Gift From a Loving Husband: Part of Himself

Croatian American Donates His Liver to his wife
 

Teddy and Elena Mocibob

The New York Times

August 2, 2003
Gift From a Loving Husband: Part of Himself
By RICHARD PÉREZ-PEÑA

In the annals of selfless devotion and far-fetched coincidence, no cheap
paperback, no opera, no daytime soap has anything on the tale of Elena
and Teddy Mocibob.

They don't quite look the part of the romantic leading lady and man
right now, what with the tubes in their arms and the groggy, pained
expressions, but they can be forgiven that. On Tuesday, surgeons at
Westchester Medical Center in Valhalla removed Ms. Mocibob's diseased
liver, cut out 60 percent of Mr. Mocibob's healthy one, and transplanted
it into her. Without a new liver, doctors say, she had no more than two
or three years to live.

To make the donation, Mr. Mocibob (pronounced MOH-chee-bob), 50,
accepted a serious risk of illness and a slim chance of death from the
surgery, and the certain knowledge that he would emerge from surgery
with great pain from a foot-wide wound shaped like an upside-down "y"
across his belly. Those were not his only sacrifices; he had to give up
the cherished vices he acquired in his native Croatia: the cigarettes he
had smoked for 35 years and the firewater he made, a home-brewed drink
that he calls "Crazy H."

Yet sitting in his hospital bed Thursday, hoping to see his wife for the
first time since the morning before the surgery, he dismissed the notion
that he is any kind of hero. He did the best he could for her "because I
love her," he said. "I would not go through this pain for fun. But what
else could I do? I could not just lose her."

A minute later, Mr. Mocibob, a handyman and a landscaper who has lived
in the United States for 21 years, tried to insist that he was merely
being practical. "She can't work; she can't even wash the dishes," he
said. "I work seven days a week. I'm poor. Maybe someday she can work."

Mrs. Mocibob, 43, took a different view. She was very weak even before
the operation, and she underwent more than nine hours of surgery, twice
the time her husband's operation took.

Her speech was barely audible, punctuated by long pauses as she caught
her breath and hunted for words through a narcotic fog.

On a few topics, however, she was absolutely clear. A nurse's aide, she
intends to work again after years of being too exhausted to leave home.
She wants, more than anything, to have the energy to play with her
grandchildren, ages 5 and 2, and to take them to the zoo. And she
understands what her husband has done for her.

"He could have just thrown in the towel any time - a lot of men would,"
she said. "I know enough to know I don't want to live with a man who's
going to have regrets afterwards. But it was his idea. He wanted to do
it."

He wanted to, but it seemed unlikely at first that he could. When the
Mocibobs, who live in Pleasant Valley, near Poughkeepsie, first explored
the idea early this year, doctors said the odds were against his being a
suitable donor.

There was only a one-in-four chance that their blood types would match,
and there were other reasons his liver might not have been right for
her: it could have been too fatty, for example, or too large, or the
risk to him might have been too great.

Live donor liver transplants are relatively uncommon. There are about
300 to 400 a year nationally, compared with about 5,000 from cadavers.
Spouse-to-spouse transplants are rarer still, accounting for about 1 in
every 300 live donations.

As it turned out, this was that one, but the Mocibobs were no strangers
to long odds. Mrs. Mocibob suffers from primary biliary cirrhosis, an
autoimmune disorder that slowly destroys the liver, and afflicts 1 in
every 20,000 people.

She was one of thousands of people on transplant lists, waiting for the
right organ to become available. About one in six people who need a new
liver dies while waiting for one.

Most liver transplants involve whole organs taken from people who have
died, and, in fact, the sickest patients need the entire liver. But the
chronic shortage of dead donors has steadily increased the use of live
transplants since the 1980's.

A living donor gives up one of the liver's two lobes. Unlike other
internal organs, a liver can regenerate, so in most live transplant
cases, each lobe grows enough after surgery to give both donor and
recipient full-sized, fully functioning livers.

But the surgery is trickier, for both patients, than most organ
transplants and comes with serious risks, a fact made clear last year,
when a man died at Mount Sinai Medical Center in Manhattan after
donating part of his liver to his brother.

"The risk of death to the donor is about 1 in 350, and there's about a
10 percent risk of complications" like bile leaks, bleeding and
infections, said Dr. Patricia Sheiner, director of the liver transplant
program at Westchester Medical, who took part in the operations on the
Mocibobs. "And we tell them, `Don't expect to feel yourself for a few
months.' "

This is the sort of complex, highly specialized care that used to be
done almost exclusively by major urban hospitals, but that a growing
number of suburban and small-city hospitals have taken up.

Westchester Medical began doing kidney transplants in the late 1980's -
it now performs more than any other hospital in the state - liver
transplants in 1997, and heart transplants in 2001.

Teddy Mocibob, whose first name is Tarcizio, and his wife met in 1992.
She was divorced, working in a supermarket and supporting four children,
aged 3 to 14. She did not seem sick most of the time, but even then, she
knew she was not quite right.

Mr. Mocibob likes to tease his wife by claiming that she knew she was
sick when they met, and won his love under false pretenses. "She tricked
me," he said. They lived in Yonkers. He did not drive then, so she drove
him to and from work. (He has since learned.) Then came the days when
she was too fatigued to drive.

In 1994, doctors found that her immune system was attacking her liver as
if it were a foreign invader. If she did not have a transplant, she
learned, the disease would lead to other ailments like osteoporosis and
thyroid disease and, potentially, a host of autoimmune disorders like
arthritis and diabetes. Eventually, it would kill her.

She worked as long as she could, and took classes to become a certified
nurse's aide, determined to work with the elderly. But by 1997, family
members said, she barely had the energy to move around the house. In
1999, she and Mr. Mocibob married.

"I always believed I'd get my liver," she said. "The Lord has too much
work for me to do."

As Mrs. Mocibob's condition worsened, she entered a paradoxical phase of
the disease. She would soon be sick enough to be placed near the top of
the list to receive a liver from a dead donor, but she would also run
the risk that no matching organ would become available in time to save
her. She would also soon be too sick to be helped by a partial liver
from a live donor.

Then Mr. Mocibob suggested that he give part of his own liver. Doctors
told him that a blood test showed that he might be a compatible donor,
but that they would not even consider him as a donor until he had
stopped smoking for three months, and stopped drinking.

He went cold turkey that day, Feb. 5, he said, quitting the Crazy H, the
beer and the generic cigarettes he ordered by the carton over the
Internet. He cannot swear that he will not want them back some day.

Mrs. Mocibob knows what she wants. "My grandson, he goes, `Grandma, come
play with me outside,' and I always have to say `No, I can't,' " she
said. "I really want to play with my grandkids. I don't even know what
it's going to feel like to be normal. I can't wait."

The Mocibobs hoped to see each other Thursday for the first time since
the surgery, but they had to wait. Mr. Mocibob had a slight fever, and
doctors could not take the chance that he might give some new illness to
his wife.

But by yesterday morning, his temperature was down, and he was bundled
into a wheelchair to go to Mrs. Mocibob's room.

He wept when he saw her, unable to speak for a few minutes. He gripped
her delicate hands in his thick ones and kissed them, and stroked her
face. "It's been three whole days," he said when he finally found his
voice. "So much has happened. I have so much to tell you."

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Op-ed

This hospital is very close to where I live. If you want to send a letter to Mocibob family, I can deliver it to them either by mail or in person.

Nenad Bach