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My Stomach Transplant

JAMES VESCOVI

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 You probably haven’t heard the story of my stomach transplant. It was not covered in the press, popular or medical, for reasons I shall reveal. What happened to me could happen to anyone who puts his faith in newfangled surgery and miraculous medical remedies, which are common as the feral cats of Rome. It may surprise you that my operation was elective. No life-threatening condition—such as cancer or obesity—forced me to undergo the experimental procedure. Rather, my problem was simply chronic stomach inflammation; unable to enjoy life’s best cuisine, I lived in a state of constant frustration and fury.

          Coffee, booze, foie gras, fried chicken and waffles, cream based soups, Wagyu rib eye—all were verboten. Even a square of dark Belgian chocolate was enough to make my stomach flare up and always in the same place: two inches above the navel, thirty degrees NW. Fierce burning harassed me for days, forcing me to consume boiled chicken and quarts of metallic-tasting Aloe juice. On my train commute into the city, I had to watch fellow passengers savor to-go cups of rich Sumatran coffee, while I sipped hot milk with flavored chamomile syrup. For a gastronome like me, business trips were even more demoralizing. Colleagues celebrated deals while quaffing Champagne and sparkling French wines; I sipped San Pellegrino on the rocks. 

          I was only a Man who wanted to eat like one.

          My condition first appeared in my mid-thirties. For the next decade, I consulted a bevy of gastro-enterologists. They poked at and listened to my stomach and took MRIs of my vital organs. I exhaled into bags to detect for H. pylori. Physicians prescribed pills and chalky liquids. They sent cameras down my gagging esophagus and studied the video. Befuddled, they streamed it to colleagues around the world.  In the end, I was told I suffered from simple but chronic inflammation, which couldn’t be defeated by any anti-inflammatory known to humanity. I had to live with it—end of story. The only hope doctors gave me was that the condition might ebb as I aged and my stomach produced less acid—but no promises. 

          One specialist charged $875 for this disappointing, simplistic diagnosis. 

          “That’s all you can tell me?!” I asked.

          “The stomach is a mysterious organ that we know surprisingly little about,” he replied. “The fact is, medical science understands even less about the stomach than the brain.”

          I thought, “Can it be that this pear-shaped sack that holds one’s food, squirts it with enzymes to dissolve it, and sends the mash along, is more of a mystery than the brain?” It appeared so.

          What further riled me up were the false expectations raised by a galaxy of natural health specialists, who doled out malodorous teas, seaweed potions, and capsules the size of lipstick tubes. These quacks assured me I’d be cured in a month; nothing was further from the truth!  Not a single remedy—nothing known to Eastern or Western medicine could heal this intransigent, mean-spirited stomach of mine.

          Suspecting the problem stemmed from the stress of a mid-life crisis, my wife, Trina, suggested psychotherapy. I tried three therapists, the last of whom had the gall to show up at our 8 a.m. appointment with a Starbucks Venti Mocha Cappuccino. She put me on an anti-depressant and, at a follow-up visit, expressed pleasure when I told her my cravings for the villainous foods had subsided. 

          “Of course they have,” I said. “Your pills have killed my appetite—and my sex drive. I’m always exhausted. My emotions are flat. You’ve turned me into a vegetable!” The remaining Paxil went down the toilet. 

          My job performance suffered. I gave up my golf foursome (who can make a decent chip shot while drinking Moussy?) Weekends were spent brooding around the house. My wife complained that I was increasingly distant. Worse, I was curt—and sometimes downright mean—to my children.      

          It was this total desperation that led me to a radical solution: a stomach transplant performed under the strictest secrecy by a gastroenterologist who was willing to risk the approbation of the medical establishment, not to mention the long arm of the law, to help me. 

          And he didn’t take insurance.

          I cannot reveal much about the man who performed my operation. I will call him Dr. Q. A native of Romania, he was a giant at 6’6” tall. He had crooked teeth and thick red hair that ended in a pompadour twice as high as James Dean’s. His hands were bigger than Rachmaninoff’s, and his chest the size of a wine cask suggested descent from a warrior tribe that ruled ruthlessly over its fiefdom. However, Dr. Q. could be as gentle as a plain egg-white omelet. 

