“Should old acquaintance be forgot, and never brought to mind? Should old acquaintance be forgot, and old lang syne?”

It continues with several stanzas of reminiscences and ends with words of clasping hands, toasting the past of moving on together.

“And there’s a hand my trusty friend! And give us a hand o’ thine! And we’ll take a right good-will draught, for auld lang syne.”

So, This New Years Eve I share my reflections of 2011 and contemplations of 2012.

Reflections of 2011

2011 began with little celebration.  I spent New Years Eve alone in my hospital room, my son celebrated a thousand miles away with friends and my wife and daughter celebrated with best friends more than 150 miles away.  So I “celebrated” in solitude, no dancing, no confetti, no balloons, the only noise makers were various pieces of medical equipment that filled my room.

Briefly I reflected upon the year gone by and I contemplated what might be ahead in 2011.  My wishes and resolutions were simple.

“That Julie [would] feel not just the peace of knowing that I [was] okay but have the strength to endure the challenges that she face[d] as my caregiver.”  I resolved “to be alive on new years 2012.  To have the physical strength to remain eligible for a transplant and have the strength to recover quickly and return to life and supporting my family as soon as possible.” (Looking Forward, a New Year)

2011 did not unfold at all as expected.  What we expected to be another year of waiting for the transplant was cut short in May when my health suddenly declined.  Exactly seven months ago my life hung in the balance as near midnight I went into the operating room with an uncertain future.  The transplant was successful and I survived the surgery.  I was given a new beginning and a new life.  With that I was able to keep my resolution and I am alive on New Years 2012.  Not just alive but beating the odds and the expectations.

It is not possible to reflect on 2011 without feelings of gratitude for so many.  Friends who helped Julie and my daughter celebrate the 2011 new year and for a moment forget about illness, hospitals and an uncertain future.  For friends who generously adopted our dog for nearly two months while we moved to be near the clinic for my care.  For doctors, nurses, dietitians, psychologists, technicians and everyone else associated with my care.  To all of you and many more I can’t list,  Thank You, I am here is some part because of your efforts, kindness and love.

My greatest gratitude is to another anonymous family.  Who in the midst of tremendous loss that final night in May; chose to give the gift of life.  The gift that made it possible for me to keep my resolution and be here to reflect back on that night.

Finally, I need to express my gratitude to my lovely wife Julie.  She put her life on hold and made uncounted sacrifices to care for me.  She faced incomprehensible nightmares as day after day and night after night she faced the unknown alone.  She watched as I slowly died and came to terms with that seemingly inevitable reality.  She witness the miracle of medical science and anonymous generosity that brought be back from the brink of death.  She rode the unimaginable roller coaster what was our life in 2011.  She was always there, she always showed her strength.  Without her my fight, my will, would have died long before the transplant came.

Contemplations of 2012

As we celebrate this New Years Eve, it is like my first New Years Eve.  I look forward to holding Julie close as the clock strikes midnight and getting the kiss I missed last year.  The rest of the 2012 is a blank slate.  The options are endless.  Again my resolution is simple, on New Years 2013 to reflect back and see that I have been able to make a real difference in the life of at least one individual.

This New Years Eve I toast Julie by paraphrasing James Watson’s 1711 ballad:

Here’s a hand my dear wife! And give me a hand o’ thine!
Together yet we’ll raise a toast, to Old lang syne

My Heart is ravisht with delight, when thee I think upon;
All grief and sorrow takes the flight, and speedily is gone;

The bright resemblance of thy face, so fills this, heart of mine;
That force nor fate can me displease, for Old lang syne.

Today as we all pause and celebrate with those traditions that we hold dear may we reflect on others. Those who’s life may not be as “good” as ours. It may be filled with hunger, poverty, pain or illness.  Pause and reflect on the blessings of our own life and how we can share of our substance, our time, our empathy to those who may need these gifts at this moment.

This is the season when we remember that event over two millennia ago when God the Eternal Father sent his only begotten son to earth.  Sent him to the most humble of circumstances with the knowledge that he would lead a life filled with many pains and challenges.  The ultimate pain and suffering would come 33 years later on the cross on calvary as he gave himself as sacrifice for all of mankind.

I have many memories of Christmas as a child and of Christmas with my children.  But the most powerful memory is Christmas last year.  It is best described as a memory of what I don’t remember.  I lay in a hospital just emerging from a coma.  The memory is brief, a paper Christmas tree on the hospital wall, a gift from the children’s group at church.  My wife, my son and my daughter at my side.  I do not remember gifts, nor feasts.  Just those simple things, for a brief moment.  In that small wisp of a memory I realized what is really important at this time of year.  Our Savior and my family.

As we all pause this season, ponder the profound nature of our Heavenly Father’s gift long ago.  In the simplicity and magnificence of that gift we can gain a clearer perspective on the important things in this life.

