Death Takes His Due

©2014 Gordon Kirkland

It’s been a rough week. Maybe it’s because Halloween is approaching, but for whatever reason, Death has been hanging around and pulling his old tricks.

In September of 2013, I was on Death’s front porch, about to ring the doorbell when an organ transplant saved my life and pulled me back from the brink. I was completely ready to cross that threshold. My funeral was planned. I had indicated that my body was to be cremated and the ashes spread on the lake where my parents had their summer home when I was a kid. My wife said that would be fitting. That way I could continue to be all wet throughout eternity.

I’m beginning to think that the old skull-face is extracting some revenge for my escape from his clutches.

Shortly after my transplant, a younger man made contact with me through an online support group for patients with, or waiting for, liver transplants. He had his transplants about two months before me. As one of the fine parting gifts you get after a transplant is medication induced insomnia, Eric and I would often find ourselves on line in the middle of the night. We would spend time, in the dark, talking and joking about our new realities, and trying not to laugh so loud that we would wake our housemates.

As the months past, we became good friends, despite the 2000 or so miles and an international border between my home in British Columbia and his in San Antonio. Eric challenged me to the Ice Bucket Challenge in August. We last talked early in October. Shortly thereafter, Eric went into complete liver and kidney failure and lapsed into a coma. He died on Monday, October 20^th.

It’s a fact of life for transplant patients. Things can go awry suddenly and disastrously. It is in the back of my mind all the time.

Death wasn’t satisfied with that one event. In the next few days, two others awaiting transplants and members of the same online support group lost their battles. That happens far too frequently. Approximately twenty people die every day in North America waiting for a transplant. There are simply not enough viable organs available.

Too few people take the few minutes it requires to register to be an organ donor. Of those, only about one percent die in such a way that their organs could be used. The donor must be in a hospital, on life support and be declared brain or cardiac dead. That status must be confirmed independently by two physicians not related to the transplant process. Of those, only one percent will have organs suitable for transplant.

And Death still wasn’t finished making my head spin. I also learned last week that Lindor Reynolds, a newspaper columnist I had gotten to know when we were both members of the National Society of Newspaper Columnists passed away on October 17^th. Lindor was funny, intelligent and compassionate. She’s leaving a big hole behind that will be difficult, if not impossible to fill.

Enough is enough, right? Well, Death is never satisfied. There will never be enough to satisfy him. On October 24^th, Dru Campbell, an author I had taught with for several years on the faculty of the Southern California Writer’s Conference succumbed to cancer. Dru was a great writer and educator. Many people benefited from her knowledge of the craft of writing, which she shared freely over the years 

Canadians as a whole were affected by Death’s touch last week. Two radicalized individuals brought terror to our country. One used his car to run down two soldiers, killing one. Another used a rifle to kill a soldier standing guard on our national capital war memorial and tomb of the Unknown Soldier, before running into the halls of Parliament. As I watched the video of that man’s last moments my mind ran through the same steps the security officials took as they chased him down. I used to walk that hall every day when I worked as a writer for then Prime Minister Pierre Trudeau. I watched in shock, knowing that he was just steps away from well over one hundred members of Parliament sitting in their respective caucus chambers.

Seven days. Seven deaths. Yes. It’s been a rough week, and I can only hope that Death is finished messing with me for now.

The Difference a Year Can Make and The Difference You Can Make

One year ago today I lay dying in the palliative care unit of a small regional hospital. I was lapsing in and out of consciousness, and my breathing had become quite shallow. Most of the time I didn’t really know what was going on around me. While I might have been able to carry on a halting conversation, a few minutes later I wouldn’t remember who I had been talking to, or what we had said.

The hallucinations were like nothing anyone had seen since the brown acid at Woodstock.

My liver had been failing for several years due to cirrhosis, which was not caused by alcohol. I was barely what could be called a social drinker. I would drink the occasional beer or glass of wine. I could nurse a shot of single malt for several hours. In fact less than 10% of the people suffering from liver disease were drug or alcohol abusers, roughly the same percentage as cancer and heart disease patients. Because of the stories of the likes of Mickey Mantle and Larry Hagman, people seem to believe that all liver disease patients are drunks or junkies.

