The Letter

I recently received a letter from my organ donor’s family. I have been very vague about the contents of the letter to respect them and their wishes (and please do not ask me to send it to you). What I have not been (or will not be) vague about are my feelings about reading it, processing it, and continuing my life knowing who’s heart is beating inside of me. 

My organ donor was young. She was in school and was involved with many extracurriculars. She seemed very loving, and was absolutely admired by all around her. She was passionate and had many big goals.

Now her loving, caring heart lives on inside of me. 

Some have asked how I felt when I read it? Reading the letter was difficult and emotional because I really found out about the girl who died and gave me her heart. She was another human living her precious life on Earth, just like me. She was a beautiful soul.

I realized that the day I celebrated the most (and have been celebrating) was the day that I was reborn with a new heart— during the early morning hours on that cold, January day. But now, I will remember that this day marked the end of her life. She will forever be a big part of me (both literally and figuratively). So do I celebrate life? Or do I mourn death? 

The obvious answer is that I should celebrate life. Her legacy will live on. I can do so much with our heart. I can go back to saving lives. She will go back to saving lives. I get it. I absolutely do. Really. I understand the positive things about this.

But I am only human. The darker thoughts will always linger. 

I am so grateful that someone young with a healthy, strong heart died as an honorable organ donor— I needed that heart quickly. But I am so upset that someone young with a healthy, strong heart died. I am so happy that I get to live the rest of my life to accomplish all of my goals. I am so sad that someone else will not be able to accomplish her own goals because of a sudden tragedy. I am so excited to spend my time with my friends and family during this (awful) medical leave. I am so angry that her friends and family can’t spend time with her, unless you count the moments they stand around her gravesite— being six feet under is just not the same.

I am so lucky to be freely breathing this fresh air with no cough and without any lifesaving pressors and inotropes— remember, I can conquer the world nowadays. 

I am feeling so guilty, though. These were supposed to be her breaths. 

It’s interesting to think about. Truly. We were both in Intensive Care Units, miles apart, at the same time. We both probably had the same procedures done to us— was her central line on the right or left side of her neck? Was she on propofol and fentanyl? Surely she was on her own life-saving medications, I wonder which ones. Did her arterial line continuously kink and need to be replaced? 

I imagine that her family was there, too, hoping that she would get better. I wonder how many balloons and gifts were neatly laid out around her bed. I wonder if her friends were there, trying to make her laugh with stupid jokes. I wonder how many times they held her hand. The words haunt me now …. “Can you squeeze my finger?”

Sigh.

On the same day, two incredible things happened: 

In an ICU, I was told that I was going to be able to live my life again. A glorious moment. My physicians and nurses came in to hug me. 

My family and friends were in and outside of my room. Everybody was hugging and crying. 

But a physician in an ICU, miles away, told a family that there was little hope left. She listened to the last of her lung sounds, her heart sounds. She checked her pupils, both dilated. A quick "Time of Death" was recorded in the chart.

Her family and friends were in and outside of her room. Everybody was hugging and crying. 

So similar, yet so different...

I guess Kurt Vonnegut put it so nicely once:

”And so it goes.”

I will write the rest of this post (selfishly) for my own peace of mind. Perhaps her family will read it someday:

My Kyank, 

Kyank is the literal Armenian word for “life,” but it is used to address the very special people in your own life (the ones you love more than anything). It’s only fitting that I call you that.

I am you, and you are me.

I had a lot in common with you. It was more than just our blood type. In fact, it was kind of chilling to read about your interests. We probably would have been good friends. But instead, our paths crossed in the strangest of ways. On the last day of your life, on the first day of my life. On the worst day of your life, on the best day of my life.

And I will be honest— I don’t know if I should be upset or happy or angry or guilty or grateful about that. I just don’t know. 

What I do know is what I've been saying since I woke up with your heart inside of me: I will do everything that I can to honor you and your family. 

Thank you for the gift of life.

-A

Pre-Op & Post-Op

They began wheeling me to the OR right around 2am. My mom and my cousin were walking down with us. My dad was on a flight back to Philadelphia. Everybody had been notified of the news. I was ready. I think.