For the past two years I have been largely isolated as I have faced my battle with end-stage liver failure. I did not venture to leave society as Henry David Thoreau did, yet I was isolated from society. While yet, I did maintained a strange and disjointed connection with the world around me.

My sense of isolation reminds me of the two years that Thoreau spent living in his cabin on Walden pond and his largely symbolic withdrawal from society. The cabin was only a mile and a half from the center of Concord Massachusetts and he had many visitors. He was also known to often walk into Concord, at times daily. None the less this was his retreat from society, his legend. His journal stated his purpose as “withdrawing to the garret… to meet myself face to face sooner or later.”

Though not by design or intent like Thoreau I have spent two years within my garret. This blog was supposed to be my diary, but circumstance prevented me from making but a few entries. Instead I have a collection of snippets of memory from which to draw my conclusions. To me these two years seemed to be consistent, predictable, a strange routine, a familiar dance. Each day seemed a copy of the previous. Now I see that it was actually a time of constant change. Each day was in fact a change from the last, some better, some worse. So, unrecognized, change was my constant companion.

Thoreau’s conclusion to his withdrawal was:

“If one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours … In proportion as he simplifies his life, the laws of the universe will appear less complex, and solitude will not be solitude, nor poverty poverty, nor weakness weakness.”

The conclusion to my story is yet mostly unwritten. I feel at time as if upon a river with an ever changing current. At times propelled rapidly toward an unknown destination. I believe Thoreau to be right. If we focus on our hopes, dreams and goals we will meet with success. My life until two years ago was a proof of his theorem. My mind was focused on what I believed I could achieve and in large part I had achieved all I imagined and in many cases against the odds.

The future is now a blank slate, I have a faint image of my dreams for the future but to achieve them requires change; at times even courage. So the first seasons of my life were driven by confidence, dreams and a sense of being unstoppable. The past season showed that I was in fact stoppable. It has shaken my confidence and left me a bit uncertain.

Today’s challenge is to embrace change. To refine and focus my dreams. To rekindle the confidence of my youth. Then “advance confidently in the direction of [my] dreams and to live the life which [I now] imagine.”

Today I sit in silence, the deep indigo ocean passes by my verandah, touched with shades of brilliant caribbean blue as the ship mixes air with the otherwise dark ocean and the sun peaks over the eastern horizon. We move slowly as we ease into port.

This Thanksgiving will be like none I have ever known.  I am far from my home and yet in some ways not so far. As we make port on the Dutch isle of Sint Maarten I am far from my physical home in Minnesota. But just inside my lovely wife lies sleeping. As long as she is near I am home and geography is irrelevant. Today will not be filed with hours in the kitchen and a house filled with family and friends. There will be no turkey and stuffing, no dishes to wash, no schedules, just peaceful relaxation and reflection. Just the two of us, on a distant island, half Dutch, half French a world apart from our “normal life.”

“Normal life,” what a concept, an ever changing moving and evolving perspective.  One that we can only appreciate through the lens of hindsight.  Thanksgiving 2009 I wrote about the Atonement, my wife, my family, medical science, tribulation and my bounty of blessings.  Those thoughts reflected “normal life” at that time.  A year later, we were fully amidst the season of tribulation and I was unable to share any personal thoughts of Thanksgiving.  Instead I shared the story of Chris James and his mothers celebration and giving thanks.  I had lost much of my mental capacity, I could not concentrate long enough to compose any type of personal message or reflection. This was now “normal life”.

So today another year has passed.  The season of tribulation, illness and suffering has also passed.  Not just my suffering but also the suffering of those around me, particularly the suffering of my wife as she has watched me slowly die and then in an instant recover.  She attended to my every need, cared for me and prayed for me.  She saw the ugliness that I can not remember, she dealt with the nonsensical and erratic behavior that was part of my hepatic encephalopathy.  She said good-by time and time again as an ambulance took me way, or in the door way of a hospital room.  She showed her strength as death seemed imminent  and it appeared her life would be changed forever.  There is no way I can imagine how difficult this past season has been for her, she bears scars that only another caregiver could possibly understand.  Several times a week she will tell me how nice it is “you can think again” or “I am so happy your brain works.”  Seeing the joy in her eyes makes me happy even though there is no way for me to understand.

Our lives have changed forever, not as is appeared they might on those bleak days in late May.  Rather it has changed forever by taking a different course.  A course of genius, recovery, new beginnings and new firsts.  ”Normal life” is now a fairytale, one of triumph, blessings and survival against the odds.  Remarkable recover, new beginnings, new changes, new directions and new life.

The things that I listed as gratitudes in 2009 are still the same.  But to that list I would like to add gratitude for my anonymous donor, and their family.  I want to express my gratitude to them for their donation and hope that they find comfort in this season by knowing of my gratitude and the new life they have given me.

