"Second Chance: A Doctor's Journey through Liver Disease and Redemption"
("Surviving the silent killer)

For as long as I can remember, my life has revolved around medicine and food. There was an unadulterated joy in relishing the delicacies of my Eastern European heritage. But my ever-indulgent lifestyle was taking a toll on my health, and it was in 2004, that I came face-to-face with a silent adversary: a diagnosis of fatty liver infiltration. My journey with the weight of this looming ailment started from here, an odyssey that unfolded over the years.

In the scorching summer of 2004, while most folks reveled under the hot sun, I visited Dr. Ronald Weiss. Known as a beacon of Holistic Medicine, his consultation became a turning point in my life. My initial laboratory tests revealed elevated levels of LDH (Lactic Dehydrogenase), a premonitory sign of liver damage on the horizon. To put it into layperson’s terms, it was as if red flags were raised, demanding an immediate course of action.

Dr. Weiss, however, didn’t prescribe a barrage of drugs. Instead, he recommended a remedy from nature: a plant-based diet. He handed me a one-page guideline, as straightforward and clear as the warning before my eyes – change your lifestyle, he said, and your body will heal.

But old habits die hard.

At the time, the concept of a plant-based diet seemed foreign and restrictive. After all, I was accustomed to devouring my way through over 10,000 calories daily! My stomach protested with visceral dread at replacing my beloved pork chops and latkes with green leaves and lentils.

Despite my initial resistance, Dr. Weiss insisted. He suggested I view the documentary ‘Knives Over Forks,’ a film showing compelling evidence of the myriad health benefits of a plant-based diet. It was meant as a gentle push, an enlightenment to sway my skewed perspective on nutrition. However, I neglected his advice and continued my food escapades, ignoring the ticking time bomb within me. Unfortunately, human nature possesses an uncanny capacity to brush away the most glaring truths, and I was no exception.

On the surface, my indiscretions have no downside. Miraculously, my body maintained a steady basal metabolic index. But beneath this deceptive exterior, the danger lurked. The levels of LDH in my bloodstream were persistently elevated. It was as though my body was trying to warn me, pleading to amend my ways before it was too late.

It was the week before Christmas 2019 when reality bit. It wasn’t the jingling of the holiday bells or the sparkle of the festive season that awakened me. It was the sharp pang of pain and a sense of dread that something was wrong. Very wrong. That’s when I faced the stark reality of my health. I had been playing a dangerous game with my well-being, one I was on the brink of losing.

Looking back, the years have been tough, but they have also been an enlightening journey. I would like to continue this. It was a regrettable truth that despite my medical background, I discounted the remarkable power of preventive medicine, a force well within our reach: our diets. Yes, it took a hard knock, a painful twist of fate, for that realization. But fortunately, it is never too late to mend. Today, I find myself on a path of healing and growth, slowly recovering scars from my past gastronomic follies.

In the clinical, impersonal confines of the urgent care facility to which I had committed my life, no one anticipated the dangerous, silent enemy quietly waging battle with my very being. It was about six years back when my fellow warriors in the medical field (you’d know them as nurses) recognized something was amiss.

In the bustling din of our urgent care center, the sharp-eyed mavens of medicine – nurses – noticed a troubling change in my step. This was out of the ordinary, for Doctor Michael Baruch is known for his relentless walk. This uncharacteristic stroll served as the second red flag, fearfully waving atop the tranquil landscape of my health’s history.

I conceded to a long-overdue appointment with my physician, praying for enlightenment in this shadowy uncertainty. The bloodwork reports that came knocking carried unexpected, frightening results – a blood-glucose reading of 347. This figure was alarming, pulsating with an urgent call for action. “Three hundred and forty-seven, that cannot be,” I uttered in disbelief, peppering an awestruck me.

The urgency escalated. Evelyn, the director of the urgent care center, held her breath as she broke the news that a test to ascertain my A1C was being dispatched. The result was staggering: 13.7!

This was a dramatic contrast to the usual figure of less than 5.7. In a chilling moment, I was on the receiving end of the healthcare spectrum. Now, I stood as a patient rather than a caregiver, preparing for an unrelenting battle against the invisible enemy – diabetes.

Swiftly, I was armed with a stringent diet devoid of carbohydrates and sugars. My pharmaceutical aid came from Metformin and Prandin, my new allies against this silent war on diabetes. My blood glucose levels were tamed in just three months, landing safely around 100, and my A1c was back in check, proudly standing at 5.7.

However, the victory was premature. Despite the detailed turn of events that saw my glucose levels steadying, I regrettably strayed from my diabetic diet regimen. The numbers soon danced erratically, revealing my faltering discipline.

Recognizing the need for more formidable support, I turned to an endocrinologist, a warrior specializing in internal battles. Taking the offensive, he prescribed two new types of insulin to aid me in this fight. And so began Dr. Michael Baruch’s brave, daunting journey through treacherous medical territories while standing on the battlefield.

The year was 2018, and as a medical professional, I found myself wandering through the stressful terrains of life, unable to shake off the persistent feeling of burnout that had somehow taken hold of my vivid consciousness. Concurrently, my moods began exhibiting a discordant rhythm and, with unexpected dismay, I realized the early symptoms of hepatic encephalopathy were manifesting in my being.

Hepatic encephalopathy, a dark horse in the broad landscape of medicine, is a condition frequently triggered by an accumulation of toxins within the bloodstream. Its elusive nature has led the medical community to concede that its precise cause is unknown, thus further shrouding its existence in an unsettling cloak of mystery.