          Educated in Bucharest, Dr. Q. had been a physician to top Communist Party officials in the 1970s and ’80s. His idea for stomach transplants originated from the problems that plagued Party apparatchiks, who indulged in spicy Transylvanian meatballs washed down with Palinka (a plum brandy) and who smoked carton upon carton of Kents, the cigarette of the elite. On top of it all were the pressures of working for Communist dictator Nicolai Ceausescu and worse, his ruthless shrew of a wife. 

          After the revolution of 1989, when Romanians revolted and the Ceausescus were executed without the dignity of even a last meal, Dr. Q. fled the country in the back of a truck carrying candied cherries for Austrian fruitcakes. After a year in Vienna as a pharmacy clerk, he made his way to the U.S., claiming refugee status. He found employment at a laboratory outside Dallas that supplied animal testing services for pharmaceutical and cosmetic companies. Late at night, when the building was empty, he continued the research he’d begun in Romania, covertly performing stomach transplants on mice, rabbits and, later, orangutans. Under an assumed name, he submitted articles to prominent medical journals, whose editors returned them plastered with sarcastic comments. 

          “What you describe is science fiction!”  

          “Your research makes my stomach nauseous!” 

          “Get yourself a brain transplant!” 

          Discouraged but not defeated, Dr. Q. forged ahead, perfecting his technique. After a decade, he considered himself ready to perform his procedure on a human.

          How we found each other is an amazing story in its own right. Late one night, surfing the Internet in a state of utter hopelessness, expecting another fruitless search of a cure for my ailment, when voila! I found myself on www.stcharlesborromeo/helpus/com. (St. Charles Borromeo [1538-1584] is the patron saint of ulcers and other stomach ailments. In fact, both the makers of the popular antacids Bromo-Seltzer and Brioschi claim their name is derived from the saint’s.)   At any rate, after reading several of Dr. Q.’s papers posted on this site—though written in a rather rudimentary English—I knew I had found my savior.      

          He responded to my first email message cautiously. After determining I wasn’t an FDA inspector or PETA militant, we spoke by phone. Several conversations later, he invited me to fly out to his office, the location of which I cannot disclose. I will tell you—so you believe me credible—that Dr. Q., worked the graveyard shift in a hospital morgue, a position that would allow him to obtain a stomach from someone whose blood and tissue type would not cause my body to reject the organ. 

          Dr. Q., of course, didn’t want to perform a successful operation only to discover that his patient had three months to live due to some prior condition. This would have reflected poorly in the medical literature. Thus, he put me through a rigorous physical examination and a battery of tests. At first reticent, Dr. Q. now warmed up to me as my test results showed I was a perfect specimen for the very first operation.

          “Your health—tip top!” he said. “You are the candidate.”

          We talked at length about the operation and its risks. If it failed, I was strong enough to live without a functioning stomach. It is an unpleasant way to exist—one must eat small amounts of food constantly—but it can be done. After discussing other hazards, he had me sign a confidentiality agreement. After adding his own signature, he beamed and vigorously shook my hand. His assistant took our picture with a disposable camera, which she then locked in the office safe.

          I’d made it!  I was to be the first human in history given a stomach transplant! We toasted our future with Palinka, which gave me a horrible pain, but I didn’t care.

          As I flew home to await further instructions, however, guilt gnawed at me because I’d lied to Dr. Q. He didn’t want to take the chance of losing a patient who had other mouths to feed, and I’d told him I had no children. The truth is, I have two kids, a girl (nine) and a boy (fourteen), and I love them dearly. However, I knew that a successful transplant would make me an infinitely better father, not to mention husband. And I had absolute confidence that under Dr. Q’s knife I’d come through with flying colors. It was full speed ahead!   

          Lest I be misunderstood, I would like to say a further word about the nature of my problem to any Freudians or prurient-minded people reading this. Trina and I have a marriage that’s more traditional than most by today’s standards, but it works for us. She’s a full-time homemaker, and I head an accounting unit for a national window and door company in Georgia. The house is always tidy, she is a fine cook, and—let’s cut to the chase—our bedroom life was A-OK. In fact, I thought I did rather well in the boudoir considering I was unable to use the props that often jump-start romance: wines, chocolate truffles, and etcetera. No, my problem was not sexual frustration, but simply that Fate had simply dealt me a stomach that was a sour old spinster.