Equally important I want to express my gratitude to Julie, she has stood by me for these past 26+ years, through sickness and health, poverty and wealth.  She is my greatest joy, the light the brightens by days, my pillar and my love.  I look forward to spending eternity with her, and in some measure repaying all that she has done for me.

As I feel the ship pull snug against the pier I need to go and wake Julie.  Prepare for our day, for our celebration.  We have called this cruise our “Celebrate Life Cruise”, our time to rest, relax and recover from the seasons passed.  To contempt the blessings which have been our bounty this year.  A time to focus on our new future and the many possibilities that lay ahead.

Today as you gather with your families and friends or perhaps celebrate alone.  Pause and reflect on the past and the future.  Your life may be filled with bounty and all you dream of, give thanks be tomorrow it may change.  Your life may be filled with pain, suffering, trial or tribulation, but amidst all this there are blessings, little jewels for which you can be grateful.  Polish them and hold them and give thanks, for tomorrow it may all changes and the pains and suffering of today may fade for a new and different future.  The the gems of gratitude are the building blocks of our lives and our character. Like diamonds the most precious are rare and formed under tremendous heat and pressure.

Each year over 500,000 unique patients from every U.S. state and nearly 150 countries go to Mayo Clinic for diagnosis and treatment. These patients and their families and friends, and 50,000 employees and students are part of a global Mayo Clinic community.

We feel very grateful to have been a part of this community for the past two years.  But our relationship is not ending, through employment and volunteer work we will remain a part of this community for the foreseeable future.

Our interviews were released today and are feature below, but please visit the Sharing Mayo Clinic blog to see other stories and learn more about what is far more than a world class medical facility, it is a culture patient focused health care, research and excellence.

Liver Transplant + Bariatric Surgery = the New Marshall

Marshall Curtis was diagnosed in 2009 with end stage liver failure and cirrhosis secondary to Alpha1 Antitrypsin deficiency. Obesity and encephalopathy were additional challenges confronting the Mayo team. He was recommended for a new study program combining a transplant and bariatric surgery to improve his chances for a transplant and long term survival. Listen to Marshall and his wife, Julie, tell how close he got to death and how this experience has changed their lives. This is an absolutely remarkable story!

 

We want to express our gratitude to the innumerable members of the Mayo Clinic staff, volunteers and community that had any measure of participation in my care, treatment and recovery.  This interview was only possible because of their diligence, care and support for both my medical needs and the emotional needs of my family.

There is a crisp chill in the air that takes me back to my boyhood and autumn mornings walking to school.  The satisfying crunch of leaves beneath our feet as the wind swirled them along our path.  In the orchard were fallen apples that we would kick as far as possible. The rotten ones would just explode covering our shoes in a layer apple slime.

Seasons and the changing of seasons are the basis for many analogies, life has been compared to the seasons, periods of major accomplishment are often called seasons and sometimes abstract periods of time are sometimes called seasons.  So as summer yields to fall I reflect upon my past “season.”  A season that has lasted for over two years, a season that has transcended the natural seasons of nature, the changes of weather, the falling of leaves, the snows of winter and the springing forth of new flowers.  This has been a season of turmoil, a season of pain, both physical and phycological, a season of uncertainty and a season of perseverance.

Now I am again aware of the change in nature’s seasons and also aware of the change in my season.  The season that has been a struggle for life itself has passed.  Slowly weekly appointments with doctors and labs are being left behind, just as the trees are loosing their leaves.  I am returning to work, to new adventure and new challenges and just like the change in seasons to a bit of the unknown.  I feel a slight sense of melancholy, while this was not a season I wanted it none-the-less became familiar and so with its passing is the same melancholy as the passing of the heady days of summer in my youth.

The air is filled with fowl of all kinds returning to their winter homes and I am reminded of the migrations in my own life.  Family and friends have flocked to my side to cheer and support me.  Like the summer songs of birds they brightened my darkest days.  Now as this season passes they too are migrated back to their homes and individual lives.

Together, a path of possibilities... a distance horizon

What extends ahead is uncharted, everything is again a first.  Julie has seen me through this past season and now together we look forward to a new season of nature and our life, to the many new firsts.  All we can see ahead is a path fading into the distance.  A path of possibilities.  Together we are moving forward toward that distance horizon.  Together we have met the challenges of this past season and together we will we will find joy in this season of fall and in the seasons of our lives that are yet to come.

A 2010 motion picture “Inception” dealt with the topic of memories and dreams and real vs. unreal and how the reality of our surroundings can be manifest in dreams.  An irony is that I saw this movie with my family at the time of its theatrical release, but I have no memory of it.  A few weeks ago we sat down to “re-watch” it on DVD, or in my case, for what I remember as the first time.  The add to the sur-reality of this situation nothing sparked even a glimmer of a memory.  The entire movie was new to me.  Even stranger was that most of my comments or observations about the movie, plot or filmography were greeted with “that’s what you said last time”.  The basic plot of the movie was the elaborate means that were required to “plant” the inception of a memory, an idea and make it feel real to the target.

