Gettysburg Review 8.4
Arthur was livid.
"What the hell do they mean by 'further tests and evaluations'? They know you need a liver. That's all they need to know."
"It's not that simple," said Nan.
"Hell it isn't."
"Haven't you heard of triage?"
"This isn't war. This isn't an emergency room."
"Arthur, there aren't enough livers to go around. What are they supposed to do? They've got to make judgments. They've got to consider general health and age and so on. I'm sixty-two."
"Sure. And what about the losers? Maybe they could go on Geraldo. Liver losers and the men who love them. `So tell me, how did you feel when you got the news you were turned down?' `Well, Geraldo, naturally I was disappointed. I've got, maybe, one year to live with my present liver, and to see your last chance go down the drain like that! It's kind of the ultimate statement on your personal worth, if you know what I mean.'"
Nan began to cry. She had been cheerful and strong through the whole thing but now she was crying wholeheartedly and unashamedly and Arthur realized he had gone too far.
Nan was approved for a transplant, and her name was put on a list. Somewhere, some hospital administrator had her specific number in the liver line, a number that was held in secrecy because other potential recipients — Johnny-come-latelys to the list — might have to be advanced in front of her if their conditions were judged immediately life threatening while hers remained no more than progressively degenerative.
She knew they were getting serious when they gave her the beeper. The beeper was to alert her that her new liver, correct blood type guaranteed, had either arrived at the hospital or was traveling toward it lickety split, either packed in ice or still entombed in the unhappy flesh of its original owner.
She was told she had better be prepared to zip out the door for a rapid rendezvous. Livers don't keep. And demand was high.
Nan and Arthur's daughter, Beth, noticed the logo on one of her weekend visits. Nan was now receiving a monthly newsletter from The American Liver Society, Long Island branch. What caught Beth's eye was the artwork in the lower left-hand corner of the cover page. There, the organization's logo cavorted — a charming little liver with Betty Boop eyes, long eyelashes, and a dimpled smile, supported by two slender legs in high heels.
The little liver was waving. The words, "Hi! I'm your liver!" were printed above it in quotes.
"Dad," said Beth, pointing out the logo, "did you ever look at this?"
"Jesus," said Arthur, shaking his head.
"Mom," said Beth, "don't you think this is a little bent?"
"I never really thought about it, dear," said Nan.
Nan did sometimes think about her liver-to-be in present day terms. She would imagine it moving about in the body it now inhabited, interacting with other organs and bodily systems, its owner blissfully unaware of the Expressway crash or drive-by shooting or treacherous heart muscle that would soon free up the coveted organ for its next incarnation.
Nan and Arthur never really discussed it. Organ meat simply disappeared from their menu. Not just liver, but kidneys and brains, too. Not that they ever ate a lot of organ meat.
Beth read the line a third time. It was from a Harper's Index containing medical ratios and statistics. `Ratio of liver transplants performed per capita in Canada last year to those performed in the U.S.: 1:1.'
It made no sense. Surely the message was that Canada had significantly more or less transplants. Otherwise, why mention it? Was it a misprint?
And what did it mean, in any case, that one country did more or less livers per capita? Was it good to do more, or did the country doing fewer have greater success with less radical treatment alternatives?
Beth wanted some assurance that the U.S. was ahead in this liver business. At minimum, she wanted to know if she should be researching some Canadian lead on Nan's behalf. The Harper's Index annoyed her with its bland and seemingly inane assertion of transplant parity. She called the editor, got transferred several times, and was finally assured by a researcher who dealt with queries like hers that the ratio meant exactly what it said.
Nan's beeper alert was excellent in concept but not totally reliable in operation. The first time it sounded, at 2:00 in the morning, Nan and Arthur bolted from the bed, grabbed her prepacked bag, and were halfway out the door in their nightclothes before Arthur thought to call for confirmation.
Arthur pondered the fact that in this day and age one can mistakenly dial a number signifying the imminent arrival of a liver just as easily as any other number.
