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    "I can and I will."

    "He who has a why to live can bear almost any how. " -Friedrich Nietzsche,” Maxims and Arrows" "I can and I will." -Michael Wise Before Jan 21, 2009, Michael Wise knew that life could change on the toss of a coin--literally. In 1902, Wise's Jewish grandfather, great uncle, and their families fled religious persecution in Poland. On reaching Belgium, they decided that they might be in a better position to help each other if one family travelled on to Britain while the other stayed put in Belgium. When the coin was tossed, luck had it that Wise's grandfather and his family would travel to England. His grandfather's brother stayed in Belgium for a time and then moved to Paris. Ultimately, though, Wise's great uncle and his family returned to Poland, where they ended up dying in the Holocaust. Now, in January 2009, Wise was to have his own encounter with the randomness of existence. Wise was a vital, fit, and professionally accomplished 62-year-old professional with a busy dentistry practice that was run to exacting standards. As an innovative expert in complex restorative dentistry who had written a textbook on the subject, Wise was in demand as a lecturer and instructor. He had taught his techniques to many. In 2007, he had been voted 2nd in a national survey about the most influential dental professionals in the UK. Everything was about to change. It all began rather mundanely. It was mid-January, 2009, and Wise was feeling under the weather. At first it was a general flu-like sense of malaise. Wise's symptoms progressed to include sweating and a mildly elevated temperature, then to vomiting, diarrhea, and shaking. By the morning of January 21st, Wise was very ill indeed. He has minimal recollection of his wife helping him out of the bath that day, of her phoning for an ambulance, and of being transported to London's University College Hospital, where a team headed by a contact of theirs, a specialist in intensive care, was awaiting him. He was suffering from septicaemia, a rare blood infection, caused by Hemolytic Group A Streptococcus, bacteria that usually give rise to sore throats. When these microbes invade the bloodstream, they release poisons that damage organs--an extremely serious condition known as toxic shock syndrome. Although the source of the bacteria that threatened Wise's life was not definitively determined, he does offer a few hypotheses. Because Wise was in considerable distress, doctors placed him in a medically induced coma (according to his account) for some days. (The accounts of Wise's wife and son that are included at the end of the book make no mention of coma, however--only intubation and sedation.) Wise writes that he possessed a certain level of awareness (particularly of voices) while sedated. At one point, for example, he heard a physician speculating that Wise had had a catastrophic stroke. Wise's dreamlike states alternated with periods of strange philosophical rumination. Eventually, he regained something resembling full, but hazy consciousness. Wise goes on to relate the very significant obstacles he faced in order to return to life. Toxic shock had left him with acute kidney injury. He was in renal failure, which meant he would need to undergo dialysis for four-hour periods three times a week. Sometimes the kidneys will, after a time, recover; Wise's did not. Additionally, his respiratory function was compromised due to one lung being filled with fluid, his toes were gangrenous, and his heart was damaged. He would need considerable physiotherapy to regain strength and would require surgery to deal with the necrotic tissue on his feet. Wise also dealt with a host of other problems: itchiness, fatigue, hypotension (low blood pressure), changes in how his senses perceived the world (hearing was heightened; distance vision was diminished), short-term memory loss, and increased emotional sensitivity which left him prone to tears. He also experienced a significant setback about seven months after the crisis: a second bout with septicaemia, this time due to staphylococcal bacteria, which had likely gained entry into the bloodstream through the permanent jugular catheter used for dialysis. When a biopsy confirmed that Wise's kidney function was irrevocably lost, doctors asked him if he was interested in being placed on the transplant list. He was. The problem, of course, is that the wait can be as long as three to four years. He and his family decided that searching out a living donor willing to part with a kidney was the better option. A donor came forward. The second half of On the Toss of a Coin, addresses issues (including the legalities), tests, and procedures leading up to the transplant, as well as the operations--the donor's and his own--and their aftermath. One of the things I learned from Wise's book is that the donated kidney is placed in a different location from that of the patient’s existing kidneys: in the front part of the lower abdomen (the pelvic or groin

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