          Trina was against the surgery, but all my life I’ve been a risk-taker, one of those youngsters who dove into ponds before checking the depth. I explained that I could not face my remaining years suffering through cups of Postum (ersatz coffee made from wheat bran and molasses) and humdrum chamomile birthday cakes. In addition, the thought of one day toasting my daughter’s wedding with sparkling apple cider, while everyone else saluted the couple with Moët & Chandon—I just couldn’t face it. I’d tried every recourse known to traditional and pseudo science. By my own estimate, I’d consumed more than 50,000 Tums during my lifetime. It was time to enjoy dinners with California Cabernet Sauvignon (2001) and Saturday mornings with a cup of Jamaican Blue Mountain coffee on the sun porch.

          After a seemingly interminable five-months, I finally got the phone call.

          “Începe pregătirea chirurgicală,” he whispered, and abruptly hung up. It means “begin surgical preparation” in Romanian, our code for all systems go.

          I was to fast for two days, taking only water, clear teas, high-potency vitamins, and a laxative that could’ve dissolved cement. However, before I started my regimen, I gave my stomach hell. Trina and I dined out at a French bistro on foie gras, Gratin of Pigeon a la Périgord, and chocolate soufflé, followed by coffee. That night, as my gut became an inferno, I envisioned Dr. Q. punting that bitch of a stomach into a medical waste pile, to the cheers of assistants around the operating table.   

          But, of course, that is not what he planned to do. A true humanitarian, my stomach would be donated to a man who suffered from chocolate eating binges so severe they sent him into comas. I could only shake my head in wonder: to think my stomach was good for something! 

          After my fast, I flew to a small rural hospital. I would be gone for three weeks. I was driven blindfolded from the airport and shown into Dr. Q’s office for our pre-surgery confab. However, he was not present to welcome me. As I waited—five minutes, ten, twenty—a foreboding took hold of me. Something was not only wrong, but different: On my previous visit, his office had been clean and orderly. Now, ashtrays overflowed with Kent cigarette butts. Stacks of yellowed papers tottered on his desk. A dried out tongue sandwich lay half eaten next to a photo of his mother. The room reeked of perspiration, and shafts of sunlight revealed swirls of dust motes. I tried to calm myself by looking at Dr. Q’s photo gallery, which contained pictures of him with world figures who’d been former patients: Georghe Comenaci, worrisome father of Romanian Olympic gymnast Nadia (he had gastroesophageal reflux); Soviet President Leonid Brezhnev (acute heartburn); and Vaclev Havel, chain-smoking Czech playwright and President (peptic ulcer). I felt even more relieved at a photo showing Dr. Q. lecturing at Romania’s top medical school. With a stomach projected on a huge screen behind him, he actually looked as if he were holding the organ upon his shoulders, like Atlas carrying the world.  

          The doctor finally appeared, though without giving me his customary bear hug. He inquired lethargically whether I’d made all the necessary pre-operative preparations, then directed me to his exam table. 

          As he took my vital signs, he embarked on a strange disquisition on the history of medicine, noting fortuitous surprises that often awaited medical pioneers. He singled out Alexander Fleming, whose unwashed culture plates resulted in the discovery of penicillin, and Edward Jenner, who off-handedly found a cure for smallpox. 

          “What, exactly, are you getting at?” I asked.

          “Today, I discovered we are fortunate in way I never predict,” he said, lighting a cigarette. 

          “In what way?” I nervously inquired.

          “In my wildest dream I never imagined we are so lucky!” he bellowed.

          He shook his head in wonder, seemingly relishing the moments before he’d spring his news on me.

          Though his cigarette lay burning in an ashtray, he lit another. His hands shook so much I helped him aim his lighter.

          “We are giving you a baby’s stomach!” he finally proclaimed, exhaling a thick cloud of smoke. 

          I felt dizzy. My mouth got pasty.

          “You are a very lucky man,’ he added.

          “Lucky?! Lucky how?!” I cried, picturing myself as a laboratory gerbil instead of a human patient.

          “Please, calm yourself,” he said, more by way of command than suggestion.

          Crushing out his second cigarette, Dr. Q. explained what had happened: The clandestine nature of the enterprise had forced him to take great precautions. He’d had to assemble a team to work under complete secrecy—nurses, administrators to forge documents, and a pathologist to pilfer a cadaver stomach. Dr. Q. had a fake medical license. Had I died, he could’ve gone to prison for manslaughter. He’d paid out thousands in bribe and hush money.

          Unfortunately, as I waited for my stomach, Dr. Q.’s team was getting cold feet. And then, as Fate would have it, the next organ suitable for me happened to belong to a four-month-old boy abandoned in a hotel alley. His body chemistry matched mine to a “T.”