Now, let me explain. This disorder rears its ugly head when the liver, the body’s despatcher of harmful toxins, fails to marshal them into oblivion successfully. Notably, it’s usually the innocuous ammonia that is left circulating throughout the body, thus setting off biological alarms.

An aspect of this disorder becomes incredibly compounding when the auditory and balance functions of the body start to falter. A degradation in auditory acuity is one thing, but when you factor in the sheer unfairness of losing your ability to balance, it’s pretty unnerving to say the least.

However, in 2018, my life as a physician was still dominated by the contingencies of the moment: the unending prospect of alarming phone calls, the atypical sleep patterns, and the persistent belief that the next emergency was just around the corner. That constant concern about the lives slipping away unnoticed in the dark of the night carried me through periods of sleep deprivation. And not surprisingly, this sleep deprivation led to a reversal of my physiological discourse – trading nights for days and living in an almost nocturnal existence.

And yet, despite this upheaval of life, I failed to condition myself for the potential signs of trouble. The signs of hepatic encephalopathy lay in my slowing typing speed, in my decelerating mentation, and in my enervating speech.

Was this the first step towards Alzheimer’s, I wondered? Finding myself struggling to retain simple facts, I resorted to the usage of the alphabet trick – an innovative mnemonic-based alternative to enhance memory retention – to aid my rapidly declining cognitive functions.

As a physician, the question that kept gnawing at my sanity was, how could I have missed these signs that played out blatantly under my stethoscope? How could I, a medical professional, fail to diagnose on-time, the early signs of hepatic encephalopathy in myself?

Recognizing these early signs should have been a stark wake-up call that something was about to take a swing at my stature, but the tragic irony of the situation was that even when the signs were within reach of my diagnostic purview, I, like many who walk this earth, failed to see them as the precursors of a life-altering disorder.

In the year 2018, I found myself in the throes of uncertainty, fighting a biological enemy within. It was an endeavor not only to wrestle the disorder but also to endure the slow and agonizing process of self-discovery – a fight I was determined, yet terrified, to bear.

In the grand scheme of the unpredictability of life, there was one seemingly innocuous day that imprinted itself mercilessly into my memory. Home had suddenly turned into a battlefield that I was physically losing against. Not once, or twice, but five perilous times, I tumbled over. I hadn’t found myself clashing against the inviting coziness of my office chair or the familiar terrain of my house; I had fallen in the austere steel grip of a parked Jeep Wrangler that resided in the underground garage of my residential building.

The insignificant slip cost me a laceration on my left eyebrow and more worryingly, the dignity I had been painstakingly accruing for years. In that moment, morphed into a hapless mess of pain and desperation, I had never felt more thankful for a single man – Steve Jobs. As I cradled the Apple iPhone he had birthed into this world, I pressed the call button for security, imploring them to come to my aid.

Humility is a tough pill to swallow, a bitter drink that finds its way down your throat when you least want it. That day, as I found myself ushered into the safety of my own apartment, surrounded by the flashing lights of paramedics, the anxious countenances of my friends and family, my ego lay shattered on the floor, much like my body. But it was in this labyrinth of fallen dignity and stripped pride that my wife, Sandra, held me together and got me safely to the hospital.

“Dr. Michael Baruch – In Residence” – that’s what they could have put on the door. I spent five relentless days within the imposing walls of the hospital, subjected to a plethora of medical examinations. My body felt like an open book that was being pored over, poked, and prodded at every juncture. Fate’s ironic humor wasn’t lost on me as I tumbled over, yet again, in the sterile, white expanse of the bathroom.

However, in the world’s darkest corners, light finds a way to seep through. As I felt myself losing to the confines of my physical plight, silently writhing in pain on the hospital bed, my Mother-in-law Beatrice, and my wife Sandra guided me towards a shimmering beacon of hope – the best hospital in the world.

It was here, in that world-renowned hospital, steeped in the aroma of medical sterility and latent healing, that I embarked on the most incredible journey of my life. False starts and abrupt pitfalls had led me towards an entirely different path, a winding route that introduced me to the most exceptional individuals – healers, companions, and warriors. I found new frontiers in myself, overcoming physical pain, braving emotional turmoil, and with the help of my array of medical assistance and a cane from a therapist, found myself standing upright against life’s sweet cruelty.

The pages of history are strewn with fallen men like me, stumble, but rise up stronger. I am merely a humble foot soldier in this vast army of the fallen. My battlefield may have been my own body and my opponent might have been my failing strength, but I had an army behind me. And it was on the battlefield that I embarked on life’s grandest adventure.

March 2020 marked a seemingly ordinary day that quickly turned extraordinary when I found myself before two exceptional medical experts – Dr. Lorna Dove, a prominent Hepatologist, and Dr. Jean Emond, a world-renowned transplant surgeon.

I was 68 years old. Vibrant and accomplished, teaching young Plastic and Reconstructive surgeons and orthopedic surgeons the various intricacies of the medical practice was my forte, my life’s calling if you will. My station that afternoon, however, posed a completely different challenge.

In a room filled with the subtle scent of medicinal disinfectant, Stan Getz’s jazz strains faintly wafted in the air, my eyes fell upon the examination table – the omnipresent fixture of every doctor’s office. An ordinary piece of furniture under normal circumstances, accusatory even, standing silently in the corner of the room, it beckoned me. I approached it with unchecked trepidation, no handrails for support, no one to lean on, and a balance as fair as a rough sea in a storm.

