How Would I Know?

How Would I Know?

Tell everybody waiting for Superman

That they should try to hold on the best they can

He hasn’t dropped them, forgot them, or anything 

It’s just too heavy for Superman to lift.

The Flaming Lips, “Waiting for Superman”


“Barbara? Barbara…”


Someone is saying my name. Or so it seems. It also seems like I’ve been hearing it for a while, fading in from far away. Easy to ignore in the soft, quiet nowhere I am.


But I’m starting to remember. I’d just gone to sleep in the OR a minute ago. I know they’re planning to check out my liver with a scope to make sure it’s okay for donation. (The surgeon really didn’t like some of the cysts and small, stiffening spots that showed up on my MRIs. Turns out, you don’t have to be an alcoholic either to abuse alcohol, or to have scars from it.)  


Oh, no. It’s so quick, because they’re waking me up because they can’t use the liver after all. It didn’t work. All this for nothing, and John’s going to die. I’m still too out of it to panic, but I do feel creeping dread. 


“Is the endoscopy over?” I carefully activate my inert tongue and ask gingerly, because I’m too scared to be direct: you can’t use my liver, can you?


“It’s all over. The whole thing. You’re all done. You did great!”


What? Wasn’t I just in the freezing-cold OR, counting back from ten?


The body has a way of logging the passage of time when we’re merely sleeping. It’s the reason some of us don’t need an alarm to wake up at our accustomed times. That sense disappears in the most disorienting way under general anesthesia, with its own Four Horsemen: analgesia, paralysis, amnesia, and unconsciousness. No pain, no movement, brain waves held hostage at such low frequency that no information can be imprinted or carried on them. It’s a profound reversible coma brought on by an injected cocktail of anesthetics, opioids, and muscle relaxants. It’s also drug-induced, physics-approved time travel; an instant trip into the future.


For me, about eight hours.


“Is John okay?”


“Yes, he’s doing fine. They’re still in with him, finishing up.” 


Oh, my God. It worked.


Amazed, hopeful, waking bit by bit into the first moments of The Great After. (That’s what I called this, in The Before Time, when all that existed were the paths that led us right here; simply no other focus.) In the lingering dopamine rush of the sedatives, The Great After was already living up to its billing. Nobody was dead, for starters: an auspicious debut!


The pain would wait for a bit.


I’d done extensive testing to see if I could donate my liver. And of course, you have to identify the reason for the barrage of tests at the outset of whatever particular one you’re undertaking. I remember getting ready for a treadmill stress test, telling the attendant what I was there for, and her saying, “Damn, I’d never do that!”


It’s surprising what people are so sure of.


I thought to myself, “How do you know?”


A giddiness accompanied my family (Mom, Dad, and my uncle) as they finally joined me in my hospital room, once I’d emerged from recovery. Their relief was so palpable it was a flavor in the air. It was the only thing I’d be able to eat for a while. The surgical team had been sending them updates on how I’d been doing, which helped them somewhat. Yet what I was there for was not just antithetical to the Hippocratic Oath, but contrary to any parental instinct: sitting by, in surrender, powerless, while their perfectly healthy daughter has a vital and functioning piece of her body removed for someone else’s use. 


Time travel was not available to them. Instead, time slowed down, catching them in the gravitational field of this event that their daughter had chosen.


My euphoria was amplified by the entrance of the anesthesiologist. Five foot nothing even in her Dansko clogs, she was a dynamo, the chirpiest, sweetest part of the days leading up to the surgery, when we were talking to the actual people who would be opening us, watching, passing scalpels and retractors and hemostats, attending, stitching, keeping our hearts beating and breath in our lungs. She’d assured us that she would be there to take care of us, and that, more than that, she couldn’t wait to see John’s transformation. This was one of her favorite types of surgery. She told us how his body would immediately respond to a healthy liver graft, how the distended veins across his abdomen would promptly return to normal, with fluids no longer shunted around a stiffening, dying organ. She told me how huge and beautiful my liver was, how ideal for this procedure, a bizarre and sincere compliment. She was genuinely excited. 


I recognized her voice calling to me as she came in, and I said, “Oh, hello, you adorable thing!” (Your filters are pretty shot coming out from under: that’s my story, and I’m sticking to it.) She came to the bed, put her head next to mine, and asked how I was. 


I told her I had never been better, which by some metrics may have been an overstatement. 


She asked, “Do you want to see your beautiful liver?” 


Hell, yes, I did. 


She pulled out her phone and opened to several shots of the ruddy piece of organ, flushed of blood, lying in a red-tinged puddle on a scale, and put the phone right next to my nearsighted eyes while she flipped through.


I couldn’t have been happier, more proud, more relieved, if it had had my eyes and daddy’s nose.


“Look at that sexy, sexy liver,” I said, a little awed, beginning to sense a surreal undercurrent in the world. “Will you send me those?”


She did.


I’ve looked at them a lot.


My family hadn’t seen pictures of my liver yet, but they had seen an image of John’s, before its pathology analysis and eventual incineration along with other medical waste, as part of the updates that came from the surgical team. It was orange-yellow, misshapen and clearly scarred, looking strangely cooked. Mom had had to excuse herself for the bathroom. She says she didn’t throw up, but that it was a close thing.


Much later, The Great After morphing into something else as John started drinking again, I wrote this down:


“An unspeakable thing lives in our house.


