BALANCING ACT
"Ross, Rachel, I commend you both for offering to donate a piece of your liver to Emma, but-"
"Have you decided if she's taking a piece of my liver or Rachel's? Which would be better for her? Which is more compatible?" Ross interrupted, wringing his hands nervously.
"I'm sorry Ross, but the truth is, we have to postpone the liver transplant, because I'm not confident Emma will survive the operation if we have it now. Her body is still reeling from the effects of bowel reconstruction surgery," Montgomery apologised.
"But Em needs this surgery, she can't survive with what little liver she has left, you said so yourself!" Rachel croaked, tears brimming her eyes.
Montgomery squeezed Rachel's hand sympathetically, "I know, Rachel, but I cannot provide the transplant unless I am confident that her body will be strong enough to physically accept the new liver. Given that-"
"Hang on, you people have anti-rejection medication for that," Ross interrupted, anxious and agitated.
"The anti-rejection medication is a necessity for Emma's body to accept the liver, but it is not a guarantee. Her body will reject the liver unless her health improves. The only option is keep her on the IV sustenance regime, and undergo further physiotherapy sessions."
"No, no, but Dr, that's just it, she can't recover without the transplant! You can't tell me the only way she'll survive the transplant is if her health improves, when it refuses to improve without the transplant! That's a catch 22!" Rachel's voice cracked with emotion.
Montgomery nodded sympathetically, "I know Rachel, I'm sorry, it is a catch 22, but I can assure you, now is not the time for Emma to undergo the surgery."
"But she's circling the drain, you've seen her, she hardly has any energy and strength to get out of bed, let alone undergo more physio sessions… her skin, and the whites of her eyes have turned yellow. I know it's the ultimate sign of liver failure… Just please, you have to let get her into surgery," Ross pleaded desperately.
Montgomery shook her head slowly, "I'm sorry Ross, I can't. I've upped her IV sustenance regime, since she's struggling to keep food down, and has very little appetite. The physiotherapist has drawn up an increased regime."
"So what are we supposed to do? Just sit here and wait while she suffers?" Ross whispered, heartbroken.
"I'm afraid so. Organ transplants are significantly more taxing on the body than the other operations Emma has undergone. A transplant involves introducing a foreign object into a body. Given that Emma is already struggling to cope with wounds of prior operations, if I introduce a new liver, her immune system will kick into overdrive and attack the liver, and attack her. That new liver would destroy her from the inside out, her chance for survival would be slim," Montgomery explained.
Rachel buried her face in Ross's shirt, her body shuddering with sobs. Ross closed his eyes in devastated agony. "I believe that with hard work, Emma can get to the level of health necessary to survive the transplant in three weeks."
"Three weeks," Ross gasped. "Can she survive three weeks on her liver?" Ross whispered anxiously.
"I don't know Ross, but I do know that the likelihood of surviving three more weeks is significantly higher than surviving a transplant surgery now. Right now Emma's treatment is a balancing act. We cannot operate too soon or she will not survive; but if we don't operate soon enough she will not survive." was the doctor's honest reply.
"A balancing act," Ross nodded soberly.