My best friend in Austin, Jennifer Berliner, died today (May 23, 2022). She was a heart transplant survivor and 44 years old. She and Adam, her husband, had just celebrated their twentieth wedding anniversary.We met playing euchre and hand-and-foot canasta and I encouraged her to start her blog, www.anewheartrocks.com. The post below is from Jenny’s blog and written some time ago. At one point, Jennifer wrote: “Honestly even if the end game is death, at some point that is okay too. Death is not a personal failure, it’s a biological ending. If I die, I won’t take it personally.”
Rest in peace, Jennifer. You fought the good fight. I will miss you, and so will the rest of your tribe.
“Maybe if I can shed light on how I endured a heart transplant, cancer and the death of my mother all at the same time, then maybe it could bring comfort to others facing their own adversity.
I’ve danced with death for so damn long that sometimes it’s work to remain optimistic, but I try. So many things are out of my control, and this infuriates me. In the face of these challenges, how do I instill hope in myself and others?
God, grant me the Serenity to accept the things I cannot change, the Courage to change the things I can, and the Wisdom to know the difference. ~The Serenity Prayer
I wish I could share some recipe with how I overcame my adversities, unfortunately my recipe is complicated and unique to only me, the chef. No one wants to hear that it takes time and persistence. People want a quick fix, a panacea, and I don’t blame them. When you’re in pain, you need it to end quickly. Maybe from my list you will walk away with one or two strategies that I know helped me to go from surviving to thriving.
How I Avoided Death in 10 steps:
My top 10 survival guide is listed in random order, except number 1, because it’s the most important and that is: Do not attempt this on your own. Humans need other humans. If we are left alone we will die. When you are faced with insurmountable adversity, you need one person who will walk with you on this bumpy road.
Admittedly that one person can get exhausted, so ideally you need several people to
support you and walk at different times. A support system or what I call “my Tribe” includes my family, friends, fellow congregants at my synagogue, and friends from my card clubs. (I love playing cards. I’m 43 years old, but I’m really an old lady on the inside).
- My Tribe:
There was a time I begged for death. For months on end, during my Chemo to treat bone cancer, I contemplated dying. I only survived that experience because of the love of my family and friends. Then when I was faced with a heart transplant, my family was still at my side, and now I also had a husband who became an amazing caregiver. Adam spent months in the hospital with me. He was exhausted and yet his commitment never wavered. My sister also helped me out significantly during this time when I lived in her home for two years. And my friends, were incredible.
After my first battle with chemo, I made a pledge to myself that I was going to have good friends by being a good friend. Twenty five years later, these same friends were at my side. Taking time away from their jobs and children to put on gloves and stay days and nights with me in the transplant hospital. Incredible.
I have many people I love, so I will endure any pain to remain on this planet to be with them; likewise, their love keeps me afloat. A good support system is vital to my existence and well being. If you don’t have a support system, a good place to start is to get yourself to a place of worship. The community will surround you and it will lift you up in ways you can’t imagine.
I’ve been in counseling on/off for most of my life. I need guided relaxation and hypnotherapy to get me through painful procedures. Then I need the talk therapy to get past the trauma.
I’ve also had to learn (and still relearn) coping skills to get me through the traumas I’ve experienced. We are not born with inherent knowledge of coping skills, they are all learned, so I go to counseling at different times in my life. I’ll keep this one short and sweet, you get the idea.
Ok, medication is really how I should title this section, but you get my point.
I don’t take anything that isn’t prescribed because I am a transplant recipient and even a herbal mouthwash can prevent my anti-rejection medication from working. With that said if I’m in pain or facing an uncomfortable procedure, I will not let a doctor or nurse shame me into thinking I’m not brave (I’ve already proven I’m crazy brave).
I am no longer willing to soberly submit myself to a drill in my back (bone marrow aspiration) or a 2 hour MRI (in a casket). My mind and body have their limits and if medication can help, then I’m taking it.
I don’t know how or where I mustered the ability to endure Chemotherapy at age 15. This was my first big test with adversity. I fought everyone and everything the entire time to avoid my chemo treatments. I mean, I literally would run away and have panic attacks to avoid my Chemo, but somehow I just kept going. I think got my resilience from my Mum.
My Mum was always at my side cheerleading me on while she received more than her share of mistreatment and suffering. My Dad also spent countless nights at the hospital. The scales were terribly unfair towards both of them, but particularly towards my Mum because I lashed out at her the most. I was rotten and had terrible coping skills, but somehow she persisted too. I think like a cub I just followed my mama bear. The biggest gift my Mum gave me during this time was being with me, so that I wasn’t alone. This empowered me, fueled my grit and gave me the ability to keep the course. Misery loves company.
