Part 7: Arriving in DC and Surgery Day

Successful Transplant Surgery – Waking Up

My plane touched down on Sunday night. There was an NIH shuttle from Washington Dulles Airport, and I stood at the stop with the other patients. The difference between us was that they were ill.  I helped an older woman with her cane and her bags. She introduced herself as ‘Marlene’ and told me she flew in from California every other week for experimental treatments for a condition with a very long name. When I told her I had come in for a kidney transplant she said I looked ‘pretty healthy for a kidney patient!’  When I explained that was I the donor we both laughed and I noticed that my laughter was masking a growing fear. Because the retesting for the cell match was at 6:30 in the morning. I elected to stay in the transplant unit on Sunday night rather than in a hotel to avoid having to get up yet again at 5 AM. When I reached the unit and saw Taro, who had made the same choice.

The next day after my tests which included blood tests and an EKG.  I met my lead surgeon Dr Pinto in person.  I also saw Dr Elster again who took out a black marker and put an X over my left kidney. ‘So we know which one we are removing’ he smiled.  I did not ask how they had selected it but I do remember that back in September at some point he explained to me that if I possessed kidneys of a different size, I would keep the larger one. I believe this was meant to reassure me but I was unhappy about it. I protested that I didn’t want the larger one, I wanted Taro to have it. He and the nurse looked at each other.  I thought I had better elaborate. It made no sense to me that I was going through all this trouble for Taro if he was not to get the best possible chance to survive. But Dr Elster was firm. ‘You’re the hero here.’ It was at that moment, at the end of all the testing, that I finally understood what Taro kept telling me, ‘the procedure is meant to protect the donor.’  After the X over my kidney the only other memorable thing about Monday was that I accidentally went AWOL. George had arrived late Monday morning once my tests were complete. We went down to breakfast and then went for a walk. In the lobby we saw Marlene who wished me luck. When we returned to the unit the nurses looked happy (and relieved) to see me and explained that I needed to sign out and that I had missed seeing one of the doctors.  One of the reasons we left was that I assumed I had seen all my doctors but there was another one named Dr De Beck who was paged and quite relaxed about our missed appointment. Taro had many more tests and I did not see him until the evening when my aunt came to call. We were on liquid diets by now and after our ‘dinner’ I gave him a little hug as I did not expect to see him before surgery the next day.

Tuesday morning I awoke before the nurse arrived at 5:30. Thanks to jet lag I had slept like a baby without the sedative they gave me. I showered and put on my surgical gown (quite a clever one with three holes for the arms so it wrapped the patient completely). The nurse prepared my arms for the IVs. My surgery was due to  begin well before Taro’s but at some point they would prepare him and then we would be in adjacent operating rooms each with a  team of  8 or 9.  Once the nurse had prepared me I sat watching the door wondering who would arrive first, George or the man in the white coat to take me away. George was late and I  worried he would arrive after I left. The kind nurse assured me that I had time.  Poor George had had a sleepless night especially having nearly come to the hospital at 2 AM because he failed to reset his watch to US time. He arrived shortly after 6 as did my mother and sister Sharon. We spoke for a very few minutes and then the nurse said ‘they’re here.’

Outside the door I saw a tall young man in white standing next to a hospital cart with the blanket turned back waiting for me. My mind reached back to my French films about the Revolution when they come to fetch  Marie Antoinette for execution with the words ‘Citoyenne! C’est l’heure!’  (Citizen! It’s time!).  I started to move toward the door which seemed an interminable distance but suddenly standing in the doorway between me and the cart was Taro. He had come to see me off. He did not greet me first. My mother and sister were nearest to the door. This was their first meeting. Taro gave each of them a small formal embrace and then he stepped back and bowed. This was done with great solemnity and later he told me that when he greeted them, he felt that he was greeting his new family. Then he walked over to me and gave me a close embrace saying ‘thank you.’  I thought about saying ‘you’re welcome’ in Japanese but the best I could do I felt was to wish that we would both survive and be well so I put my hands on his shoulders and looked him in the eyes and said ‘good luck to us!’ — twice.  Although I was not crying my eyes filled with tears and they ran freely down my face. Taro also had tears in his eyes and they stayed there. After the second ‘good luck to us’  I walked to the cart clutching pictures of the children.  My mother stayed but George and my sister came with me. I wanted to walk but the young man told me that I had to get into the cart which made me feel very vulnerable.

We took the lift to prep room and almost as soon as I arrived Dr Swan the chief anesthetist arrived. He was (like all the doctors and nurses) very cheerful and nice. He quipped that he was pleased that he had arrived before the surgeons for a change.  He told me  I probably would not remember him or our conversation. He then put a green and a red liquid into my veins which he said was not the general anesthetic. I don’t know what it was but I began to lose consciousness so I gave the pictures of the children to George who held them up for me. Their faces are the last thing I remember before dropping off completely.

When I regained consciousness I was in a hospital room which seemed overflowing with people. That is saying quite a lot since hospital rooms at NIH are large and transplant patients do not share. My family was there of course and my surgeons but there were many others I did not know. At first however I was only aware of someone holding and stroking my left hand. The touch was light as though I had lost feeling in my hand. When my eyes fluttered open I saw that it was Dr Pinto.  He told me that the operation had been a success and that the transplanted kidney had begun functioning immediately.  My first reaction was shock that after so many months of stress, and testing it was over. He continued telling me that I had been very brave and that I would be fine.  Now as he spoke my eyes began to scan the room and I realised that I felt very strange indeed. With the exception of my eyeballs, I could not move a single muscle.  In fact I felt paralysed.  Clearly the  articles I had read about donors had left this little tidbit out.  I was excessively hot.   I had a very high fever and my throat was parched. I could tell that my lips were cracked and blistered as though I had been walking in the desert. However, it must be said that I felt no pain or very, very little. They were certainly right about that. I did feel very nauseous.  As I began to take in all this information about my condition I felt panic mounting inside.

My first terrified thought was ‘What is to become of me! How long will I be like this!’ My eyes moved to the various people in the room especially George who looked very tired. My sister Sharon noticed and told him that he should go and get some rest. She said she would stay and look after me and Taro.  Unfortunately, as George was about to leave the room the nausea sent me into a coughing fit. I wanted to tell George that I was all right. That it was only nausea and that he should go but I couldn’t.  Even if I could have stopped coughing, I could not speak.  So everyone watched me as I coughed and coughed. Dr Pinto was watching me also but after a few moments he spoke to the others. He said it sometimes happens after the breathing tube has been removed the body still thinks something is stuck in the throat. That was true. I certainly did have that impression. I was very grateful as my sister recovered and took charge again, firmly shooing George out of the room.