A few mumbled greetings later and the examination formally began. I could feel Dr. Emond’s cool, experienced hand lightly pressing against my upper abdomen. His quiet, calculating expressions were in stark contrast to the bombshell he was about to drop.

“You have no liver left”, he said, as casually as if stating that Labor Day was coming up. The words hit me like a gong in a silent cathedral. “No liver…gone?” How could that be?”

What followed was an enlightening discourse on NASH or non-alcoholic steatohepatitis – a fancy medical term that in layman’s language spelled a fatty liver from eating the wrong foods. The prognosis was dire. I would need a liver transplant.

How often do you hear those words and not think of a loved one lying in the hospital, young and full of potential, battling for their lives and pinned against an unrelenting disease? Or a retiring man, reflecting on his past, his triumphs, his failures, his regrets, and being told – you are out of your liver, pal.

Before I could fully digest the gravity of this reality, a flurry of pages, filled with instructions and booklets to read about the procedures and tests I needed to undergo, were handed to me. This was to be my routine before becoming a candidate for the liver transplant list.

The doctor advised me not to drive and to temporarily idle my practice. To cease the constant dance of sutures and stitches, the intricate art of reconstruction, and the humbling privilege of healing was akin to depriving Michelangelo of his paintbrush.

The road ahead bore the promise of a battle – one where the adversaries were time and medical complications. My sword and shield were the good doctors, my resolve, my will to return to my operating room, a warrior returning home victorious.

Thus began an unexpected chapter of my turbulent life. A renowned plastic surgeon thrown into the roaring depths of lifelong illness with a looming liver transplant. A journey, painted with uncertainty, anxiety, and the absolute craziness medical fate had chosen to hand out to me. But, if there is one thing I have learned from this experience, it is the power of resilience. The power to bounce back, to defy odds, and to rise above.

In what I can only describe as a cataclysmic series of unfortunate events, this great nation was drastically overwhelmed by an insidious attack, not from guns and bombs but from a silent, invisible force known ominously as COVID-19. Its timing was impeccable. As Murphy’s Law would have it, the pandemic struck me at the worst possible moment—I was battling liver disease, with an initial MELD score of 13, a number that haunts me to this day.

The Model for End-Stage Liver Disease or MELD, for those who are blissfully unfamiliar with this grim term, uses a formula that incorporates the patient’s level of serum bilirubin, INR, and serum creatinine to estimate survival chances. My score of 13 was high, unnerving, and demanded immediate attention.

But, just as I was preparing myself for the necessary workup, the world came to a grinding halt. COVID-19 had arrived, scattering our lives like dandelion seeds in the wind. I found myself caught in a merciless vortex of despair and depression, my life was on hold and my livelihood threatened.

My medical office, once a safe haven for those seeking care, now shut—the great need of the hour. The creditors were relentless, their demands only adding to my burdened conscience. My passion for healing, the very pulsating force that once nourished my spirit, withered away in the face of the insurmountable odds.

While the nation and I grappled with the calamity, another silent assailant lurked—an almost invisible one—my liver disease. The sudden interruption in my life’s rhythm deprived me of the vital information I needed about Lactulose and Xifaxan. These two medications could have prevented the onset of hepatic encephalopathy, a condition characterized by a rapid mental decline due to liver disease.

And so, I slipped. I grappled with foggy memories, a shaky balance, and a failing ability to perform the simplest tasks like writing my name, while the world frantically searched for a way to combat the virus. I felt lost in a labyrinth of confusion, my once agile mind now a maze of lost thoughts.

Then, like a shining beacon in the galloping darkness, Stella, a relentless combatant against my disease, began to help set things right. Coupled with Myra of the pharmacy department at New York Presbyterian, a dogged advocate for affordable medication, I got the much-needed Xifaxan. They not only secured the medication but ensured I got it at a considerably reduced price from Canada – a victory hard-earned and sweet.

Play the video and sing the words

Now, Xifaxan, an antibiotic currently in off-label use to treat encephalopathy, was my lifeline. And it baffles me that our country still grapples with the debate of affordable medication, while lives hang in the balance.

But that debate won’t cease today, and neither will my fight. After just a day of use, the Lactulose and Xifaxan began to restore me. My mind cleared, my balance steadied, and my recovery was tangible.

The COVID-19 pandemic may have caused chaos, but it has also been a stern reminder of sheer human resilience. As I pen down my experiences, I hope this serves as an illuminating tale about the fight against not just one, but, in my case, two deadly adversaries. While we prepare for the future, we must appreciate the present, a gift to be cherished. Even in the grip of despair, there is always hope if you believe, and if you fight.

In the late spring of 2020, as the world grappled with a global pandemic, I embarked on a different, highly personal health journey, battling with my deteriorating liver and a potential death sentence. The commencement of my medical work-up included a daunting series of impenetrable tests: scans, endoscopies, and a particularly unsavory experience of arterial blood gas extraction. However, the most taxing trial was the dreaded colonoscopy, not for the procedure itself, but the bowel preparation beforehand. It was meant to be a mild ordeal, but it was far from it.

Simultaneously, I waged war against an elevated MELD score, a grim reminder of my fading liver function. The score dipped to eight momentarily, thanks to an appropriate diet but swiftly spiked back to an alarming 13. This fluctuation followed more bouts of a sinister condition known as hepatic encephalopathy – a scientific term that my struggle-dulled mind could hardly articulate.

In these dark depths, when the vultures of debt circled and the specter of mortality loomed, I hesitated. The prospect of a liver transplant – of becoming a recipient of someone else’s organ – was shrouded in uncertainty.

