possible stresses the can result form the surgery and wants to know the reason Dennis wants to be a donor in the first place.

“My father died from liver failure when I was ten years old,” Dennis explains. I want to do this to honor his memory.”

His answer’s perfect. He got 100% on the Reason for Donating form. I guess that’s what they’re looking for.  If anyone says, “I want to find out what it’s like to go through something like this”, they automatically flunk. It’s hard to believe that anyone would desire that, but you would not believe some of the answers given. One woman said she wanted to win her husband back from another woman and thought being a living donor might do the trick. Boy! She’s nuts. Of course, she flunked.

Now that Dennis has been emotionally certified as an excellent candidate, the real tests begin. Then they start testing his blood to see if he has any diseases or any underlying liver disease himself, or any medical conditions that might make being a donor unsafe for him or for Garrett. They take so much blood it’s a miracle he has any left. But he’s pronounced a good candidate and then begins stage two of the testing process. He gets an echocardiogram, a pulmonary function test, a CT scan, and then another complete history and physical exam to see if anything has changed in the last twenty-four hours. And then the real fun starts. They do a liver biopsy of his liver using a needle that’s longer than a yard stick and thicker than a pencil.

“This procedure doesn’t require anesthesia,” the technician explains. We use a topical local anesthetic, instead.”

Right! He probably recommends baby aspirin before a root canal, too. Dennis just nods. He’s got nerves of steel. He climbs up on the table and bares his backside. I cover my eyes and groan.

After the biopsy he has an angiogram. They inject some dye into the arteries going to his liver with this tube they stick in his groin. I’m about ready to puke.

All the tests come back acceptable and Dennis is told he’s a perfect candidate for the living donor liver transplantation procedure.

“If you wish to participate, sign these forms,” the social worker says.  Dennis eagerly signs the forms then meets with the doctor who will perform the surgery. It’s Dr. Grüen, this adorable little man with a Hercule Peroit mustache. He says the surgery will take up to ten hours

“Report to the hospital at six a.m. tomorrow morning,” he says and shakes Dennis’s hand. Then he hands him a patient manual that describes what’s going to happen. It’s pretty gross. After the donor surgery is started, a second team of doctors operate on Garrett. But the evaluation process doesn’t stop when the surgeries begin. It continues throughout the surgeries and if at any time the doctors believe the donor’s at risk, or that his liver’s not safe for transplantation, they stop the surgery and sew him up. All that to be cut open and then just sewn up. Bye. Have a nice day.

“This happens approximately five percent of the time,” Dr. Grüen says. “And of course there are risks to any surgery.”

He explains what those risks include, like a bad reaction to the anesthesia.

“Or the most common one,” he says, “Bile leakage.” Yuck!

“This happens in about fifteen per cent of the cases, but bare in mind, tubes are placed through the skin and into the liver to aid in the healing process. Shouldn’t be a problem for you,” Dr. Allen, Dr. Grüen’s colleague points out.

Excuse Me? Like having bile leak out of your body, making it necessary for you to have tubes stuck into you like you’re some kind of porcupine isn’t a problem, right? Exactly.

I should go find Pete and make sure Dennis’s name is written in his saint book, if Pete has a saint book, which he must. He keeps track of everything, including the fact I’ve been avoiding him. He keeps pestering me about that trip through the Silver Lining with him.

“Lorelei, you can’t put this off forever,” he says. “You agreed, remember?”

I remember. The trouble is I’m trying hard to forget.

*      *      *

I’m curled up in the Silver Lining keeping an eye on Garrett. Pete’s nowhere in sight.

Garrett’s doing really good with a chunk of Dennis’s liver in him. He’s his old self, and the doctors are happy with his progress. Best of all, the immunosuppressant  drugs are working well!.  They gave him hugs doses of anti-rejection drugs right after the transplant. They do that to avoid what the doctor called “acute” rejection. That type of rejection happens most in the first year after the surgery. I’m getting so smart, let me tell you.

“After the initial high-dose immunosuppressants,” the doctor explains, “we’ll put you on a lifelong course of relatively high doses of anti-rejection drugs to prevent long-term, or what’s known as “chronic”, rejection.”

“In certain rare patients,” Dr. Allen says, “the immune system naturally accepts the transplanted organ without immunosuppression.”

“How can that be?” Garrett asks.

“We think in these patients, the immune cells that normally attack the organ are themselves eliminated by a second, beneficial, immune attack,” the doctor says.

Sounds good to me.

Garrett’s parents are with him now. His father teaches history at the local college and his mother’s a high school English teacher. They look exactly like the kind of people who would have a son like Garrett. Not one hair is out of place and they both wear glasses, and they have on comfortable clothes that aren’t the least bit in style. Sorry, but that’s the way it is. And nothing against Garrett—you know how I feel about Garrett.

