The Big One

Rewind to 6 p.m. Sunday night.  Jim gets a phone call.  Duke’s transplant coordinator starts the ball rolling with the words:  “We think we may have something for you.”  

We’ve been waiting for this announcement since Thanksgiving.  But the mood in Jim’s hospital room is suddenly tense, not wildly celebratory.  Yes, there’s grateful excitement, but it’s tempered by nervous caution.  Like a woman who’s just found out she’s pregnant, but doesn’t yet want the world to know. What if it’s not a perfect match?  What if some complication derails the whole thing at the last minute?  

Yep.  Call the neighbors.  This is the one you've been waiting for.

The family huddles closer.  Jim calls a couple of close friends.  He’s in good spirits, but nobody passes out cigars.  Nurses draw blood.  One vial.  Another.  Four more.  Testing.  A lot more testing.  More closely than ever, they’re screening the component parts of his blood.  Has a recent transfusion left him with enough antibodies for a successful transplant?

9 p.m. The transplant surgeon puts his kids to bed in a comfortable Durham neighborhood.  He considers taking a nap.

Meanwhile a helicopter ferries the “procurement surgeon” from North Carolina to Pennsylvania  and back again.  A procurement surgeon.  A harvester.  The “go-take-it-out-of-the-donor” guy.  “It’s a young heart,” he observes.  What does “young” mean?  20?  40?  But there can be no specifics.  Apart from its blood type, that single adjective is probably the only identifying information we’ll ever get.  Can it be said that Jim is about to become “younger”?

1 a.m. Monday.  Orderlies wheel Jim to an operating room.  He needs to be prepped, of course.  But he also needs to wait.  For two hours.

3 a.m.  The surgery begins.  And it’s tough.  For two months, Jim’s tissues have been hardening around tubes in his chest.  In a way, that’s good news.  It speaks well of his body’s healing power.  But it makes his heart damnably difficult to remove.  Think of dragging stubborn tendrils of kudzu or ivy from a chain link fence.  Later, one of the two surgeons will liken this part of the procedure to “getting something out of cement.”

5 a.m.  Nurses tell a waiting family that Jim’s still in surgery.

7 a.m.  Nurses tell a waiting family that Jim’s still in surgery.

9 a.m.  Nurses tell a waiting family that Jim’s still in surgery.  

Fortunately, no one gets antsy.  Absolutely no one.  Nope.  Why would anyone get worried at this point?  I mean, what could possibly go wrong?  He’s only been gone for eight hours.  Only in active surgery for six.  Six hours.  The length of the average school day.  The time it takes to fly from New York to Los Angeles.  Nobody in the waiting room thinks about strokes or breathing problems or kidney failure or blood clots or bleeding.  No one.

11 a.m.  Mission accomplished.  Jim returns to the ICU.  A machine is breathing for him, but the room is otherwise strangely silent.  Buni and the kids had grown used to the wheezing clicks of a heart pump the size of a refrigerator.  The pump is gone now.  Its absence makes the room seem bigger.  Like the day you drag a Christmas tree to the brush pile.  Suddenly, the living room opens right up.

Yes, the surgery was a success.  Jim’s new heart is doing what it’s supposed to do.  But the man won’t be awake for days.  Good thing, too.  Despite his healthy pallor, he might be startled to learn his chest is still open.  Doctors expect they’ll need to mop up some routine bleeding.

7 a.m. Tuesday.  Enough with the open chest, already.  Time to sew him closed.  Back to the operating room.  Remain calm, people.

Now what?  Now, he sleeps for a couple of days.  Surely no one can begrudge the man a catnap.