It’s 11:00 a.m. and I am sitting in the doctor’s office with my son.  It is my turn to take the day off and make the 90 minute trip each way.  Right now, my wife’s job is more important since it is her health insurance that will pay for the transplant.

It’s almost six weeks since his TIPS procedure.  His condition is up and down.  He’s lost more than 50 pounds in the last couple months and looks like he is suffering from malnutrition.  He’s been back to the hospital a couple of times since the procedure.  The first time was for a bad infection, the second time was fluid buildup around his lungs.  Both times, his MELD score temporarily climbed.  It was as high as a 28. 

Without going into a huge explanation; 28 is a high MELD score.  But not at the University of Pennsylvania Hospital.  Not in UNOS Region 2 which includes Pennsylvania and New Jersey.  Liver transplant candidates routinely wait until their scores are quite a bit higher in this region.

The doctor comes in and greets my son warmly.  He seems to genuinely like him.  Maybe I just like to think he does.  After an examination and a review of my son’s most recent blood work, he asks if we know anyone in Florida.  I do have family in Florida but I can’t imagine what he was about to say.  In fact, I think he is going to tell me he ran into my brother in Orlando.  But what he actually does say changes the course of our lives in a profound way.  It leads to the first ray of hope.

“The competition for livers is not as fierce in Florida.  You might want to look into multi-listing him.”

I drive home.  My head is swimming with the whole concept of multi-listing.  Doesn’t everyone have the same chance to get donor organs as everyone else?  The answer is: not exactly.  There is less competition for organs in different regions of the country, which includes Florida.  I can’t wait to tell my wife.

We check with her insurance company.  They tell us that they will pay for one additional region listing.  With the help of the Internet, we find statistics that tell a very interesting story.  There is quite a disparity in waiting times for different regions of the country.  Region 11 is one of those that has less competition.  It includes Memphis, Tennessee.  Steve Jobs recently got a new liver by multi-listing there.  According to a speech he gave on organ donation, had he stayed in California (Region 5) where he lives, he might have died.  The pictures of him just before he had the operation remind me of my son – skinny, frail, hollow eye sockets. 

Mr. Jobs was one of the reasons we pick the Methodist University Hospital in Memphis, Tennessee as the place to multi-list our son.  They are at the forefront of the latest, greatest liver transplant techniques and protocols.  Their survival rates are among the longest in the world.  Our son’s doctor arranges for us to meet the hospital’s liver transplant specialist. 

Put on my blue suede shoes
And I boarded the plane
Touched down in the land of the Delta Blues

He knows my son’s entire medical history before he even enters the room.  He talks softly but directly.  He is a combination of confidence and compassion.  He is the doctor who will be our “liver doctor” here in Memphis.  I feel myself wanting to believe him.

“Your son will be all right.  He will get a liver when he needs it”. 

No one had said that to us before.

Then I'm walking in Memphis
Walking with my feet ten feet off of Beale
Walking in Memphis
But do I really feel the way I feel?

The week in Tennessee is tough on my son but he likes Beale Street and we walk the three blocks every night after all the tests are done for the day.  The atmosphere is pure carny weirdness mixed with out-of-state gawkers and local bumpkins coming to the big city to drink beer in the street and eat all the fall-off-the-bone tender ribs they can stand. 

We stop to listen to the blues bands that vie for attention on either side of the street.  Playing in the doorway of a local bar is an old man with a trumpet and a microphone.  His voice is raspy and his playing is simple and perfect.  My son says, “Give him some money, dad.”  We watch the tumblers do their fearless flips in front of Silky O’Sullivan’s.  My son loves them and he smiles for the first time in weeks.  I realize, we are all smiling.

On the final day of this five day visit, we meet my son’s surgeon.  He is about my age and looks like a strange mixture of Albert Einstein and Jeff Goldblum.  His hair and bushy mustache are grey with streaks of white and black mixed in.  He has an Austrian accent and a great way of looking you right in the eye when he talks to you.  He makes us feel confident – not just hopeful… confident.

“He vill get his liver, okay?”  I feel my head nodding. 

They've got catfish on the table
They've got gospel in the air
And Reverend Green be glad to see you
When you haven't got a prayer
But boy you've got a prayer in Memphis

We fly back on the smallest commuter jet I have ever been on.  As we approach Newark Airport, the pilot reminds us to keep or seat belts fastened securely.  He says the landing might get a bit choppy.  Within seconds of his announcement, the plane begins to bounce – not violently, but enough to make me wonder how ironic it would be to go through all of this only to die in a plane crash.

We land at noon in one piece – shaken but just glad to be back on the ground.  It is a cool and sunny day.  After being left alone with our thoughts on the plane ride, especially the bumpy landing, we are now ready to talk about what we’d been through in the car ride home.  We all agree that the trip was an amazing success.  My son will get a liver.  He will enjoy a wonderful quality of life.  We may even be happier than we were before this all started.

It could still get a little choppy but we will land safely.  I now know we will.

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