A funny thing about comedy...

...it's not as easy as it looks, but it provides healing in the most stressful of times. There is an oft quoted acting maxim, attributed to several sources: "Dying is easy. Comedy is hard." Of course, this refers to the art of using comedy in performance. However, it crosses over into real life as well.

When I was waiting for my liver transplant, one of the things I struggled to maintain was my sense of humor. So many people would tell me to "keep my spirits up," without any real suggestions on how to do that. I figured out that all I needed to do was what I have always done, and that was gravitate towards those things I found hilarious. I watched a lot of Robin Williams, George Carlin, TV shows that would make me laugh my ass off all the time, funny movies - you get the gist. What I also found were ways to make myself laugh, along with others.

I made up two lists of "Top Ten Ways Of Knowing You've Been Living With Liver Disease Too Long." While very esoteric, I was able to share with friends that I met through transplant and liver disease support groups, as well as the medical people that were taking care of me.

It made them laugh. It made me laugh.

About two months before my transplant I gave a lecture to a group of EMT students on death and dying. It drove home a lot of what I lectured about, looking as sick as I was and also being funny at the same time. The lecture was more focused on what they will encounter out in the field as EMT's, but certainly had a bigger impact having it delivered by someone that was dying by degrees right before their eyes. The opening part of the lecture was a series of video clips I put together of how Hollywood views death, both seriously and comedy-wise. This is one of the clips I used:

http://www.youtube.com/watch?v=D9tAKLTktY0

It had a great impact on those students, and I can only hope they understood what I was trying to get across and use in their daily working lives.

Now to that end, I'm organizing a similar presentation to my transplant support group here in Rochester, with a little twist. The idea is to show how to use comedy as a coping mechanism, and is part lecture, part floor show, with some local improv actors that I'm friends with and have worked with. It's all in the planning stages now, but hopefully we can make this work.

"I'm always relieved when someone is delivering a eulogy and I realize I'm listening to it." - George Carlin.

The white patch.

"I'm going to wear my old pair of scrubs." said the artistic director of my improv troupe. He was referring to the presentation that we were going to make to the transplant team of the money (that was raised through a special performance) for the patient's Special Needs fund by the improv troupe a little over a month prior. Being an improv troupe, we were thinking of doing something a little different rather than a straightforward, formal presentation of the $1,400 that was raised. We hit on the idea of presenting this donation in an organ transport box, which I was able to obtain from my old place of employment, the organ donor network here in Rochester. We were going to run in to their weekly meeting as if delivering an organ.

What he asked next however, was wholly unexpected.

"Do you still have your old paramedic uniform?"

I had not been asked that question in a long while, and I felt the blood drain from my face at the question.

"Yeah, I do." I knew where he was headed, and while I silently smirked at the thought, as it was rather funny, but it still scared me. "Great." he said. "I think you should wear that."

Every instinct inside of me was screaming "NO!" Somehow, the word "Okay" came out of my mouth. I don't know why it did, but it did. It has been 12 years since I wore that uniform, 12 years since I was part of a profession and a world that I never envisioned leaving, as I did 10 years ago. Why the number discrepancy? Well, for the better part of the last three years as a paramedic, I was in management, and wore a suit more often than a uniform, and didn't touch a patient.

I tried to convince myself that it was really nothing, that I would put in on, wear it for a couple of hours, and then take it off. It wouldn't mean anything. It was simply a costume for this purpose. I was going to be acting, and why should my old uniform be nothing other than any other stage device that I have used in the past.

The answer, of course, was far more complicated.

So, the morning came for me to prepare for the presentation. Going through the morning ritual of showering, brushing my teeth, taking my transplant medications, and all the other mundane tasks carried an air of tension. I then went down into the basement of my house, and found the box where I keep all my memories of my EMS life, and found my shield and collar bars. Shield #6241. Collar bars with my unit, 35V. The black shield holder and securing pin. I remember this being part of my mrning ritual for so many years.

I went upstairs and found the long sleeve uniform, as this had the perforations above the left breast pocket sewn into the fabric where the securing pin would pass through, pinning the shield to the shirt. The shield holder also had the small metal plaque with my name, and then below it, "PARAMEDIC."