Then, along came Maggie, the blunt-speaking financial coordinator, who imparted a hard-medicine reality: the transplant, a matter of life and death. With her help, I was thrust into a supportive environment, a familiar harbor amidst the storm: a pre-transplant group run by Aimee.

Under Aimee’s committed stewardship, the group served as a beacon, guiding us through the turbulent waters of what to expect during and after the transplant process. The group members, each on their journey, sacrificing a piece of themselves to save another, formed a fraternity of strength and compassion that deeply imprinted on my heart.

The crucial call came in July 2020. I was on the list. However, the notion of involving my family as living donors hounded me; a potentially catastrophic event lurking in the wings. I fretted. Would the act of saving my life endanger theirs?

My qualms were soon quashed. Michelle, a close friend prompted by my wife’s persuasive communication, threw her hat into the ring. Against the backdrop of a broad spectrum of emotion, she offered the ultimate gift – a part of herself. Our shared blood type propelled her into the same labyrinth of medical evaluation. Yet, providence intervened. The piece of her liver offered for donation was deemed too small, a relief that washed over me. I remain in awe, both humbly and profoundly, of the scope of Michelle’s kindness.

My journey to the transplant list in the summer of 2020 was fraught with medical jargon and grim diagnoses. The specter of a liver transplant hovered over every conversation, every decision. However, bolstered by determined professionals like Maggie and Aimee, the support of a collective facing the same struggles, and the great compassion of individuals like Michelle, I found the strength to face the uncertainty of the future. This arduous path in my life story serves as a testament to human resilience, kindness, and the incredible capacity we have to support one another even in our darkest hours.

It was a time when the world was in the grip of a nameless terror – an invisible enemy. Like a mighty wave it swept across the globe, leaving in its wake an aftermath of despair, desolation and death.

I, Dr. Michael Baruch, trained physician, was suffering from a life-altering condition, Hepatic Encephalopathy. This liver disease had rendered my mind fragile, a dilapidated mansion of rusted cogs and faded wallpaper. The COVID-19 anyway made my professional life cease as my office closed down. My routine was abruptly halted, and my emotional health strained.

My very core was restless, my mind perpetually daunted by our pandemic inflicted reality. I was a captive in my own home, relentlessly battling my affliction, my eroding mental faculties a worrisome companion.

A beacon of hope pierced the bleak canvas of my life in the form of an email from a local university hospital. They were seeking volunteers to act as a lifeline to the families, who were cruelly kept away from their beloveds, aching for their touch or yearning for their presence. It was a call I could not reject, impulses from past experiences whispering a visceral response.

I was quickly granted emergency privileges to assist the hospital remotely. A computer, my digital stethoscope, was my link to the distressed relatives. Though I was astonished at how my admittedly precarious mental health fell into shades of normalcy, as I conversed with the families, the ingrained doctorly dedication gradually overpowering the havocking splinters of my encephalopathy. It was as if a dormant switch had been turned on, and with every interaction, I was drawing from a deep well of familial memories, equal parts bitter and sweet.

In the harshest of circumstances, my profession called upon me, and my disease-ridden mind valiantly rose to the occasion. Those two months were a whirlwind of remote consultations, countless bitter-sweet anecdotes, and sleepless nights. Amid the scenes of desolation, I bore witness to the indomitable spirit of the human heart.

However, the grim shadow of the virus loomed ominously over every conversation. Despite the physician’s ceaseless efforts, many patients were relentlessly claimed by the unsparing virus. I was their buffer, absorbing the heart-wrenching cries of despair and the helpless anger.

Yet amidst the tragic symphony of emotions, there were singular moments of resilience and unyielding hope. Families, who even in separation, managed to find a fortitude that seemed to defeat even the monstrous pandemic. A father’s love for his children, a wife’s desperate plea for her husband’s recovery, a young man’s guilt for his ageing mother – these were but a few examples of human courage and love in full view.

As a doctor, I have always committed myself to the unwavering service of humanity. Yet, during those two indescribable months, even as my own condition gnawed at my sanity, I was reminded of how intrinsic and instinctual this commitment is. It made me realize that being a doctor is not merely a chosen profession, but a predetermined sentiment deeply etched within me. In these concealed folds of my psyche, I contained an unwavering urge to heal, labouring lovingly despite my incapacitated mentation.

And so, in these unforeseen circumstances, my mind rallied, unleashing its dormant capacities of care and empathy. My incurable ailment was momentarily tamed, my silhouette sharpened in the bleak canvas of the pandemic.

In the end, it was a tender confluence of my wanting to be healed and to heal others.

During the crisp, icy winter month of January 2021, shrouded in the heaviness of uncertainty, I had a pivotal encounter with Dr. Emond—the revered physician vested with a prowess in organ transplants. The ticking clock of my age was relentless and unremitting; I had turned 68 not long ago, edging closer to the line drawn by scientific limits and medical ethics. With his firm, measured voice, Dr. Emond reminded me that the oldest patient on record who had successfully undergone a transplant was a weathered veteran of 75 years.

The medicine man’s words had an eerie atomic resonance—”tick-tick-tick-tick.” They became a metronome, a constant whisper in the winding corridors of health, existence, and time. However, the question posed to me was unequivocal—did I want the transplant? Without a sliver of doubt clouding my judgment, I knew I yearned for that second chance; that miraculous intervention was grafting a new lease of life onto my aging soul. Unfortunately, they crash-landed with a painful thud before my hopes could reach the skies. The patient, whose generosity expanded beyond his physical life, had tragically passed away.