“Good to see you up and around, son,” Mr. Jennings says. That’s Garrett’s father

“We’ll have you home in no time,” Mrs. Jennings says. “Toby and Daisy are unhappy pigs without you,” she adds.

They certainly are. They’ve torn Garrett’s room to pieces. It’s a major wreck. Don’t they have pig kennels or something where they could have been kept under lock and key? Garrett’s parents hired Mrs. Nielsen from next door to feed and check on them. Which makes no sense at all—she’s terrified of Toby and Daisy. They aren’t too happy with her either. They make these sounds when she comes around like an old man who has something disgusting caught in the back of his throat and he’s trying to cough it up. This sound scares the dickens out of Mrs. Nielsen. So she shoves their food into Garrett’s room and slams the door shut and leaves them to tear it completely apart. She must really need the money to take this job. She’s not any good at it. And she hasn’t put their cute little leashes on to take them for their potty breaks, not once. This is a major oversight, let me tell you.

Garrett only laughs when he sees the mess.

“Missed me, huh, guys?”

Then he cleaned up the mess. Garrett’s quite extraordinary. I would have wanted to rub their little pig noses in it. They even ate holes in his underwear.

Of course, this is the Silver Lining. He’s doing well here, but none of this really happened. And Garrett’s not doing well in real time. My liver isn’t doing a good job for him. The fact of the matter is I’m probably going to meet Garrett up-close and personal—and sooner than I expected. You’d think this would make me happy, but it doesn’t. I’m thinking those pigs are going to have a major meltdown when Garrett’s gone for good, and who will want to take in two potbellied pigs that tear a room apart in a matter of days and eat holes in underwear?

SIXTY-FIVE

The Window of Dreams

Carla and I have a major surprise for Miss Lily. We’ve been planning it for days. It all started with the Window of Dreams, which is just the coolest place.

“Anything goes,” Pete says.

Finally, we’re all set. Everything’s in place. We make a big ceremony out of it. First I tie a silk blindfold around Miss Lily’s eyes. Then we each take one of her hands.

“Goodness, are we playing Blind Man’s Bluff?” she asks. She’s in very good spirits and enjoying our company.

Carla and I have tried for hours to cheer her up. Finally—progress!

“We have a big surprise for you!” I say, and pat her back. “You’re going to have the best time.”

Miss Lily puts her hands on her cheeks. “Goodness,” she says. “It’s not my birthday is it? Oh dear,” she adds, “I can’t remember when that is.”

“Oh, it’s better than a birthday,” Carla says.

It certainly is! I can’t wait to see her face when she finds out what we’ve planned.

Carla skips ahead and leads the way while I guide Miss Lily. It’s another beautiful day. The sky’s brighter than a Christmas tree and the clouds are fluffier than fresh whipped cream. All our days are like this. Still, they stand up and shout
Look at me. Would you just look at me!

We’re almost there. The Window of Dreams is an arm’s length away. Our surprise is ready and waiting. I lead Miss Lily to the table we’ve prepared and help her into her seat. Carla takes off her blindfold.

“Okay, you can peak,” she says.

Miss Lily’s eyes slowly open and her mouth drops down like it’s not connected to her face. Her cheeks are pink as candied apples.

Spread across the table are all her favorite foods. There are croissants and strawberry jams and petite fours and pastries. There’s shrimp and lobster rolls and filet mignon. There’s baked potatoes and pastas and platters of vegetables. The table’s set with china and crystal and crisp white linens. The chairs have white satin covers with silver satin sashes. There are candelabras and white roses for the centerpieces and elaborate pitchers of milk with matching goblets at each of the place settings.

 “Goodness, it
must
be my birthday?” Miss Lily exclaims.

“Well it’s kind of like a birthday,” Carla says.

I put my hands on Miss Lily’s shoulders. She’s whisper thin. “Now close your eyes, and make a wish,” I say, and wait until she does. Then I motion for Pete to bring in our two special guests.

This is the Window of Dreams, remember—anything can happen!

“Ready, set, go! Look!” Carla says.

Miss Lily eyes flutter open. Carla’s sitting to her right. I’m on her left. Pete’s next to me. And directly across from Miss Lily are Madeline and Theodore! They’re dressed all in white.

“Mummy,” they call out in unison and run into her arms. Madeline reaches her first, but Teddy’s not far behind. He doesn’t have any trouble keeping up. He’s no longer blind.

“Goodness, how did you
ever
recognize me?” Miss Lily says. Tears are running down her face.

“Silly,” Madeline says. “You look exactly the same, Mummy!”

Of course she does—this is the Window of Dreams.

SIXTY-SIX

The Golden Window

When I was six I got walking pneumonia. You would not believe the attention I got when the doctor announced what was wrong with me. It was a very exciting time. My mother started acting like one, and made a big fuss over me.

“Walking pneumonia is officially known as Mycplasma Pneumonia and it’s transmitted from person-to-person contact through respiratory secretions during coughing and sneezing,” the doctor carefully explained.