Liver Transplant No. 108

Inga Clendinnen

Big Louis is dead. I found out only yesterday, because the last time I went to the Clinic I didn’t meet any of the people who might have told me, which can happen when you’re down to three-monthly visits. He might have died as long as five months ago. It’s odd to discover you have been orphaned for months without knowing it. Louis was the first person to receive a liver transplant at the Unit when it started at the Austin Hospital here in Melbourne in 1988. Units were already working in Brisbane and Adelaide, but he was our first. They’d tried transplanting livers long before that, but everybody used to die, so they gave up for a while, but in the early 1980s they began again. What had changed the odds were better operating techniques and yet another miracle drug, this one called Cyclosporin. Cyclosporin controlled rejection without damaging the patient too much. It came into use only in 1989, so Louis must have survived his first few months without it. The Unit must have been proud of him.

So Louis was Number One. The last one, operated on about a week ago, is Number 301. I am Number 108, from April 1994. We write our history in the old-fashioned way here: dates and numbers matter in this long, thin, accidental family I have joined. We care about lines of descent, too, so Louis was our grandfather. He was a big, slow-moving Frenchman or Belgian in his late sixties who couldn’t or wouldn’t speak English. He would sit peaceably in the waiting room on his too-small chair, one large hand on each knee, and exude the mild benignity of an elephant, or perhaps a bishop. It was good to see him slowly moving up the corridor ahead or lying back in the padded chair for the routine blood test.

The family has no politics or class, and prior relationships are erased on entry. Because humans happen to be endowed with two kidneys and only one is necessary for life, a friend or kinsman might surrender the other to a specified donee, as Kerry Packer’s helicopter pilot recently did to his employer in a blare of ambiguous publicity, but even our richest man couldn’t buy himself a liver. ‘Living cadaver’ transplants, as they’re called – liver, heart, lungs – are done democratically, in designated public hospitals, with public patients queued according to need. We are nonetheless selective; there are no honorary members. The only way into the family is through the operation. People on the waiting list aren’t supposed to meet us post-transplant people except for the one selected by the Unit to be their counsellor or ‘next friend’. This segregation might be no more than a way of ordering the doctors’ time between pre and post-transplant duties, but I suspect it is also policy. People on the waiting list panic easily. They need to know some things, but not others, and they haven’t learned to trust the medicos, who naturally want to control the information flow so that no one gets muddled or demoralised.

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