Careful with that axe

“The horror of that moment,” the King went on, “I shall never never forget!” “You will, though,” the Queen said, “if you don’t make a memorandum of it.” --Lewis Carroll

Remember back in high school when everyone had their favorite rock band that they marketed to their friends? Meg, like you, favored the Dead. I was a fan of Pink Floyd. Go back and listen to “Careful with that Axe, Eugene” with this episode in mind.

Back in Montclair, old friends of my father who had been a doctor (he had died only a few years before) could not believe, despite my presenting with all the symptoms of acute liver failure, that my liver was so badly damaged. There was no reason they could find to explain my liver failure . (Turned out to be Wilson’s disease, a hard to diagnose genetic disorder where the liver is unable to kelate copper and the excess accumulates in the liver and leads to cirrhosis.) They could not find a reason for my liver to fail. They foolishly decided to do a liver biopsy. (I say foolishly because regardless of the cause there was no treatment for liver failure other than transplantation. At that time liver transplantation was highly experimental, and only just becoming successful with the very recent development of the anti-rejection drug cyclosporine.) Because of the risk of bleeding in end-stage liver disease, they could not do a simple needle biopsy. They decided they needed to do an “open liver” biopsy. By then it was a struggle for me to just stay conscious. I was the verge of falling into a hepatic coma. Because of the near absence of liver function, giving me anesthesia or even sedating me would push me over the edge.

So they did what they call a “local vocal”. In the operating room they laid me out like Jesus on the cross, tying my arms out to the side. Then after administering a local anesthetic, they started to cut and I started to scream. Remember those amputation scenes in movies about the Civil War? Strong hands held me down. It felt just like you’d imagine it would to be cut open and have someone stick his hand inside your belly. I could feel the surgeon handling my liver. I heard him say “micro-nodular cirrhosis.”. I screamed, “Just get your fucking hands off my liver and sew me up!”

There was a young protege of my father’s that had recently had a patient that he had sent to Pittsburg for a liver transplant (the only real place to go at the time). This little girl was alive and doing well with a liver transplant. It seemed impossible to me, but he insisted that it could work. I had no other option.