          “If we don’t take this one,” Dr Q. informed me, “my anesthesiologist will jump the ship. Others will follow.”

          He picked up his first smoldering cigarette, now down to a nub, and took a drag.

          “This may be your only chance—perhaps forever,” he added. 

          I had no idea what to do. I’d expected to receive the stomach of a teenager killed in a car crash, or a 40-year-old dead of a brain aneurysm. 

          Capitalizing on my indecision, the doctor, in salesman mode, began to speak rapturously about the beauty, health, and perfection of the baby’s stomach, now safely stored and bathed in a special cleaning solution of his own invention. He assured me that he had the skills necessary for the delicate task. I was healthy. All was waiting. 

          I stared at Dr. Q’s Tagamet wall clock. Time was ticking. I remained speechless.

          He cleared his throat.

          “My friend, listen closely to me. On December 21, 1989, Romanians in Bucharest Square gathered to listen to a speech by Comrade Ceausescu, lauding himself as savior of the country. Everyone knew it was all lies, and worse, everyone knew they were facing another cold winter with only four hours heat per day because of government incompetence and corruption.

          “But there was one man, one voice, who spoke out!” he continued. “No one even recalls exactly what he shouted or even who he was, but he shouted, “Ceausescu este un mincinos! Ceausescu is a liar!” Now more people spoke out with jeers! With insults! Ceausescu—he shouted and threatened—but it was too late. The crowd was too strong. He had so much fear he fled. Within days, executed—he and the wife. No revolution happens unless one man has courage—to speak out, to choose. Same for you, my friend.” 

          I got to my feet. “Let’s do it,” I said.

          He summoned a nurse who escorted me off to prep for surgery.  I was wheeled to an operating room via a circuitous route, given an anesthetic, and told to count backward from ten. 

          A giddy mood overtook me. It being December, I counted backward to the tune of “The Twelve Days of Christmas”: 

“Ten cups of coffee, nine Belgian beers, 

eight bites of foie gras, seven chocolate sodas...”

Next was “six shots of whiskey,” but I didn’t make it.

          The operation took amazing dexterity on Dr. Q’s part in attaching the esophagus on one end and the duodenum on the other. He used pig parts, as well as strips of Gore-Tex, to make the fit. After I woke up, the nurse informed me that the operation was a surgical tour de force. So no one was the wiser, my hospital chart indicated a gallbladder removal.

          In the coming days, there was more good news. My recuperation time was halved because the baby’s stomach was so vital and healthy. As predicted, there was little problem with rejection. I was raring to go, ready to return home and start my new life.  

          The morning of discharge, Dr. Q. came to my room.

          “Well, tomorrow you depart...” he said.

          “I’m so grateful to you, Doctor,” I said.

          “I am leaving you with a list of your prescriptions. The last page is explaining the various 'Do’s' and 'Do not’s'."

          He handed me the packet. I immediately flipped to the final page (with its misspellings):

Dear Patient:

So that recovery will be one thousand % success, I ask you to follow this guideline. Its important you must realize that a babies stomach must be treated delicately. Though healthy, its still young and developing. Therefore, proceed slowly on your New Food Odyssey. 

  1. Please, no caffeine until puberty, or this will have a delirious effect on your organ. 

  2. Foie Gras, must also be delayed. A baby’s stomach isnt ready for rich food. Wait until it is fifteen months old, then a tiny bit once in a while. By puberty, no problem with full servings. Watch for allergic reaction.

  3. Acid from chocolate isnt good for the stomach lining and could have long term bad effects. Avoid for first 3.5 yrs.

  4. No alcohol, please. After the stomach is six years old, an occasional sip of wine or beer is okay; at puberty a half glass with meals on holiday; and, at eighteen years old, as much as you like, within reason. 

 

          It was a gargantuan disappointment! During recovery, I’d been gazing out my window at an Indie espresso bar across the street from the hospital. It was to be my first stop after discharge—for an espresso doppio. My wife and I were planning to inaugurate my stomach at a two-star French restaurant. My children would be devastated when I said I couldn’t join them in a DQ hot fudge sundae.

          “You said this operation would fix me!” I yelled at the doctor.

          “And it has. But think of it like sports medicine. After the cutting and stitching, the pitcher must have months—in your case, years—of ‘therapy.’”

          “But I’ve been waiting too goddamn long already!”