As the aftershocks of this incident receded, I remembered a comforting wisdom shared in the past during a transplant support group meeting. The proverbial silver lining was shared that once the medical team reaches out to you for the first time, the actual transplant is usually pretty close.

In the following month, the fingers of destiny reached out again, uncurling themselves just shy of the witching hour. On February 23, 2021, the phone’s shrill ring snapped my late-night tranquility into shards. It was the message I longed for—a call to action, a summons at midnight to make my way to the hospital’s admitting office.

Dr. Zacchariah Nephrologist

Nestled in the heart of New York City, I lived but a short 15-minute drive from New York Presbyterian Hospital—a towering bastion of medical breakthroughs and heartfelt care. The iron-clad grip on my emotions was unbuckled. A rush of frenzied excitement surged through my weary soul, lighting up every fiber of my being with renewed vigor.

Like a drawn moth to the glow of a promising flame, I rushed to the hospital, leaving the tendrils of fear and apprehension behind in the cold, glistening streets of the sleeping city. I allowed no questions to intimate fear or hesitation into my positive outlook concerning the extended donor criteria patient.

Checking into the hospital, I remember being ushered onto a floor buzzing with the tireless machinery of medical jargon and silent but profound prayers. My veins pumped adrenaline and anxiety as I surrendered to the barrage of additional tests. The disarray of my senses stripped away the ability to remember these procedures’ specifics. Yet, the surrounding blur and focused chaos affirmed my belief—in the face of this relentless ticking clock, the time for my life-altering transplant had finally arrived.

In the early sunlight hours of an otherwise ordinary day, I found myself being whisked away towards the heart of New York Presbyterian Hospital, a bustling, world-renowned medical heaven. Much of my journey to the hospital’s abyss remains arcane, my mind’s recollections scattered and evanescent, much like fragments of a dream slipping away as you awaken. Picture Dorothy’s whimsical Kansas world torn asunder by a vicious tornado, violently transposing her into the dark, otherworldly realm of Oz; only replace Dorothy with a veteran physician and Oz with an alien hospital environment, and you get an approximation of my disorienting narrative.

How did I, a decorated physician, find myself in this bewildering space of illness and not healing? The causes were manifold, interlaced in a morbid combination of stress, professional burnout, prescribed medications, renal failure, and anemia. They acted as a wicked potion concocted to throw me into a delusional state, a realm suspended between consciousness and unconsciousness. The shreds of my six-week-long hospital sojourn come mostly from the narratives relayed by my wife; my own memory, suffused in forgetfulness and confusion, failing to reproduce an accurate account.

The hospital halls whispered to me murmurs of a surgeon taking charge of my treatment; a Dr. Emond, a seemingly familiar figure in my hazy consciousness. However, my wife later revealed that the man behind my survival was, in fact, Dr. Kato, an individual of enviable resilience and sheer willpower. You see, the good doctor himself was unfortunate enough to succumb to the vicious tentacles of the COVID-19 pandemic soon before my transplant. He spent perilous weeks lying on a hospital bed, suspended between life and death, a machine pumping oxygen into his system.

Dr. Kato, however, did not simply survive the ordeal. He transformed his adversity into an inspiring tale of human resilience, completing the formidable New York City Marathon with a commendable timing of five hours and forty minutes. A tale of a man who sprints across miles, bearing the torch of survival, is a tale of triumph for every patient that Dr. Kato treats.

Amusingly, despite my extensive interaction with this extraordinary individual, I do not recall meeting him until two years post my surgery. At this fortuitous meet in a hospital corridor, I found myself being guided by a familiar-looking Asian physician. Unable to put a name to the face, I scanned his white coat for any information. And then, sliding across the right sleeve, my eyes beheld the name—Dr. Kato. Overwhelmed with gratitude, I expressed my heartfelt thanks to the man who extended my lease on life.

Upon discussing this encounter with my wife later, I was informed about our frequent, intellectually nourishing conversations during my stay at the hospital that my fogged memory had erased. This revelation underscored the fascinating duality of Dr. Kato—an exceptional surgeon and a captivating conversationalist, making him the epitome of a modern-day healer committed to his profession.

In the dim light of dawn, a clear, chilly morning, medical staff bore me resolutely towards the forbidding doors of the operating theatre. The confines of my memory hold but scant details of this fateful journey; my recollections are a peculiar mash-up of the homely simplicity of “Little House on the Prairie” tarnished by the chaotic darkness that is Ozzie Osbourne.

Indeed, I found myself coursed into a world haunted by delusion, coaxed into this realm by a potent cocktail of psychological stress, professional burnout, a heady mix of medications, renal failure, and debilitating anemia. In all honesty, my memory of my hospitalization remains fragmentary at best; a jigsaw puzzle with innumerable missing pieces, only completed in parts by the vivid recollections from my dutiful wife.

Delusion had such a grip on me that I spent most of my hospital stay under the impression that my designated surgeon was a certain Dr. Emond. Imagine the shock when six weeks later, my wife casually informs me that the laurels of my surgery were actually borne by another – a Dr. Kato. In my gratitude-filled haze, I can state with assured certainty that Dr. Kato is a remarkable man, a formidable presence in white.

A true warrior, Dr. Kato too had succumbed to the insidious clutches of COVID-19 before my transplant, spending a grueling six weeks in a hospital, with a portion of his recovery centered on extracorporeal membrane oxygenation. But there was more to Dr. Kato, more that is testament to his indomitable spirit. He emerged triumphant, a survivor, nay, a conqueror, dragging his brutalized body across the finish line of the prestigious New York City Marathon in five hours and forty minutes. To say I was impressed is an understatement.