My mom kissed my forehead. We all hugged. And then I blurted out the million dollar question, “Mom, what if I die?” 

And then she replied with the same thing that she had been saying for weeks. 

“If you had to die, you would have died already. You tried dying so many times already and you didn’t. You have a lot of things left to do in this world. You aren’t going to die.”

I’m not particularly spiritual, but in that moment, it was such a perfect thing to hear. Moms really are the best. 

The OR was so bright. I hadn’t been in one of these rooms since my General Surgery rotation in medical school. And this one was top-notch. Huge. Probably the size of my whole apartment. There were at least two large HD screens staring at me. Everything was white, blue, sterile. Cold. Fascinating. I saw a generic OR checklist up on a screen, and my name was written somewhere already.

The technicians were getting some things together. The nurses began asking me some basic questions about my birth date, my allergies, etc. I don’t know if it was because my voice cracked, or because I was unusually quiet, but I think everyone around me knew how nervous I really was.

They tried to make me laugh by saying things like, “You’re gonna be famous after this, girl.”

I reacted with sarcasm, of course. I think I asked them to try not to kill me. 

“We know what we’re doing. This isn’t our first rodeo,” they replied. We laughed some more. 

The attending Anesthesiologist came in to help with the placement of my (millionth) arterial line. 

“You know, these don’t hurt as much as I thought they would. I don’t feel a thing. I actually feel great,” I told him.

“That’s because of the Versed we just gave you.”

I chuckled.

“You ready? We gotta get you back to saving lives,” someone else said. I smiled. Yeah, I guess I did have to go back to saving lives. That made me feel better. Just a little tiny hurdle, a speedbump if anything. You’re going back to work in a few months. This is nothing.

There were a few people coming in and out of the room— making me smile, shaking my hand, giving me high fives. The CT Surgery fellow came in and asked if I had any last minute questions.

“Can you get rid of my uterus while you’re in there? Just take that thing OUT!” I asked him.

“We really only deal with the chest … but we’ll see what we can do,” he replied, with a smile.

Someone asked me what kind of music I wanted to listen to.

There was no question about it. The man who had gotten me through all of my life’s struggles. Always do your best, don't let the pressure make you panic and when you get straaaanded and things don't go the way you plaaaanned it…

“Tupac.”

And then they actually put on Tupac radio! I felt at ease. I felt good (again, might have been the Versed…). 

I heard one of the nurses say that the “heart was good to go” (I didn’t know this, but apparently the surgeons have to do one last visual check on the donated organ after it has been procured and tested extensively). They had just finished examining it, and the attending was preparing to start the surgery. “They'll all be in here soon, okay? We’re gonna finish getting you ready.”

The attending and the fellow are probably changing into their scrubs, tying their caps. They're in the locker room, probably talking about how the Sixers have been doing. There’s a medical student reviewing the nerves and vessels around the heart; she knows that she'll be pimped on them. She’s nervous because this is her first open-heart case. There’s a resident running towards the OR while inhaling a protein shake because he hasn’t eaten anything in several hours. My case woke him up from sleep. I’m sorry about that; I know how much you hate cases in the middle of the night.

Alin, this is nothing for them. It’s second nature. One beautiful incision after the other. Their well-trained, delicate hands know the ins and outs of open-heart surgery. They check off each action, one by one, in their brilliant minds. Cut here. Snip there. Be careful of the recurrent laryngeal. Remove heart.

Take my heart out. 

…

No. You know what? Violently rip my heart out of its cage! Get rid of it. This stupid heart that put me here in the first place. I was proud of you at first for living so long, but now I’m angry with you for dying so early. My life had been going so well. So well. I had worked so hard. I rarely complained. I was a good person for the most part. I did nothing to deserve this. Here I am now, all alone on this cold metal slab, just patiently waiting for the most frightening moment of my life. You’re barely working. You’ve decided to be difficult. You’ve made everybody put their lives aside to worry about me. I hope you’re happy.

I had a love-hate relationship with my old heart, but I spoke to it often. I was very open with it. (And, in case you’re wondering, I can say the same thing about most of my human relationships. Sigh.)

I felt it, though-- I was getting more anxious. Angry. Sad. Self-pity at its finest.