The shirt has two patches. The left sleeve at the shoulder had my hospital's blue and white patch. The right had the one that has been earned by only a comparatively few, the one that said 'EMS-PARAMEDIC - CITY OF NEW YORK." White, with an orange border, orange and blue lettering, and the blue star of life in the middle, it was simply known to us that rode the ambulance as 'the white patch." It was coveted by anyone that worked in EMS, in any capacity, in NYC. There were, and still are, far more EMT's than paramedics. We were an elite group, and we knew it.

I attached the collar bars, pinned the badge on, and slipped the shirt on. As I buttoned it, I was first pleasantly surprised to find that it still fit, and like a glove too. I then went and looked in the mirror, and a wave of emotion overcame me.

I cried. I cried, and cried, and cried. It went on for about 10 minutes.

I missed it. I missed it all. The good, the bad, the silly, the insane, the danger, all of it. I missed my friends, my colleagues, the two partners I had that I worked so closely with for so long, that they became second and third spouses in a way. I was in grief. I was in grief for a life that I left behind so long ago, that I was never able to grieve for, and that I was never able to fully accept that I left behind. I think it was just then that I honestly faced that emotion, as I faced myself in the mirror, in that uniform.

I was grieving for myself.

After I stopped, wiped my tears, and pulled myself together, I went to the presentation. I went into character, and along with my artistic director, made everyone laugh. We presented the money, had some nosh, pressed the flesh with the transplant staff, and then left. I got home, took off the uniform, hung it in my closet, but left the shield and collar bars on. I have yet to remove them and put them away.

I went to my therapist earlier this week, and related this story to him. He just let me talk, not offering any advice, but rather smiling and nodding with each major point that I brought across. We're going to discuss it further next time around.

As I unburdened myself of this grief, I began to realize that this was one of the biggest obstacles, if not the biggest, that has stood in my way all this time. While I was not living in the past, it was always close behind, and impeding my progress in life. I think now however, that I can move forward with more confidence.

The white patch will always be with me. It is part of who I am, a source of pride, and always the greatest title I will ever have, that of NYC Paramedic. From now on however, it won't stand in my way.

Returning the favor.

"A friend is a friend
Nothing can change that
Arguments, squabbles
Can't break the contract
That each of you makes
To the death, to the end
Deliver your future
Into the hands of your friend"
- Pete Townshend

There are moments in life when things hit you in the face and make you pause, just for a moment, to consider where you are going and what you expect out of the journey. Sometimes, it's better not to have any expectations and just go with the flow. Sometimes, you just have to fight against it. Sometimes, it's odd being on the outside looking in, when usually, it's the other way around.

Reality has a strange way of being a harsh taskmaster.

I have two friends, one from college, and one that I know from my organ donation/liver disease circle of friends. One is dealing with the sudden appearance of strange symptoms that have left him numb in all his extremities, and exhausts him when he climbs a flight of stairs. The other is in a hospital in Hawaii, and is battling for her life while she awaits a liver transplant. It's a bit of role reversal, as usually I was the one that was either sick or in the hospital.

Scott and I go way back. We met my sophomore year at SUNY Buffalo. We were both on the campus volunteer ambulance, both from the Bronx, (excuse me, he was from Riverdale. They don't consider themselves as being from the Bronx. yeah, right.) I knew almost from the beginning that we would be friends, especially when he made a snippy remark at me, and I responded, rather in a crass manner with a remark about the health of his dog, which I didn't know whether or not he even owned. Let's just say that his comeback stopped me in my tracks.

We've been friends ever since. He's a notorious practical joker, of which he takes great delight in inflicting on me as often as possible. We found that we shared a love of many things, from music to movies, and we hung around in a group of closely knit friends back then. As often happens however, people's lives diverge. He stayed in Buffalo after we graduated, got married a year before I did (I was in his wedding party), had a son, got divorced, and then remarried.

We would go through long stretches of not talking to one another, not because something was wrong, but because life was just getting in the way as well as the distance. We did try to get together when we could when Mrs. N. and I would visit Buffalo to see her family, which was at least twice a year, most years.

Now that we live only an hour apart from each other, we have probably seen each other less in the 10 years I've been here in Rochester than at any other time. Go figure. Still, I was unprepared for the phone call I got from him earlier this week. He told about some odd symptoms he was having, numbness in both extremities, and his extreme fatigue after climbing even one flight of steps. These symptoms started slowly, and after a few weeks of not getting any better, he went to the doc for a series of blood tests and other procedures.

