Pulling the Goalie

Recently, my husband and I were invited on a weekend trip to hike with friends in Arches National Park. Oh, how I had been looking forward to it! I love hiking almost as much as I love running—that toxic lover of mine. And to do it surrounded by my husband and friends felt like such a gift. We even managed to snag coveted permits for the Fiery Furnace, a maze of sandstone canyons with no marked trails.

Aaron and I made the four-hour drive to Moab almost giddy, ready for a much-needed getaway and some time outdoors before the holidays. We arrived as night fell, greeted our friends with enthusiasm and began making preparations for the next day. We were buzzing with excitement.

After a not particularly restful night, we woke early, divided into carpool groups and headed to the park. We wandered through the Fiery Furnace for hours, climbing over boulders and squeezing into narrow slot canyons, before I began to slow down. Even with peanut butter and honey Uncrustables and Reese’s peanut butter cups fueling me, my energy started to fade. My quads burned in a way that didn’t feel normal. I was more tired than usual and so, so thirsty.

Still, the conversation drifted toward the next hike and tomorrow’s plans. Which arch should we explore next? Who wants to see Delicate Arch?
Me, my heart shouted. I do!
But my mind countered with reason. I needed rest.

That night, as we gathered in the Airbnb swapping stories and playing games, a brutal migraine struck. The nausea, the pounding pain—it all hit at once. Ugh. Why now? By the time Aaron and I headed to bed, I knew I wouldn’t be able to join the group for their hikes the next day. Even though I understood it was the right choice for my body, the sadness settled in deep.

The next morning, Aaron and I made an early retreat and headed home. As we made the four-hour drive we listened to Malcolm Gladwell’s Revisionist History podcast where he talked about hockey. I don’t know anything about hockey. I don’t even like hockey; I’m in no way particularly interested in hockey. But what they were talking about caught my attention. Pulling the goalie. I’ll try explaining.

In hockey, when a team is down late in the game, the losing coach might pull his goalie  and substitute them with an extra attacker, so instead of having a full offensive team and a goalie, the coach now has six offensive players and no one guarding the net. It’s a risky move that, while making it easier for the other team to score, also increases the losing team’s chances of scoring a goal and tying the game. The coach is making a calculated risk. Pulling the goalie too early will undoubtedly upset the fans in the short term–possibly in the long term if things don’t go well. But if things play out the way the coach would like, well, then who’s the hero?

I’m the type of person who suffers from Fear of Missing Out (FOMO). When people gather, I want to be there. I want to share in the laugher, get in on the inside jokes, make all the memories. You see, as a child, I spent most of my time with just my sister as my companion and friend. Due to divorce, job changes, moving, and general upheaval, we found ourselves separated from family and frequently changing schools. While teaching me how to adapt and quickly make new friends, I also took on a fear of being left behind.

For three years—while I waited for a heart transplant and later recovered—I was, out of necessity, left out of get-togethers and girls’ trips. I watched friends and family travel and enjoy activities that felt so exciting, yet out of reach for me. From home, it all felt distant, and I often felt lonely and left behind. Even now, during our walks, my friends sometimes reminisce about jokes and stories from the trips they took while I was unable to leave the area. It’s no one’s fault, but hearing those memories still hurts in a quiet, complicated way. Since then, I’ve fought hard—both mentally and physically—to rejoin the world: joining groups, getting active again, going on walks, hikes, and weekends away.

Until I have to pull the goalie.

Another way to explain this—drawing on an example Malcolm Gladwell uses, without getting political—is through America’s gun laws. In many states, there is a legal principle called “Duty to Retreat,” which requires a person under attack to retreat safely, when possible, before resorting to deadly force in self-defense.

It feels counterintuitive, right? Your property, your safety, your family may be at risk—and you’re expected to back away? To rely on retreat as your defense? Yet research shows this is actually safer. In states where “Stand Your Ground” laws have replaced the Duty to Retreat principle, homicide rates have increased, according to Gladwell’s podcast. 

