Life on the waiting list: A liver patient can dream, can't he?

ALAN BERNER / THE SEATTLE TIMES Richard Daverman, left, from Nashville and a friend of Jack Slater's from their college days, laughs as they have breakfast at Pike Place Market. Humor is a Slater hallmark.

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My wife's 90-year-old aunt has polio in her legs, is full of good humor and intelligence, and is very bold in speaking her mind. I love her dearly. She was married for 57 years and loves to talk about her fine husband, who died 15 years ago.

We were talking a few months back at a New Year's Eve party. She was telling me how glad she was that I looked so good, especially given all the reports that I am deadly sick with hepatitis C and have been waiting a year and a half for a liver transplant. Then she said to me, "Do you mind if I say something naughty?"

"Not at all," I said.

She glanced around the room to see if anyone was listening, leaned close and said, "Well, I think you are kind of handsome."

I'm sure it felt naughty to her because she saw it as a betrayal of her late husband and of my wife, her niece.

As for me, I was flattered.

Hey, looking good!

This killer disease actually has some cosmetic effects

Hep C is called a silent killer because there are so few external physical symptoms. You don't necessarily look ravaged by disease as your liver is slowly becoming useless.

I was diagnosed in 1997, and I still can't believe this is happening to me. And odd as it sounds, in some ways hep C has actually helped improve my appearance. The disease causes fatigue, and at times my exhaustion shows. But it also means I sleep more than the average bear, so I look well rested for a 57-year-old man.

Organ transplant forum Jack Slater will be a panelist this week on a forum titled "The Lifesaving Gift of Organ Transplants: Availability, Ethics, Science & Experience." The CityClub Health Care Forum will be moderated by Seattle Times Executive Editor Michael Fancher; other panelists include Dr. Jorge Reyes, chief of the Transplantation Division at the University of Washington School of Medicine, and U.S. Representative Jay Inslee. Thursday, noon-1:30 p.m. at the Women's University Club; $40 general public and $30 for CityClub members. Reserve by Tuesday by calling 206-682-7395.

And by order of the dietitian at the transplant clinic, I have to be picky about what I eat. Plenty of protein, fruits and vegetables; no sushi, olives, pickles, smoked meats, steak tartare; no cigars, no fine wines, no cheap wines, almost no salt. Lettuce, tomato, onion, a bit of carrot and some red pepper make a nice sandwich. But no mustard and no bread (highly salty).

I've lost about 35 pounds, one chin and can see cheekbones I thought were gone forever. I've been on medical leave from my job as a high-school history teacher for two years, so I have less of that daily stress. I am sleeping sans frontiers — no alarm clock to respond to, no job to rush off to, no reason not to nap — but that thrill been done gone a long time ago. I would be happy to lose the afternoon snooze.

When I bump into friends I haven't seen in a while, they often tell me how much better I look than the last time they saw me. The next time I see them they say the very same thing. I'll take the compliment.

Want to be a donor? LifeCenter Northwest has information about how to become an organ donor, including registering online: www.lcnw.org

Each morning, I face my ugly mug in the mirror and contemplate my failing liver. It's a one-two punch that clobbers me every time. So when, after a few minutes or hours of feeling sorry for myself, I recall that yesterday somebody told me I looked good, I am only too happy to believe them. I believe it in a skin-deep kind of way. Deep down I can be very shallow.

One time I asked my primary-care physician, Dr. Ellen Lackerman, about how she tolerated the daily exposure to blood and guts, stink and ooze and she said, "I love it all." She says she cares for the whole person, not just the ailment. That's the kind of doctor you want in your corner.

Surgeons snip veins, muscles, nerves. They cauterize and tie incredible knots with stupendous dexterity, sometimes one-handed, to hold everything together. The exposure to the glorious workings of the human gut and the technology that allows for transplantation must bring the entire surgical team closer to God on a daily basis. The pills I take just as easily thrill me.

Because we all live in the real world, however, it could happen that, on the same morning I'm called in for my transplant, my surgeon's dog gets run over. Everyone is allowed to have a bad day.

But then what of my day?

Here comes the fantasy

So why the big hurry with the knife?

So I have this fantasy. I'm trying this out to see how this feels to say it out loud:

	ALAN BERNER / THE SEATTLE TIMES Holding one of his artistic creations, Jack Slater downs a dose of a prescription supplement.

I don't want somebody else's liver. I don't know where it's been or what it's been through. Although I don't mind eating food that slipped off my fork onto the floor, I am not enamored of the cooties from somebody else's unknown insides. Nothing personal to all you wonderful people who have promised to donate.

I am comfortable and impressed by much of the modern world. In fact I can set the clock on any VCR. But I want to avoid this intense surgery. (Please remember this is a fantasy.)

I don't need to be any more of a walking miracle than I am right now. I am happy to wait for the cure. My blood tests indicate over the years I have actually improved on the numbers necessary for a pretty decent life.

