How to Do a Liver Transplant (20 page)

The morning that Lynn woke up, I kept the delicious news to myself. Every day at 11 am, the big transplant
ward round with all the transplant surgeons came into the ICU to see her. For the last six months we had all stood solemnly at the foot of her bed and discussed ‘Lynn's body' in a cold, matter-of-fact way. We discussed numbers, ventilator settings and medications. We had all naturally lost sight of who was lying in the bed. It was the only way for us to cope with something so awful. On this momentous day, the nurses had done what was left of Lynn's hair and sat her upright in the bed. She still had a breathing tube protruding from a hole in her neck but was more than ready to greet everyone on the round and give them a lovely surprise. They came into the room and a smiling Lynn gave them the thumbs up. They could barely speak as they crowded around the bed to say hello. I wiped away tears. This was the moment that made all those hours of work worthwhile.

Lynn then began the long process of recovery and spent another month in Intensive Care. I had to go and have my baby just after she had made this big step forward. Everyone was under strict instructions from me not to allow anything to happen to her while I was away. She was still in a precarious state and could easily take a step backwards. Five days after Abigail was born, I took her into Intensive Care to show her off to Lynn. This was a big priority for me because we had gone through the whole pregnancy together. It made her day to see this little person I had been discussing with her during our long nights together in the
ICU. I was a little worried about all the bacteria in that place, so I stood at Lynn's door and held my tiny daughter aloft so she could admire her.

After several more difficult surgeries and many months of rehabilitation we managed to close Lynn's abdomen and stop the holes in her bowel from leaking. For a while there during her recovery, Lynn had the unique opportunity to watch the food she ate reappear out of the holes in her bowel a few minutes later. It is extraordinary what a human body can endure. One year and one day after her transplant, she left the hospital. This happened to coincide with my last day of work in the US and we had a huge farewell party together.

Lynn and I are still close and talk regularly. She is now back living a relatively normal life with just a few annoying long-term problems with hernias and numb feet due to the hours spent motionless in Intensive Care. She cherishes every day and has seen her daughters grow up, finish school and get married. Her transplanted liver is working well and she has no signs of her original cancer.

There is a final, incredible twist to this tale. Sadly Lynn's relationship with her partner at that time did not weather the stress of her illness. They parted on good terms. A short time later, though, Lynn met a lovely man who made her happy and they were married. During her time in the hospital, Lynn had developed a friendship with one of her nurses and they had kept in touch after she went
home. It just so happens that this nurse had battled kidney failure for many years. She had already endured two kidney transplants and now she was back on dialysis waiting for a third. She had been waiting a long time for another chance at life and was getting sicker. There were no donors on the horizon. Incredibly, Lynn's new husband asked if he could give one of his kidneys to Lynn's friend the nurse. He was so grateful to have met Lynn and realised that he never would have if it wasn't for someone giving her a piece of their liver. He wanted to show his appreciation by helping someone in the same way. Amazingly, he was a match and gave his kidney to Lynn's friend. It has been a huge success and both ladies are living their lives and enjoying every extra day they have. I am humbled to know them. They are fighters who have looked death in the face and said, ‘I'm not ready yet.'

Transplant Mom

S
ix weeks after my beautiful daughter emerged, it was time for me to start back at work. Americans take extreme pride in their jobs – they live to work and their enthusiasm easily rubbed off on me. With most working mothers only stopping for a short time to bond with their newborns, I felt like I had to get back to it quickly too. No one seemed to bat an eyelid when I kissed my daughter goodbye and picked up my job again like I had never left. Those six weeks at home with Abigail were blissful. There is no doubt that being a new mother is tough, but for someone like me who was used to going without sleep, getting up at 3 am to feed a baby rather than
driving in to deal with a bleeding liver transplant patient was sheer heaven.

Because Andrew had to continue working just to keep food on the table, we made the decision to hire a babysitter to look after Abigail during the day. Even though it was difficult heading back to work so quickly, I was careful not to lose sight of the bigger picture. My sole reason for being in the States was to become a transplant surgeon and I did not want to be away from it for too long. As much as I wanted to stare at my lovely little baby all day long, I reminded myself that I was doing this for the three of us. It wasn't about being a superwoman, it was about keeping a commitment I had made to my job and achieving my goals of being a working mother. Instead of a ‘soccer mom' I became a ‘transplant mom'. I hoped my passion would rub off and set an example for my daughter that everything was achievable with drive and good planning.

I was more than a little emotional when I went back, though, suffering with the baby blues. Every morning when I left the house I would sob, knowing that it would be hours before I saw Abigail again. I tried my best not to let my sadness show at work but I struggled, and for a while I'm sure they all thought I had lost my mind. Going back to work so early did very little for my self-esteem, either. I looked and felt absolutely wretched. Not to go into too much detail but I was either leaking breast milk, bleeding or peeing my pants every time I coughed. I was literally
covered in protective padding just to get through the day dry. To add to my discomfort, unlike gorgeous celebrities, after six weeks I had most definitely not returned to my ‘pre-baby body' and had to endure several well-intentioned questions about when my baby was due. This did not improve my mood.

Just like my pregnancy, starting back at work as a new mum presented all sorts of interesting practical difficulties. Breastfeeding has never been easy for me, but in my quest not to miss out on any important aspects of mothering, I was determined to give it a go. In those first few weeks it was a real problem. I would be operating away and I would gradually become aware of an uncomfortable wetness running down my abdomen. My squirming always drew the attention of my male assistants in particular, and when they discovered what was happening, they would delight in mimicking the sound of a baby crying to ensure my let-down was even more prolific. This was more than any breast pad could cope with and I would grin and bear it whilst milk leaked through my bra and onto the front of my scrubs in ever expanding circles. I smelled like a rancid milk bottle by the end of the case by which time a shower and change of clothes were definitely in order.