I cried when the migraine hit. I cried again when I realized my health wouldn’t let me join the group on another hike. More than anything, I wanted to stand my ground, take some pain medicine, and be right there with everyone in the national park the next day. But logic was the rule of the day. I needed to take the calculated risk of leaving–choosing my health and well-being over my social standing. I might miss the jokes, the memories, and maybe next time even the invitation. But if I stayed, the risk could be far greater.

After my transplant, I had a lot of expectations for myself–most of them centered on participating again. I wanted to run again, to race, to take classes and teach classes again, to join every activity that crossed my path. If people were doing something, I wanted to be right there with them. But life never unfolds the way we picture it. It unfolds the way it will. And so we adapt–something I’ve become very good at. Sometimes the wiser choice is that quiet, calculated retreat. Sometimes we have to pull the goalie. Stepping back isn’t failure. Sometimes it’s survival.

In the end, I’ll be better for having made the call. My friends will be there on Monday with another invitation–I know they will. Hopefully I’ll be well enough to join them. And if not, I have faith that the people who love me will always hold space for me, just as I hold space for them.

The Secret Language of Worry

I’ve heard it said that honesty is the first casualty of illness. I’d argue that honesty is the first casualty in any struggle. I first learned this when I took my then fourteen-month-old daughter in for a developmental evaluation, ordered by her pediatrician after we first noticed her having seizures.

After watching her “play” for nearly an hour, a speech therapist and a registered nurse brought me their assessment: moderate to severe global delays. With a cry trapped in my throat, I asked, “Will she catch up?” The two women looked at each other, glanced at my daughter, then at the floor—never at me—and said, “We’ve seen miracles.”

Was it a lie? Maybe. Maybe not. I don’t know. But I do know it wasn’t complete honesty.

This was my first exposure to the secret language of worry. Since that time, I’ve become fluent in this unique dialect.

It begins with the eyes. They look down and to the right, or over your left shoulder. The face may turn toward you, but the eyes wander elsewhere. There may be a smile, the conversation might seem jovial, but the eyes are elsewhere. Even when truth is spoken, the eyes often drift away.

You will try to gain eye contact, and you might succeed momentarily, but then your attention is drawn to the mouth. Around the lips is a tightness—a subtle stiffness. Perhaps the laugh is forced, the smile lingers too long. In some settings, masks conceal this nuance, but you’ll notice the sound in the throat, the clearing of vocal cords. Even a brief pause before answering can be a tell in the language of worry. What is this person really trying to tell me?

As you become fluent, you notice the subtleties of speaking this language. You learn its origins. Suddenly, you avoid eye contact when your spouse asks if you’re feeling okay. You find something on the floor to study when a friend asks about lab results. Your voice weakens, and your throat clears when a son or daughter asks about a future date. Will you be well enough then? Who even knows?

The secret language of worry exists as a shield, both for the speaker and the listener. We live in a world overflowing with information—sometimes empowering, sometimes overwhelming. The truth can hurt. We carefully release it, bit by bit, gauging the reaction of those we love. Can they hold this worry with us?

In a few weeks, I will return to the hospital for my two-year heart transplant follow-up. They will run labs to monitor my organs—especially my struggling kidneys. They’ll perform a chest X-ray, EKG, echocardiogram, right heart catheterization, myocardium biopsy, and even a left heart catheterization with angiogram to monitor cardiac allograft vasculopathy (I just wanted to flex some medical jargon). As the date approaches, I find myself slipping into the secret language, explaining and justifying my concern repeatedly.

Oh, how I wish I could replace this language with the foreign tongue of celebratory optimism. I rehearse affirmations and speeches of positivity in my mind. But over the years, the language of worry has become ingrained, and it pulls me in too easily. Gratitude helps. Prayer helps. Patience helps. Until then, I practice them all.

If you catch me slipping into this secret language, try to relate. Empty platitudes have no translation in the language of worry; they ring hollow to those fluent in this tongue. Just listen. Listening helps.

In the end, we all speak the language of worry in our own way—it is, after all, a universal language.