“Can I just talk to my mom one more time?"

“Absolutely. Here, call her,” said my nurse. She handed me a phone.

I called my mom and I told her that they were about to start. People were setting up around me. There was music playing. Things were getting blurry. I think the medications were kicking in because I started tearing up. I felt really warm.

“Mom, I’m not going to die during surgery, right?”

“You’re not. What do I keep telling you!"

“But remember, this is risky open-heart surgery.”

“But remember, you have so much left to do in this world."

I remember nothing else, other than a very distinct and overwhelming feeling of peacefulness (but again, that might have been the Versed…).

I understand the basics of Critical Care Medicine. I read the literature when I can. I know that less sedation and early mobility have the best outcomes for our intubated patients. Blah blah blah. 

“Can we just decrease their sedation? See how they do? Let’s get them off the vent by tomorrow?” I recalled asking an ICU nurse many-a-times in my career. 

Oh but I am so sorry for all of the times that I’ve done that. So, so sorry. I want my patients to do well, but I never knew how uncomfortable that breathing tube was. I would be called to go back into their hospital rooms because they were becoming agitated. “SIR, I KNOW ITS UNCOMFORTABLE! BUT JUST WAIT A FEW MINUTES! PLEASE!”

But no. No no. I didn’t know how uncomfortable it was. Now I do.

Here we were again. Me vs. The Vent. I gagged on my own secretions, and tried to grab the Yankauer suction handle. F&#%! I’m in restraints again!!! I think I was trying to scream. There were a few people around me. My nurse walked in, surprised. “It’s okay! We’ll see if we can get that out soon? I’ll be back.”

A respiratory technician came in and I kept pointing to the tube in my mouth. I started crying. Pure agony, I promise. Please someone help me, I just want this thing out.

My nurse came back in with some paper and a pen. 

Any complications?

Increase fentanyl or propofol?

Increase propofol?

EXTUBATE?

I felt like nobody was listening to me. Or reading me, or whatever. And then the attending walked in. “Hey Alin, I’ll be the attending doc for the night, okay? So we were going to extubate you in the morning, but if you're comfortable with it, we will do an SBT, get another gas, and go from there.” 

Oh, cool. He knew that I was a doctor. I liked that doctor talk. I gave him my restrained thumbs up, miserably losing my battle with The Vent in tears, while coughing up all sorts of secretions. My lips were dry and bleeding. There was sputum just slowly dripping down my chin and onto my gown. It was probably the most pathetic moment of my life. Those poor restrained thumbs up…..

(I laugh about it when I look back. Why? I came to find out later that the intensivist on call during those nights was someone who I had looked up to for years— one of the reasons why I was even going to do an ICU fellowship. I knew about his work since medical school, and wanted to be just like him “when I grew up.” Funny, right? So imagine drooling in front of your role model— just a humble, world-renowned ED/Critical Care physician, no big deal— who you’ve been excited to meet for years. Yep.)

He said that he’d be back in a few minutes, and the respiratory technician came back in. 

“We are just waiting on the blood gas results, okay, dear? I know it’s uncomfortable. I’m so sorry. Just a few more minutes.” 

I tried to glance at my ventilator settings. I passed the SBT. Please. WHAT DO YOU NEED AN ABG FOR!

Honestly, I don’t even think that I realized that I had just had heart transplant surgery. I couldn’t think of anything except getting that tube out.

The respiratory tech started setting up another oxygen machine (something we do when we extubate people instead of letting them breathe on room air right afterwards). And then, she pulled out the tube. And I took my first breath as Post-Transplant Alin. 

I felt wonderful.

I was so excited. My family was standing around me. They were clapping. I tried to feel for my own radial pulse. Top-notch! Bounding. Surreal. Beautiful.

I took a look at all of the new fun medications that I was on. 

Insulin drip? What the hell? Why do I have these wires coming out? What even is THAT wire? Do I have TWO central lines? What does that machine do? Is this a pacemaker? Why do I have a pacemaker? 

I lifted up my gown (I had no shame, ever). Woah, look at all of these surgical chest tubes! I looked at Matt and pointed to the chamber. I wanted to see how much I was draining. 