Stunningly, my recollections of Dr. Kato were devoid of any real-life interactions. Our paths crossed unknowingly at New York Presbyterian Hospital two years post-surgery during my routine blood work and Aranesp injection. Seeking directions, I was aided by an Asian physician whose face bore a familiar mien. The answer to my puzzled look lay, not on the name tag I had vainly sought, but rather emblazoned boldly on the right sleeve of his pristine lab coat – Dr. Kato.

Overwhelmed with gratitude, I showered my thanks on him, expressing my indebtedness for his life-saving skills. The irony of it all was not lost on me. For those two and a half months, I had been wheeled in and out of conscious awareness inside the hospital, remaining blissfully unaware of even meeting Dr. Kato. With wry amusement, my wife later informed me about my daily repartee with Dr. Kato, often of a highly intellectual nature. Evidently, the ghost of my subconscious was having a fascinating hospital stay!

Indeed, the realm of delusion had woven a complex tapestry around my conscious cognition, obliterating my experiences, blurring my interactions and playfully creating a labyrinth of delusion around what was real and what was not. It is often said that reality is a matter of perspective. In the lens of delusion though, the lines often blur.

Postoperatively, I spent time in the intensive transplant care unit. Initially, it consisted of the attendings, residents, students, and nurses to manage my daily activities. They kept checking my mental status by asking me who I was, where I was, who was the president of the United States, and the date of my transplant surgery. From the dribs and drabs my wife gave me, I returned to the operating room because of post-operative bleeding. I was not the world’s most excellent patient. I pulled tubes out, destroyed equipment, sun downed quite frequently, and tried to walk out of bed when I could not stand up. Post-operatively I blew up like a balloon from renal failure, third spacing of fluid, and inactivity. I entered the hospital at 186 pounds, went up to 23o pounds, and left at 149 pounds. The hospital food was the pits. They tried everything to get me to eat, but I lived on clear Ensure and grape juice. The water they wanted to give me tasted like 3 in 1 oil, and I wouldn’t say I like apple juice or apple sauce. My wife came to see me every day for two and half months and played “KISS THE RAIN BY YIRUMA” continuously (which I have no recollection of to this day and could not even remember the tune.)

Michael Baruch had the privilege of a two-and-a-half month residency in one of the leading hospitals in the country, but it was nothing like a leisurely stay with room service on call. Instead, it presented a meticulously bound series of trials, each one more daunting than its predecessor: postoperative bleeding, troublesome extubation, anemia, renal failure that demanded dialysis, pneumonia, septicemia, abdominal fluid collection, alarming fluid shifts within the body and the specter of orthostatic hypotension. Each complication was a mighty skirmish in a war that seemed far from victorious.

But despite the grim circumstances, not a single contest went untended. The hospital’s star-studded medical team fought tooth and nail for their patient, demonstrating a tirelessness and tenacity only paralleled by their skillful management of every situation.

More than halfway through his visit, when the urge for movement grew irresistible, Michael staged a daring and ill-advised escape. Unsteadily he climbed over the right side bed rails but instead of freedom, he was rewarded with a swift introduction to the hospital floor. As he laid there, he earned himself a neck brace, a head CT scan and an electroencephalogram. Lying in dizzy aftermath, the formidable presence of a neuropsychologist demanded assurance that his brains had not been rattled out of their wit.

The harrowing story of Michael’s hospital stay veers on surreal at this point. Sleep eluded him, delusions swirling, mocking as he floated in an uncanny alternate universe. Reality fractured and reassembled itself in an intricate dance. A reflection in the sterile glass doors became his portal to a fantastical world.

The staff’s answer to this cognizant derailment was a relocation of Michael’s room, nearer to the bustling nurses’ station and windows that looked out into the everyday world. And thus, a beacon of mundanity began to coax him out from his illusory realm.

For six weeks he didn’t sleep and the stubbornness of his insomniac state is not just an anguished claim but is supported by a two-day Electro Encephalogram recording that showed no signs of REM sleep. As if the situation wasn’t arduous enough, the aftermath of the EEG came with the bodily toll of glue and hair torn from his scalp, constant reminders of a neglected duty.

Yet, through this labyrinth of medical tribulations, the light at the end of the tunnel always shone bright. It took the form of his wife, a sturdy pillar of support amidst the shaking grounds. With a set of family photos in her hands, she stood up to the challenge of reintroducing Michael to the world he had seemingly left behind.

At first, the faces in the photos blurred, names eluding him. But, as the days cycled, their identities began solidifying. With each recognized face, each remembered name, Michael was drawn an inch closer to recognizing himself again. Igniting sparks of memory were arduous, but they helped illuminate the path that led back to the real world.

So, this tale concludes, not with a tragic loss, but rather with a hard-won victory. Michael’s story is testament to iron will and resilience in the face of adversity. True heroism is demonstrated in the darkest of hours, and sometimes, the battlefield might just be a sterile hospital room.

In the week following my taxing liver transplant surgery, my esteemed colleague and friend, Rick, a respected plastic surgeon like myself, was besieged by the clutches of pulmonary thrombosis. The unrelenting COVID-19 pandemic had severed our united front, relegating us to fighting our health battles in isolation.

Rick’s engagement in the war was far more intense than mine; the sterile hospital walls incarcerated him for over a quarter of the year while I was released earlier. My concern for him overruled my worries about my health.

