Every night, when she should have gone to bed, Gail Menefee moved restlessly, resting his head on her husband's chest to make sure he was still breathing.
When the clock rolled in the first few hours of the morning, she listened to the machine in the background keeping oxygen flowing through his body putter. Kirk suffocated and died easily, so she leaned her head near his lungs, hoping that he could live until the next morning.
This is why Gail was almost awake when the phone rang at 5:05 am on September 11, 2019.
Someone died. The lungs fit Kirk well.
Idiopathic pulmonary fibrosis-an advanced disease that causes scar tissue to accumulate in the lungs-has taken over the 69-year-old man's body. A few months later, he went from a healthy retiree who swims two miles a day to a frail person. He needs to stop and rest every two steps on the stairs.
A few hours before the call, a few friends came over to play cards with Menifez. When they said goodbye that night, some people wandered in the driveway, wondering loudly if they could see Kirk alive again.
All the colors left his face. There is not much time left for him.
The past few months have been terrible for Kirk and Gale, and this news finally brings hope, a second chance, and many reasons to be grateful.
"I know if we don't receive a call soon, he might not be here for Thanksgiving," she said.
So Gail grabbed the travel bag that was waiting for this moment and dragged the seven oxygen tanks into their car, just in case.
Within 120 miles between them and the IU Methodist Hospital in Indianapolis, anything can go wrong.
When they arrived, Kirk still needed to breathe.
The death sentence brought by idiopathic pulmonary fibrosis began to be naive.
Three years ago, before driving to Indianapolis in the early morning for a transplant, Kirk had a mild dry cough. His family doctor gave him an ineffective antibiotic and gave him a chest X-ray in April 2016.
At that moment, they found scars on his lungs. Later tests confirmed that he was in the early stages of idiopathic pulmonary fibrosis. They learned the final diagnosis two days before their daughter's wedding in July 2016.
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Dr. Michael Duncan told The Courier that the disease would slowly damage his lungs, causing them to shrink. Duncan is a pulmonologist at the IU Health Methodist Hospital in Indianapolis, one of the top lung transplant programs in the country.
Scar tissue cannot exchange gas well, and for IPF, just inhaling oxygen and releasing it from the body in the form of carbon dioxide becomes a chore.
Kirk’s lungs can work for a while, but if he doesn’t undergo a double lung transplant, he will die.
But it took a few months for Kirk to feel "disgusting." Even if he seeks a mentor to help him complete the diagnosis and transplantation process, the terminal illness does not seem to be real.
Kirk is very suitable for a man in his 60s. He sold his family's paint manufacturing business at the age of 58, and after getting bored after his early retirement, he started an unusual second career: caddy. He was an avid golfer, and he was strong enough to carry two golf bags on the green at the same time.
When the cold weather hit and the boredom after retirement came back, he moved to Florida for the winter and worked as a caddy at the famous MacArthur Golf Club in Hobby Sound, Florida. Every morning, he would swim two miles and then go to work, where he would drag the bags of major celebrities and golf masters.
He originally intended to spend his golden years like this, but now they are going to be shortened. Doctors expect him to live only three to five years, unless he undergoes a transplant.
Two years after the diagnosis, he first noticed a drop in his performance in the pool in the summer of 2018. Despite this, he immersed his head in the water and pushed forward, even though he needed to surface to breathe air more frequently than before. A slight shortness of breath did not stop him.
In the next few months, he has been working hard to get through those troublesome moments. In December 2018, he still had a good time, so much so that he and some friends went to Arizona to play golf.
When lying in bed the first night, he woke up suddenly and out of breath. Of course he was not swimming, but the pain felt like someone was pressing his head underwater.
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He was frightened and gasped for 10 minutes until his lungs slowly opened again.
He said: "I can't breathe, my chest is ups and downs, and I can't breathe. This is the most terrifying and terrifying thing in the world."
He shortened his schedule and flew back to Louisville.
The next day, the doctor began to give him oxygen.
Kirk used only a small amount of oxygen at the beginning, and he still exercises on a treadmill every day. He was determined to keep going, even if it meant transporting oxygen tanks by his side.
In March of that year, the Menifez family went to Indianapolis to see if Kirk was eligible for the transplant list. He feels lower than ever, but there is an optimal time for when IPF patients should undergo transplantation. It's just that Kirk hasn't arrived yet. Duncan, a pulmonologist at IU Health, explained that if a person undergoes extreme surgery prematurely and suffers complications, it will actually shorten their lifespan.
So Menefees returned to Louisville and was preparing for a full decline from spring to summer.
In the end, Kirk gave up the treadmill. His body can no longer withstand these unnecessary movements.
By April of that year, an 80-foot-long rope was wrapped around the first floor of his house as a small machine called a concentrator that allowed oxygen to pass through his lungs.
The concentrator can only pump out about five liters of oxygen at a time. As the condition worsens, his body needs more oxygen. Standing still, the concentrator can support him, but if he wants to consume any energy, he needs a traditional oxygen tank.
That summer, as his breathing became more difficult, his health declined sharply, and he became fascinated by how many cans they had on hand.
"We have 18 in our garage," Gail comforted him. "There are two in the bedroom, two in the kitchen, and two on the porch. We are fine, but if you want me to call (more), I can."
"This is a normal conversation, because he is very afraid of running out of oxygen."
On August 29, 2019, he suddenly realized that he was dying. It was a Thursday, and that day was carved into his mind like scars scattered on his lungs.
He made himself a margarita, which seemed to be the last touch of normalcy he could have.
