I used to live 2 doors down from Bob in Somerville. I saw Bob in early November 2007 to drive him to Mass General for a regular checkup. Bob is as funny, brilliant, loving, and charismatic as ever. His daily window of alertness has shrunk considerably though over the last year. He said that he sometimes only has a few hours a day of awake time in between his naps. He seems in good spirits, though he's not looking forward to going through the winter--always a tough time of year for him.

At one point, Bob was a candidate for a living donor liver. In a living transplant, a large portion of a healthy liver can be removed and transplanted, and it will regenerate to its original size in both the donor and the recipient. Bob is no longer a candidate for a living donor transplant because his spleen is enlarged and is forcing a very high blood pressure through the liver. Doctors are concerned that the high blood pressure coming from the spleen would damage the small transplant liver before it had a chance to regenerate in his body. So he is no longer a candidate for a living donor transplant. That leaves him to rely on an organ donor.

Bob's MELD score, a measure of how healthy the liver is, had been stable for some time, but has been climbing in recent months. (The higher the score the worse shape the liver is in.) Bob is now on two organ donor lists for a liver: one list at Mass General and the other at the Cleveland Clinic. He and Anne make periodic trips to Cleveland for checkups, which receives a larger number of donor organs than does Mass General. He is in the middle of the lists, which are prioritized by a variety of factors including state of health. If someone comes in who is sicker than Bob they'll be moved higher on the list. If Bob gets sicker, he'll be moved higher. He could be called at any time, which means that he'd have to get himself immediately to the hospital and prepped for a transplant operation. He has been called several times in the last few months, and even got to the point of getting into hospital scrubs at Mass General, but for various reasons a suitable organ was not available. So he waits... I don't know how Anne holds it all together--between her work at RISD, and raising Kate who is as shy and retreating as ever (NOT!), and running a household. And all the while a smile on her face. My hat goes off to you Anne! Bob's boys seem to be flourishing--Sam is at Yale and studying economics and Chinese. John has finished his first semester at Duke. Kate is a source of bright, effusive energy. Bob and Anne have an arrangement with their upstairs tenants to help out several days a week with dinners and occasionally with watching Kate. They think they'll also be able to hire someone to come in to help with household cleaning, which will take some of the load off Anne. I keep Bob and Anne and kids in my prayers, and invite anyone who is reading this blog to do the same.