All came up negative. My own former paramedic brain went into overdrive, and and the first thing that came to mind was multiple sclerosis. The docs had pretty much ruled that out he said, but they were going to do a CAT scan anyway to check for the lesions that are typically found with them. His symptoms were atypical for MS, but they were going to explore that avenue anyway. Today however, I got a text message from him that was a little unsettling.

At 6:30 this morning, he had a spinal tap done. It seems that his doc began to put some things together, and suspected that it might be Guillain-Barre Syndrome. I needed a slight refresher on this syndrome, but it all started coming back. It's an autoimmune condition, and there is no real cure, though symptoms can be manged, if it is caught in time. The spinal tap will more or less confirm the diagnosis, as there is no specific test for it, other than the presence of proteins in spinal fluid.

This was a shock, especially knowing Scott as I do. He's a big guy, a little shorter than me, but big, barrel chested and very strong, so to think of him as being debilitated by anything, much less something like this was unthinkable. it has affected his ability to work regularly, but his current place of employment seems to be working with him and supporting him. (He's a nurse for an outpatient program that services people with developmental disabilities, amongst other things.)

We're going to try to get together next week. I'm going to go out to Buffalo and we'll have lunch at his home, on me. I'll bring him some Chinese or Thai food. We've been through a lot together, and he is still one of my best friends. There is actually more going on with him, that has made this situation even worse than it already is, but I'm not at liberty to bring it up here, until he gives me the OK.

Then there's Tammy. Tammy and I met through through a support group for people with liver disease back in 1996. Along with my friend Susan, who died in 2001 while waiting for a second liver transplant after her old liver disease returned unexpectedly, we split away from the original group due to the fact that it was too big, too out of control, and formed a smaller, more intimate and private group. The three of us were the 3 Musketeers in many respects, Tammy from Long Island (at that time), Susan from New Jersey, and me from the Bronx. Susan and I were transplanted within two weeks of one another, while Tammy was newly diagnosed with her autoimmune liver disease and was still pretty healthy at the time. We finally all met face-to-face in November of 1997, a few months after Susan and I were transplanted. We all stayed close, even after I moved to Rochester, and Tammy and her family moved to Austin, Texas.

Tammy had a multitude of issues stemming from the medications she was taking to slow the spread of her particular liver disease. In particular, prednisone was the demon that haunted her an literally made her crazy. Things got to the point a few years ago when she simply stopped taking her meds, unbeknown to her docs at first. This caused a great deal of consternation on the part of the first transplant service she was registered with, and she was labeled "non-compliant," which really wasn't the case. The reality was that the transplant team she was with was not addressing her issue seriously.

She finally wound up getting registered at a major transplant center in Texas, and they did not put her back on prednisone. somewhere about 6-8 months ago, she moved to Hawaii to be closer to her daughter and new granddaughter. She was estranged from her son (long, long story there), and also close with her other daughter, who was still living back in Texas. Along the way she got divorced from a husband that could not deal with her illness, and wound up treating her like garbage, along with the rest of the family.

Flash forward to a few weeks ago. It's now been about 13 years since her original diagnosis, and she is in end stage liver disease. She called me from a hospital in Honolulu, where she almost died from a ruptured esophageal varice. She was stabilized, but it was clear that she needed a TIPS procedure to reduce the varices, and buy her more time to get transplanted.

I was fortunate, in that I never had to go through that procedure, even as sick as I was. For Tammy however, this is the last option. She will die without a transplant, and she almost didn't want it. I had to convince her to go through with it. Why? Because after a transplant, she would be on prednisone for a time, and that just scared the hell out of her. She did not want to go through steroid psychosis again. I reassured her that more than likely, her time on prednisone would be short, as they try to wean transplanted patients off of it as soon as is feasible. I am on small doses of it for life, due to the nature of the liver disease that I had. It helps keep my old disease away, which is fine with me.

She had the procedure this past Monday, and it seemed to go well. Now, it's all up to the wheel of fortune for her, and her own will to hang on until she can get transplanted.

It's strange being on the outside looking in. They both were there for me, so now it's my turn to return the favor.