The Toxic Ex-Boyfriend

I have this toxic ex-boyfriend, and he haunts me. In fact, I run into him almost every day. It’s becoming problematic.

We were first introduced in elementary school. I hated him then. I couldn’t understand the kids who liked him—mainly the boys in my class. He was always chosen for all the teams, and all the boys loved to play with him at recess. I personally never understood the attraction.

In junior high, he started drawing the attention of some of the girls. Not me, however. I tried steering clear of him, but no matter how hard I tried, it seemed we were always partnered up in gym class. It was torture.

In high school, my sister started hanging out with him a lot. She and her friends spent quite a few summer mornings and Saturdays with him. Their time together looked so easy—so fun and refreshing. Though I didn’t understand at first, you could say I was intrigued; maybe there was something there. Maybe if I gave him a try, I’d understand the appeal. And so I began a flirtation, if you will. Sometimes I’d join my sister and her friends when they’d hang out with him on a Saturday, hoping maybe there’d be a spark between us. He was kind of popular, and I wanted to like him and really wanted him to like me.

Let me tell you, in the beginning it did not go over well. I guess you could say our chemistry was lacking. Yet time and time again, we’d continue to ask each other out—I’d chase him, he’d chase me. Around and around we’d go. This went on for years, until one day it all clicked, sometime after the birth of my first child.

Most weekdays I’d set aside at least a little time for just the two of us, usually in the morning after my husband left for work. I’d put my son down for a nap and sneak off to spend time with him. But there were other times when I’d bring my son along, figuring that the early introduction was somehow good for him. Our relationship was easy and flourished then. Those mornings were so fun; sometimes I’d add an afternoon. With just one young child and so much free time, I put a lot of focus on him, and our relationship was strong.

But with the birth of each additional child, our dates became more difficult. I couldn’t just put a child down for a nap or bring one kid along to meet up with him. Suddenly, I’m juggling schedules. I’ve got preschool and soccer carpools. I’ve got toddler meltdowns and orthodontist appointments to work around. Timing things got harder and harder. Sneaking away to find time with him became more difficult. Our time together became more precious, so when I did find time, I wanted to really make it worthwhile. I hung on longer, or more intensely—anything to make the time more meaningful.

Eventually, I found ways to add dates to the weekends. I might sneak away for a Saturday morning with him. And that’s when things became torrid. That’s when my friends found out.

Once my friends got involved, we began planning weekend getaways. Aaron managed the kids while I went away with my friends and met up with him. I still feel guilty admitting that those were good times. I felt wild and alive. Adventurous. I was another person away with him and my friends. We ran free, and we laughed until our breath caught in our throats and our heads throbbed. And at the end of the trip, we almost felt hung over from the experience. But there was a price to pay.

This went on for more than twenty years. Over two decades of our love affair began taking a toll on me. And Aaron began noticing.

I began feeling tired. A lot. But this boyfriend demanded my time. And, oh, how I wanted to spend that time with him. I felt young with him. He validated me in a way nothing else did. But eventually, he broke my heart—completely destroyed it.

Wouldn’t you know it, as soon as my health began to fail, he left me high and dry. There was a part of me that thought I could hold on to him until I was an old lady, that I’d go to the grave with him by my side. At least I’d be able to tell my grandkids about my love affair, and they’d blush and whisper about it to their friends, secretly proud of their grandma.

Nevertheless, when my health went south, I came to peace with ending our relationship. I’m a happily married woman of a certain age, I figured I didn’t need him anymore. Believe me, I mourned the loss—I grieved, for sure. I felt broken inside. We had been together for so long, he had become a part of my identity. But I did blame him—his toxic nature. And there was a piece of me glad to be rid of him. I put that relationship firmly in the past.

But then my heart transplant surgeon brought him up, named him by name. Said he’d like to see me get back together with him. Perplexed, I turned to my husband, who sat beside me. He nodded his head in agreement. “I think you should try again.”

And so, after completing thirty-six sessions of cardiac rehab, I laced up my running shoes and tried again.

