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Deceased Organ Donation Readers Corner

Sick Girl by Amy Silverstein book review

When she was 24 years old, Amy Silverstein was diagnosed with an irreparably failing heart. She celebrated her 25th birthday in the hospital and a short time later underwent a heart transplant. Since then she’s practiced law, gotten married and adopted a son (plus published a book), AND she’s still kicking almost 20 years later with the same heart beating in her chest.

Pretty amazing story, right?
Not if you ask her.

Public perception about post-transplant life is mostly rainbows and lollipops. In reality, a transplant recipient’s day to day existence becomes about multiple medications, a suppressed immune system, opportunistic infections, and the looming awareness that your happy ending has a very time-limited warranty. There is a serious misconception out there – a transplant is not a cure; it is merely a treatment.

This is why Amy’s story is valuable to the conversation. She doesn’t just scoff at all those warm-fuzzy, inspirational, second-chance essays, speeches and articles; she grinds them to bits under the sole of her Jimmy Choo shoe. Despite the amazing results of her surgery, Amy is still down-right pissed.

That’s part of what makes reading “Sick Girl” so difficult.

Amy’s unrelenting anger, while understandable, never seems to abate. She mistreats all of her doctors and specialists, and even her descriptions of the social workers and psychologists charged with supporting her are condescending and uncharitable. The only person she seems to have a kind opinion about is her boyfriend-fiance-and-eventual-husband Scott, and she manages to dehumanize him in the other direction, referring to him as “her angel” repeatedly. While I think we can all agree that a loving and supportive spouse is irreplaceable, no one is infallible. By categorizing him and their marriage this way, Amy manages to distance it and her experience from her readers.

Some of the complaints about “Sick Girl” as reported by Amazon.com users focused on the author’s socio-economic status. On the surface, this seems shallow and possibly jealous. Is Ms. Silverstein supposed to hide her upbringing, her education and her standard of living so she doesn’t potentially offend anyone? Of course not. The problem lies in her inability to recognize how fortuitous her situation is. To have “the number one internist in New York”, and be whisked away to a “private hospital” for tests is perceived by the average reader as privilege. They can’t help but think that if they were the ones with the failing heart, they would be long dead before they would be able to locate the entrance to the building where her specialists practice.

Many of the author’s flaws could be overlooked if she expressed any sort of self-awareness. After all, nearly twenty years have passed since her transplant; by all calculations, she should’ve learned a thing or two. Yet near the end of her memoir she whines (I’m reluctant to use that particular word, but it is accurate) that only one person in her life, aside from her family, knew her when she was “healthy”, as if the person she’s been for the past seventeen years isn’t her “real” self.

Despite her age, formal education and by all appearances, above average intelligence, Ms. Silverstein completely refuses to accept her condition. No one, least of all me, is saying she should be happy her life was radically altered at such a young age, but her shock toward her husband’s insistent “You have a transplanted heart!” borders on delusional. It is as if she views the whole ‘sick girl’ persona as a hiatus from the life she envisions for herself, an unrealistic perception that will simply never come true.
A friend of mine asked me why, if the book contains so many deficiencies, did I continue to read it. Aside from simple curiosity, I hung in with Ms Silverstein because some of her observations deserve attention. How quickly she learned to hide her condition from her law school friends because reminding them of her imperfect health made them uncomfortable, for example. And the realization that doctors, no matter how well-reputed, are human and painfully imperfect, which means that a patient must, must, must take responsibility for their own well-being by researching and asking questions, even to the point of making demands. Finally, Amy exposes the reality of living with a transplanted organ, which is a truth the media and popular culture continue to deny.

You might find the messenger behind “Sick Girl” abrasive, but it doesn’t negate the truth of her words. In a world as complex as organ transplantation, it’s what she has to say that is the most important.

2 replies on “Sick Girl by Amy Silverstein book review”

I think the root problem goes even deeper. I have numerous family and clients that are involved with medicine and trying improve the medical system.

Our system (by system I mean the providers, the insurance, the media, and the government) is very flawed. It creates a vision that 1) we really know what we’re talking about almost all the time, 2) we all deserve to live a pain free perfect life, and 3) the system has the tools to make this all happen.

In reality, the subject matter is incredibly complex and most of the time our providers are guessing by elimination, reality is that there is going to be a lot of pain, and the tools are designed as fixing symptoms not dealing with root causes.

There is virtually no management or human development training in the medical education system. The focus on expensive end-of-life cures is unsustainable financially. No one will ever make a statement of reality such as – pain and suffering are part of the human condition – We don’t have the money to help everybody – And these expensive ‘fixes’ we try (like transplants) aren’t panaceas.

Really magnificent points, Michael. There definitely is, especially in America, this sense of ‘entitlement’ wherein we want a quick fix to our problems. Wanna lose weight? Take a pill. Feeling sad? Take a pill.

I can’t help but think back to the dawn of medicine where a village doctor would quote a ridiculously high price to ‘heal’ if he knew the person’s illness was beyond help. This way the person’s death was attributable to a family’s inability to pay and NOT the limits of the doctor’s knowledge or skills.

Part of the great irony here is that the very professionals (therapists, counselors) that could help people cope with the pain and suffering inevitable in the human condition (as you put it) are not employed by the medical community, and are not valued by our society. On average, their paychecks rival the local pizza delivery guy’s, only they’re required to have graduate degrees and professional licenses.

I’d love to hear more of your thoughts on this…

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