I was The Quintessential ICU Patient. Post-Op. In the CTICU. Lines, tubes, and wires everywhere. Dressings on top of dressings covering I-don’t-even-know-whats. My hair was a complete mess. My whole body was orange (from prepping me for surgery). I looked like a puffy, orange (but smiling) blowfish with wires coming out of every orifice. A child’s 5th grade science project.

Or, as my best friend (who is not in medicine), put so eloquently: “You look like an outlet.”

I guess most people wouldn’t be that excited, but when you’re almost an intensivist-in-training and also critically ill in the ICU, you may just look at these things in a different light.

And I guess that was the lesson of the day, confirmed over and over again throughout my struggles earlier this year. Your psyche, your perspective really do go far when it comes to life’s hardships. 

What do I mean?

Thanks to my mom, I calmed down about the surgery. She helped me realize that I was strong. It became nothing that I couldn’t handle. 

While I was in the OR, I was surrounded by lovely people who reminded me that they do this all of the time. I talked myself into the fact that it wasn’t a big deal— I literally knew what they were going to be doing. It became no big deal. 

After the surgery, I didn’t see my lines and tubes as painful torture devices that were there to just irritate me or perhaps leave awful scars. Instead, I saw them as incredible pieces of medical technology, each playing a major role in my healing (and some even keeping me alive). They reminded me of the reason why I had gone into medicine in the first place— why I was especially fascinated with Emergency Medicine & Critical Care: to help the sickest patients who needed the most support. I wanted to make sure that our fierce, determined attitudes and excellent resuscitation skills helped save not only their lives, but their souls. I wanted to remind them that there is so much hope and potential left, even after dancing with death and slowly sinking into the worst moments of their lives.

Sure, I was in pain, but I was lucky. It was such a humbling moment. The most humbling moment of my life.

And here is where I’ll say it: It was an honor to be in my patients’ shoes.

I’d be able to laugh and cry with them. I’d be able to physically feel their pain, their anxieties. I’d be able to read their minds— all of their thoughts about death and if their lives had any meaning at all, if they had truly lived it well. I’d know that their dignity meant everything to them. I’d know that their insomnia only came from every single one of their life’s regrets just being replayed over and over again in their heads during those nights. Every single one.

I would say things like, “MRS. SMITH, I KNOW ITS TOUGH!”...

... and I would really know how tough it was. 

How phenomenal was that? 

What an honor it truly was...

How interesting life is... 

But hey, that’s just how I saw it. 

Sorry I yelled at you earlier, Old Heart. I guess that you taught me a lot over the last few weeks.

To end this post, just remember …

…. keep ya head up.

The Call

Going back to my hospitalization…

I always had many people around me, especially in the evenings. On this particular day, I had two of my friends visiting me. My family had decided to go out for the night after I pushed them into doing so. “Please go. Have fun. FOR me,” I told them. 

Where did they decide to go? A nearby casino. My family really is amazing. 

My friends were sitting next to me— I was particularly close with them and was very excited to have them there that evening. We chatted for a while. I told them the story about how I accidentally snapped at the CT surgeon earlier in the day, because I mistook him for Matt. We talked about the overly zealous guy from dietary services, who was so keen on always getting my order right. I told them that I had argued with the Cardiology fellow and Anesthesiologist about keeping me NPO for a procedure—“It’s not like I ask my dying patients what time they’ve eaten before I emergently intubate them!” Right? (I mean, I’m right.)

After a while, they let me unleash my anger.

Every day, I would have to explain to people that I didn’t care if the food wasn’t the best. I didn’t care if the sun wasn’t shining into my room that day. I didn’t even care about my gown being too big on me. Thank you for reminding me how shitty my situation was (even shittier than I thought) by bringing up all of those shitty little things that I wasn’t even worried about in the first place.

I barely had an appetite, so when I did, I was happy to eat. And you know what else? My hospital wasn’t a restaurant. My hospital was a world-renowned academic institution with some of the most brilliant doctors and nurses that I had ever met. I actually didn’t want my hospital to be a restaurant.

Honestly, though, I was lucky to even be alive to have the option of eating. Even syrup-less pancakes with apple juice were delicious when you were constantly being reminded that you might die that day.

