Signposting a life.

It is somewhat incredible as to how certain events in a life signpost that life. August 1st is an enormous signpost in my life. You know the kind. You round a corner and it hits you in the face, demanding attention. You need to pull the car over, and take stock of what it is saying.

I still remember the early hours of Aug. 1st, 1997, lying in my hospital bed at Mt. Sinai Hospital in Manhattan, dying of liver disease. I had been locked in a battle with an autoimmune disease for 12 years, and at that point it was winning. I reached the point about a week prior where they needed to admit me. My lab work was becoming worse and worse, and I could feel myself dying by degrees. My hope was hanging on the possibility of getting a liver transplant, and after 6 months on the waiting list, each day became harder to keep that hope intact.

I remember about the third or fourth day, having a bad bout of pain and nausea, going into the bathroom in my hospital room, looking at my emaciated frame. I'm 6'2", 175 pounds, normally. I was at 120 pounds at this point, my muscles being wasted away, 1/4 of my hair gone, and most body movements being painful in one way or another.

I was sick of being sick.

I just looked in the mirror, and pounded my fist on the smooth tile that framed it. I just wanted someone to make a decision. Transplant me or let me die.

I began to empathize with so many of the patients I treated that, for one reason or another, were in the same boat. I was always taught not to encourage such thoughts, but the only thing I could think of was that I could no longer remember a time that I was not sick.

Then, 12:15 am a woman walks into my room, waking me up from the sleep that I was desperately trying to get. Hospital beds are not comfortable enough as it is, even worse when your limbs and joints are so thin skinned. I was a little pissed that someone was waking me. "More blood work at this hour?" I thought. The words that came out of her mouth next however, did not seem real at first. I thought I had hallucinated them.

"We believe we found a liver for you." This woman would turn out to be my transplant surgeon.

I found myself flooded with a wave of emotion that I was not prepared for. I had been waiting for this moment, and it was here. I still didn't know quite how to react. Her next words however slapped a little reality into the situation.

"This still may not go forward. We are running our tests on the donor now, but everything looks good so far." This is not unusual. Transplants can be scuttled at the last minute because something goes wrong with the donor, a test comes back with something that prevents it, or a myriad of other reasons. I knew she was getting me ready for the best, but preparing me for the worst.

I immediately picked up the phone, called Mrs. N. Her voice was controlled, but I knew she was scared and excited at the same time. I then called my brother, told him to call mom, and then called my assistant from work, one of my best friends. (I was director of EMS at my hospital at the time.) I told him to call the boss, as she wanted to know when I was going to go in, my boss being the Executive Director of my hospital.

The surgery was scheduled for 7 am. The wife, my brother, and my mother arrived around 2 am. My brother had his hands full, as his wife gave birth 36 hours prior to my niece. Nurses, techs docs revolved in and out of my room. More blood work, bowel prep, (my first, and only meeting with an enema.) and a host of other things.

I then remembered that I wanted to have some fun with the surgeon and OR staff, so I got a hold of two loose-leaf size pieces of paper and a felt tip pen. On one piece of paper, I wrote: "THIS LIVER'S FRESHNESS DATE EXPIRES 8/1/97" and taped it to the right side of my belly, over my liver. On the left side, I had another piece of paper that said "OPEN OTHER END," with arrows pointing towards my liver. Too bad I wasn't going to be awake to see the reaction of the operating room staff, not to mention my surgeon.

6:30 am, and the stretcher comes for me. I kiss mom and brother good-bye. Mrs. N accompanies me down to the outer area of the OR, where she can wait with me until they are ready to wheel me in. A very pregnant anesthesiologist comes to ask me some questions. After she is done, I motion to her so I can tell her something. Surgery doesn't scare me; anesthesia does . "Don't fuck up." I tell her. (She knows I am a paramedic and hospital department director, so she just smiles. She knows what I mean.)

7:05 am. I kiss the wife good-bye, as they have come for me.

9 hours later, I wake up in ICU on a ventilator, (normal for this) and my life has been saved.

11 years later, I have been given time that, all other things being equal should not have been. I wonder what will happen tomorrow? I'll keep an eye on those signposts.