Hard frost last night, the first this season. There have been light frosts in recent weeks, but this one, just now visible in the dawn light, has left long swaths of rime on the lower slopes of the hills below my house. The light has blended from its first purples to orange. In all, a textbook dawn, no flaws.
I am qualified to evaluate dawns because my sleeping has become splintered into short snaps. Whether by will or accident I seem to have timed my sleeping fragments so I am often wakeful at dawn, the best light for critical thought. Or painting.
At the doctor’s Friday, finally had the conversation I’ve been waiting for and dreading. I’m healed enough from the August bleed to contemplate the big picture, the frost on the far slopes. I have a liver disease. NAFLD. I’m in the end stages. There’s nothing they can do.
The doctor sketched my liver on the paper covering the examining bench, explained what my blood numbers meant, talked about what I can expect as the disease progresses. We speculated on causes. My theory is a prescription medication I took for many years; his is fructose in processed foods, but the truth is we don’t know. If I were a drunk, we might suspect that as the cause, but I’m not and so we don’t know why. At this point would it matter if we did?
My liver is going to fail. When is the more important question.
Even though most of my liver is scar tissue, I could probably live out my natural span. The disease is that slow, he said. The complications from the disease are more likely to kill me than the disease itself. Since only a small portion of my liver is working, the blood to be processed backs up and causes all sorts of uproar, the bleed in August being one of the deadliest. And there’s not much they can do to manage the complications either. Keep my blood pressure low; minimize acid in the stomach; eat carefully; avoid colds; exercise lightly. And start talking to the Cleveland Clinic about a liver transplant. Their job, the doctor bluntly explained, will be to find reasons not to put me on a waiting list for a transplant.
I was grateful for his bluntness. Stark reality is so much easier to deal with than denial or hope. Just get on with things; just live. In a way, I’m fortunate. If I had end stage kidney failure, I’d be on dialysis now and uncomfortable most of the time; if heart failure, I’d be bedridden and in terrible pain. End stage liver disease, no pain. Except for the constant fatigue, it’s not so bad. I can live with this, one dawn at a time. Painting is going to be very important now. Wonder if reality will impact my art?
Above: Study for Windmill at Dawn, pastel and oils on board. Copyright 2009 ptw.