With a new, young heart and with ARVC in the rearview mirror, I jumped on the treadmill and began cranking up the speed. I started with just a few awkward, toddler-like steps for only thirty seconds at a time, eventually working up to running a full mile. My stride was clumsy, my cadence slow. But I did it.

Did I love it? No. In fact, I’d say we’re back where we started, with me watching all the runners around me making it look so fun and so easy, making me wish I liked it. Just like those days in elementary school, those boys at recess who ran with so much freedom and ease—at least now I know the feeling. My sister and her friends in high school who made their Saturday morning hill runs seem fun—now I understand the appeal.

I know I’ll try and try again. Some runs will be good, and other runs will be horrible. I might chase him; he might chase me. We might go around and around like this for a while. I don’t know if my love affair with running will ever be rekindled. But I hope one day to tell my grandchildren about my love affair with running and make them proud of their strong, resilient grandmother.

He Swept My Floor

My son is currently facing one of those big life choices: which path to take after college. He’s pre-med, but as we all know, while many are called, few are chosen. Not everyone who intends to go to medical school will actually find themselves on that journey. He’s also considering applying to a PA (physician assistant) program. Whatever path he chooses, his goal is the same: to work with patients in healthcare. And he’s diligently preparing himself now, no matter what the future holds.

Recently, someone close to him said, “We’ve decided you need to go to medical school because one day you’ll regret not going all the way.”

I bristled immediately. While I believe my son is smart enough to get into medical school, if he chooses a different graduate program, I will be proud of him. I would never see him as not having gone “all the way.” And here’s why: my son’s motivation for entering the medical field—at least in part—is to have a positive impact on the lives of others. He doesn’t need to be an MD to do that.

I may not know everything, but I know a lot about being a patient. I’ve spent my fair share of time in hospitals, clinics, ERs, procedure rooms, and recovery rooms. I’ve interacted with everyone from surgeons to nurses, CNAs, patient care techs, therapists of all kinds, pharmacists, and imaging technicians. I’ve been impacted both positively and negatively by all of them—no special credentials required.

I recall one early admission in the ICU. It was terrifying. They were listing me for my heart transplant while simultaneously trying to stabilize my erratic heartbeat. I was bewildered, scared, and miserable—and to top it off, my ICU room had no windows, no privacy, and no toilet. The cardiothoracic surgery team came to meet me. I don’t remember much from that meeting, but after everyone else left, one PA stayed behind. With tears in his eyes, he said, “What you’re going through is very scary. We’ll do everything we can to help.”

Another memory comes from a particularly rough pre-transplant clinic visit—perhaps when I was told my transplant listing would be paused while I underwent treatment for thyroid cancer. I broke down in tears. I’d been stoic until that moment, but everything spilled over. My fake eyelashes fell off. My nose ran. It was embarrassing. The doctor hugged me—a gesture unusual for physicians, at least in my experience. Then, that weekend, on her own time, she called to check in on me.

Even now, I sometimes dread my visits to the cardiac clinic. I occasionally leave feeling gaslit or hopeless. The clinic isn’t my favorite place. Yet, even there, I’ve noticed small acts that matter. A medical assistant compliments my outfits and tells me I look nice. That simple kindness motivates me to show up with a smile, to demonstrate that I am worth supporting.

I’ve had nurses hold my hand, patient care techs remember my name and greet me with a smile, echocardiogram techs treat me like a human being, and doctors treat me more like a friend than a body in a bed.

One of my favorite stories comes from a hospital stay while being treated for Lippy. I was trying to make the best of it, to find silver linings. There was a housekeeper who swept my floor almost every day. I could tell by the shine in his brown eyes beneath his mask that he was genuinely happy. Aaron, ever the conversation starter, asked where he was from. He paused, smiled, and shared his story.

He was a refugee from Eritrea in East Africa, who had spent 14 years in forced military service and 15 years in a refugee camp in Ethiopia before coming to America. He had lived in Seattle before settling in Salt Lake City. He had a wife and five beautiful children, proudly showing us photos. He bragged about his daughter, who had earned a scholarship to a local college.