We’re tied together at the waist. (At the liver. What a waste.) Tied together. And he wants to drown. And, tied together, I must go with him. 


Or slice the tie.


But the tie is made of my own flesh. My own (two) pound(s) of flesh. It was a lovely piece of meat, sitting on the scale (divided against itself, for another). Its disconnected side crawled with vessels and ducts like strange hollow worms. But if you folded that raw slice under, put it on a Styrofoam tray and wrapped it in plastic, you could sell it at the butcher’s. And if you were prone to the charms of this organ, you’d fry it up with onions. And you’d eat it.


A lovely piece of meat.”


My family has, of course, since seen those pictures. Mom says she’ll never eat liver again.


As part of the pre-surgery testing, I also had to undergo psychiatric evaluation. They wanted to know the state of my marriage. I told them that I gave us a fifty-fifty chance of staying together for the long haul. You know, average? A follow-up question was “How would you feel if your husband drank again after you’d given him your liver?”


I said, “How would I know?”


Apparently, that passed for a sufficiently sane response.


John was in a separate hospital room, when the surgery was finally over for us both. An idea. A possibility. A dream.


He was alone. He hadn’t wanted any of his own family around.


Mom and my uncle went to see him, when the staff texted that he’d come to.


He refused to see them.


They came back to my room, and through my exuberance and burgeoning nausea I could hear Mom tell Dad that John wouldn’t see visitors. Right then, I pulled the bedpan, the newest feature of The Great After, up to my face, the wave cresting awfully. 


“Do you think that upset her?” Mom asked Dad and my uncle, in that stage whisper that the somewhat hard-of-hearing favor.


Over the rim of the bedpan, I offered, “No, that didn’t upset her, she knows her husband is a dick.”


Mom was startled. “Oh my god, you heard that?” 


“Yes, I heard that, you guys are shouting!” 


I think this is really funny. I did then, I still do. I tease them about it to this day. (Still no hearing aids, though.)


It wasn’t that I was upset at all, it was the anesthesia sickness. There wasn’t any pain yet, not really, just a strong urge to throw up the nothing in my stomach, and a niggling fear that I’d pull apart the stitches that I knew were keeping me together, where I could feel the vacuum bandages covering everything. Keeping it safe.


I needed to walk. I hadn’t really been able to get out of bed yet, though, and we were well into the second day post-surgery. So with Mom, Dad, and my uncle around me on the bed, I worked to swing my legs down to the floor. So far so good, until I blinked, and Mom went instantly, and rather spookily, from the foot of the bed to my side. The expression on her face had flashed like a flipped channel, silent yet somehow high-pitched worry. 


“What are you doing here, Mom?” 


Oh, I passed out, didn’t I? Yeah, that’s why I’m lying down across the bed, instead of sitting up with my feet on the floor.


“I’m sorry, I’m sorry, I’m sorry,” I kept saying over and over. I’d really put them through enough worry for one hospital visit, right? How rude of me to just keel over.


For anyone who ever told me how strong I was in the lead-up to surgery, I wanted them to know first and foremost: this is just me, doing everything I can not to be a widow.


So, selfish, even?


Most of the experiences in the hospital were expected, fine, tolerable. And, luckily, I was mostly not alone. Until the night the epidural came out, and pain worsened to levels that I kept thinking were intolerable, but I seemed to have no choice but to tolerate, because I couldn’t get out of bed without assistance. A new night nurse was apparently on duty; apparently, because I didn’t see her for hours, despite repeated hits on the call button, and calls to the front desk that assured me she’d be there as soon as she was available. 


We were crawling slowly toward dawn, when she finally came in, and crossly stated that she’d told me to call her pager directly if I needed her. We both looked at the white board she was pointing at, and the blank spot left there when the day nurse had erased her number and told me someone else would be in soon. 


“You haven’t been in this room yet.” I told her, hoping urgently that karma might be both real, and speedy.


Her embarrassment, while enjoyable, had no analgesic effect. She switched gears, and said instead, “If you want to go home, you’re going to have to get off the painkillers.” 


So she hadn’t looked at my chart, either. I’d had the epidural taken out that afternoon; I wouldn’t be going home for another four days at least. 


She was the first person who didn’t seem to care what I’d been through, what I’d just done, how strong I was. She didn’t treat me with deference, or like a hero. There was a part of me, made so small by so much pain, that wanted to say, “Don’t you know who I am?”


An interesting experience to have someone give not a bit of a shit.


There’s no accepting it, that kind of enforced powerlessness. It doesn’t require you to acquiesce. It is, independent of your indiscernible, irrelevant will. 


You are less than a gnat in a gale wind. 


You are meat on a tray.


I didn’t like it then, and I don’t like it now, but it was a hell of a lesson. 


For all the would-nevers, could-nevers, it’s hard to say how you’re going to respond to a situation until you’re in it. For all the you’re-so-strongs, nobody starts bench pressing a hundred pounds. You start with twenty, thirty. Funnily, it’s an analogue for how alcoholism builds its own muscles: sneakily, gradually, incrementally. 


What even is the measure of strength?


It’s not how much you can lift. It’s how much you can bend.


If you are ready for support from people who understand your struggle to bend to the alcoholism of your loved one, please consider joining us in Echoes of Recovery.

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