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By Roy Tate
The following is based on real events, it is recounted in a fictionalized timeline from a caregivers point of view.
“The Waiting List is the computerized list of candidates who are waiting to be matched with specific donor organs in hopes of receiving transplants.” -U.S. Department of Health Resources & Services Administration
January 13, 1982
Gerrit Kelly had never thought of himself as terribly brave, and although he often took ridiculous risks, this certainly did not count. He admired bravery; however, he was not necessarily capable of performing such deeds himself. Occasionally Gerrit even wondered if he were not a coward. He questioned where the threshold was for the average man to risk his existence for the benefit of another.
On the subject of bravery, Gerrit usually thought about Lenny. On January 13, 1982, Gerrit watched, mesmerized, as the Air Florida Flight 90 disaster played out on live television. The Boeing 737-200 slammed into the 14th St Bridge outside Washington National Airport instantly killing 4 motorists. An earsplitting cry of engines straining for nonexistent lift, coupled with the sound of tearing metal, foreshadowed a screaming belly flop by the 50-ton jet. It broke up and stumbled through the ice-covered surface of the Potomac.
Priscilla Tirado remained in the water with a handful of survivors. She was a 23-year-old mother, screaming and hysterical as to the whereabouts of her newborn child and husband. She did not know that her husband and baby perished.
Priscilla was too weak to hang onto a helicopter’s life preserver. She repeatedly dropped back into the water and dipped below the surface. Gerrit scarcely believed what he saw next.
Vietnam veteran Roger Olian, tethered to a lifeline of battery cables, scarves and pantyhose, worked his way over broken ice, dropped into the water within 10 feet of the wreckage. Only the airplane’s tail, a beacon for six survivors, remained above the water. Roger later described the water not only cold, but more as an electric shock. During nearly 30 minutes in the water, he could only shout encouragement to the survivors.
In front of the hundred-odd spectators and emergency personnel, a clerk from the Congressional Budget Office stripped off his jacket and shoes. Before today, a scarce handful of people knew Lenny Skutnik. After this day, virtually no one might ever forget him.
First was the spray of impact from Lenny’s body slamming the frozen surface. This came from the force of the hovering Bell Ranger’s prop wash, coupled with the sheer violence with which Lenny hit the Potomac. A cascade of near-frozen water and mist spit over 20 feet up in the air.
What was, and always will be, unmistakably burned into the videotape recording was the fear Lenny betrayed on camera. He was afraid of not reaching Priscilla Tirado in time. Lenny crossed thirty feet to the drowning women in about four seconds. The shepherd slipped an arm around her ribs and coaxed the limp and failing mother back to shore, saving her life.
Lenny now knew something that nobody safe on shore or watching from any corner of the globe could guess, and it was this: At the instant he hit the water, there was no guarantee of success, but not trying was worse than drowning.
December 17, 2008
Kate met with Dr. Geoffrey Storm who asked “Why, why,” and a final ‘why’ injected with feigned compassion, “did she wait so long? If you had just got here sooner, we might have had a chance.” Every MD who treated life-threatening disease had said this to a tardy patient.
The result of her new lab work was discouraging. Storm made no claim to professional error surrounding her follow-up from four years gone.
Dr. Storm was one of the high profile Beverly Hills M.D.’s with a referral mill of patients that kept him in perpetual motion. Geoffrey was boyishly handsome and could lie about his age by ten years.
He specialized in gastroenterology, but if a patient or even a referring M.D. thought of or referred to him as a Hepatologist, Geoffrey again, refused to correct them. Dr. Geoffrey talked down to his patients as if they were stupid, when they were usually just ignorant of what is learned in medical school. And, depending on severity of their health problem, any patient may be scared, to death. Dr. Storm ordered and billed for every conceivable test on Kate’s first visit. Storm loved to soak his patients.
January 9, 2009
Kate arrived at Newport Imaging, referred by Storm to “r/o tumor” in the ultrasound report. “R/o tumor” was Doctor’s speak for “let’s just make sure there’s no cancer.”
Gerrit and Kate reported the next day for the results. After waiting thirty-five minutes, a nurse guided them into an examining room. The report sat in a patient folder holder on the exam room door. Gerrit snapped it up without hesitation and flipped to the radiological findings:
“9 mm lesion in the anterior segment of the right lobe of the liver is suspicious for hepatocellular carcinoma…” Or in English, liver cancer.
Kate burst into tears. She wept like a schoolgirl who had lost her first love.
There is no amount of, “Relax, we don’t know what this means…” or “Let’s just wait and listen to how the Doctor sees it…” to soften this blow. Kate has just read in black and white what amounted to a death sentence. Untreated liver cancer held an average life expectancy of twelve months.
Gerrit got up and went in search of the Doctor.
The adjustable recessed accent lighting peppered across the ceiling appeared brighter and seemed to guide his steps. Did someone change up the lamps wattage in the last six minutes?
Gerrit felt like he sank suddenly underwater, drowning, and trying to break the surface for a sip of air. He chose not to stop at the interior nurse’s station, nor did staff challenge the person who was clearly not lost. Another few steps and Gerrit was in front of the open door of Dr. Storm’s private office, where he found the overdue physician in front of his computer monitor reviewing messages in Outlook.