Then, humbly and tenderly, he spoke of his son, whom he thanked God for before recounting how his son had become involved in a gang and tragically lost his life to senseless violence at a nearby trailhead. I remembered hearing about the incident in the news. My heart broke for him, this unassuming man.

“I do not judge,” he said. “I thank God; he was a gift.”

In that moment, this man—through his vulnerable authenticity—made me feel seen, valued, connected, and human again. And perhaps, in that connection, I found the medicine I truly needed to begin healing.

The lessons I take from these experiences are clear—and there are always lessons:

  • Never let adversity dim your light.
  • Never let your circumstances interfere with your ability to connect with another person or to act on what you feel called to do.
  • Life itself is the best course in kindness, the best training in compassion.
  • No credential is required to be a decent human.
  • And there is no gatekeeper to having a positive impact on someone’s life.

It’s not about titles or degrees. It’s about showing up, being present, and living with empathy. Any human can do that.

Deep in the Sweet Melancholy

In the movie Elizabethtown, the character Drew Baylor stands in his aunt’s kitchen with a group of new-to-him relatives following his father’s viewing. While visiting estranged family in Kentucky, Drew’s father had passed away from a heart attack and Drew was sent by his mother and sister from Oregon to take care of the funeral and bring his father’s remains home. Chaos ensues. In this particular scene, the night is warm, the light is low, they’re obviously tired both physically and emotionally, yet they’re smiling as they revel in a sweet melancholy that often follows traumatic life events. 

I love this scene. It calls to mind a difficult-to-describe sentimentality that you have to experience to understand. It is this almost peaceful longing, a reverent recall of difficult times. As if the slow let down  that happens following the adrenaline rush and fear, provides its own serotonin release, cementing a beautiful nostalgia all its own.

This is what my family experienced in the month following my heart transplant.

As you recall, my miracle phone call happened on December 14th 2023, with surgery taking place in the wee hours of the morning of December 15th–just in time for the holidays. I had a record recovery and left the hospital eight days after surgery—it would have been seven but I begged for one more day to learn how to manage my medications and get a hold on my blood sugars. Nevertheless, I was released from the hospital on December 23rd—just in time to celebrate Christmas with my family.

Coming home from the hospital felt a lot like bringing home a newborn infant. For me it meant a whole new way of life. While I had gone through a lot of training on medications and things to watch for, I felt unprepared and scared. My body did not feel like my own. I was weak and sore and dependent on everyone around me—something I wasn’t used to. Even showering was a new experience with procedures and regimens that needed following and for which I needed assistance. It was bewildering. 

As I was so fresh from transplant, I basically had no immune system. My transplant team asked us to keep visitors to a minimum. We decided to basically act like it was the 2020 pandemic again and go on lockdown. Our married daughter came back home with her husband, our college-age sons moved back in (it was winter break anyway), and we hunkered down. Even though surgery had gone well and my recovery was, for all intents and purposes, on track, we were still taking things day by day. 

We fell into a rhythm of sorts: wake up, take medicine, check all my vital signs, make our way to the family room, take medicine, eat cheese (seriously, we ate six pounds of cheese), take medicine, assemble legos, take medicine, share a meal, take medicine, make the strenuous journey up the stairs to my room and take all of my vitals again, take medicine, make our way to bed for a restless night of worry and night sweats (oh, the joyous transplant medication side effects).

There were the inevitable excursions out to the lab, the pharmacy, or to the hospital for right heart caths and biopsies. I hated those times. Those days were long for me. I could barely walk across a room, let alone last an entire day navigating the halls of the University of Utah hospital. I was expected to arrive, fasting, at the hospital usually before 7:45 a.m. for my then weekly biopsies to check the progress of my heart’s healing and monitor any signs of rejection, and we wouldn’t arrive back home before 5:00 p.m. Thankfully, neighbors and friends often provided dinner for our little tribe on those harrowing days. 

For me, just the like the early weeks of motherhood, the days were simple but hard.

The holidays came and went and we existed in our own little bubble. 