On-demand feeding meant having a freezer full of little packages of breast milk, so when I was away from the house, Andrew could just thaw them out and satisfy our hungry girl. I made good friends with my breast pump; in
fact, at every spare moment I was attached to this device. As though they had ‘transplant moms' in mind, some ingenious person invented a double-barrelled battery powered pump complete with a freezer storage compartment and picture of my child (to aid let-down) all housed in a discreet black leather handbag. That bag went everywhere with me, allowing me to pump on the run and do my job at the same time. I had it down to a fine art and I could procure a whole feed in under ten minutes in a process not dissimilar to milking a cow. Because I needed to do this every three hours or so, I had to pump in some odd places and at some unusual hours of the day. I did it perched on the edge of toilet seats during short breaks in operations. I did it in the back of the aeroplane on the way to a donor, throwing a blanket over myself to hide the confronting sight of a pair of engorged boobs hooked up to the device. The chug, chug, chug sound of the machine was difficult to ignore, though, even with the sound of the jet engines roaring, and my three male colleagues sitting opposite me in the plane didn't know where to look while I was attending to milking time. I can't imagine why!

Whenever possible I would take a leaf out of Dr Nancy Asher's book. She was the San Francisco transplant surgeon who also took motherhood in her stride. Whilst I didn't have the financial means to have a full-time nanny waiting outside the operating room with my hungry baby, I would take Abigail to work with me on the weekends
when I knew I could give her some time. She became a regular fixture around the wards, strapped to my chest in a baby sling, loving every minute of the attention she got wherever we went. The patients were visibly cheered up by her visits and the sight of a smiling infant made them forget their troubles for a moment. She was a great baby, just happy to come along for the ride. She would usually be taken from me the moment I got to the ward and passed around between the nurses and patients. She would sometimes disappear for an hour or so but I would only have to look for the big crowd of admirers to find her. A few months old and she was already a social butterfly.

Before we knew it, our two years of living like Americans were coming to an end. We would have loved to have stayed and made our life there. Denver was a happy place to work and raise a child, with plenty of fresh air, activity and optimistic people. Sadly, unless I could be of value to the US and do something like win a Nobel Prize, my work visa stipulated that I had to return home. Dr Kam, my generous boss, hosted a huge farewell party for us and it was very hard to say goodbye to those kind people who had given so much support to Andrew and me as we started our family so far from home. It was with a heavy heart that we boarded the plane back to Australia with considerably more luggage than when we arrived. It marked the end of an amazing chapter in our lives but, as much as I wanted to stay, I was content to be returning to
Australia holding Abigail in my arms. It was like taking my own little piece of America with me. I received a treasured letter from the White House when she was born. It read:

Welcome. The day you were born will always be a special day. Your birth has brought great joy to your family and your life symbolises the promise of tomorrow.

We wish you a happy and healthy life that is full of love.

May God bless you and may God bless America.

Signed George Bush and Laura Bush

As a finale to our stay, Andrew and I took our little family on a traditional American road trip, taking in at least 25 of the 50 States. After six relaxing weeks, our previously trusty car's transmission deposited itself in several pieces on a road in rural Mississippi, directly in front of a prison work gang. Despite feeling for a moment like we were the social workers in the movie
Mississippi Burning
, the prisoners were just delightful and stayed with us until a Baptist minister with ‘I honk for Jesus' painted on his car window gave us a lift into town. From there, we sold what was left of our crippled car and headed for home. God Bless America indeed, we loved every minute and will forever hold you in our hearts.

During my time in Colorado, I was involved with 120 liver and 180 kidney transplants. It was a fantastic grounding and I hoped on my return to Brisbane to get a job where I could build on my experience. True to his word again, Professor Lynch had arranged yet another post for me as Fellow, this time at my alma mater, the Princess Alexandra Hospital. This would give me two years to perfect the other aspects of hepatobiliary surgery aside from transplant – including liver resections, where different sections of the liver are removed, taking enough to clear a cancer but leaving sufficient liver for the patient to survive. Learning to remove sections of the pancreas was also on my ‘to do' list. Only after I had mastered the other operations that could be performed on these organs, in addition to my transplant experience, would I have any hope of handling all the problems the liver and pancreas could throw at me. Only then might I have the right to call myself a hepatobiliary surgeon who was good enough to work at the Princess Alexandra Hospital.

A fully fledged surgeon at last

O
n our return to Australia, Andrew and I set about adding to our family. Madeleine Shelby, named after Coloradan and former US Secretary of State, Madeleine Albright, was followed eighteen months later by Priscilla Dana – named of course for the wife of the King (aka Elvis Presley) and my hero from
The X-Files
, Dana Scully. Three girls in three years, what were we thinking? We were thinking that we could have everything and we were right, we could – satisfying jobs and a lovely family. I wasn't getting any younger, so we had to get on with it.

Again I worked right up until the day of the girls' births and, not wanting to be away for long, I was back at work again within two months. The reality of our lives was that I was the main breadwinner and I had to keep food on the table. For both Madeleine and Priscilla I needed to have a caesarean section to deliver them safely. For me, having surgery was so much better than the traumatic labour I had had when I pushed Abigail out.