As I graduated to the rehab floor, I was able to bridge the gap that the virus had instated between Rick and me. Disregarding the stringent hospital rules, I wrangled a visitation with Rick. My wife was my steadfast aide, pushing my wheelchair through the winding hospital corridors to lead me to my friend.

Upon my solitary return, my absence had not gone unnoticed. Dr. Beckley was engrossed in the throes of disbelief, condemning my visiting Rick as an act of rebellion, misinterpreting it as my attempt to escape the hospital confines.

Nevertheless, my recovery was augmented by the unwavering support provided by Ilsa, Yeung, and Brittany. Their unassailable motivation led me to confront my daily physical therapy and occupational therapy sessions, a task that seemed Herculean due to my fight with orthostatic hypotension.

What loomed as a daunting task list – maneuvering ordinary objects, walking, tackling stairs – soon morphed into a victorious routine, thanks to the commendable work of the therapists, who threaded an invisible lifeline of hope each day.

An unprecedented milestone was touched several weeks into my recovery. The pleasure of showering reminded me of life’s simplest joys, ones we usually take for granted.

This chronicle is an homage to resilience, survival, and enduring friendship in the face of numerous personal and global hurdles. It is a testament to our undervalued healthcare warriors and a tribute to the indomitable human spirit. As we inch towards reclaiming normalcy, we are reminded to cherish life’s most minor pleasures and the strength of relationships, the heralds of resilience in the face of struggles.

My stay in the hospital did more than merely tend to my physical ailments—it revealed to me the awe-inspiring insights science offered on the human mind’s resilience and indomitable spirit. I had the good fortune of encountering Dr. Marykathryn Pavol, a neuropsychologist, who mirrored this symbiosis of compassion and academic prowess.

Upon her visit, her purpose was unequivocal. She was there to embark on a mission—a journey through the recesses of my cognition, determining whether my recent past, filled with a liver transplant and a nocturnal fall from my hospital bed, had made detrimental inroads to my memory. What laid ahead was a memory test, and I steeled myself, albeit with a sense of apprehension, for the challenges to be confronted.

Dr. Pavol initiated the journey with puzzles. Piecing together each fragment, I was vaguely reminded of military strategists preparing for an uncertain yet decisive battle. The act was more than a mere pastime—it was a tactical exercise gauging my mental agility and logical reasoning ability. Each piece was a silent quiz master probing into my cognitive health.

We then moved to an exercise of reproducing images. As I sat pen in hand, the scenario could be likened to a soldier standing guard in a smoke-filled battleground. Mentally performing high-wire acrobatics of sorts, the act of drawing the images was a mental workout, challenging each nerve and synapse within the cerebral hemisphere.

Further probing into the cavernous depths of my memory, Dr. Pavol retold stories; sagas filled with characters, motives, and intricate plot developments. I was expected to repeat these narratives, not missing out on any detail—a demanding task that served as a true testament to the strength of my recollection.

Throughout the anxious passage of time marked by her cognitive tests, Dr. Pavol’s demeanor remained composed. Her unwavering focus brought order to the chaos of uncertainty and anxiety that shrouded my comprehension. In the cold, sterile room illuminated by the harsh hospital lights, she stood—a steady beacon guiding me through the testing times.

In conclusion, Dr. Pavol’s tests, seemingly simple, held within their folds, meticulous analyses. The stakes couldn’t have been higher, with my memory as the disputed territory. This extraordinary encounter with neuropsychology was a revelation, transporting me from a hospital room to a captivating journey through the realm of memory.

t had finally arrived, the day marking my transition from the sterile, white confines of my hospital room to the cozy comfort of home. This significant turning point felt as monumental as the pre-flight preparation of an airplane, lining itself up on the taxiway before hitting the bustling activity of the runway.

Everyone in the hospital had been nothing short of fantastic. The collective effort was made to ensure my transition was smooth, with the therapy department as the guiding force. These exceptionally talented professionals had undertaken a thorough prepping journey, getting my wife accustomed to the imminent changes. They secured a convenient parking spot right in front of the hospital, providing us with an opportunity to practice entering and exiting the vehicle. This task, seemingly simple in more normal times, had now become a challenging chore, given the height of our Jeep and the temporary difficulties posed by my condition.

With great efforts and precise hand positioning, I finally managed to conquer the seat, marking my first win towards normalcy. Arriving at the lobby, the rollator I’d become dependent on was my temporary resting spot while my wife tackled parking the car in the comparatively labyrinthine hospital garage.

We returned to the designated unit and were welcomed by a heartwarming poster adorning the door. Demonstrating the extent of our journey, it was adorned with each parking ticket my wife accumulated during the long, dusty days of my two and a half-month long hospital stay. It was a testament to the life-altering journey we had undertaken, reminiscent of something Dr. Kato had once shared with my wife: some people tread short distances, while some traverse life’s long winding roads.

The next phase of my journey was to commence at home, with the therapy routine structured around the familiar surroundings. The humdrum of my daily life was punctuated by anticipated visits to the hospital for obligatory blood work and visiting friendly faces I’d gotten acquainted with during my stay.

However, my victories were still shadowed by the nagging orthostatic hypotension that refused to let up. Just as I was on the brink of heading home in the comfort of my own car, a frantic call from Lauren, my trusted nurse practitioner, dragged me back to reality. The blood reports had revealed a potassium level that had skyrocketed to 6.8, exceeding the normal levels of less than 5. The urgency of the situation demanded an immediate return to the fortress-like hospital building I’d just started adjusting to live without.