I also focused on the idea that there’s light at the end of the tunnel, that someday this Chemo will be over or that I will heal from my heart transplant. Honestly even if the end game is death, at some point that is okay too. Death is not a personal failure, it’s a biological ending. If I die, I won’t take it personally.
5, Goal Setting & Rewarding Myself:
My idea of setting goals happened organically. I was refusing Chemotherapy at age 15 and I bribed my parents for money over the course of many months to help me buy a car. I’m not proud of this manipulation, but we both got something we wanted out of the deal. They got a more compliant, less hostile patient who did her Chemo and I got to dream about my car and freedom. (My car was an old beater and I loved it).
Since then I’ve kept my eye on the apple. I have set many goals in my life and achieved every single one of them. It takes time, patience and mindfulness to set and achieve your goals. These steps can be slow with setbacks at times. However, the reward is sweet.
I’m still setting goals, most of which include traveling somewhere. On my bucket list after my heart transplant is going to Paris. This is a big one and I’m hoping to go next year. I’m planning now for it.
6, “It Could Be Worse” & “Not Sweating the Small Stuff”:
I’ll use bumper sticker mantras any day if will help.
Not sweating the small stuff is easier said than done. The more I’m faced with challenges, the more I have to let some things or even relationships go, so that I have the energy to battle with the life and death issues in my life. Some might say, that I have developed a fuck-it attitude or that I don’t care. This is actually not true, I care so much that I have to walk away sometimes or I will make myself physically sick from worry. I have to set boundaries sometimes, and these lines can be tough to draw.
“It Could Be Worse” is a mantra I’ve used many times to get me through painful procedures. Like an athlete before the big game, I have to use self-talk to get ready to do a procedure, like when I talked myself into staying strong right before going in the OR for my heart transplant. I was tearful at the idea that my unknown donor died leaving me such a profound gift. I was so grateful that I had a heart. I spent months exploring this issue in therapy. And when it came down to it, I thought it could be worse: my donor could’ve died with viable organs and not be an organ donor and I wouldn’t have a heart. It really could’ve been worse.
In the meantime, I encourage you to consider what mantra helps you and is uniquely you?
I was born at the right time, in the right country with the right resources.
I was born in time when Chemotherapy was available and had been honed over 25 years to become more effective at curing childhood cancer. Then when I needed a heart transplant many years later, Cyclosporine (an anti-rejection drug) revolutionized the body’s ability to keep the transplanted organ, increasing my chances of survival.
Finally, not many want to hear this but this, but it’s the brutal truth–I was born with access to the right financial resources. I could afford health insurance and I was born in the United States, which performs 66% of the all the transplants in the world.
In many ways, I won a lottery. The odds that I slipped through the time-space continuum to make all these things happen, which have contributed to my ability to cheat death, not once or twice but three or four times is incredible.
I can’t not explain my luck other than the circumstances of my birth. I have deep gratitude for my position and realize that many others at home and around the world do not have my opportunities.
I know that time also makes a difference and I’m mindful to honor those they went before me. My paternal grandfather died at age 36 in the 1960s with his “body riddled with cancer,” per his autopsy. I suspect he had the same heredity cancer than I had (something I only discovered in the early 2000s, thanks to the Genome project and the advent of the internet). My grandfather and others like him, endured great suffering to help our medical advances.
American values teach us that if you work hard enough, your merit will be rewarded. However, I believe that luck also plays a part in making someone’s dreams come true. Well how do I get Lucky? I don’t know, and for that reason I apologize that Luck is even on my list of how I cheated death, because you can’t recreate luck. It’s unfair.
- Violence Fast
For years, I avoided internet searches and I didn’t watch any videos about Heart Transplant prior to having the surgery. That’s pretty unbelievable when you consider I read reviews just to buy new bed linens. When it came to transplant, I was too scared. This surgery is not optional and I just had to plow through it, so why get bogged down in the gory details. Ignorance is bliss.
Instead I met face-to-face with a few heart transplants recipients that I met through friends (we’re a small community). Interestingly they all approached me the same way. They told me briefly about the what’s, why’s and where’s but when it came time to really get down to the details, they said “ask me questions. Every person’s experience is different, so rather than me just go on and on, ask me your questions and I’ll tell you my experience.” Wow, this blew my mind. Especially, now that I’m on other side, I understand why they approached our talks with opened ended questions and avoided advice giving.
Everyone has their own journey. When I mentor a pre-transplant recipient, I don’t offer advice, instead I listen, I validate, I empathize and I share my feelings. Ok I will offer this advice, when in the hospital always pack an extension cord, so that your cell phone can be in the bed with you and you can reach it. Jokes asides, no one can predict how well they will do during the transplant, so all I can do is sit beside them on their journey, and perhaps my presence encourages hope that they will survive and thrive too.