There were two more wrong numbers before the real thing.
The operation began forty-five minutes after Nan arrived at Mount Sinai Hospital and was successfully completed in just under eight hours. This was considered quite fast for a liver transplant.
The liver donor was a thirty year old Latin male. That was the only information Nan would be given about him.
The drugs puffed Nan's fine features out into a barely recognizable cartoon, a funhouse mirror version of herself. Arthur and Beth sat beside the hospital bed doing almost all the talking because it was difficult for Nan to move her grossly swollen lips.
The phone beside Nan's bed rang. Beth answered. "It's for someone named Raoul," she said. "Was there someone in the room before named Raoul?"
"Could be for the liver," Arthur suggested.
A week later, Nan spoke to her doctor as he examined her.
"It feels like it's too big," she said. "It feels like I swallowed a football. By the way, how big was this guy Raoul?"
The doctor laughed. "Why do you call him Raoul?"
"Have to call him something."
"The liver's actually a pretty good fit," the doctor said, "but everything around it, all the connecting tissue, is still very swollen."
Nan was out of the hospital in less than three weeks, a remarkably good recovery according to her doctor and the others on the transplant team. Her fever was gone and her blood counts were within acceptable ranges. Still, it was difficult for her to move around and Beth arranged to stop by in the afternoons to help.
Accommodating a stranger's liver is no easy task. After three days at home, Nan's counts began to spike, signaling a possible rejection. Arthur drove her back to the hospital. The next morning, as Beth sat and watched, a dozen medical students followed Nan's Doctor into the room and ringed her bed. Nan was having various reactions to the drugs she was taking to suppress her immune system, not the least of which was a bright red rash on her buttocks, crotch, and stomach.
"Want to see my rash?" she asked coyly, raising her hospital gown to her waist.
Beth was amazed. Later, she spoke to Nan's doctor.
"Do any of the drugs she's taking ever have... a disinhibiting effect?"
"Not that I know of."
"You go through all kinds of physical trauma and embarrassment with major surgery like this. Sometimes it loosens up people's attitudes."
Nan was released after four days. On her first evening home, Arthur announced he would fix dinner. Beth heard pots and pans banging around after the 6:30 news. She wandered into the kitchen where Arthur was vigorously chopping something.
"What are you making, Dad?"
"Liver and onions."
"Not funny, Dad," said Beth, trying to suppress a giggle.
"Waste not, want not. The liver's kind of worn out, though. Maybe I'll stew it."
"Not funny in a major way, Dad," said Beth, the giggle bursting irrepressibly through the hand covering her mouth.
While in the hospital, Nan had begun watching a steamy historical mini series, a sweeping saga of passion, honor, and duty set in South America in which the hero and heroine were parted by tragic circumstances for fifteen tumultuous years. Home again, Nan was watching the third and final installment wherein the hero and heroine were finally reunited, and on their first night alone together, proceeded to go at it like there was no tomorrow.
"He has a hot dick," said Nan suddenly, flashing a truly unchristian leer.
"I beg your pardon?" said Beth, who had fought a running battle with her mother since adolescence over what Nan had termed her `foul mouth.'
"That's the liver talking," Arthur muttered. "That's Raoul."
Nan looked at Arthur. Her face was merry and her eyes were shining.
"I want to learn the tango," she said, "and the rumba. What d'you say, Arthur, you old fart. Are you up for that?"
"Jesus," said Arthur, sounding genuinely alarmed.
"Art the fart," said Nan, smiling. "I want to do Carmen Miranda. I want to dance with bananas on my head. How about it, Arty?"
"It's the drugs," said Beth. "A reaction. I'm sure of it."
"It's Raoul," said Arthur.
"Farty Arty, want to party?" cooed Nan.
Arthur and Beth looked at her, speechless. Nan sighed and rolled her eyes heavenward. Then she stood and swung her hips to a Latin beat.
"Ai, Caramba!" she said.