At the worst points of my encephalopathy I would drift between reality and a semi-conscious dream state.  Many of these dreams felt more real than consciousness and the reality of my surroundings would play into my dreams.  As I have began navigating the labyrinth of dreams and memories that represents these past two years I have seen how many of these “dreams” were based on reality but took on added dimensions and details.  Simple conversations that consisted of a few words or phrases became elaborate and lengthy discussions in my “memories.”

As I review the collection of photographs and try to put together memories of the past couple years and filter out the “dreams” I feel like a target of a poorly planned “inception.”  I am left me with many memories that feel as foreign to my mind as my new liver is to my body.

One of the last vivid, real and clear memories that I have prior to the transplant was that of hundreds of crows that would come to roost in the trees outside the Gift of Life Transplant House where we were staying.  This was January 2011 and was a very unexpected sight, I has just been released from the hospital after spending most of the time between Thanksgiving and Christmas in a coma.  This had a strange on ominous feel reminiscent of Alfred Hitchcock’s The Birds.  So this was the starting point for my short, dramatic one minute video that summaries the six months.

Marshall and the Mayo Brothers, 105 days post transplant - 15 Sept 2011

It was 27 months ago, 9 June 2009, that I was diagnosed with liver cirrhosis, 25 months ago the cause of the cirrhosis was diagnosed as Alpha1-Antitrypsin deficiency.  At that time the doctor told me I had about two years to live without a liver transplant. This thought would haunt me for the next 22 months. Three months ago my condition had suddenly become very grim and the possibility that I would not see today had become suddenly real.

Throughout this two year journey I had held tight to my faith.  I had received several priesthood blessings and always felt or assumed that I would receive the needed transplant and survive.  This is not to say I was without periods of doubt or challenge but through all of these lows it was my faith in the Savior that gave me strength.  As my health took a sudden turn for the worse in mid-May, I held tight to my faith, but as the end of the month approached my organs began failing and I was moved to the ICU and spent most of my time drifting in and out of consciousness.  I became very aware of my mortality and that my days were at an end.  I was troubled by this realization which seemed contrary to the blessings and feelings that I would survive.  It was at this point that I remembered hearing a talk by S. Michael Wilcox about answers to prayers and the Lord’s timing.  This talk was given just days before my initial diagnosis.

He spoke of Christ and his disciples and the struggle of the disciples on the Sea of Galilee after they He had fed the 5,000.

“And when he had sent them away, he departed into a mountain to pray.  And when even was come, the ship was in the midst of the sea, and he alone on the land.  And he saw them toiling in rowing; for the wind was contrary unto them: and about the fourth watch of the night he cometh unto them, walking upon the sea” (Mark 6:46-48)

The hebrew night is divided into four watches.  The first watch—sunset to nine,  the second watch—nine to midnight, the third watch—midnight to three in the morning and the fourth watch—three in the morning to sunrise.  The disciples had boarded the ship and set to sea at sunset, the beginning of the first watch and were met with rough seas and “contrary” winds.  This verse illustrates that Christ saw the disciples struggling on the water as he was upon the mount praying but did not immediately intervene.

Christ chose to let his disciples “toil” and struggle with the “contrary” winds and rough seas as a point of instruction.   So, he waited until “about the fourth watch” before he went to them and demonstrated his power walking upon the water and calming the seas. He was teaching them that he is always near and is aways aware of our toils, trials and struggles.  But for the disciples to learn this principle they had to “toil” and struggle on there own to recognize the need for the Savior and the strength and power he couple provide.  I realized I was being taught this same lesson.  I had spent almost two years “toiling” with my “contrary” winds, I had faith in the Savior but only through that toiling and the realization that I might perish could I fully appreciate the blessings that were at hand.

So on the 31st of May 2011 I stood at the veil between mortality and the eternities.  I had pronounced my final blessings upon my wife and children. This was not the out come I had expected but I put my faith in the Lord and his will.  I was at peace knowing that at any time I could be beckoned through the veil and leave this mortal life.  For me and my two year journey it was the final hour of the “fourth watch”, my very hour of need and as with Christ’s disciples I was comforted, protected, the storm about me was calmed.  If was beckoned not through the veil but away from it and the promised blessings came in that hour.

So today with gratitude in my heart for my Savior, my donor and their family I celebrate my 48th birthday.  The birthday that almost didn’t come.

Looking Forward, a New Year - 1 January 2011

A Mother’s Decision to Give Life – 25 November 2010

Activation Milestone – 10 October

Living Donors – 30 April 2010

Please take the time to read Julie’s post “The Gift” and consider if you are willing to give the Gift of Life, you can make a difference!