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plein air landscape by James D. Southerland

"I think I can do it," he tells her.

Buni waits, two steps below him.  "Take your time," she says.  "Whenever you're ready."

"No, really.  I can do it."  Gripping the rail, his knuckles go a shade paler.  Jim Southerland is descending the stairs.  The stairs of his own house.  Of course, going down is measurably easier than going up.  Thank you, Merciful Gravity.  Getting from the main floor to the driveway taxes Jim's skeletal limbs.  He's lost a lot of weight since November.  Hasn't exercised much.  And -- oh, yeah -- he's had a heart transplant.

After only four days at home, his wife drives him back to Durham.  Even without her hand on the wheel, the truck probably knows the way.  It's been up and down Old Fort mountain more than a few times in the last three months.  They spend Tuesday night in a hotel.  Up for tests Wednesday morning.

"You're going to feel a little pressure," the doctor says.  Turns out he's not lying.  A tube crawls into a faint blue blood vessel on the side of Jim's throat.  It snakes down into his chest.  A tiny claw at its tip snatches a sample of Jim's new heart.  Duke labs will test its tissue for any sign of rejection.  They've performed two such biopsies already.  Neither has given the slightest cause for concern.

The only red flag since the surgery was a small pocket of fluid that collected just under and behind Jim's sternum.  Some folks fretted that it might signal infection.  But that turned out not to be the case.  Nevertheless, it postponed Jim's parole until the 24th of January.

Now, his B.P. is normal.  Likewise, his blood sugar level.  His incisions are healing.  His pulse is a little fast, but that's not atypical for the newly transplanted.  Since his discharge, Jim and his family have been meticulous.  A daily regimen of 30 pills.  A PICC line for preventive antibiotics.  Meals cut into childishly small pieces.  Visits from a corps of home care nurses and therapists.  "Don't want to violate the warranty," he jokes by phone.  The check-up concluded, they're following I-40 west to Black Mountain.  Until next week when they'll do all over again.

Everything is going as it should.  The odd caregiver goes so far as to describe his recovery as "miraculous."  Still, everyone is cautious.  Like people quietly circling a game of Jenga.  Impressed by resilience.  Aware of frailties.  Yet above the necessary tiptoe of careful prudence, one truth shouts loudly:  Jim Southerland is home.

Miracle Man

Jim and YoYo 2014.  Before the trauma.

First, the raw vitals:  Today makes 18 days without dialysis.  Not that everyone’s counting.  Jim still hasn’t passed his swallow test (so, no solid food yet).  He has his laptop these days, but his fingers aren’t yet as facile as he’d wish.  He’s in no pain whatsoever.  “Are you pain free because you’re on good meds?” I asked. 

“No medication,” said an emphatically bewildered Jim.  “I’m pain free because there’s no pain.”

“Does that surprise your doctors?”

“I got holes all in me, Brian.  It surprises everybody.  There’s just… no pain.  No pain, no pacemaker, no anything.  The heart feels like it belongs here.  Dude, I’m a miracle man!”  He makes it sound like he just been cast in Marvel’s latest feature film.

Tomorrow, doctors have scheduled the first of six routine weekly biopsies.  They’re monitoring him for signs of rejection.  But so far, nothing remotely suggests an organ mis-match.  His progress is so promising, he’s been moved to a step-down room:  Jim Southerland, 10 Duke Medicine Circle, North, Room 3117, Durham, NC  27710

Jim talks about coming home within weeks, not months.  But a visitor dropped by his room today, a graduate of the program, you might say.  A man whose own transplant is 13-months young.  He advised Jim to “take it easy.  You’re running a marathon, not a sprint.”

But Jim’s thinking about more than the mechanics of recovery.  It seems he is remembering with new clarity spiritual milestones of the recent past.  “I died, Brian.  I died.  Sometime, way back in November, when I was still in Asheville, still at Memorial Mission, I was dead.   But I wasn’t fearful.  I was sad; of course I wanted to be with my family.  But I wasn’t scared.  I felt safe.  

“I felt like I was being offered a choice.  I knew that if I lived, it was going to be a painful, expensive fight.  And maybe I wondered whether it would be worth living through that kind of hell.  

“I also felt that I could have simply let go.  I felt like I understood what it means when we say ‘death has no sting.’  I really was ready to go to the next level.”