Sure, the sun wasn’t shining into my room and my view wasn’t the best, but when was a hospital room supposed to be a hotel room? Plus, I preferred this sub-par hospital room over a shelf in the morgue. I assure you.

And ah, my favorite complaint: my gown didn’t fit me. What did people want me to do about that? Every time my visitors were dramatically worrying about my gown size, I remembered that old Brian Regan bit. Brian's optometrist once confronted him about his lazy eye, and followed it with, “It’s no big deal. It doesn’t affect your vision or anything. I just thought you’d like to be self conscious for the rest of your life.” Ha.

So others complained for me most of the time, while I just laid there and wondered when they were going to stop being so pretentious and ignorant. When were they going to start worrying about the things that they really needed to worry about? Sometimes, I wondered how they would feel if they were in my place. There is no way that they’d be complaining about the cafeteria food if they were on their deathbed.

Maybe.

I don’t know.

People are strange.

I had always hated perpetual complainers, but throughout this hospitalization, I came to the conclusion that I never wanted a toxic complainer in my life ever again. I remember reading something like, “You have to die once to really learn how to live.” Take that piece of truth to your heart. Swallow it whole. Remember that constantly complaining isn’t going to change anything. Life is so incredible and has the potential to be lived so well. Some definitely need to realize this more than others.

Anyways, back to my story.

It was a good visit with my friends. After the visit, I was basically alone in my hospital room— a rare occasion for me in the evenings. I was feeling very tired that day. I didn’t really know what I wanted to do before going to bed, so I was just staring at the walls. I looked over at my monitor. I glanced at the medications I was on. For once, I decided to turn the TV off (if you know me, you know that I cannot live without background noise— the noisier the better).

And I just sat there. 

I then remember my nurse coming in with a phone and telling me that I had a call. He handed me a phone and left the room. 

“Hello?”

The only thing I remember from the phone call was:

“Blah blah blah blah MATCH blah blah blah HEART blah blah ACCEPT?”

“Yes. I have to go call my mom now.”

And that was the best I could do. I have to go call my mommy now. No “thank you,” no “OH MY GOSHHH!” There were no balloons. There was no party. There was no clown, no party favors, no crowd. My residents and nurses weren’t throwing confetti into my room, either.

I was just comfortably alone. During the happiest moment of my life. I felt pure bliss.

And then, I felt nauseated.

And then, I vomited.

(Just like I always did, since I was a child, when I was nervous about something. Physical manifestations of how I was feeling psychologically, I think.)

I called my nurse and asked for some Zofran and mouthwash. 

“There’s a heart!” I told him. He was very excited too, and he told me that he’d come back in a few minutes with a plan. 

I had promised my family and closest friends that I would call them the moment I knew that I had a match. But (please don’t hate me), in that moment, I just wanted to sit with myself. It was a quiet 10 minutes. I did some reflecting.

I thought about who my donor could be. Maybe a 20-year-old female involved in an MVC. Perhaps a 26-year-old male who was braindead after a sudden illness. Maybe my donor was that other 30-year-old female who deteriorated after losing a battle with some random genetic condition that she didn’t know she had. 

Did my colleagues try to resuscitate this person? Could I have ever potentially resuscitated this person?

Moment of silence. I thanked my donor and their family.

I wrote in my journal, “Thanks for 30 years of service, Heart.” Super cheesy, I know, but I didn’t want to forget how I was feeling in that moment. Grateful that my poor heart had come such a long way with me. Thirty years of craziness.

I found myself smiling. I was going to live. The rest of this was going to be easy. They were going to crack my chest open, take my heart out, put a new one in, put a few vessels together. It wasn’t an extremely complicated surgery (from what I remembered during medical school). I would wake up afterwards. Probably with some pain. I would get discharged in a few days. I would go back to my normal life. Kind of.

I guess one of the hardest thoughts that I ever had (and continue to have) was this: things were never going to be normal normal.

But I would get as close to that as possible. 

