Chimeras Live Among Us
Length: • 9 mins
Annotated by Mark Isero
Emerging Writer Series
Every two weeks or so I am publishing an essay from an emerging writer. This week, we are publishing “Chimeras Live Among Us” by Leilani Graham. Leilani is a writer and healthcare consultant based in the Bay Area, California. Having survived four cardiac arrests and a complicated heart transplant, Graham uses her arts background to teach, write, and speak about her passion for healthcare reform. Her writing won 2nd place for the 2020 Paul Kalanithi Writing Award. She is currently training to become a Certified Child Life Specialist and is pursuing a Master's in Practical Ethics at Oxford University.
The heart beating in my chest is not my own.
I received a heart transplant when I was 24 years old. Sawed through the middle, ribs splayed open by retractors, my heart was extracted with forceps and scalpels. The thawing muscle of a stranger was sewn into the place of my own heart. Conductive metal prongs followed, sending currents through the very telomeres of someone else’s genes. Someone else’s heart.
I am made of two bodies: one alive and one dead, stitched and seamed into one human canvas. There are two sets of DNA in me. Scientists call this a chimera: an amalgamation of more than one set of genetic body parts fed by the same blood, inhaling the same oxygen. The term is borrowed from mythology: sphinxes, griffins, mermaids, cherubim, and Frankenstein’s Monster. Chimeras range from monstrous to angelic, usually prophetic, and often cloaked in secrecy. As a child nurtured by the adventures of a boy wizard, chimeras were proof of mortals and magic coexisting. But shortly after childhood ended, the spell broke.
Medicine can save lives, but it is not magic.
All was well, better even, coming out of anesthesia, removing the breathing tube, and sitting up in a chair. Then, the new heart crashed, beating only ten times per minute. Dozens of people rushed into the room. A nurse climbed onto the bed and straddled my pelvis. She interlaced her hands and, using all of her body weight, began to pump the heart from the outside, slamming herself against my chest. Four of my ribs cracked as we were wheeled, a bastardization of the beast with two backs, out of the ICU and back to the operating room. No one knows for sure why this donated heart failed one day after surgery. I stabilized through the help of ECMO, extracorporeal membrane oxygenation, a risky and dangerous life support in which all my blood was pulled out of my body and oxygenated by a machine, then pumped back in again, letting the heart and lungs rest. In time, the heart slowly regained function.
But like a storybook trope, exactly on the one-year anniversary of my transplant, a hidden secret emerged. Again, I lost consciousness, the heart dropping to ten beats per minute. “Have I not suffered enough that you seek to increase my misery?” Frankenstein’s Monster asks his creator. My own native heart could have stopped beating at any moment. A transplant was supposed to cure me of this imminent cardiac arrest, borne of my genetics. Instead, I was forever marked by someone else’s previously undiagnosed disease.
What else did I inherit?
Clinically, transplant recipients are told that we take only flesh from our donors: the form and function of a particular organ. But experience tells us something else. Some recipients inherit new allergies. Others tell stories of newfound love for foods and sports, cravings, and fandoms their donors once held. They report inexplicable memories. Science has no answer to these presentations. However, it hypothesizes that the “heart-brain” connection, or the neural network responsible for energetic function, brings a history from one body to the next.
Something may also be happening on a cellular level. Research suggests that this transference, such as that of generational trauma, is somehow written into DNA, a phenomenon known as epigenetics. If memory-making can happen epigenetically, then what part of this exchange of bodies is psychosomatic and more profound than our conscious understanding? Was this borrowed heart in my chest not yet ready to leave its owner? Was it rebelling against its new vessel out of spite? Did this new heart resent me? As my cardiologist once put it, “Hearts weren’t meant to be cut out and sewn into someone else.”
I often wonder what else might be woven into my fabric, like colorful threads extending from my donor’s arteries into my veins. She was 52, a highly atypical donor age for a 24-year-old recipient. If I live to be 52, my donor’s heart will be more than 80 years old, with all the natural weakness and stiffness of age. Time will wear it down: tests show that this has already begun.
The truth is, I am not likely to live to 52, not with this heart. The average survival of a transplanted heart is 17 years. The Monster again, “Of what a strange nature is knowledge! It clings to a mind when it has once seized on it like a lichen on a rock.” All these calculations, all this hypothesizing: sometimes I wonder if my relentless pursuit of more data only deepens my grief. But I can’t stop searching.
The Greek chimera is described as a creature who, in life, does not grow old and never dies. Is this not what transplantation is, the putting off of death so that the patient may grow older? So, too, is part of the donor made something more than mortal in their gift. We both shall die someday, if from nothing else than the complications of the very medications keeping my immune system from rejecting her heart. But until then, do I not have the burden, the responsibility, to uncover more of her legend: to seek to understand my donor in an attempt to understand myself? Less generously, I wanted evidence that someone had made a near-fatal error in affixing her to me. I wanted proof the fatal flaw already existed before we became one.
My donor was childless, with no mention of a partner. She had schizophrenia, her mind in constant battle with psychosis. What if I inherited not an allergy to pine nuts or a craving for barbeque but rather my donor’s fate: to wade through life alone, battling an invisible force in my head? I have often wondered if I might lose reality from the endless existential cycling of a brain kept alive by this broken heart. Scarier still: what if I, too, am meant to walk and leave this earth alone?
This is a mystery I cannot solve. No amount of Googling or combing through my medical record will find certainty. Yet such persistence for truth is how I know all of this information about my donor. The supposed black box of organ donation is meant to prevent the exchange of personally identifying health information, but it is fatally flawed. Too much survives online, too many news stories of horrific accidents with date stamps and obituaries noting the deceased’s legacy of gifted life. I would know. I have read more of them than I can count, searching for her.