UPDATE: Scott's spinal tap came up positive, so now they're deciding on the best course of treatment for him Keep your fingers crossed.

Re-birthday.

12 years ago today, a family made an incredibly brave decision and donated their 17 year-old's organs so that 5 other people could live. I was one of those 5 people, receiving that boy's liver. While I've never met them, I am, and will be forever grateful for their incredible generosity in a time of unimaginable grief.

Donate Life: "Don't Take You Organs To Heaven: Heaven Knows We Need Them Here."

Another interview meme.

Julia, over at In Java, Literally, has answered an interview meme, and passed along her willingness to do the same. While I did this a few posts ago, I thought it might be nice to try a different one, but will make it my last for a bit.

1. You walk into a room, what do you see?

A mess. A bloody, awful mess. This is my home office, and I really need to make more headway in getting it into shape. The funny thing is, when I was the director of QA back in my medical center in NYC, having a messy office was so anathema to me. I kept it very organized, so I am trying to remember back to my days of yore and figure out what I need to do to get organized.

2. What year changed your entire life?

Easy. 1997, the year I had my liver transplant. Everything changed after that, mostly good, some bad.

3. What are you proud of?

The work I did as a NYC paramedic. I did things and helped people in ways that most others only read about. Of all the titles I may carry, that of NYC-EMS paramedic will always be my proudest. I also am proud of what I see as my growth as an actor. I have been asked to do plays and movies without needing to audition, which tells me I must be doing something right. I also am proud of the things I have written, even though there are many times I really don't believe I'm any good at it.

4. Why do you live where you live?

Quieter life, and because while I miss many things about NYC, I simply can't live there anymore.
I needed to slow down.

5. What is your favorite hobby and why?

Not to beat a dead horse, but acting. It is very, very freeing. It allows me to express things that I have hard time doing in my everyday life. It is also the thrill I get from feeding off the energy of an audience, or the sensation of what can only be akin to an orgasm when I do or say something that makes an audience laugh. I love taking the printed word, creating a character with it, and bringing it to life.

Want to be interviewed?

Follow these instructions:

1. Leave me a comment saying, “Interview me.”
2. I will respond by emailing you five questions. I get to pick the questions.
3. You will update your blog with the answers to the questions.
4. You will include this explanation and an offer to interview someone else in the same post.
5. When others comment asking to be interviewed, you will ask them five questions.

I am a Scrabble board.

While I was awaiting the call for my liver transplant, I remember making a series of top ten lists; in my case, the "Top Ten Ways To Know You Have Been Living With Liver Disease Too Long." Among these little amusements was:

"You think that your blood test names (ALT, AST, CREAT, HbG, etc.) are perfectly acceptable words when playing Scrabble."

Let's face it: when you live with any form of chronic disease, whatever it is, your life tends to be reduced to these acronyms, from time-to-time. These days however, I've needed to learn a new one: HbA1C. (Gycosylated hemoglobin A1C.) Since I became a diabetic last year, this is an important test that I get done every six months, and is a better indicator of how well my blood sugar is being maintained, especially since I am on insulin. Today I went to my primary doc for my six-month check-up, and all is hunky dory. My A1C is right where it should be, and he is pleased with the way I have been controlling things. So, while I hate sticking myself with needles, it has been a good way to keep things as they should be. Small sacrifices, I suppose.

Now, the one thing that I have been trying to overcome is the disease of procrastination. I suffer from an extreme form of this disease, and have been desperately trying to overcome it for some time. To that end, a colleague at the conference I attended a week or so ago recommended this book:

I am starting it today, as in right after I finish this post...if I don't procrastinate about it.

I am NOT a morning person!

One of the yearly rituals that I undertake is a visit to the transplant clinic to let them poke, prod, and give me the the general once over. It's a bit like taking your car in for a yearly overhaul, though in this case it involves an early morning start, like at 7 am. This wouldn't be so terrible, except for the fact that I get out of work at 3 am. Yes, I do telecommute, but it's still oh-dark-thirty, which means that going to the lab to get bloods drawn before the actual clinic appointment was going to be an effort. Oh, I should clarify. I need to be at the lab by 7 am so that the test results will be at the clinic by 9 am.