No Christmas Eve parties. No family Christmas dinners. No Sunday services. No New Year’s Eve party. Just the seven of us gathered around the six-pound block of Muenster and the Titanic lego set.

The thing is, however, when we each think back on that Christmas and holiday season we each remember it with this deep, sweet nostalgia for the melancholy of that time. And though this is just my retelling of that season, we talk about it in a similar way. While we’re all grateful to have moved on and healed from that winter of 2023-24 we all express a longing, if you will, for those simple-but-hard days.

There can be a pulling together, a unifying in times like these. Where difficult events often force change—change in our lives and changes in ourselves—nostalgia pulls us back together. Whether it arises through grief brought on by loss or through the emotional release that takes place following periods of great stress, this sense of exhausted tranquility helps us process intense feelings into something–well, transcendent.

Call it a coping mechanism, call it delusion—call it what you will—but I call this experience a blessing for enduring well the hardships life throws our way.

I can recall one other time when I felt deep in this sweet melancholy before. It was after the passing of my brother. At the end of a long, emotional day of funeral planning we had gathered in the office of his home to go through some papers and photos. It was a warm summer night, not unlike that scene from Elizabethtown. We ended up crying and laughing, laughing and crying into the night, remembering better, easier, more innocent times. Recalling times when laughter came without tears, when memories were either good or bad, when we were uninformed on the nuances and complexities of adult relationships, and we simply would not have been able to fathom a world where joy and sorrow could exist side by side, and the understanding that we are all better for it. 

A world before we knew the longing for simple-but-hard times—and the joy of a six-pound block of cheese.

But I Didn’t Like My Face

I’m no Pollyanna, but I wouldn’t consider myself a pessimist either. In any situation, given time to think, I feel I have the ability to see both the good and the bad. When I was listed for transplant, Aaron gave me this cute little trinket—a cloud-shaped tchotchke engraved with the words Always find the silver lining. And that has become a mantra of sorts.

I decided early on that I was going to use the opportunity of receiving a heart transplant as a chance to improve myself—to truly have a change of heart. I often fantasized about waking up from surgery, or at least coming through recovery, with this grand new perspective that granted me wisdom, patience, kindness, and the ability to find a well of joy in life that was so often more difficult to find before. Receiving this second chance at life, this priceless gift, would make me a better person. And I tried—I really tried.

But it’s an uphill battle.

I had been warned about the nasty-but-necessary steroid prednisone. The one that makes you angry, tearful, sleepless, hungry, jittery, giggly, ravenous, and basically causes you to climb the walls. And for me, it did all of those things. I hallucinated (ask my family about the jelly-headed aliens and the Christmas light parade); I stayed up all night writing and rehearsing my TED Talks—plural; I broke down in tears in front of the poor cafeteria worker when I was reminded the quesadilla didn’t work with my dietary restrictions, just to name a few of my adventures on prednisone.

And then, one month post-transplant, I had my first rejection episode—a condition where the immune system attacks the transplanted organ. I was called back to the hospital for an extra blast of IV Solu-Medrol, an intense steroid. After a three-day stay, I left the hospital and waited for the inevitable… moon face.

I would place a picture here, but I don’t want to. Just Google an image of Alec Baldwin.

I tried everything to take the swelling down: gua sha, red-light therapy, lymphatic drainage, depuffing masks—you name it, I’ve dropped dimes on it. To no avail.

I was so sad at what my life looked like, I cried, “I am a monster!” Aaron hugged me and assured me, just like everyone else had, that it would go away soon.

It took about a year for the swelling in my face to go down—at least in my opinion. It took just long enough for me to have a recurrence of thyroid cancer that required surgery, which threw me back into rejection—again. Another blast of steroids, this time outpatient, led to another, albeit slighter, moon-face period.

You don’t even have to wonder—I’ll save you the energy and volunteer that I am, indeed, vain. I’ll admit it. I like to look nice. The first thing I do in the morning is put on makeup. Well, actually, I brush my teeth first, but makeup comes before I leave my room. Even so, I tried finding the silver lining: “Look how the prednisone puffiness has almost erased my fine lines and wrinkles. Maybe I’ve found the fountain of youth!”

