The Most Dangerous People I Love

There are few things in life more dangerous to a transplant recipient than a three-year-old with a runny nose.

There are also very few things more irresistible.

Nobody really prepares you for that contradiction.

Before my transplant, I imagined the difficult part would be the surgery.

The recovery.

The medications.

Learning to live with someone else's lungs.

All of that was difficult.

None of it prepared me for grandchildren.

People often ask transplant recipients whether we're afraid of infection.

The answer is yes.

Every single day.

Not in a dramatic way.

Not with constant anxiety.

More like background music.

Always there.

A cough that lasts a little too long.

A crowded waiting room.

Someone who says,

"It's probably just allergies."

Those words rarely make transplant recipients feel better.

Children, unfortunately, have their own relationship with viruses.

They collect them.

Trade them.

Share them generously with everyone they love.

It's one of the many ways they express affection.

My grandchildren are exceptionally generous.

The problem is simple.

Their immune systems are learning.

Mine is deliberately being held back.

The medications that protect my transplanted lungs also reduce my ability to fight infections.

The same virus that gives a grandchild two miserable days at home can become a much more serious event for me.

That's the biology.

The emotion is much more complicated.

Every family gathering becomes a quiet risk assessment.

Who has a cough?

Who had a fever this week?

Has anyone mentioned a stomach bug?

How recently?

Should I hug them?

Should I keep my distance?

Should I wear a mask?

Sometimes I feel less like a grandfather and more like an airport health officer.

People imagine these decisions are made logically.

They're not.

They're made emotionally.

Because then a small voice says,

"Grandpa, come and play."

And suddenly every carefully constructed medical guideline begins negotiating with your heart.

I have to admit something.

I haven't always made the medically perfect decision.

Sometimes I've hugged first and thought later.

Sometimes happiness won the argument.

Sometimes common sense lost.

If I'm being completely honest...

I don't regret every one of those moments.

Medicine teaches us how to reduce risk.

Life occasionally reminds us why we accepted the risk in the first place.

One afternoon we were making paper airplanes together.

Nothing extraordinary.

A kitchen table.

Colored paper.

A great deal of disagreement about the correct way to fold the wings.

I remember stopping for a second and simply watching them.

A few years earlier, I wasn't sure I would ever have afternoons like that again.

COPD had quietly stolen that future long before I noticed it.

The transplant gave it back.

Not perfectly.

Not permanently.

But genuinely.

Travel has become another version of the same story.

A few years ago we spent time together in Tuscany.

Beautiful villages.

Long family dinners.

Children running through narrow streets.

The occasional argument over which gelato shop was clearly the best.

Every now and then I'd quietly notice everyone around me.

Not because anything remarkable was happening.

Because something remarkably ordinary was happening.

I was simply there.

Participating.

Not watching life from the sidelines.

Joining it.

That may be the greatest gift transplantation has given me.

Not longer life.

Participation.

There's an important difference.

Length is measured by calendars.

Participation is measured by moments.

Of course, none of this means I ignore the rules.

I still wash my hands far more often than I used to.

I still avoid obvious infections.

I still listen carefully to my transplant team.

They're remarkably good at keeping me alive.

I have no intention of making their job unnecessarily difficult.

But I've also learned something they understand surprisingly well.

The purpose of protecting transplanted lungs isn't simply to preserve lung function.

It's to preserve the life those lungs make possible.

Living with chronic illness taught me that love often means sacrifice.

Living after transplant taught me something different.

Sometimes love means accepting uncertainty.

Not recklessly.

Not carelessly.

But consciously.

Because the safest life imaginable isn't necessarily the fullest one.

People occasionally ask whether I worry about getting too close to my grandchildren.

Of course I do.

Then one of them reaches for my hand.

And for a little while...

the statistics quietly step aside.