Nothing Here Is Promised

“Nothing here is promised, not one day.” — Lin-Manuel Miranda

It was a Tuesday. I don’t remember anything about the weather, though I suppose it wasn’t raining or snowing—I’d probably remember that. I had a 12:30 meeting to discuss headline writing best practices with our staff, then a 1:30 marketing meeting and a 2:30 revenue planning session.

Somewhere in there, Amber texted me from her regular OB-GYN appointment to let me know that her blood pressure had spiked dangerously high. She said the doctor would recheck the pressure, which had never been elevated before, but that if it didn’t improve she would need to go to the hospital.

It would probably subside, I thought. Her blood pressure had never been a problem before. Besides, the baby wasn’t due until January 31.

Six hours later, I was seated in a chair in an operating theater, holding my wife’s hand and discussing who knows what while a surgical team performed a C-section. I wasn’t ready for the baby to come—we hadn’t even picked out the car seat yet. But I remembered this Lorne Michaels quote about his years at SNL: “The show doesn’t go on because it’s ready; it goes on because it’s 11:30.”

After what seemed like just a few minutes, I heard a shrill little scream as a doctor hoisted a little baby boy around the side of the curtain that shielded the surgical field. He was so tiny, balanced in the surgeon’s gloved hands, a beautiful screaming creature with a full head of black hair. Stanley.

Later, in the recovery room, I sent a gchat to my managing editor:

“the baby came this evening”

That was one year ago. In between that chaotic day and this quieter one, Stanley Joseph Gleason-Allured has undergone four surgeries for his liver and eyes and come out on the other end happy and thriving and a little stronger every day. At 1 year old, he’s already endured more challenges than many people face in their entire lives—me included. And, without meaning to, he’s reset my outlook on what it means to be fortunate.

Fear and trauma aside, we represent the lucky ones. We were fortunate to have the means to afford good insurance that gave us access to incredible health care, we were lucky to live in a city with leading hepatology experts, we were lucky to have employers who gave us the flexibility to work around all of the doctor appointments, surgical rounds, medical procedures and therapies, and most important of all, lucky to have had a son born in 2016.

Liver transplantation was, until relatively recently, chancy at best. And it took unknown risks and sacrifices from countless patients and their families to make it a reality, as well as a tireless evangelist: Thomas Starzl.

Born in 1926 on March 11—my birthday—Starzl was the son of Anna, a nurse, and Roman, a science fiction writer who dreamt up worlds in which humans could be shrunk down into the subatomic world. What better parentage for an experimental surgeon?

It was Dr. Starzl who performed the world’s first human liver transplants, in 1963. His first patient bled to death on the operating table. The subsequent patients died of various infections within 23 days. Further surgeries were performed, but the outcomes were so poor that, for a time, there was a global stop on all liver transplant procedures.

As Dr. Starzl’s own website puts it: “The operation had come to be perceived as too difficult to ever be tried again.”

Here’s another name: Julie Rodriguez. She was born on January 1, 1966, almost exactly 50 years before my son, and died on August 26, 1968. What was a tragically brief life was also the first ray of hope—Julie Rodriguez was the first human liver recipient to live more than one year, post-surgery. The medical community now had proof that liver transplantation could be viable.

By the 1970s, when I was born, 25% of liver transplant patients survived at least one year. The introduction of new immunosuppressants into post-surgical therapies improved outcomes beginning in the 1980s. But Starzl and his colleagues around the world still had no idea why one organ was accepted by its recipient, while another was rejected, until 1991-1992, when Starzl and others confirmed that donor cells lived on in recipients. The understanding of the complex interactions of donor and recipient immune cells led to what Starzl’s site describes as “seismic” shifts in transplantation immunology.

Today, one-year patient survival rates vary, but have shot well above 80% at many hospitals, with continual improvement in outcomes.

Starzl is now 90 and lives in Pittsburgh. I will certainly be toasting him this and every year to come, as well as all the unknown patients and doctors whose sacrifices and hard work led up to my son having his first birthday as a happy, flourishing child.

I’ve lost count of all the things I love about this boy and can hardly articulate everything he means to me. So I will simply say: Happy birthday, Stanley. I love you.


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