I am the child in the storybook warned not to enter the locked room, trespass the west wing of the castle, or open the spell book. But I cannot help myself. How do I live this halved existence in the dichotomy of my aliveness and her death, not knowing who she was? I can never meet, never touch, never see my donor. This itself makes her mythical.
What does that make me?
Who are we after surgery or illness takes? What is left? And what have we been given, wanted or not? We move around with these miraculous bodies that seem to function without conscious thought, and yet the subconscious of the ill often remains wracked with grief and confusion. Author and cancer survivor Suleika Jaouad proposes that the ill inhabit two kingdoms: that of the sick and that of the well. I have inhabited a third state of being, a no man’s land: perhaps a place not wholly dissimilar from that of lost socks and trains of thought and opportunity. An “in-between,” to quote author and hospice nurse Hadley Vlahos. Not a purgatory per se, but a suspension: liminal space between this earth and the otherworldly. Here is where the mind cycles when it cannot sleep or where dreams of flying meet those of dying. This is where I spend distracted moments of dissociation, knowing my life holds both prophecy (a shortened lifespan) and probability (no one is guaranteed a tomorrow).
This is the place where mythological chimeras dwell. They are made of multiple creatures in one: mortal and immortal, reasoned and also painted with insanity. In stories, they inhabit the earth and a parallel space—something tangible and unknowable. I will never truly know my donor, and yet the very heart of her now gives me life. Her heart collides against my pericardium about 89 times a minute, 24 hours a day, week over week over week over week. Her cells perfuse my blood through her chambers and into my body. We ripple within each other, our symbiosis making rhythmic splashes appear on ultrasound screens. So, does she still exist, even now? Or is she, like the hair on her head, the joy in her smile, the light in her eyes, gone? She did not leave alone. A core piece of me literally died one early February day when I supplicated to the operating table—the thing that gave me life sliced and extracted into a cold metal dish.
Months after the transplant, I insisted on making an unusual appointment: a patient entering the sanctuary of the clinicians’ laboratory, asking to view proof of their disease. Still reeling from the surgery and its complications, I questioned whether it had all been for naught. So abruptly had I been informed of my end-stage heart failure, despite living so much life: graduating with honors, traveling abroad, and beginning a career. I had not felt I was dying. I walked into the hospital for my transplant, but I was wheeled out. Was it possible the doctors were wrong? Had I been wrong to trust them?
Though masked and gloved, I felt utterly exposed in the glaring fluorescence of the pathology lab. Even through the filter, I could smell the sterile sharpness of alcohol and peroxide, cloaking any putrid hints of decay. The surfaces of stainless steel benches were covered in plastic bottles, glass beakers, and all measures of polished instruments whose names I did not know.
I shifted my weight on tenuous legs, still unsteady from learning to walk again. I could see that the moment was just another case for the clinicians assembled: their unconcern unsettling me. Was this not momentous? I had been told there was a chance it had already been incinerated. But then, my eyes fell upon the mass of grey and yellow human specimen atop green surgical towels. There it was: soaked for weeks in formalin, dissected and biopsied, but still, unmistakably, a heart.
My heart.
I cradled it in my hands, playing gently with the tension of my heartstrings, thumbs noting the bulk of the ventricles. I pressed into the mottled ring of thick white scar tissue that had threatened for over a decade to end my life. She was terrifying, and she was beautiful. A kind of chimera herself: composed of two sets of parental DNA, the unforeseen confluence of two separate mutations for the same cardiac disease.
“Life,” the Monster says, “although it may only be an accumulation of anguish, is dear to me, and I will defend it.” I had done all I could to stay in rhythm with the devil I knew. My heart had persisted despite incredible odds. The heart: the myth, the legend. But it was clear to me now, holding the proof of disease in my hands, that the doctors had been right: without the transplant, I would have died.
Organ transplantation, a delay of certain death, is miraculous and also simple. It is mythical in its proportions: the scale of clinicians and surgeons involved, the astronomical financial costs, and the life-altering exchange of a terminal illness for a chronic one. And yet, donation is the most natural gift one can give of oneself.
I traverse dangerous waters by even questioning my suspended mortality. There is enough myth-busting to be done to assuage skeptics of organ donation: lack of available donors being a significant cause of death among those on the waiting list. To question the moral character of transplant is to risk perhaps persuading some to revoke consent. Many ask how I could resent such a chance at life.
I don’t resent my donor. She gave of herself freely. This is why organ donation is truly a selfless gift, not because it is so difficult to give something the body can no longer use, but because it is a gift given unconditionally. Donors have no say over to whom their organs might be given. Yet, conditions were bestowed upon me. The age of this heart, its primary failure, its conduction disease, the beginning of stiffening arteries: for these, I am ungrateful.
But I am still grateful to be alive.
Like separate DNA, these coexist: a conglomeration of two strong feelings, two contradictory states of being. I am the fantasy’s protagonist, given great power without choice, one who must find a way to live with this transcendence of nature. I am the chimera: at once, two people, two sets of DNA, and countless memories stowed in the vessel of one being.
There is a third definition of “chimera:” an unlikely hope—a pipe dream, illusory. At one time, the idea of saving humans through the use of organ transplantation was impossible, even criminal, to enact. It took the determined characters of the de novo transplant recipient’s story to help write further chapters for countless others. Maybe, instead of in the medicine, the magic lives in the human ability to persist despite all odds.
Proof of these otherworldly creatures walk among us. This, I am certain, is no myth.
Because I still exist.
∙
 | A guest post by
|