So, I get out of work Wed. at the appointed hour, and I can't get to sleep. Nothing. Nada. 3:45 am rolls around, and I am finally getting sleepy. I'm thinking, "This is going to be fun. I'll probably fall asleep while they're putting the needle in my arm." I make an executive decision, and opt for more sleep. They'll have to deal with the the possibility of the results not being ready when I get to the clinic.

I wind up at the lab at 8 am, wait about 20 min to be seen. A good looking blond phlebotomist does that voodoo that she do so well, and then I grab a bagel and coffee at the stand in the hospital lobby. The clinic itself is actually part of the University of Rochester Medical Center, where my transplant center is. All my bloodwork needs to be done as a fasting one, especially now since I was diagnosed with diabetes last year from the long-term use of my transplant meds. Food in hand, I amble up to the clinic waiting area, along with a Stephen King book that a friend lent to me. It is 'Different Seasons," the series of novellas that he wrote that includes "The Shawshank Redemption." Now, if you live here in the States, and get TBS on your cable or satellite system, you know that the movie version of this is played endlessly. Seriously, I am surprised that no one has simply started a Stephen King Channel, all Shawshank, all the time.

I wanted to read the original version, as with most books, they are usually better than the adaptations for movies. The movie itself I have only seen in bits and pieces. I know this is going to be a long haul, and since it is a novella, only just over a hundred pages, I figure I could get a good hunk of it in before I get seen. It was a good choice. I arrived at the clinic promptly at 9 am, and settled into the waiting area.

Thursday's are for the post-transplant people like myself, with Tuesday's being reserved for the pre-transplants. They are the ones who are just being evaluated, or already accepted as transplant candidates and are being followed by the team. Us post-transplants, with the exceptions of the ones that are fresh out of transplant, generally don't take as much time being seen. People like me who are far out, (not in a hippy-dippy weatherman sort of way) usually take even less time. Still, I didn't get called in until close to 10:30.

In many ways, I am glad that they made this change some years ago, making the pre-, and post transplant people go on different days. It was sometimes difficult prior to that, when we would all go on the same days. Looking into the eyes of those pre-transplant folks, the desperation on their faces and those of the relatives that brought them brought back some difficult memories. Of course, at the same time, when they would ask me if I already had my transplant, and I would say yes, that got their attention. When I would tell them how long ago I had the operation, there would be this look of astonishment, then followed by the peppering of questions. They were scared, and rightfully so. However, I would always ask the patients one quesion:

"What are you prepared to do?"

The sad fact is that while a tranplant can save their lives, they have to be willing to accept certain things, and understand that the idea of a "normal life" is going to change forever.

So, they call my name, I get weighed and have my vitals taken. All good. then I wait again for either the transplant surgeon or the nurse practitioner to see me. In this case, it is a nurse practitioner that I know well. All seems to be in order, and lo and behold, my bloodwork actually turned up. My liver numbers are slightly elevated, but they have been this way since my little stint in the hospital last year. They don't seem to be too concerned, as they have remained steady, have not spiked, and it is only some of the numbers that are up. The rest are right where they should be, my kidney function is perfect, and my blood sugar is right on the money.

I get a physical exam, and she comments on how well my scar healed over the years. We make some small talk about some people we both know, and then I am on my way. Come back in another year. I still get bloods drawn once per month to check liver functions, and the level of anti-rejection meds floating around inside of me. This is one of the trade-offs, and what I was referring to before about "a normal life."

Back to the car, and life goes on. Oh, the story was fantastic! I will Netflix the movie now, but the stroy was just so well written, as many (but not all) of his things are.

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.

A wish for words that work.

Falling, falling, falling. Looking deep into the past 11 years, still wondering why? Why they never answered my letters? Why they chose not to know how their selfless act breathed life back into a dying man? Why I can't have the opportunity to thank them myself, while others have enjoyed that privilege?

Did I ever write something wrong, or was their pain simply too deep? Five times I tried to reach out to them, and each time I was answered with silence. I am aware that I need to respect their decision, but it is still frustrating to not know something, to not be able to share my feelings about what they gave to myself, and the four others that received transplants from their child.

So much is unknown. Was this child living with parents? Grandparents? Uncles and aunts? What did he want to be? What caused him to lose his life in such a violent way?

My brain debates the wisdom of trying one more time, to reach out again. Will they even be able to be contacted after all this time? Are they still living in the same place? Do I even have the words that can persuade them to connect with me, when nothing has in the past?