This was nothing that I couldn’t handle. I had gotten through Organic Chemistry at UCLA. I used to work full-time night shifts while attending an accelerated Master’s degree program in the mornings. I had moved from Los Angeles, CA (population: 10 million) to Cumberland Gap, TN (population: 500) all on my own, without knowing one person, and had beautifully made it through medical school there.

I had once battled a complicated case of appendicitis (not surprisingly, I had been very stubborn about going to the ER then, too) and I had been able to make it out alive. I had actually showed up to Anatomy Lab just three days post-op (I was kicked out by my professor, though … “You need to go home and rest!”)

This was just a minor little speed bump in my life.

My friends would repeatedly remind me that I hated anything that came too easy— we’d joke about how this would happen to me just because I loved challenges. 

Everything was going to be okay.

In that moment, I also decided that after I woke up from the procedure, I was going to do *something* with my life. Something special to honor my donor for the rest of my life. It would be something to make that family proud. I didn’t know what, but I knew that I would. 

With this inconvenient life event, I would grow. I would learn from it and I would use it, ultimately, to change the lives of a few other people (or perhaps the world, ha).

“Your character is built on how you handle moments of adversity,” I read somewhere. 

I think I was handling it well.

After my contemplations, I called my mom and asked her to kindly step away from the slot machines and return to the hospital (that part of my story always makes me laugh). I then proceeded to call the rest of my family and closest friends. I sent a message to my residency Groupchat. I texted some of my attendings. 

My nurse brought in some Zofran, some mouthwash, and chlorhexidine for my final ICU basin bath. OR Start Time was scheduled for 2am. Eventually, my family and friends came running into my room. The night float residents and interns barged in to give me hugs. Even the Pulm/Crit fellow (who had been consulted a week ago) came by before leaving the hospital. “I just wanted to say congrats. We were all rooting for you in the MICU. Thank you for being you.”

The Anesthesia resident came in with some paperwork and a hug. A few of my former nurses surprised me with “Congratulations!” and tears of joy. The CT Surgery fellow walked in, excitedly. “I’m so happy for you! Let’s do this!” he said.

“Yeah, okay! But who’s gonna be cracking my chest open in 6 hours?” I asked him.

“I probably will,” he said.

“That’s f&*%ing awesome. And don’t worry about the scars. I’m not one of ‘those’ patients.” I told him.

“You’re not like most patients, Alin.”

We all laughed.

“Oh yeah, speaking of, I’m apparently really difficult to sedate.” I told the Anesthesiologist.

“Yeah, that’s not surprising, but we’ll take care of that.” We all laughed some more.

I was so happy. I’m telling you— pure bliss.

I knew that everything was going to be okay. Life was going to be different, but everything was going to be okay.

To end this post, here are some memories from the day that I got The Call:

One Thousand Visitors

“MOM THERE ARE LIKE A HUNDRED PEOPLE AT MY APARTMENT RIGHT NOW, CAN’T TALK!”

“LIKE THIRTY OF US ARE GOING TO THE BASKETBALL GAME ITS GONNA BE SO FUN.”

“I WANT TO INVITE A THOUSAND PEOPLE TO MY GRADUATION PARTY!"

For years, my parents would say things like, “Alin, you can’t possibly even KNOW a thousand people! You exaggerate so much.”  I proved them wrong while I was hospitalized.

I had a lot of visitors when I was hospitalized. A lot.

My program director would come by multiple times a week with candy and gifts. He’d be patient with my parents, who would ask him both medical questions and questions about what was going to happen with residency. I’d wake up after long naps to other ER attendings in my room, just sitting there with my parents— sometimes crying, sometimes laughing, but always there for me.

“I can still be an ER doctor, right?” 

My attendings would reply, “Absolutely."

One of my ICU attendings would come by on her days off with People and In Touch magazines. “This will help you get your mind off of all of this.” She would take the time to ask me how I was *really* doing. “I feel fine! I really do!” And then she would stare at me until I said what I *really* wanted to say.

“Chest tubes hurt so much more than I ever thought they would,” I’d admit while looking away.

Priya, my favorite surgical resident, would come by with a bag full of anything she found at CVS Pharmacy on her way home from work every night. She’d be tired as hell after doing a liver resection or a laparotomy for hours. “Today, I got you a neck massager and these scrunchies." She’d lay in bed with me. I would have to force her off because the bed weight alarm would sometimes start beeping. “I don’t care,” she’d say. 

