Mr. S

Mr. S is in his early 70’s. For most of his adult life, Mr. S struggled with respiratory issues until recently when he received a bilateral lung transplant. It was an opportunity intended to prolong his life; a chance to have the luxury many of us so often taken advantage of: To breathe.

An organ transplant is a contradicting process. It is a blessing dressed in its very best disguise. It is years spent on a long waiting list, waiting for a match, waiting for a generous yes – if ever. And if the yes comes when it does, a thorough social, psychological, and physical examination is conducted by a specialized health board to determine one’s eligibility.

There will be many questions. Has the person historically adhered and cooperated with treatment? Will they comply with future treatment? Does this person have a strong support system? Is the person physically strong enough for an invasive operation? What is the likelihood of the person developing any secondary health complications? Will the body reject the organ transplant? And most importantly, will the person survive?

An organ transplant is a contradicting process, one that takes and one that gives at once. When one’s organ is removed and replaced, the body registers the new organ as a foreign substance. The body’s most natural response is to defend itself from harmful foreign substances. The immune system will naturally attack the organ, a process we call, “rejection.” During this time, patients are placed on immunosuppressive medicine and must follow careful, strict treatments.

Like so many other organ transplant recipients, Mr. S’s transition to accept his newly gifted lungs was riddled with difficulty. Over the course of the year, he was hospitalized then discharged then hospitalized again. The transition was difficult but nonetheless, his body accepted the new lungs. Mr. S was living through a second chance; a second chance to breathe new meaning into his life.

Last month, Mr. S was admitted into the hospital. But this time for Covid-19, the unforgiving Coronavirus, a respiratory illness of our global pandemic. The infection had spread to both his new lungs and he was placed in palliative care with a specialized medical team.

The type of care here is holistic, a kind of treatment developed based on his needs and not his prognosis. It’s not quite hospice which means Mr. S has a chance to recover but his odds are unlikely. The treatment options have been exhausted and management is the last viable option left. In his medical records, Mr. S is DNR and DNI: an order to not resuscitate and intubate should he draw his last breath.

During a morning round, the medical team visited Mr. S. When asked what he was most afraid of – Was it not being able to breath? Was he afraid of suffering? Was it death itself? – Mr. S said he was most afraid of leaving his wife. Who would take care of her after he was gone? Would she be okay? How will she cope with the loss?

The attending, a young physician in her thirties, began to quietly cry. The young medical student in his second year of medical school hung his head low in the corner having lost his Uncle to Covid-19 and now treating his first Covid-19 patient.

All their years of training washed up shore here in a small hospital room. No amount of training could ever replace the human lessons they would learn from their patients. When confronted with death, people rarely fear death itself. Rather, they fear being without.

I thought back to a moment when I laid in the grassy lawn of my college. The sun had set. The yoga instructor asked that we breathe – deeply and so very intentionally – our last breath in Savasana.

I laid on my back and closed my eyes. I inhaled the summer night air following its coolness close behind as it entered my nostrils and traveled down my throat and into my lungs. I exhaled letting my breath leave my lips slowly. The warmth of my breath vibrated from my lips into the blanket of those ever-glowing cataclysms in the night sky – my loved ones watching over me.

Mr. S, I lost my grandfather that year. I learned that loss is just that – loss.

Death is the absence of our physical being, but it is never being without not for as long as you are remembered by those who love you. And when you lose all physical presence and return to the Earth, you give back – of lessons learned, memories of joy, and immense love.

S.