Garret was not even five foot seven and a hundred fifty pounds. He did however, have the innate ability to scare the living daylights out of someone over six feet tall if he chose to. He now chose to. Garret’s green eyes steeled instantly to near coal black as he focused across the four feet of desk, placing the distracted M.D. in the cross hairs, leaned forward and pushed the power button on the I-Mac monitor. His head snapped up as the monitor went blank to lock gaze with Gerrit, who now held the shocked Doctor’s rapt attention.
“You need to come with me right,” and pausing a full two seconds, “now.” The ex-firefighter said this with a level of conviction that erased any need for apology, explanation, or dalliance.
Dr. Storm instantly stood and followed silently back to exam room number three. Devastated, Kate cried uncontrollably. Her pitiful image gave way the report before the Doctor viewed it for the very first time.
Here, the Gastroenterologist did something Garret had never seen before. He climbed up on the examining table and folded his legs beneath himself Indian style, to absorb the report. In a moment, he looked up. He was scared. If it was due to Gerrit, the lethal nature of the prognosis or both was unknown. At best, this problem rose way above his pay grade.
“Don’t start planning your funeral just yet.” This was the strangest attempt at reassurance Gerrit ever heard, still, it seemed to have a calming effect on Kate.
“This is not good, obviously. There are still options. You may qualify for a liver transplant. In fact, one of my best friends Doctor Stephen Hickok is head of the transplant department at Angels of Mercy here in Beverly Hills. I will refer you to him and he can review my records.”
Sadly, Dr. Storm’s records sucked. After ordering several thousand dollars of medical tests, the written record amounted to two chicken scratchin’ pages of virtually illegible notes.
Gerrit had the sick feeling that this doctor of medicine worried more about his image than with the health of his patients.
Well, goodbye and good riddance.
Kate and Gerrit drove straight to Dr. David Cutter. David was a simple country physician who practiced in Beverly Hills. He is Kate and Garret’s primary care physician. David had snow-white hair, a disarming continence, unmistakable affection for his patients, and a unique ability to bring calm to the chaotic. David treated Gerrit in 2000 when Kate divorced him.
David explained that the Doctor Kate needed was considered akin to a rock star, or a gunfighter the likes of Wyatt Earp. They talked and talked until Kate became noticeably reassured and waxed calm.
Dr. Cutter felt that the transplant Doctor’s would love Kate due to her health still appearing robust. David shared about a patient in need of lung transplant that died in part due to bureaucratic and administrative wrangling. By the time many of the patients in need of transplant made it into the operating room were already one foot in the grave. Unknown to Kate and Gerrit is a horrifying statistic that now applies to Kate. Across the country, twenty people a day died waiting for transplant. Or more specifically, on a yearly basis seven thousand children parents and friends, succumbed waiting.
What no one in the room knows is the reason behind this.
“You both need to stick close together Dr. Cutter counseled. It will improve your chances dramatically. I will be with you every step of the way.”
The blood rushed to Garret’s head threatening to put him to sleep, maybe even into a coma.
“Does anyone object if I just climb on out of this chair, wander out of this office, step outside, and am never heard from again? I mean, let’s be realistic. I’ve been around a few months, exploring a redo with the ex, but seriously, who would jump up and volunteer for this nightmare?”
January 16, 2009
With referral in hand, Kate and Gerrit grabbed the next available appointment at the once legendary Angels of Mercy Medical Center. It ranked as a “Center of Excellence” for care in organ transplant. Still, the center as a whole suffered decay in its prestigious ranking from the preceding 25 odd years.
Health Insurers required a “Center of Excellence” status to qualify a Hospital for payment in the case of organ transplant. Generally, nobody knew or cared about this fact until they faced a transplant. Every insurance carrier had different rules and levels of payment depending on organ, facility, progression of disease and a file cabinet of other mind numbing data.
The Outpatient Consultation for Hepatobiliary Transplantation was in the Center for Liver Diseases and Transplantation department of Angels of Mercy (Cedars) in Beverly Hills. The waiting room looked like a mash unit in Viet Nam. There were Asians appearing gut shot, An African American akin to one having just survived a lynching, and a Caucasian woman with un-brushed blonde hair, blue eyes in her 40’s that appeared to have been in a bar for the previous three decades.
One hour forty-five minutes later, Kate and Gerrit were lead to a consulting room. It is roughly the size of three phone booths, claustrophobic, and absent any amenities. Another twenty minutes pass, a nurse entered to ask a number of health screening questions.
Finally, Dr. Hickok entered. And by Jingo, if Dr. Hickok did not actually look like some century old pistolero as his famous name implies. He had flowing nape of the neck length hair, disarming but unflinching light eyes, a full mustache, and unshakable, utter confidence.
New patients, especially females fell madly in love with the dashing Doctor. Why wouldn’t they, as he was now in a position of life and death over the sick. Unlike an affliction with Shingles, Chicken Pox, or Pneumonia, without Hickok’s help, everyone he meets in exam room two will die.
The community of liver transplant surgeons was small. It numbered in the neighborhood of 600 Doctors who staffed the 132 Liver transplant centers in the United States.
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