I know I must be careful about what I wish for. I could be developing cancers on the liver of size and quantity enough to render a transplant moot. Maybe it will all be decided for me in the phone call in the dead of night, or my liver turns into a last-gasp, last-will-and-testament kind of thing.

The other night the phone rang at 3:30 a.m. I was immediately awake and my only thought was, "It's show time!" It was a wrong number. I am glad that at this point I have the luxury of considering this fantasy.

When they call me to come in for a new liver when I am more conscious, however, I might want to say something like, "I'm cleaning out the garage. Let me get back to you later." Why not wait awhile longer? I've waited this long.

The hideous-insidious truth is that a transplanted liver will not eliminate the morbid virus inside me. So what's the rush? Is this like a preemptive invasion of Iraq? I know that my body is home to a weapon of mass destruction. I prefer diplomacy over an all-out invasion. A preemptive liver transplant will provoke a fierce battle as the new liver tries to overcome my own Axis of Evil — powerful drugs, my old dirty blood and my religiously intolerant virus. And meanwhile, science marches on. The next big thing could see us all dancing in the streets. Can't I please assume that my fantasy can become the reality?

The liver is capable of regenerating. I don't know why, but it's true. So is the scarred terrain of the liver lost and dead forever? Does it matter? People live just fine with one kidney, a stapled stomach, no gallbladder, shortened intestines, hearts powered by batteries and, like me, no bellybutton. So why not treat the beautiful liver like my best friend? And the two of us will carefully dance in my living room as I wait for a cure.

Game for alternatives

Bring on the rocks and antioxidants

On the Web You can read earlier installments of Jack Slater's diary on www.seattletimes.com/jackslater

So in this fantasy I'm just trying to find a bit of wiggle room in order to stop worrying and get this mess out of my mind. Or am I out of my mind? Some would cheerfully say that in my brain there is plenty enough room to wiggle. Enough room to turn around a battleship at sea.

I beg your patience as I work out this ragged and desperate fantasy.

I worry about the shock of my "new" liver being "harvested" (hospital word, not mine) from a body which has gone through some sort of unanticipated screaming hell on its owner's way to death. I worry that the liver might bring post-traumatic stress with it as it is forced to rearrange its fragile self in a new space. First it was a happy organ working its magic, then — Pow! — it was almost dead, then it was harvested, packed in ice and rushed to the pathology lab. If it is of good quality it is transplanted and then it's not dead anymore as it again swells with my blood. My infected blood. Sounds like shock and awe. The liver is shocked and I am in awe that it actually will start filtering whatever pizza and Pepsi I pour into my system.

In medicine we trust

But hope springs eternal for miracle cure

So why not use acupuncture, herbs, psychic healers, hypnosis, food supplements and drug trials instead of a full-scale invasion? Why not meditate for days on end? Somebody wrote to me that I should hold certain rocks in my hand and all would be well. Why not meals-ready-to-eat for virus war? Why not invest in massive antioxidants, aloe vera and the whole list of things being hyped on the Internet to make a buck off me? I'm game to try them all.

	ALAN BERNER / THE SEATTLE TIMES Once an actor always an actor: Extrovert Jack Slater encourages two visitors he does not know to put a little more spice into their souvenir photo at the Fremont Troll under the Aurora Bridge.

Why am I so late in coming to this ambivalence over a transplant versus the more gentle alternative therapies? I know exactly. When I showed symptoms of liver disease, I asked my doctor what he thought about a popular liver cleansing herb called milk thistle. He said, "Well, you could try it, but they buried a patient last week who had been taking it right up until the end." This disease was so terrifyingly serious, and my liver was so scarred, that it would be impervious to anything so benign as herbal soups and natural voodoo. So I decided to place myself firmly in the latex-covered hands of the medical establishment. I am a Westerner, and these doctors are the current flowering of Western Civilization.

So to all those who tell me that they are praying for a transplant, bless your little pea pickin' hearts. But let's change the subject. Let's go for the gold. Let's go for the cure. There has got to be some tree sap or bug excretion in the mighty bosom of the Amazon jungle. Is it too much to ask that a cure be found soon hiding in a mushroom cloud of spores? I'm kind of in a hurry.

First, though, I'm going to turn on my beeper that keeps me linked to the transplant center. I'm tired. I have to sleep. I don't want to because waking up is hard to do. And yes, I know the alternative.

I also know that, every time I do wake up, that one-two punch will be waiting for me all over again.

Still, it's hard to hit a fantasy. Bring it on.

Project footnotes

Jack Slater is on a medical leave from the Seattle Public Schools, where he teaches history. He was born in Chicago, graduated from Calvin College in Michigan and worked for 20 years as an actor and humorist. He has been a community and political activist and is an avid artist and gardener. He lives in Ballard with his wife, Deborah Swets, the executive director of CityClub.

You can reach him at jslater@seattletimes.com.

Seattle Times photographer Alan Berner can be reached at 206-464-8133 or aberner@seattletimes.com.

To reach an editor about this project, contact Jacqui Banaszynski at 206-464-8212 or jbanaszynski@seattletimes.com.

Copyright © 2004 The Seattle Times Company

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