Will it even matter to them after all this time?

Weapons of dental destruction.

So, in between hacking, coughing, and general lousiness, I did have to take a scheduled trip to the dentist yesterday. We transplant recipients have to be careful about many things both medical and dental, especially since some of the medication we're on can cause issues when it comes to the latter. I take a small dosage of Prednisone, which is a steroid, and while I won't be hitting longer home runs, it can cause problems with bone loss if you are on it for long periods of time. (I've been on it for 11 years come this August.)

As such, and for other reasons, good dental care is a must. I went yesterday, feeling like death only partially warmed over because to reschedule would have meant a longer than a month wait. Good thing the techs who scale and clean my teeth wear masks and gloves.......in this case for their sake, not mine. All went well, I won't be required to leave my teeth in a glass at the bedside table anytime soon, and I was given some new dental tools in which to keep the choppers in a minty fresh state.

First, there was this nifty little device:

Now, aside from looking like a tiny tree on a stick, this little device gets in between the teeth to get at the places where, if you tried doing that with your toothbrush, would require several thousand dollars worth of orthodontia, not to mention a gross of pain medication. It really does work quite well...

Now next, we have this:

Maybe it's just me, but this looks suspiciously like a toothpick. It is made of wood, is flat instead of round, and you won't find them on the table at your local diner. In fact, aside from your dentist, you can only get them at the local pharmacy. (Chemist, for my Brit friends.) Of course, this means that these fancy toothpicks cost more money and you get less of them. (They are called Stim-U-Dents, as their purpose is to stimulate the gums.)

If of course, you want to have the appearance of being environmentally friendly and save the life of a tree, you can now use these brand-spanking new devices, fresh off the assembly line:

These do the job of the aforementioned stimulator's, but are probably more expensive, as they are new. We'll see. I have the choice of killing a tree, or putting more plastic into landfills, as these are not biodegradable or recyclable. So many choices! ;-)

So that is all from the dental front, but oh, just to update you on my scoping of a few weeks back; everything turned out fine. As a matter of fact there actually has been improvement. The new drug they put me on for the colitis last year is working nicely, and there is less inflammation than in the past. My GI doc was very pleased, and I was as well.

Juxtaposition........

The father stood up and spoke to the college health class about his son. He told them how he was a child born later in his marriage, how when the boy was starting kindergarten, the eldest child was starting college, on the same day no less. He spoke at times with his voice nearly breaking, of how his son had been a curious child, always getting into things and running off. He recounted the story of how the boy had wandered off after mom turned away from him for 30 seconds. The whole neighborhood was out in force looking for this missing child. He was found after a short search, asleep in a cardboard box in their garage. He just crawled into it and took a nap.

As the boy got older, he became more involved in sports, with soccer and basketball being his favorite. His father spoke with a glean in his eye about how the boy was not one to take the glory, although he had the talent to do so. In soccer, he was the one who passed the ball to the one who would eventually score. The same held true for basketball. Dad recounted the story of how in one basketball game, the boy kept passing the ball to another kid who kept missing lay-ups, even though he himself could have easily scored. It was an example of the kind of giving person he was on and off the court.

The boy had his wild side too, which made its appearance at puberty. Not all that unusual. He started hanging around with other boys that did not necessarily make the best choices. Dad caught him smoking weed on one occasion. Underage drinking reared its head. His son then made a choice that would cost him his life. He chose to get into a car with a drunk friend, drive down a stretch of road at 70 mph, and they hit a curve that would hit them back. The boy was dealt a severe blow to the head from a stereo speaker, and ended up with a skull fracture, in the ICU and on a ventilator.

It was every parent's nightmare, to see your child helpless on a hospital bed, multiple tubes in just about every body orifice, machines keeping him alive. His head was swollen as a balloon is from the devastating injury. Mom is a nurse, with too much knowledge. She knows what is happening, and is powerless to do anything about it. Knowledge may be power, but in this case it was merely overpowering.

It may have been a parental instinct, it may have been from the mother's long years of experience in nursing, it may have been both, but they both knew that they were not going to get their son back. The injury was far too devastating. They approached the ICU neurologist, and told them that if they were not able to save him that they wanted to donate his organs. The doctor was a bit stunned. "Wait a minute," he stopped them. "We need to think about getting him through this." he said. They reassured him that they indeed wanted him to do everything possible, but that they wanted to make it clear that if all failed, they wanted his organs donated.