Aaron would say, “You’re still beautiful to me, and you don’t look anything like Alec Baldwin.”

Friends kindly told me they didn’t even see a difference. Yeah, right.

And, of course, I heard the inevitable: “It could always be worse.”

Never—I repeat, NEVER—say these words to anyone, especially a transplant patient.

It got worse.

In June, I bit my lip. Who hasn’t? It seemed innocuous at first. But over the passing days, that bite turned into a canker. I’m no stranger to cankers—especially since transplant and being put on the immunosuppressant sirolimus. I didn’t think much of it and just steered clear of the right side of my mouth while eating for a while. But things got worse—in a big way.

Two weeks later, we flew to Ohio to help our daughter move from Cleveland back home to Utah. She met us at a hotel with her car loaded with boxes, and we began driving across the country. My canker hurt, and I was mainly eating soft foods and shakes to avoid injuring it more. Nevertheless, while stopped for the night in Nebraska, I woke up in excruciating pain. I went into the bathroom of our hotel room to inspect my lip. It was so swollen I thought the skin might actually split. The canker itself was about the size of a corn kernel, but the lip was hugely swollen, and I began to worry.

Here I was, literally in the middle of nowhere Nebraska, far from a hospital, a full day’s travel from my transplant team, and I didn’t know if I had some kind of rare, raging infection or what. I kept ice on it the next day as we made our way home, where I got myself to Urgent Care as quickly as I could.

Over the next few days, I went back and forth to Urgent Care and back and forth on the phone with my transplant team, trying to figure out what was going on with this mouth ulcer—until I found myself in the hospital with the world’s worst canker sore, which I had begun calling Lippy. It was so big it deserved a name.

Again, I would place a picture here, but I don’t want to. It makes me sad. But you can find it on my Instagram. Just imagine a gnarly mouth sore about the size of a large gumball, with swelling into the cheek.

I was in and out of the hospital over the course of two weeks as Lippy got worse and worse. I couldn’t eat due to the intense pain it caused—anything I consumed had to go through a straw. I couldn’t talk, and I frequently drooled. At the same time, I was struggling with terrible migraines. And every professional and specialist at the University of Utah looked at me with pity and said, “I have no idea what this is, but it sure looks bad.”

These are words nobody should ever hear.

I was tested for a myriad of infectious diseases, parasites, amoebas, autoimmune diseases, even multiple forms of cancer. I gave blood samples, stool samples, tissue samples and biopsies, and had a CT scan. But in the end, the doctors were split: it was either a bad reaction to sirolimus or a reactivation of Epstein-Barr virus. Either way, the treatment was time to heal and—yes, you guessed it—more steroids.

I was struggling.

My heart transplant had been nothing short of a miracle—I was truly grateful. And in the grand scheme of things, I’d been blessed with a fairly easy time and few setbacks with regard to transplant. Others really did have it worse. I knew this to be true.

But I didn’t like my face.

And I hated myself for it. I wanted to like myself, inside and out. I wanted to be 100 percent happy and grateful all the time post-transplant. But here I was, regretting everything. If life post-transplant meant constantly worrying about cancer, infections, rejection, and hating what I looked like, maybe I’d made the wrong choice when I accepted this heart. Ouch—that hurts to admit.

At the end of the day, the only choice I had was to sit it out and wait. Wait for Lippy to heal and for, eventually—hopefully—the swelling in my face to go away. And after two months, Lippy did pretty much go away, except for the scar tissue left behind. The puffy face, well, that may just be my new normal, at least in part.

I think it’s fair to say that two contrasting things can be true at the same time. I am finding that I can be grateful for my transplant and also be upset about some of the hardships it brings to my life. I can find joy in celebrating life’s milestones I get to witness—like my son’s wedding and the birth of my first grandchild—and still bemoan the chronic condition I now live with. I can be grateful for life and still not love my puffy face.

