March 25, 2012

These are miracles

It is easy to be cavalier with a life not tied to your own.  When the lives do not belong to us, statistics do not feel like lies.  They feel like a promise that things will go just fine.  When the surgery is done on someone else, it is easy to forget that every procedure has risks, some of them significant.  We deal in the abstract: organ donor, open heart, cardiac bypass.  Intellectually, the procedure seems so simple: open the chest; remove the old, broken part; replace with a newer model; reconnect all hoses and wires; start things up and close up.  Emotionally, however, I found out the hard way that heart transplants evoke a visceral reaction born of acknowledging the prospect of imminent death.

My uncle has been on the transplant list since early December of last year, and he was called in for a heart early Tuesday morning.  One of the strange things about it, though, is that he had to wait a much longer time than I would have guessed before the surgery.  The heart is the last organ to be harvested, and the transplant teams had to wait until the other recipients were assembled and prepared for their respective surgeries.

He finally got word that he would go into surgery Wednesday afternoon.  I thought I would be happy, at peace;  instead, a tightly coiled spring was centered in my chest.  The hollow abstract notion of "organ transplant" was replaced with cold reality, and I could see the surgery in my mind's eye with its real implications.  My uncle would, in a way, die and be brought back to life in the operating room.  He would depend only on machines for breath and blood to circulate.

The frightening nature of this scene was inescapable.

Not even reading UpToDate on heart transplants was that comforting--if anything, I was only more aware of how close we had come to losing him, how short our time would truly be without this surgery.

I waited in tension all afternoon, the infrequent text-message updates from my mom only a mild antidote.  He came through just fine, though--more than fine, the surgery went very well and by Thursday evening my uncle was already looking years younger, with better color and energy enough to crack jokes.  Today, he took his first walk around the recovery floor where he will stay for the next week or so, and his ejection fraction is back up to within normal.

I am in awe of the audacity of medicine--of the faith that prompts patients to put themselves in our hands, of the confidence that allows us to take drastic measures, of the daring in our thinking that creates procedures like this one.  The abandonment of an old heart for a new one, the stopping of an old life and subsequent rebirth, the extension of a lifespan: these are miracles.

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