So, with heart pounding and concerns swirling like an ominous cloud, I steered towards the emergency room, diving headfirst into the next chapter of my healing journey. Navigating this dramatically changing landscape mirrored the unpredictability of life, its challenges, and the age-old wisdom that every journey, no matter how daunting, begins with a single step. A step that I was bravely venturing to take.

I am recounting a period that tested my courage and will, during my stay in what I not so affectionately referred to as the gloomy triad– the stretcher of doom, the hallway of doom, and then the ominous room of doom.

In a modern hospital, an individual expects to be provided immediate medical attention when they’re in crisis. However, the harsh reality can often be a far cry from this expectation, a fact that I vividly brought to life. I highlight the severity of my condition, waiting in agony while my bladder filled to agony, as my blood bore toxic levels of potassium, heightening the risk of renal failure. With the enduring persistence of a soldier on the front line, I waited for someone to collect a urine specimen, waiting to ward off the imminent threat to my heart, threatening to erupt like something out of an alien invasion horror film.

Thankfully, like the dawn breaks a dark night, a group of medical professionals gave him some relief through routine blood work. Yet, the delay to get insulin and glucose to curb my dangerously high potassium levels left me in an extended state of painful suspense, and my heart, an imminent ticking time bomb. My recount doesn’t lack a touch of gratitude though. I was admitted to the same floor I had stayed on before, lauding the familiar and excellent staff that catered to me.

My three-day stay, under the eagle-eyed supervision of Dr. Crew, ended with my discharge, and on the note of embracing a low potassium diet and Lokelma. It was a glimmering ray of hope on the gloomy canvas of my trials. It was as if I was on the brink of recovery, until the brutal and unexpected twist in the tale.

My journey of miseries had yet another obstacle in store – the development of a Cytomegalo Virus infection – a consequence of my medications Cyclosporine, Mycophenolate, and corticosteroids. Let’s not underestimate the hurdle that this posed. It was a battle within my own body, pushing me closer to my limits. But luckily for me, Lauren Kemp, an adept healthcare provider, was there to rejig my medication regime, providing me with Valcyte.

No battle is without casualties. For me, it was leukopenia, a side effect of the Valcyte. My solution was self-injecting Nupogen, a testament of my resilience and fighting spirit.

Anemia, the result of cyclosporine-induced stage 3 renal failure wasn’t absent from my medical trial. My ally, Dr. Crew, my nephrologist, equipped me to fight this with Fluorinef and Furosemide. In another twist of events, Dr. Eisenberger joined the battle, confronting my bone marrow suppression of red blood cells with Aranesp and Ferrous Gluconate.

This account bears resemblance to Bill O’Reilly’s Killing book series in its candid description of a patient’s crusade against medical emergencies. It’s a narrative of courage and perseverance, interspersed with elements of extraordinary camaraderie and unyielding human spirit.

A chilling reminder of the unpredictable nature of medical emergencies, and the resilience of human spirit, my journey underlines how each ordeal is an opportunity for a remarkable story.

Two years ago,, my life took a drastic turn when I underwent a significant medical procedure; a transplant. It was a period of high trills, deep troughs, with hope and anticipation commingling with a certain degree of dread, like a sailor stepping into uncharted waters.

I experienced a profound setback shortly after my surgery. An incisional hernia recovery put on my shoulders out of the blue. Medical opinions pointed to the removal of the mesh, which was incorporated during my original surgery, as the most plausible cause. Additionally, a subsequent trip to the operation room owing to a bleeding complication further complicated the matter. It was if my ship hadn’t just ventured into uncharted waters, but was now caught in a violent storm with the winds of fate raging against it.

However, the steadfast sailor is not the one who avoids the storm, but the one who navigates it. I had decided to weather the storm. Exhaustion seemed to creep into my bones as an anemia condition took root. Anemia is known to cause severe fatigue, a phenomenon that I was all too familiar with. Fighting it felt like battling an unseen enemy, pushing back against a relentless tide that was constantly pulling me under.

I firmly believe that the human mind is an invincible weapon. In my case, it seemed to spring back into action with an inspirational resilience. My memory, which I feared I might lose, not only stayed but gradually improved over time. My typing speed, which had significantly reduced due to my tremors, began to regain its former pace.

In an effort to combat the tremors, I consulted my ever-reliable advisor in matters of the unknown – chatgpt. After researching, I discovered that everolimus induces less tremors than cyclosporin. Acting on this newfound knowledge, I was able to incorporate everolimus into my treatment plan, and the results were nothing short of miraculous. The sea that was once stormy and violent, started to calm down.

This improvement also led me to revisit one of my previous medications – Propranolol. It was a drug I had replaced with Carvedilol in the hopes of better outcomes. But as the saying goes, “Change is not always progress.” I reverted back to Propranolol as part of my therapy, and it proved to be the change my body responded favorably to.

Another crucial factor in navigating this storm has been my phenomenal team of physicians and medical staff, who have been ceaselessly working to keep my ship afloat. My support group – my loyal crew – helmed by the indefatigable Aimee, have been my rock. Together, we have been battling the storm, dark and ominous; together, we have been counting the stars, bright and twinkling; together, we have been navigating the sea of life.

While it has been two years since my transplant – two years where life seemed to hurl profound challenges – I perceive it differently. To me, it’s been two years of immense learning, two years of countless victories, and above all, two years of resilient sailing. It is the triumphant tale of a steadfast sailor, determined to chart his own course, no matter the storm, no matter the sea.

"Second Chance: A Doctor's Journey through Liver Disease and Redemption"("Surviving the silent killer)

"Second Chance: A Doctor's Journey through Liver Disease and Redemption"
("Surviving the silent killer)