Trial by Transplant

Amy Silverstein is 44. She got a heart transplant as a 25-year-old law student.

After my 11th sinus infection in less than a year—my suppressed immune system made me vulnerable to every bug—I complained to Lynn, a close friend. "You've just got to stop getting all these infections," she said briskly. "I think you should do what aids patients do—take these new drugs that pump their immune systems way up. If you got your doctor to prescribe them, you wouldn't be so sick all the time."

"Yes, but I would be dead!" I expected a dear friend like Lynn to understand the fundamentals of transplant immunosuppression. Then it occurred to me: Perhaps Lynn would have been able to grasp more if I had hidden less. If she didn't get it, whose fault was that, really? Mine.

The sound of time passing became unbearably loud, but no one around me heard it. "You always make the best salad!" they'd rave. I'd been sick when I made that salad, so weak I had to sit down at the kitchen table three times before I got around to chopping the tomatoes. Hospitalizations, clinic visits, heart biopsies, illnesses, infections—everyone preferred to pay attention to other things. I landed in a therapist's office. "Suffering is suffering," Dr. Fisher told me. This was supposed to make me feel better?

Dr. Allen pressed two fingers far up into my armpit. When his fingers reached the lymph node, his eyes closed tight as if something had just caused him great pain. "Yeah, yeah, I feel it," he said. Here it was, after 17 years. Post-transplant lymphoma. Cancer. I couldn't find my breath. "Get dressed," he barked. "Get on the phone. Call your transplant cardiologist. You need to biopsy this lump—now. You don't want to waste one minute, believe me."

I was frozen in place. To start down this road would mean breaking a promise I'd made to myself soon after my transplant: I would fight through the little illnesses, and I'll even do the bigger ones if I have to, but never again would I fight the killers that are going to get me no matter what I do.

Dr. Allen came back to the exam room. "Did you call?" I stared at the floor, ashamed. "I can't. I mean, I won't. I can't do cancer, Dr. Allen."

"But you're such a brave soldier! You can do this, easy. Don't be ridiculous. I'll telephone myself if you like."

"No," I said. "I'm not a brave soldier. I don't want to be a soldier at all. I've fought my battle for a long time. I'm exhausted. I have my limits like anyone else, and I think I've reached them."

He reached down and took my hands in his. "As long as you live, you must fight. Always fight."

"But I've already fought."

"It's not something that begins and ends. Life is a journey, Amy, hasn't anyone ever told you that?" He kept his other patients waiting and held my hands tight until he could tell that it was ok to let go.

I didn't have cancer—but years of built-up emotion were about to explode anyway. Even Scott failed to fully understand how the accumulation of health problems had worn away my resilience and devoured my sense of hope. Transplant illnesses are not discrete occasional events that come and go. They were my everyday life. A 10-hour emergency-room visit, complete with medical errors and a hospital admission at 3 a.m., was just another big yawn to those who looked on. It was just something Amy did. A surgery no longer warranted a phone call from a friend. Why bother? Amy has them all the time. Lymphoma? Well, these things happen.

Too many things were wrong with me, too many illnesses and issues were vying for urgent attention all at once. I was overwhelmed. Exhausted. And so I fell into the dark place where people go just before they give up completely. I told Scott that if the biopsy showed lymphoma, I would kill myself immediately.