Where The Fuck Is Everybody?

The Meaning of Life

Deborah and I had known each other for nearly three years and had lived together for about two when this story begins. We were both divorced and neither of us gave much thought to marriage as we were very happy with life the way it was. But then I discovered that what I thought was basically an upset stomach was something far more serious.

Dealing with major health issues was not something either of us had ever really thought about as we both seemed healthy and fit. We took daily three mile walks around the reservoir in Silver Lake, we regularly went to the gym and sometimes took yoga and spinning classes, we ate organic foods as often as possible, we drank bottled water, and we consumed enough wine to give us all the benefits promised by the French Paradox.

So neither of us was prepared when I went to see a doctor and faced in real life the kind of look you only expect in melodramatic movies and pulp novels. You know, the look that says “You are dying, and there is nothing all of modern medical science can do to save you.” I have always loved movies, but why did it have to be this one? Couldn’t I have played out a scene in a Bond film, even a bad Steven Seagal action flick instead?

Only the day before, I had been enjoying myself at a luxury lodge in the middle of a forest in New Zealand. But on the flight home, I experienced excruciating pain. I figured it was a kidney stone, or maybe the salmon I had for dinner shortly after takeoff. I barely remember the flight though, as I most likely blacked out. The last thing I recall was wondering if my condition was bad enough to justify asking a stewardess to land the plane or find a doctor on board.

I went straight to a gastroenterologist once back in Los Angeles. He immediately seemed concerned, but it was when I answered his question about a change in weight (I happily told him that I had recently dropped 15 pounds), that’s when I got “the look.”

That day began an odyssey that went from an initial diagnosis of cancer in the bile duct – inoperable – to a more hopeful one of EHE (epitheliod hemangioendothelioma), a rare and obscure tumor in my liver, allowing the option of transplant; and from Cedars in Los Angeles to the Mayo Clinic Florida, where I would ultimately receive a new liver less than three months later.

Deborah was there every step of the way. She literally passes out when she has to give blood, and gets queasy if anyone even says “blood” or “needle,” but she stood by me through hundreds of vials of what we came to call the “b” word, countless IVs and a handful of visits to – and stays in – the ER and ICU.

What if Deborah had not been around? Hard to say. My family did everything they could, and two of my siblings with the same blood type offered to donate half their livers, but I’m convinced that it was Deborah’s tenacity and refusal to take “no” for an answer – from me, the doctors and the insurance company – that got me through this.

And if I had been with someone else? One friend was recently in Deborah’s position, as she confided to us. “I was dating a guy for three months,” she said, “when he was diagnosed with cancer. I wished him luck and I said goodbye. I wasn’t going to get bogged down with that.” Certainly understandable, but not good from my side of the equation

And one ex-girlfriend was extremely New Age in her views. A militant atheist, I do not believe that the universe provides, especially livers – just ask the many people who die every year on the waiting list – and would not have been comfortable in those circumstances with someone who did. I needed someone who would fight inertia, fear and bureaucracy, someone who knew that some things come to you only if you were willing to fight to the death.

So I learned that relationships are about more than the superficial stuff, more than going out to nice restaurants and fun clubs or trips to Hawaii. They can be about life and death as there may be no one else around to take care of you. Choosing carefully is pretty important, and little things, like different taste in music, fashion or nightlife, really are far less important than you imagine in your youth.

We married two months to the day after the transplant because we wanted to celebrate being alive and being together. I was still frighteningly skinny and weak, but it was a beautiful ceremony on a perfect late summer night in my parents’ back yard. I’m very fortunate to have stuck around long enough to get married, and I attribute that to making the right choice in this most essential relationship.

It must be said, however, that The Esurient Man is no less shallow than others, and Mrs. Esurient is a dazzlingly atractive Brazilian. Sometimes, you can have it all -- well, except for the original liver.

My First Sip

I walked down into my basement a couple of weeks ago and rummaged through the wine racks, the small wine refrigerator, even the haphazard, precarious piles on the floor. I write about wine for a living, so I have more than the average person – okay, probably more than 50 average people put together. I needed a really special wine, so I searched through the 1000 or so bottles I had amassed over the past decade.

I kept being tempted, though, to grab something less than extraordinary, something of which I had several vintages, or several bottles from the same year. I had to fight with myself to pull out a one of a kind, one of the few big guns in my collection. I soon unearthed a ’96 Penfolds Grange and knew that it was the right bottle to open for this occasion.

I brought the dusty bottle upstairs, where my wife, my sister and her girlfriend waited. I grabbed four Riedel syrah glasses (Grange, Australia’s best-known wine, always features syrah as the dominant grape, and this vintage was 96% syrah, with just a splash of cabernet) and a corkscrew and joined them in the living room.

It was Thursday, December 28, 2006, and I wanted to open a bottle that would be memorable. The Grange would qualify, I suppose, for any wine lover. But the first sip that evening would have special significance for me.

Nearly nine months earlier, on April 5, I first became aware that I was seriously ill, and that the problem was in my liver. I had experienced intense pain the day before on an overnight flight home from New Zealand. Even in the comfort of Business Class, with a fully reclining seat/bed, I was in agony. Nonetheless, I had gone to a family dinner the evening of the 4th, bringing along a precious bottle of Sea Smoke Ten pinot noir. Though the wine was delicious, I couldn’t drink much as I simply did not feel good. My family gladly took up the slack.

Most nights before this, I had opened a nice bottle of wine and shared it over dinner with my wife. But the Sea Smoke turned out to be the last wine I drank as a diagnosis of a vascular tumor, EHE (epitheliod hemangioendothelioma), in my liver soon followed. The malignancy was so rare my older brother labeled it a “boutique” cancer, a play on the small production wine we had so recently shared.