It would not be long before the boy was declared brain dead. The call was made to the organ procurement organization, the agency that determines whether or not brain dead individuals are suitable candidates for organ donation. (They work with the organ transplant teams - doctors taking care of the patient do NOT make that determination!)

I was sitting on the side of the classroom listening to this story. I had accompanied the father as an organ recipient to tell of my experience to this class. My own experience happened 3 years prior to his. As I was listening, the bells, lights and whistles started exploding in my head. Why was this story familiar? I never met this man before, but I could not shake the feeling that I knew his son. Once he told the class when the accident was, only then did things fall into place.

I was one of the two organ procurement coordinators that worked on his son' s case. I was in the operating room, working the placement of his organs, and my partner at the time was working in the ICU, and evaluating his case. This was my first job here in Rochester, as an organ procurement coordinator. I did that for a year.

I am a rarity; a transplant recipient that has seen both sides of the coin. It is a bit like being the President of the Hair Club for men; I'm the president and a client. There are not too many of us around.

When his story slipped into place for me, and after he had finished speaking, I got up to address the class. At the right moment, I stopped, and told him that I think I was the other coordinator on his son's case. We both were kinda stunned for a minute, but we exchanged thanks, and I continued on.

I thought of my own donor, a 17 year-old boy that was shot to death in the same Brooklyn neighborhood that I worked in for so many years. I have never been contacted by his family, though I have written letters. This is of course, that family's choice. It can be a little disheartening at times.

As I was listening to this father's story, it made me hope that the father, mother, or whoever cared for that 17 year-old child was passing on their story, somewhere.

Parts is parts........

"It's too bad she won't live.....but then again, who does?" - Gaff.

I have a few links on this blog to organ donor organizations that I support. I support them with good reason, as 10 years ago, my life was saved due to the generosity of one family. There were actually 5 of us that benefited as a result, and while I am not sure of the status of the other 4 recipients, I'd like to believe that they are all as alive as I am right now.

I will try to encapsulate the story of my liver transplant into one, easy to use pill. (Sorry, but when you are on the daily doses of medication I am, you tend to think in pharmacological terms.)

In 1985, at the age of 26, I was diagnosed with primary sclerosing cholangitis, a degenerative disease of the bile duct system of the liver. I lived with this disease for 12 years, and began to see the signs of advanced liver disease somewhere around late 1995, early 1996. I was placed on the transplant waiting list in February of 1997, and at that point, had about a year, to a year and a half to live.

Dealing with death as I did all throughout my EMS career, it took on an entirely different approach when it is the possibility of your own death that was staring back at you. The wall that helps you to deal with the death of patients crumbles easily. Your emotions run so wildly, that any of the scariest roller coasters in the country are nothing in comparison. I don't think I necessarily went through a Kubler-Ross type of event, but at the same time, you do find yourself looking in the mirror and wondering why all this is happening.

As the disease progressed, I began to exhibit all the hallmark signs of liver disease; jaundice, weight loss, loss of hair, etc. Things finally got bad enough in late July of 1997, and I was admitted to Mt. Sinai Hospital in Manhattan to wait for my shot at a liver. (Being put in the hospital is one criteria for being moved up on the transplant waiting list.) I still understood that it could be months before I received a transplant, but at least I had a shot. One week after admission, it happened, and on August 1st, I received my gift of life.

There is certainly more to this story, as it has been 10 years, getting closer to 11 now, since that momentous day. There have been bumps along the road: a rejection episode in 2002, an infection last June that almost did me in, but all-in-all, I really have no cause for complaint. I have 10 years that I might not have had otherwise. I have been able to see my niece, who was born 36 hours prior to the transplant, growing up faster than I care to think about, and I have been able to accomplish things I never would have had the opportunity to do.

More transplant stories later. For now, just remember, "Don't take your organs to heaven. Heaven knows, we need them here."

Now, the procedure is not quite like this, but, laughing a lot helps one get through such an ordeal....Fortunately for me, they did use anesthesia.....(Warning: Really not suitable for kids, but tame compared to other things.)