Then he put it to his lips and took a sip, which he could barely swallow.
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"I can't stand alcohol anymore," he recalled. "My organs and body tell me they are starting to shut down, and I better prepare for what happens next."
Six days later, he returned to Indianapolis for another round of testing, where he was panting just a few steps along the track, with 15 liters of oxygen around him. When they told him to sit down and stand up quickly and do it again, this simple action made him lose everything.
"My oxygen level has dropped," he said. "My body exploded inside because of lack of oxygen. Everything runs on oxygen."
"He won't recover from this incident," she thought. "If he did, it would be a miracle."
When they left Indianapolis, Kirk was in stable condition and his name was on the transplant list.
Pulmonologist Duncan suspects that Kirk's life is less than a year, and it usually takes three to six months to find a suitable transplant match.
Gal worried that her husband didn't have that long.
But the lung transplant list is not a first-come, first-served operation, Duncan explained. Patients are assigned a score indicating how sick they are and how desperately they need a new lung. The system helps to balance the needs of patients with IPF (which usually experience rapid decline) and patients with emphysema (which can survive for several years after diagnosis).
Kirk's scores in these traumatic endurance tests put him in the best position to undergo transplant surgery.
The miracle that Gail was waiting for was much earlier than they expected.
They certainly didn't know, when the phone rang at 5:05 am 7 days later. That morning, they didn't know that a woman named Irene was griefing for the sudden loss of her husband, and Kirk was getting a second chance in her life.
Gal was prepared for the worst of the drive. When they drove north for two hours to prepare for Kirk's surgery, she had a list of emergency contacts that she might need. Menefees has four hours to arrive at the IU Health Methodist Hospital. If they need escort or even a helicopter to take him there, she knows who to call.
But that morning, Kirk, Gale and the seven oxygen tanks went to Indianapolis smoothly and safely.
She took him to the hospital door to check in, and his heart beat faster as he searched for the wheelchair. He was exhausted just by walking from the car to the door of the hospital.
As soon as they entered the door, they began to wait. Menefees has heard stories about "air running". Lungs can only survive outside the body for 4 to 6 hours, and usually transplant patients find that the donor's lungs are no longer viable when they are preparing for surgery. So many transplant patients received coveted calls, teased their chances of a second life, and then left the hospital with nothing.
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At 2:30 in the afternoon, the anesthesiologist came in and they prayed for the success of the operation. It was time for Gail to leave Kirk, but she didn't want to say goodbye.
Instead, she said "I love you" and "See you later." She gave him a small salute, which was a small joke they adapted from watching an old replay of JAG.
They pushed Kirk back to the operating room, and he wondered if his life was good enough. He thought of his mother and wondered if he would see her in heaven soon.
At about 3:30 in the afternoon, the doctor told him that he would get a new lung today.
When they started the anesthesia, he made a prayer, gritted his teeth and thought, "Let's do this."
When Kirk opened his eyes 17 hours later, Gale and his two daughters were with him in the intensive care unit. Kirk remembered to let them go forward so they could hold hands. He wants them to get closer.
The operation took a long time, but the doctor told Gale that the operation was successful and even safe.
Later that morning, when they pulled the breathing tube from Kirk's throat, James' lungs gave Kirk the first real breath.
"I can say that I breathe deeper and better now," Kirk said. "It's like magic."
With every breath, Kirk felt more like his former self.
Menefees is ready to spend four weeks in the hospital and four weeks in the rehabilitation center, but Kirk has surpassed every milestone. They left the hospital 15 days later and he recovered in three weeks.
When they returned to Louisville in October of that year, Kirk rushed into the house and Gale drove the car into the garage, smiling.
There are 25 cans of oxygen waiting for her. They don't need them anymore.
Inside, Kirk climbed the stairs on the second floor in a matter of seconds. Just a few weeks ago, he needed to stop and rest for more than 30 seconds every two steps, but his new lungs allowed him to easily climb to the top of the mountain.
Later that weekend, Kirk and Gale walked across the Four Bridges together, just as they did before Kirk fell ill.
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James' lungs not only allowed Kirk to survive, but it also allowed him to restore everything he had enjoyed in life. Back to the swimming pool, even the golf course, seems to be within reach.
The following month, November 2019, the Organ Sharing United Network gave Menefees the opportunity to write a letter to James' family. He struggled to find the right word.
Kirk survived, but only because someone died. He told James' family who he was and how he promised to respect the man who saved his life by caring for the lungs they gave him.
In the end, his wife Irene wrote back saying that James was an avid fisherman and a devout religious figure. He often joked that only one person would walk on the water. This is why he never went ice fishing with his friends.
They learned that James was the life of a grandfather, a welder, and a party. Now he is gone, and a small part of him lives in Kirk.
Later that month, on the first Thanksgiving after the transplant, Gale planned to pray during the meal, but she couldn't let herself do it.
The emotions are too strong, and her gratitude is too great.
Kirk has less than a year left, and now he is relieved.
"What James did for us was to give us a fresh start," Gale said. "Because sitting around and watching (Kirk) fail is the most difficult thing I have ever done."
Columnist Maggie Menderski wrote about what makes Louisville, southern Indiana, and Kentucky unique, exciting, and sometimes strange. If there is something that fits this description in your family, town, or even closet—she wants to hear from you. Say hello at firstname.lastname@example.org or 502-582-4053. Follow @MaggieMenderski on Instagram and Twitter.
Please visit the unos.org online organ donation joint network, or contact Kirk Menefee directly at email@example.com.