When it became obvious I was no longer able or allowed to drink, I wondered if it would be difficult to give up. Luckily, the answer was no. I happily opened and poured wine for my wife and often inhaled the aromas, but felt no urge to drink, or even taste.

I needed a new liver, and I needed one fast, and the doctors at Cedars Sinai had told me they did not expect to be able to find one in time. In early June, my wife and I relocated to Jacksonville, Florida, to be close to the Mayo Clinic, perhaps the top facility in the country for liver surgery. I was no longer really able to travel, so we got there by air ambulance, a fancy term for a not so fancy yet very expensive private jet complete with a stretcher and a team of nurses.

Ensconced in our condo and awaiting the call that an organ had been found, I spent the days at the hospital undergoing a series of tests and was in and out of the Emergency Room with a variety of related ailments. A glass of wine each night helped my wife maintain her sanity, but drinking was the furthest thing from my mind. I was too busy trying to survive.

Miraculously, I got my liver just three weeks after arriving in Jacksonville, on June 26, and was home a scant three weeks later. I had lost 70 pounds and, temporarily, my mind, but somehow made it through the ordeal, even if I looked more like a concentration camp survivor than the well-fed food and wine writer I had previously been. I slowly resumed my exercise routine – a daily three mile walk around the reservoir in my neighborhood – and returned to work and other facets of a normal life that once seemed hopelessly distant.

As Christmas approached, I realized I was nearing the six month anniversary of the surgery – a major watershed as I would be moving past the most dangerous phase for organ rejection and other complications from the transplant. I had switched to a diet of mostly organic foods and, of course, continued to eschew alcohol. I felt fantastic by almost any measure.

But wine was a significant part of my work and my life, and I hated to imagine a future without it. Thinking ahead to the day I would hit my main liver doctor the big question, I asked a couple of specialists along the way, and neither had any objections. In fact, the tumor specialist I visited in New York turned out to be a major wine geek, and he advised me to “spit the crap, and drink moderately of the good stuff.” Good advice for anyone, really, and close to how I had lived my life with my first liver.

Still, I knew I would abide by the decision of my liver specialist at Cedars, as he had been part of the team that diagnosed me and had been overseeing my post-transplant care since my return to Los Angeles. I had given him a bottle of Krug Champagne, taken from my cellar, before I left for Jacksonville. It was a genuine token of my appreciation – and it seemed likely I’d never be able to drink it, one way or another. And if it helped sway his decision, well that was just a bonus.

Finally, I gathered my courage and sent the question by email. I had worried for months that I would never be allowed to drink again, and that I would have to find a new field of work. Naturally, surviving was far more important than continuing in my previous job, but I needed to work, and I’d have to find another subject if I weren’t allowed to drink. So I was thrilled to find out my doctor had no problem with “moderate” consumption of wine for me. I didn’t even bother to ask him to define the term as I knew my wife’s interpretation would be far more strict than his – and the one I would most likely have to follow.

I sat down on December 28 with three people very close to me to celebrate one more step towards reclaiming my earlier, “normal” life. I wondered as I opened the bottle of Grange if I had been too ambitious, if maybe I should have started with a simpler wine, sort of like training wheels, to ease me back into it. But then the cork was out, and the decision was made. Luckily, I had not forgotten how to drink. It is, apparently, much like riding a bicycle: it all came back to me in a second.

I filled each of the glasses about one third full and passed them around. Fortunately, I had retained my wine swirling skills by muscle memory: there were no embarrassing missteps, spills or other accidents on this first outing. Finally, I raised the glass to my nose and inhaled, savoring the aroma – a total knockout in the case of this bottle.

I silently toasted the anonymous donor and his or her family; their thoughtfulness and generosity at what must have been the most difficult time in their lives had literally saved my life. And then I took that long-awaited first sip.

Wow – it was explosive. I was afraid something like wine might seem trivial in my personal new world order, but I was immediately blown away by this rich, complex wine. Sure, I could say it had strong cassis aromas and a subtle hint of licorice, but – far more important – the wine was life itself. Bottled nearly a decade ago, this Grange was vivacious and bursting with energy. I temporarily forgot my long, enforced abstinence and was caught up in the complex web of flavors. “Really nice,” said my sister. Yes, it was. We all sat in silence, assessing the scale of this massive wine.

Was I just caught up in the moment? Would a bottle of plonk have had the same effect? My emotions had been ramped up ever since the surgery, partly from the anti-rejection drugs, partly from the sheer thrill of being alive. So it was probably both the greatness of the wine and my general heightened emotional state that produced such a profound effect, much as I had wept at the sheer beauty of the music when listening, post surgery, to Joseph Arthur, Peter Gabriel and Ludwig van Beethoven on my iPod in the hospital bed.

Websites showed a price range from $250 to $450, perhaps even higher, for the ’96 Grange. Robert Parker awarded the wine a 93 on his 100 point scale, with the provision that the score might go up as it reached optimum age. For me, it was simply off the charts.

Now, having learned the hard way that life is truly too short to save just about anything for a “special” day that may or may not arrive, I will no longer hoard these big wines. Anyone who has been through a similar life-threatening and life-altering experience will almost certainly tell you that every day you are alive is special.

Most of all, it felt miraculous to be sitting there, back to 100% good health, surrounded by loved ones – with the added bonus of a glass of very fine wine in hand. I got woozy from just a few sips. Not drunk, really, but more an intoxication of the senses. I basked in the warm, mellow feeling that permeated my body as I remembered – and experienced again – the unique warm camaraderie of people sharing good conversation and a great bottle of wine.

Go to www.donatelife.net to find out how to become an organ donor.