          “Not my fault. You Americans are impatient. Do you know once, when I was practicing in Bucharest, people had to wait days, even weeks, for antibiotics. In America, I’d have been sued!”  

          “Maybe I’ll do the same!” I screamed.

          Dr. Q. gazed at me with such hurt eyes, that I immediately apologized.

          “I know you have done your best,” I said.

          We parted with the Romanian proverb on the back of his business card—adio, deci pe carand, which means, “Good bye forever, so see you soon.” 

          Biding my time at the airport, I transposed the letters of the last word and came up with “canard”—French for “duck,” which I couldn’t eat. I was really struck dumb when I recalled that “canard” in English means “false” or “baseless.” 

          I moped during the long flight home. Because I couldn’t eat the airline food, Dr. Q.’s nurse had packed me warmed formula, which I drank from a Thermos.

          The moment I walked through the door, Trina could tell something was wrong. I assured her that I was going to survive, though part of me wished I were dead.    

          “I am now the owner of a baby’s stomach!” I blubbered. “All the gastronomic circumscriptions! No Scotch for now! Decaf coffee only! Foie gras—who knows when?!”

          I could consume nothing but wretched baby formula for four months; after that, my solids were limited to dried cereal and stewed vegetables. Before my stomach reached the age of one, I could have no ice cream, as I might be lactose intolerant; no honey in my tea because of spores; absolutely no Chinese food (MSG was out). No strawberries because of pesticides. The list went on and on...

          Worse, I had to take small meals throughout a 24-hour day. If I didn’t have a 2 a.m. feeding, I woke up with stomach cramps.

          Supper was especially mortifying. My son ate like a horse, and it pained me to know that he would be boozing it up long before I would. Out of my mouth came that fetid air that made me recall the days when my infant children belched. 

          At my first post-op check-up, the doctor said, “Everything is proceeding as planned. I know you are disappointed. But the time will go fast. But don’t cheat, please. You don’t want to be first human to get an ulcer before he is two.”

          Searching for something that might solace me, I asked him about the man with the chocolate binges. Had my old stomach helped? 

          “Oh, him—he cancelled the surgery,” Dr. Q. replied, wearily. “He found a successful substitute in carob.” 

          As I was leaving, he told me of his own great disappointment.

          “There is no possible way for me proclaim my exciting results in a prestigious medical journal,” he said morosely. “Proof of success will come only when your stomach reaches adulthood. By that time, I will be in my eighties and, quite possibly, food for worms.”

          He aroused little pity in me. During the coming months, I consulted a lawyer about a lawsuit.

          For my final post-op visit, I was told Dr. Q. had moved his office five hundred miles away to a Western town of less than 2,000. The waiting room was so sparsely furnished one might think he was renting by the month.  

          And it wasn’t Dr. Q who entered the examination room.  It was a woman of similar size and also of Romanian origin. She refused to tell why the doctor wasn’t present nor where he was. 

          “This is highly unorthodox, not to mention unethical,” I said after she told me to disrobe.

          She snickered. “Says whom? You are on Romanian soil now,” she said, in English that was much better than Dr. Q’s. 

          “I should really sue the hell out of you people, considering all the pain and suffering you put me through.”

          “Your lawyer will not know where to find us,” she replied, putting her stethoscope in her ears. 

          There was nothing more to argue about. I allowed her to complete the exam—everything was fine—and flew home. 

          Recently, a close friend said, “Maybe you’re lucky that you can’t eat all these rich foods and liquor. Doctors say they shorten our lives.” 

          “I should be so lucky to have a shortened life!” I snapped.

          “But think about it. You’re carrying around a stomach decades younger than you.” 

          “So?” 

          “Well, when I’m in my eighties, I’ll be eating cottage cheese and Saltines. You’ll have the stomach of a forty-year-old who can feast on New England clam chowder, followed by gamey stews and beer—which cause the runs in octogenarians. When our dessert is canned pears and decaf, you’ll top off your meals with Mississippi mud cake and rich Kenyan coffee.”

          His words made complete sense and brought a burst of optimism to my ridiculous situation. Glorious food—soft cheeses! Florida grapefruit! Chicken Diablo! Bourbon! Fried chicken! Shellfish!—what a way to stave off the specter of death! 

          And I’ll finish every meal with a shot of Palinka in homage to Dr. Q., alive or dead, and wherever he may be.

JAMES VESCOVI has no direct connection to the medical community, but he generally likes doctors.

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