Trial by Transplant

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

Mine was a sick-girl kind of exhaustion, the result of a combination of immunosuppression, infection, and nauseating medicines. "I used to be normal," I had told Scott once after he had implied I was exaggerating. "I remember what 'sick' felt like before my transplant. It was nothing like this."

A killer cancer might be the best thing for everyone involved, I thought. If I had died five or 10 years after my transplant, as I was supposed to, Scott and the other important people in my life would not have gotten to the point of losing all patience with me. So Amy was just going to lie on her couch for a day or two, and stop trying. I knew it was selfish and ungrateful. I was lucky just to be alive.

Wasn't I?

My underarm was still a fiery raw mess when I saw Dr. Davis, my transplant cardiologist for 17 years.

"I don't want to suffer anymore," I said. He ignored me. Out came the patient information form. "Trouble sleeping?" he inquired. "Sore throat? Dizziness, fainting? Appetite? Mood?"

"How do you think my mood is, Dr. Davis?"

Silence. "I'm completely unraveled. I can't even move my left arm. And it's not just the arm, Dr. Davis. It's the years of crap. It's illness and hospitals and specialists and denervated heartbeats and immunosuppression. I don't want to do it anymore. There's no end, and you know it."

"We need to get you feeling well again," he said.

"You always say that. It's pure bullshit!" Dr. Davis lost his smile. "I'm going to stop taking my medicines—all of them. Maybe I'll live, maybe not. I can be an experiment."

Afterwards, Scott and I stood waiting for the elevator like strangers. I could tell a storm was brewing within him. "No one can save you," he said. "It's not fair to expect Dr. Davis to make everything ok. You had a heart transplant. It's been 17 years. You have a transplanted heart, Amy. It's all up to you. It's in your hands, and you know it." Here it was again: the moment of choice.

"I'll try," I said.

From Sick Girl, published by Grove Press, copyright 2007 by Amy Silverstein

You can read reactions to Silverstein's views and her reply on the Comarow on Quality blog.