Nicholas Sparks: The Best of Me

After hanging up, Amanda called her mother. Explaining what had happened in the last twenty-four hours somehow made the nightmare even more real, and Amanda broke down before she was able to finish.

“I’m coming,” her mother said simply. “I’ll be there as fast as I can.”

When Frank arrived, they met with Dr. Mills in his office on the third floor to discuss the possibility of Jared receiving a heart transplant.

Though Amanda heard and understood everything that Dr. Mills said about the process, there were only two details that she later truly remembered.

The first was that Jared might not be approved by the transplant committee — that despite his grave condition, there was no precedent for adding a patient to the waiting list who’d been in an automobile accident. There was no guarantee that he would be eligible.

The second was that even if Jared was approved, it was a matter of pure luck — and long odds — whether a suitable heart would become available.

In other words, the odds were slim on both counts.

I’m not sure how long he’s going to last.

On their way back to the waiting room, Frank looked as dazed as she felt. Amanda’s anger and Frank’s guilt formed an impenetrable wall between them. An hour later, a nurse stopped by with an update, saying that Jared’s condition had stabilized for the time being, and that they would both be allowed to visit the ICU if they wanted to.

Stabilized. For the time being.

Amanda and Frank stood beside Jared’s bed. Amanda could see the child he’d been and the young man he had become, but she could barely reconcile those images with the prone, unconscious figure in the bed. Frank whispered his apologies, urging Jared to “hang in there,” his words triggering a flood of rage and disbelief in Amanda that she struggled to control.

Frank seemed to have aged ten years since the night before; disheveled and downcast, he was the picture of misery, but she could summon no feeling of sympathy for the guilt she knew that he was feeling.

Instead, she ran her fingers through Jared’s hair, marking time with the digital beeps of the monitors. Nurses hovered over other patients in the ICU, checking IVs and adjusting knobs, acting as though the day were completely ordinary. An ordinary day in the life of a busy hospital, but there was nothing ordinary about any of this. It was the end of life as she knew it for her and her family.

The transplant committee was meeting soon. There was no precedent for a patient like Jared to be added to the waiting list. If they said no, then her son was going to die.

Lynn showed up at the hospital with Annette, who was clutching her favorite stuffed animal, a monkey. Making a rare exception, the nurses allowed the siblings into the ICU together to see their brother. Lynn went white in the face and kissed Jared on the cheek. Annette placed the stuffed animal next to him on the hospital bed.

In a conference room several floors above the ICU, the transplant committee met for an emergency vote. Dr. Mills presented Jared’s profile and case history as well as the urgency of the situation.

“It says here that he’s suffering from congestive heart failure,” one of the committee members said, frowning at the report before him.

Dr. Mills nodded. “As I detailed in the report, the infarction severely damaged the patient’s right ventricle.”

“An infarction that most likely stemmed from injury sustained in an automobile accident,” the member countered. “As a general policy, hearts aren’t given to accident victims.”

“Only because they don’t generally live long enough to benefit,” Dr. Mills pointed out. “This patient, however, survived. He’s a young, healthy male with otherwise excellent prospects. The actual cause of the infarction is still unknown, and as we know, congestive heart failure does meet the criteria for transplantation.” He set the file aside and leaned forward, facing each of his colleagues in turn. “Without a transplant, I doubt this patient will last another twenty-four hours. We need to add him to the list.” A note of pleading crept into his voice. “He’s still young. We have to give him the chance to live.”

A few of the committee members exchanged skeptical glances. He knew what they were thinking: Not only did this case lack precedent, but the time frame was too short. The odds were almost nonexistent that a donor could be found in time, which meant the patient was likely to die no matter what decision they made. What they didn’t mention was a colder calculation, though no one on the committee gave voice to it. It had to do with money. If Jared was added to the list, the patient would be counted as either a success or failure for the overall transplant program, and a higher success rate meant a better reputation for the hospital. It meant additional funds for research and operations. It meant more money for transplants in the future. In the big picture, it meant more lives could be saved in the long run, even if one life had to be sacrificed now.

But Dr. Mills knew his colleagues well, and in his heart he knew they also understood that each patient and set of circumstances was unique. They understood that numbers didn’t always tell the whole story. They were the kind of professionals who sometimes took risks in order to help a patient now. For most of them, Dr. Mills guessed, it was the reason they’d gone into medicine in the first place, just as he had. They wanted to save people, and they decided to try again that day.

In the end, the recommendation from the transplant committee was unanimous. Within the hour, the patient was given 1A status, which awarded him the highest priority — if a donor could miraculously be found.

When Dr. Mills broke the news to them, Amanda jumped up and hugged him, clinging to him with desperate force.

“Thank you,” she breathed. “Thank you.” Over and over, she repeated the words. She was too afraid to say anything more, to hope aloud for the miracle of a donor.

When Evelyn entered the waiting room, one glimpse at the shell-shocked family was enough for her to know that someone had to assume control of their care. Someone who could support them, not someone who needed supporting.

She hugged each of them in turn, holding Amanda longest of all. Stepping back to inspect the group, she asked, “Now, who needs something to eat?”

Evelyn promptly herded Lynn and Annette off to the cafeteria, leaving Frank and Amanda alone. Amanda couldn’t fathom the thought of eating. As for Frank, she didn’t really care. All she could do was think about Jared.

And wait.

And pray.

When one of the ICU nurses passed by the waiting room, Amanda raced after her, catching her in the hallway. Voice trembling, she asked the obvious question.

“No,” the nurse answered, “I’m sorry. So far, there’s no word on a possible donor.”

Still standing in the hallway, Amanda brought her hands to her face.

Unbeknownst to her, Frank had emerged from the waiting room, reaching her side as the nurse hurried away.

“They’ll find a donor,” Frank said.

At his tentative touch, she wheeled around.