I had been told that the only thing that could save my life was a liver transplant. The chances of getting one were so microscopic that we had no hope of that occurring. I had a rare blood type, one shared by roughly five percent of the population. I am 6’4” and the liver would have to come from someone with a similar build. Less than three percent of the population is 6’2” or over. While those two factors alone significantly reduced my chances of a liver being found in time, they were not the biggest obstacle I faced.

Eighty-five percent of the population agree with organ transplants and would gladly have one if they needed it. The majority of people think that anyone who needs a transplant should and will get one. Unfortunately that is not the case. In my area, less than twenty percent of the population has registered as an organ donor. Of those only one percent will die in such a way that their organs can be used, and many of those organs will not be suitable for transplantation.

To be a donor, a patient must be in hospital, on life support, and two independent teams of doctors must rule that the individual is either brain or cardiac dead. Every effort must have been made to save the person’s life before organ donation is even considered. If all those efforts fail, then the family will be asked about donating the organs.

Mathematically, there was no realistic hope that I would receive a transplant. My family and I were told to prepare for the end. I was given a workbook to use to write out my wishes for my funeral and what was to be done with my remains. My wife had already nixed the idea of setting up a motion detecting tape recorder in my casket so that when people looked in at me I could say things like, “Hi! Thanks for coming!” “So this is what it took to get you to visit?” or my personal favorite, “It sure is hot here… but it’s a dry heat.”

On that morning of September 18, 2013, I woke up early and watched the sun play on the dew on the leaves outside my window. As I looked at the day breaking, I thought it would be a good day to die. The usual hospital breakfast of cold eggs, cold cereal, and an English muffin that was so stale it might have been shipped by surface mail from England. The doctor from the local long-term care/hospice facility came to see me. As we were talking, the phone rang.

On the other end of the line was the coordinator for the transplant team at Vancouver General Hospital. She said that they had found a liver that was going to be available shortly that was a perfect match for me. I thought it was someone playing a joke. It took her three times to convince me that I was going to get the transplant, finally saying, “Look, Gordon. I’m hanging up now and calling for an ambulance to go out there and pick you up.”

The doctor who was there said, “Well, I guess you won’t be needing me now.”

I buzzed for a nurse, but they were all busy with other patients in the unit, most of whom were in their eighties and nineties. I started shouting “I got a liver!” hoping one of the nurses would hear me. I heard some shuffling outside my door, and looked to see a small group of geriatric patients staring in at me while I lay there shouting. “One old dear turned to another and said, “Did he say he got liver for breakfast? I sure don’t ever want liver for breakfast.”

After about twenty minutes I thought it might be a good idea if I called and told my wife what was happening. There was a chance she might like to know. (See. I told you my mind wasn't working on all cylinders, and if that wasn't reason enough, I am after all a husband, and we don't always think quite straight.) I still have a slight ringing in my right ear from the scream that came through the phone lines. Dogs in a five mile radius probably stopped what the y were doing and wondered what that noise was.

At 6:00 the next morning I was wheeled into an operating, and here I am, a year later. My bi-weekly blood tests show that my new liver is functioning perfectly. I think my donor must have been in incredible shape.

Across North America twenty people die each day waiting for a transplant. One donor can save the lives of up to eight people through heart, lung, liver, kidney and pancreas transplants. Up to 50 lives can be impacted directly through skin and cornea donations. Registering to be a donor is a simple and charitable act. If you don’t know how to do it in your area, I have placed all of the organ donation registration information for the United States and Canada on a web page at http://www.gordonkirkland.com/donor.html.

Please, for the over 150,000 people currently waiting to receive a transplant, take a few minutes out of your day, and register to be an organ donor. You sure won’t need them after you’re gone, but they could mean the difference between life or death for someone else.

A Funny Thing Happened Looking Out From The Top Of The World

^©2014, Gordon Kirkland

The last time I published something on this blog was March 5, 2012, two and a half years ago. A couple months before, my second novel, The Plight Before Christmas had hit number one on the Amazon Kindle Parenting & Family Humor Bestsellers list. I was on top of the world. A lot of you have forgotten about it. Some of you probably thought I had just packed it in and quit. A few of you probably thought I had died.

