Michael McCrerey wanted to die at home. In the four years since he’d been diagnosed with liver disease, he’d been hospitalized at least a dozen times (six in the past 12 months), his abdominal cavity had been flooded with toxic fluid, and he’d shrunk from a beefy six-foot-four, 225-pound hunk of a man to a sack of bones weighing 135 pounds.
Michael’s wife Rita documented the whole ordeal. In the living room of his donor Mario Pinedo’s childhood home in National City, she heaves a large white binder into her lap, opens it, and flips to a picture of her husband at Scripps Green Hospital. Though Michael was 62 at the time, the combination of his sunken cheeks, the wheelchair, and the hospital gown ages him a good 25 years. When Rita passes the picture around the room, three of Mario’s sisters marvel at the difference between the Michael in the picture and the Michael sitting now in a chair against the far wall, beefy and healthy again, a somewhat bored look on his face.
“We got married in 1973,” Rita says. “Fool that I am. I should’ve read the fine print.”
The women laugh. The corner of Michael’s mouth twitches, but he doesn’t smile.
In 1977, after 11 years as a California Highway Patrol officer, Michael was forced to retire at 33 due to an on-the-job injury — a herniated disc. He had always wanted to be a policeman, and the retirement “pulled the carpet from under him,” Rita says. So he took to golf and scotch.
“We always liked our cocktails,” Rita says with a smirk. “Back in those years, they were doing lots of happy hours, and you could practically go have dinner with the hors d’oeuvres and that kind of thing. So he wound up having liver disease because he fell into the habit of drinking a lot.”
The average human liver weighs 2 1/2–3 1/2 pounds. The largest solid organ in the body, it performs essential functions, including detoxification of the blood and the metabolization of fats and proteins. In October 2002, Michael received his first diagnosis of cirrhosis, a disease in which scar tissue replaces healthy liver tissue, resulting in the liver’s inability to function. Cirrhosis is not reversible, and Michael’s doctor told him it was likely he would one day need a transplant. While Rita initiated the process of obtaining referrals and taking other necessary steps to get him on the transplant list, Michael went from sick to sicker, eventually developing ascites.
“[Ascites] is when your liver’s not processing the bile or liquid that it’s supposed to be processing to get your bloodstream cleaned up, so it oozes out and becomes liquid in the cavities,” Michael explains from across the room. “It balloons your stomach right out to where it looks like you swallowed a beach ball. I mean, huge and tight.”
Several times, the fluid caused Michael’s lungs to collapse.
“See. This is what his stomach looked like,” Rita says. She flips to a picture of Michael, ancient-looking and skinny, save for the giant stomach. “We went in, and they take a nice, big, long needle, poke it in your gut, and drain out the fluid.”
The first time the doctors drained Michael’s fluid, they told him he’d probably be in again in a month, and then again the month after that. But it would be another 14 months before he had to be drained again. Later, however, as his illness progressed, he went to Kaiser’s Otay Mesa gastroenterology department every Tuesday, and each time, the doctors drained 20–22 pounds of liquid from his body. That’s the equivalent of three to four two-liter bottles of soda. Every week.
“They’d suck it all out of there,” Rita says, “and when he’d come out, of course, [his stomach] would be all flat.”
Michael sits stoically, nodding every now and again. Rita’s women friends raise their eyebrows and shake their heads in sympathy. Rita doesn’t have the patience for boo-hooing, though. Once, when faced with a condescending Kaiser administrator who said something to the tune of “I know you love your husband, but there’s nothing I can do,” Rita replied, “Don’t give me that ‘woe is me, poor little wife’ stuff. This is business.” And then she proceeded to school him about a thing called “denial of medical care,” for which she would not hesitate to sue if he didn’t find a way to help her husband.
Rita’s binder, her facts, and her big silent man are all part of what she calls her “dog and pony show.”
“I’m the dog, he’s the pony,” she says.
Eventually, Michael’s loss of liver function also meant that toxins such as ammonia, which are normally made harmless by the liver, began to build up in his body. This resulted in hepatic encephalopathy, a disorder of the brain that often causes confusion and altered levels of consciousness.
“It’s like your brain waves would say, ‘I’m going to have a cup of tea,’ and then you would do something totally different,” Rita says. “He would use the TV remote and think it was the lamp or the phone.”
Along with the confusion, the encephalopathy also scrambled Michael’s personality.
“One of the special little fun side effects was that he became a secret shopper,” Rita says. “A shopaholic.”
At the time, Rita worked an express mail route for the United States Postal Service. Because she had a flexible manager who allowed her to eat lunch at home, she was able to check on Michael every day. One day, one of her neighbors stopped her and asked if she realized that packages arrived via FedEx, UPS, or DHL at her house almost daily, sometimes two or three boxes at a time. Rita was shocked. She’d never seen any of the packages.
“I was home one day, and I heard the delivery truck, so I hid and kind of watched from by the door,” Rita says. “[Michael] got the item, the delivery guy left, and he closed the door, picked up the box, and went scurrying down the hall to hide it like a damn chipmunk. He hid it in the closet. I didn’t realize that, for a year, he’d been buying things from catalogs and on the internet. Anything that said you’d get something for free, anything like free shipping, it was a trigger for him.”