A Dying Transplant Recipient Explains the 'Gratitude Paradox'

Amy Silverstein is grateful for her donated hearts but laments 'sorry state of transplant medicine'
By John Johnson,  Newser Staff
Posted Apr 18, 2023 4:31 PM CDT
A Dying Transplant Recipient Explains the 'Gratitude Paradox'
   (Getty / Alex Raths)

Amy Silverstein learned last month that she has incurable cancer. Now, in a New York Times essay, the author of Sick Girl says goodbye to her heart. Which is to say, she says goodbye to the heart beating within her that she received in a transplant. It was actually her second one—Silverstein underwent her first transplant at the age of 25 and has lived for nearly four decades now thanks to those two strangers' hearts. She expresses her profound gratitude for the life she was able to lead, but she also writes about what she calls the "gratitude paradox" she and another transplant recipients have. While the "miracle" of these transplants gave her life, the "sorry state of transplant medicine" means her life won't last as long as it could have.

Silverstein explains that she has been on essentially the same "toxic triad of immunosuppressive medicines—calcineurin inhibitors, antimetabolites, steroids" for decades now. The same drugs that saved her have over time resulted in the cancer that will kill her in a matter of weeks. Yes, she is grateful to have been given life, but she objects to the narrative that "discourages transplant recipients from talking freely about the real problems we face and the compromising and life-threatening side effects of the medicines we must take." It's long past time that the medical community raise the bar for post-transplant medicine, she writes. "I am speaking out while I still can for my magnificent hearts." Read the full essay. (Read more heart transplants stories.)

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