Every day, Matt would sneak in muffins and watermelon juice, sit down next to me, and work on his fellowship research with his laptop. Every day, I would tell him that I felt like a burden, that he should go back to fixing ACLs. Every day, he’d tell me to shut up. “You need to stop pushing people away. We all care about you a lot.” I’d roll my eyes and take a sip of my juice.

One of my attendings, known for his stoic demeanor and strict ways, once surprised us all by walking into my room. He stayed and chatted for a long time, in complete shock about my whole situation. When he was leaving, he almost made it to the door before he turned around and looked at me. “Alin, I want to tell you one thing. You have been so strong throughout all of this, it’s been unbelievable … and I just want to say that I would expect absolutely nothing less from one of the best residents I’ve worked with.” 

The whole room teared up. But I held my tears back. Instead, I said something along the lines of, “You’re just saying that because I’m dying!” 

He shook his head. He walked back to my bed to give me a hug. “You can’t die. We have to clear the waiting room on every shift when you’re back.” 

I teared up.

One of my close friends would always bring me breakfast bagels after being on 24-hour-call at the hospital. We had a rule: to not talk about my illness, and to treat me like he would on any other normal day. “When are you coming back to work to admit patients that probably don’t need to be admitted, you dork?” he’d ask. We’d laugh. We’d hug. I appreciated that.

My best friend from medical school flew in from sunny Miami and surprised me. She sat down next to me, and we joked about all of our old times. I sighed. “I miss coming home with you on Thanksgiving breaks."

“You’re gonna still come home with me on every Thanksgiving that you’re off, don’t worry,” she replied.

My girlfriends (aka my sisters) from Los Angeles, Linda and Ateena, even flew in. Ateena would help me with my daily walks around the ICU. She would hold onto my milrinone pump, and I would make jokes about how my life was always in her hands. Linda, who is one of my only friends not in the medical field, walked into the room and asked, “Wait so what's a Cardiac A-ha! diet?” 

My brother, cousins and relatives flew in and surprised me as well. “We cannot wait until you’re back in LA,” they’d tell me. My cousin and I would go down the list of everything we were going to do when I was back home on vacation some day.

A former attending of mine, someone I looked up to dearly, once came by with a David Sedaris book and a sketch pad (which really made my day). We laughed so much at my old “intern year” memories. She then showed me a part of her sternotomy scar from a valve replacement years ago. “You’re gonna be in the Zipper Club with me when you get out of here. Pretty cool, right?” 

My good friend, a cardiologist, would come by after working long hours (no matter what time it was). He knew that I was always going to ask him all of the super specific cardiology questions that my little brain had thought about all day. “Can we go over the Fick formula? Where exactly is this catheter sitting? How do they check wedge pressures?” One time, we drew out the human heart together on my iPad. I think he knew how nervous and anxious I really was deep inside. He watched me color in the ventricles. 

“So, as a cardiologist, not as my friend, but as a cardiologist … am I gonna make it out of here alive?”

“YES! Like no other! You’ll be back at work with a new heart! We’re gonna be going out so soon! First drink’s on you, though, because coming here after being a cardiologist at the hospital all day has really been taking a toll on me.” 

I wish I could tell you a story about each visitor who dropped by, but IT WOULD BE LIKE A THOUSAND PAGES OF READING BECAUSE I HAD SOOOOO MANY VISITORS EVERY SINGLE DAY!

Then came New Year’s Eve.

On this particular day, I went to the Cath lab for the umpteenth time only to come back to, literally, ten people in my room. We didn’t have any champagne, but ginger ale worked just as well. One of my friends got me Sour Patch Kids (a real treat when you’re in cardiogenic shock) and I ate the whole bag. "Cheers to 2018. Hope 2019 is a little better than this,” I said, dryly, with SPKs in one hand & a plastic cup of ginger ale in the other.

“It’s gonna be so much better. Hashtag, new year new heart!” One of them said. 

“Hashtag, can you guys go out and celebrate FOR me? All of you know that I LOVE this holiday.”

