I Feel My Liver Donor's Presence

“I had a feeling that something was wrong for a long time.” Fifty-six-year-old David Clark says as he lies recovering at a friend’s home from a liver transplant he received on June 13, 2008. He pauses for a long moment during which he is time-traveling back to 1971. “The best explanation was the injections I had gotten in the Army, even before I got to Vietnam. I was with a group of returning second-tour NCOs, and we had all gotten injections using jet-injectors, which are no longer used. They had no protective measures to prevent flashback [indication of blood in the syringe]. They really didn’t understand viruses at that point. We walked in a line down a hallway, and various medics shot us in the arm with these air guns, and they splashed blood back on us. Everybody had a bleeding arm.”

Seeing Clark on July 3, little more than two weeks after surgery, the normally robust, mustached man in the California wine industry looked pale, shaven, gaunt, and weak. He smiled and his eyes seemed clear. His demeanor was one of optimism.

“While I was in the Central Highlands several months later, I had an episode, an unexplained illness. They first thought it was malaria. Medical records show ‘unexplained virus or viral-like symptoms.’ I had general weakness, loss of appetite. I really felt bad, but they

couldn’t nail it down. I was with the 101st Airborne, just transferred. Actually, the 101st had just stripped down and took their colors back to Fort Campbell, Kentucky. I was transferred from this company in Cam Rahn Bay and then shipped up to the Central Highlands at Plei Ku [or Pleiku]. I was a foot soldier, 11th Bravo. MOS code. Our assignment was guarding the outskirts of this attack helicopter base at Camp Holloway. We did this by patrolling during the day and then setting up ambushes nightly in the open areas, the kilometers surrounding the camp. Booby traps, things like that.

“It was several years after that that I again experienced symptoms of hepatitis: weakness, but not jaundice. At the time they called it non-A and non-B hepatitis, which to me meant nothing. Being a cynical Vietnam vet, I

didn’t really believe anybody about anything. I didn’t trust authority, and the war had done a job on my attitude. When I heard ‘non-A’ or whatever, I heard ‘We don’t know.’ It turns out they were on the threshold of understanding viruses at that point. Then about three and a half years ago, I had some blood numbers done. They came back and I was told, ‘We really don’t like these numbers.’ They did more tests and confirmed a diagnosis of hepatitis C.

“Over the years, it had caused cirrhosis. I went through various medical protocols, such as interferon, and was monitored pretty closely. I had cleared the virus pretty much, but it came back. It was resident in my liver. My circulation

wasn’t good, and I hadn’t eliminated the viral infection completely. The doctor said, ‘Well, that’s it. Check out the Internet, maybe, and see what kinds of treatment are available.’ I wasn’t real happy with the endgame part of the carrot on that particular episode. I had been MRI’ed, CAT-scanned, sonogrammed a million times. My wife Diane was really my advocate here. She went toe-to-toe with the insurance company and finally got me a one-time consultation with Dr. Rose. He’s nationally recognized, a top guy in liver transplants. He looked at my images, and there were two tumors in my liver, one really small, the other large, and they were extremely diffuse. He pointed us in the right direction. I went to the UCSD Liver Transplant Clinic, and they’ve been handling it ever since.

“With the presence of those tumors, three surgical procedures were indicated, including one almost like a laparoscopic kind of insertion guided by imaging. They generate a microwave field around the tumors and, in effect, cut them out. After two operations, they had to go back in and make sure they had everything. Thanks to Dr. Rose’s good care, that cleared the decks for me. All this time I was on the waiting list for a liver transplant, but because of the tumors they had to be sure this wasn’t something spreading through my body. If that were the case, it would, like, have been all over, basically.

“I got through that period okay. It was a matter of waiting. I did go through another course of interferon for about nine months, which was a weekly thing, injections and taking pills several times a day. It was a very demanding treatment, and that again reduced my immunity. During this time, I was going through various support groups for people with hepatitis and who were pre-transplant. I also decided I should go to counseling, and so I did at the veterans’ Center in Vista, where I live. I discovered I had all the key symptoms of post-traumatic stress disorder.

“My experience with the waiting list was that this is usually a matter of a few years and is, was, enormously frustrating trying to keep my spirits up and stay positive. It was a challenge because it went on so long. A few months ago, I was told by doctors that they would probably do this transplant in the fall [2008], so I would have some advance warning. But you could get a phone call at any time during the day or night, and you’d have to rush down to the hospital and be available to receive a transplant. [These are] what they call ‘standby people,’ a number-two or -three person on the list. You have to be there, in case something goes wrong with the primary person, who might not be able to arrive on time or [in case there are] other problems, so that they cannot receive the donated organ. It can happen at any time, without warning, and every transplant patient understands this. But in my case, having been led to believe this

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