I almost did.

Shortly after publishing the blog right below this one, I left for a vacation in the Barbados. I wasn’t feeling all that great. I knew that it would probably be the last time that I would travel while still walking on the crutches clipped to my arms that I had used for eighteen of the twenty-two years since I became a paraplegic in an automobile accident. I knew I would be dusting off my wheelchair in the not too distant future.

On the way home, at 38,000 feet over the Atlantic Ocean, I collapsed in an airline lavatory. The flight attendant was obviously concerned when I fell backwards through the door and landed at her feet. 

She continued pouring cups of coffee for her first-class passengers.

When we landed at home I went straight to the hospital, thinking that the few nerve connections that allowed me to continue “walking” on the crutches had finally eroded. In the small, overcrowded regional hospital, rooms were at a premium. I was put into a space not much bigger than a janitor’s closet in a corner of the emergency department. I lay there for 3 days.

A young doctor came to me one morning and said that he had noticed something unusual on a blood test, and wanted my permission to do more tests. Well, I wasn’t doing anything else at the moment, so what the heck.

Over the next two days, enough blood was drawn to feed a family of vampires for a month or two. I had a CT scan, multiple x-rays, and an ultrasound. In case you’re wondering, I wasn’t pregnant. I felt injected, inspected, and rejected.

A few days later a specialist came into my room, and without so much as a howdy-do, said. “Mr. Kirkland, you’re in deep shit.”

He went on to explain that I was at end-stage of liver failure due to cirrhosis. I told him I couldn’t have cirrhosis because I wasn’t an alcoholic. I was certain of that because alcoholics went to meetings, and I didn’t like going to meetings. The doctor went on to explain that what I had was something called Nonalcoholic Steatohepatitis that had caused the cirrhosis, or in laymen’s terms, I was in deep shit.

He went on to explain that the only thing that could keep me alive was a liver transplant, but that I wasn’t a good candidate for getting one. I had a rare blood type (less than 5% of the population.) Fewer than 20% of the population register as organ donors, and less than 1% of them die in such a way that the organs can be used. At 6’4” the liver would have to come from a donor of similar build (less than 3% of the population.) Mathematically, the likelihood of a match becoming available in time was somewhere between microscopic and nonexistent. 

Over the next year my condition worsened dramatically. Liver failure causes a build-up of ammonia in your system, which in turn causes your brain to turn into mush.

I never wrote another word.

By the end of May 2013, I was hospitalized and at times did not even recognize my wife. Let me tell you something, when a man has been married for 40 years, it is not all that healthy to look at your wife and ask who she was. By August, I had been moved into palliative care, and was being told to prepare to die.

On the morning of September 18^th, 2013, I was being examined by the doctor in charge of the local long term care and hospice facility. My life expectancy could be counted in days. Suddenly,the phone rang. The transplant team at Vancouver General Hospital had found a liver for me. I was transferred there later that day, and the surgery started at 6:00 the next morning.

I woke up later that day in the intensive care unit. A nurse asked me if the doctor had given me a Mercedes Benz of a Lexus. My immediate thought was, “Man, this Canadian healthcare system is even better than I thought. I just got a new liver, and they’re giving me a car, too!”

It turned out she was asking me which car company’s logo looked like the incision that had been cut into my abdomen. It turned out that I got the Lexus cut. If I take my shirt off I look like a billboard for an over-priced Toyota. I’m just glad the doctor didn’t give me a Dodge Ram.

So I am back. I won’t say I am back to normal. Normal is not a word that anyone ever used to describe me. I’ve been writing again for a few months, working on a book about the experience of walking up to Death’s door, but not quite ringing the doorbell, as well as a sequel to my novel Crossbow that I have been promising my readers for several years. Next month I will be releasing a Kindle short story called Duke’s Christmas featuring the characters from Crossbow.

I’ve also decided to start writing short humorous essays again. My syndicated column ran in newspapers from 1994 to 2007, but I’m not going to go through the joys of trying to deal with newspaper editors again. Transplant surgery was bad enough thank you. So I will post the essays here as regularly as I can.

I hope you’ll stick around for the ride.