“We know that you love this holiday. That’s why we’re staying."

I fell asleep sometime around 10 or 11pm. I didn’t want to, but I did. Melatonin is a helluva drug.

Anyways, let me tell you the best thing ever right now. Let me tell you that every single person stayed in my room until midnight anyway. 

I thought it was kind of weird that they wanted to spend NYE in my hospital room.

Nonetheless…

Thank you.

My dad asked me the next morning, “You remember when you were younger, we’d always hate that you were exaggerating so much? You still always say things like ’There are forty people coming over so I have to get dinner ready!’”

“Yes."

“You were never exaggerating that much. There are a lot of people besides me and your mom who love you. You’re lucky."

Yep. And during that time in my life, I felt extra loved. My support system was actually the reason why I got through what I got through. My “enablers,” as I liked to call them. They were constantly asking the techs to get me blankets, to get me some tissues. My friend once told my nurse, “Her teeth are sensitive. Do you have any toothpaste for sensitive teeth?” (** face-palm ** SO embarrassing, I know.)

They would answer all of my medical questions when I wanted to talk about what was going on. But they would pretend like there was no invasive central line jammed into my little neck on the days that I didn’t want to talk about what was going on. 

They would hold the back of my way-too-large gown and walk around the unit with me. When I looked short of breath, they’d say that they’d want to sit down for a second (because they knew that I would never admit that I was short of breath). I knew what they were doing. 

They would bring me all of the sweets that I wanted. They’d pretend like it was theirs if my doctor or nurse walked in. Ugh, that Cardiac A-ha! diet…

They would tell me that I looked so good, even when my hemoglobin was 6 and I hadn’t waxed my eyebrows in three weeks. They would sit down and do manicures with me— even the guys who had never had their nails painted before. 

They would watch everything on TV with me on the days that I felt down and just didn’t feel like talking. They would pretend like they wanted to watch the 3rd run-through of early 1990s Forensic Files. “We’ll watch these when you’re discharged, too. I’m coming over with popcorn every night."

They would let me vent about how much my F&#(ing arterial line kept F*#$ing up. I rarely complained, but this was one major complaint of mine. “F*$& that line. It’s gonna be out in no time,” they’d say.

They would bring me flowers when they weren’t supposed to. In fact, they would bring me gifts, so many gifts, every day. I couldn’t wear shoes in the hospital, but one time, I told my friend that I badly wanted a pair of Doc Martens. “It’s gonna be the first thing I buy when I’m out of here,” I told him. He came by one day with a neatly wrapped shoebox— Doc Martens. “This is for when you get discharged. You’re gonna wear them on the day you’re out of here.”

“AHHHH! YES!!! Think I can wear these to the OR when I get my transplant?” I asked, as I checked for pitting edema before trying them on.

“You can do whatever the hell you want to do. You’re Alin.”

You see, my support system gave me a lot of hope. They’d give me hope about being out of the hospital “in no time.” We’d talk about being at work again, and how we’d be reminiscing about these terrible (but darkly humorous) times at future get-togethers. They’d tell me that, very soon, I was going to be in California and watching the sunset from my favorite secret spot in Venice Beach. And very soon, I was going to be a New Yorker living the life in the Lower East Side (my dream since I was practically five years old). According to them, I was going to handle all of this so well and so gracefully because "I was Alin” and nothing was going to stop me.

With their validating words and their incessant love for me during this incredibly insane experience, I became a little bit less scared and a little bit stronger each and every day.

I hated it at times, because I would feel like a burden. I would push them away. In fact, I got into arguments with my enablers on some days— I didn’t want them seeing me sick and barely able to walk. I didn’t want them being late to work because of me. But these crazies just kept coming back. 

So where I’m at right now in life (still smiling and still determined to kick ass)— this is all thanks to them. So, thank you— all of you— for giving me so much of your beautiful, genuine hope during the absolute worst days of my life.

And to my nurses who were taking care of me (if you’re reading this), I’m sorry for ALL OF THOSE THOUSANDS OF PEOPLE in and out of the unit every day for me.

To end this post, here are some photos of me and several of my enablers from when I was hospitalized.