Laughter really is the best medicine. During my darkest days, I find that I watch the most vapid, silliest TV shows or read trash novels. I don’t have the heart for violent movies (pun intended). But give me back-to-back episodes of “Schitt’s Creek” or “The Derry Girls” and I’m a happy woman. I need light hearted humor and laughter to offset my tears.
Prior to my transplant, I was crying a lot. I was depressed and grieving my Mum’s terminal cancer diagnosis. My brother-in-law, a funny guy, set his ring tone to a woman sobbing, so that when I called he heard tears. He said he wanted to be prepared to take my calls. I quickly stopped sobbing myself and laughed until I was out of breath. The Greeks taught us that Humor is a powerful antidote to Tragedy.
The secret to Humor in the face of adversity is that you have to actively seek it out. Be mindful to block media that takes you down and instead focus on the stuff that lifts you up. Yes, I am telling you to binge watch your favorite TV shows.
- Asking for Help & Self-Care
The first time, I reached out to ask if friends could make meals felt awkward and embarrassing. I couldn’t eat restaurant food because it was too salty, so food had to be prepared at home during my quarantine. I was physically incapable of cooking, my sister & her husband both had full time jobs and a baby, my Mum had cancer and my Dad was her Caregiver. My husband worked in Austin three hours away and when he was in town over the weekend, he would make low sodium casseroles to last for the week. But if he couldn’t cook them, we had a challenging week.
When a friend said to me, “let me know how I can help you,” I wasn’t prepared. Don’t let the moment just flitter away in fear and awkwardness like me. Be prepared for a real conversation the next time this question is asked. Consider replying with, “Well, how or what do you think you’re up for?” Then be ready with a small list they can choose from: meals, babysitting, yard work, driving or attending doctor’s appointments.
Most of your loved ones may be unsure of how to help you. Each person has a desire to help, combined with some sort of skill that can be brought to the table, so take a moment to consider their best role. My neighbor adores dogs and she was invaluable to us with last minute pet sitting that turned into weeks at a time.
Asking for help is a form of self-care, but more specifically the act of “self-care” is doing things that make you feel better. Maybe it’s taking a walk in the park. Ok, well with Congestive Heart Failure it might not be a walk, so take a beautiful Sunday drive.
Me, I love to go to the movies. For those two hours, I get to escape and enter another world. My dad and I would go to the Dollar Theater once a week when I was in chemo. We snuck in candy from the nearby Walgreens. The whole ritual was fun and a diversion from my grim reality. Caregivers, just as much as the patients, must engage in self-care to combat Caregiver Fatigue or Exhaustion. The point of self-care is to actively pursue JOY. So it is my hope for you, especially during times of adversity, that you are mindful of experiencing JOY every day.
Bonus 11) Try to be “OK” with not knowing….
I’ve talked to many people facing a heart transplant and the answer they really want, that they need to hear is: Am I going to live? Am I going to be ok?
No one, not even the doctors can give a straightforward answer on your mortality. Sitting with the anxiety that your dying (that’s the only way to qualify for an organ transplant), compounded by the lack of knowledge of when you’ll get The Call for the transplant surgery, only to then consider if you’ll live through the surgery…well, this will make you lose a lot of sleep. You may experience restlessness, anxiety, bouts of crying and maybe even agitation at times. This is normal considering the extraordinary circumstances you are under as you wait for an organ transplant.
Connect with someone who’s had a transplant or is in the chemo chair next to you. If you’re on the other side then consider mentoring someone on the wait list. Your hospital social worker or nurse coordinator can make introductions. Or join a Facebook group in your area for your specific issue. When you’re facing a medical crisis, you realize that the community attending your hospital is relatively small.
You do not have to do this alone. And there will be moments when you will be in the dark and it’s feels vulnerable, annoying like info is being purposely withheld (it isn’t) and ultimately, thoughts wander to those of death and dying, another thing out of your control. Take deep breaths, cry when you need to cry, and consider what coping strategies you can use to get you through moments of anxiety. Me, I would call or text a loved one or a friend.
In closing, find comfort in both prayer and the science behind the medicine. Transplant recipients are chosen for the likeliness that will do well in the surgery. Check your transplant program’s surgical outcome rates, they should be posted everywhere. Finally, remember you are surrounded by your medical team, family, friends and supporters from all over the world rooting for you.
If you need to chat or you have questions, send me a message or email. I read every comment and reply.
Thank you for taking the time to read this blog post. I hope that in some small way it helped lessen your burden for whatever troubles you are facing.”