What I’m learning is that change is a choice that comes only by consistently showing up with gratitude. That new perspective and change of heart I hoped for with my transplant is up to me—and that it’s also perfectly acceptable to see the clouds along with the silver lining.

In Good Hands

Sit with me for a minute, will you, and let me tell you about a dream I had that wasn’t really just a dream at all.

First, a little backstory. We were driving through Salt Lake City when Aaron’s phone rang. It was a friend from work who had a connection to a PA working with an electrophysiologist—a cardiologist who specializes in heart rhythm disorders—who could fit me in for an appointment quickly. Desperate, we accepted the next available opening.

Unbeknownst to us, we had agreed to see the very doctor who had treated me 25 years earlier. I hadn’t liked him then—let’s just say his bedside manner was lacking—and sadly, we did not like him now either. Nevertheless, within a month, he diagnosed me with ARVC, placed an ICD, and referred me to an interventional cardiologist for follow-up care. Over the next two months, Aaron and I both had misgivings; we woke up in the middle of the night feeling I needed a change of providers.

At that time, I was receiving care at IMC in Murray, Utah. Our insurance covered most services, but some things required referrals elsewhere—a frustrating hassle. There were other issues, too: a hospital admission where my doctors could not be reached, test results that never came, and a general sense of lack of urgency regarding my care. Eventually, we made the switch to the University of Utah—a decision that pleased our insurance but left us uncertain.

That’s when I had the dream.

I was in an empty banquet hall with windows overlooking the city. It was just my family and me when in walked Russell M. Nelson, then president of the LDS Church and a former renowned heart surgeon and researcher, and his wife. He sat next to me on a padded window seat, placed his hand on my knee, and said, “We are aware of what’s going on, and you are in good hands.”

That was it. That was the entirety of the dream. Yet I woke feeling warmly comforted.

Fast forward a few months and several traumatic events, and I found myself waiting for a heart transplant. At the University of Utah, three surgeons performed heart transplants, and the surgeon on the day of surgery was the “luck of the draw.” Patients are encouraged to consult with one or more surgeons while waiting. I met Dr. Selzman during a particularly grueling two-week admission following a VT storm—an episode of uncontrolled ventricular tachycardia. I was informed I would be listed for a transplant and then bombarded with the pre-listing battery of tests. I met countless specialists, residents, med students, fellows, technicians, social workers, and nurses—their faces blurred together, and Dr. Selzman’s was just another among many.

I met another surgeon, Dr. Goodwin, during the following 18 months of my waiting. He was friendly, quiet, confident, and passionate about his work. Aaron and I felt reassured that we were in good hands.

Then, on December 14, 2023, the call finally came: “Fiauna, we have a heart for you. Are you ready?”

Nothing can prepare you for that call. No matter how many times you rehearse it in your head, checklists you’ve crossed off, bags packed, or prayers said, when it comes, you are struck speechless. We made phone calls, gathered our family, had a small Christmas gift exchange—because we had no idea what life might look like on the other side of this day—and headed to the hospital.

During pre-op, scheduled in the early hours of December 15, the staff repeatedly told us how lucky we were because Dr. Selzman was on call. Their words barely registered. I felt dizzy, nauseous, and weak. Anxiety consumed me. Soon, a surgeon I had barely met would cut into my chest and remove my most vital organ. And if things didn’t go well…

I was acutely aware that somewhere, for some family, this was the worst night of their lives.

As the anesthesia team inserted an arterial line into my arm, my blood pressure plummeted. I felt myself losing consciousness and prayed silently: “Heavenly Father, please hold me.”

I have no recollection of what happened next, but Aaron says Dr. Selzman walked in calmly, said, “Oh, I know how to fix this,” and wheeled me to the operating room.

Later, after recovery, while walking the cardiology unit, I saw a plaque on the wall bearing a picture of President Russell M. Nelson embracing Dr. Craig H. Selzman.

Remember my dream, where President Russell M. Nelson told me I was in good hands? Had it been just a dream, or did President Nelson somehow know I truly would be?

In 2018—five years before my transplant—the University of Utah created the Dr. Russell M. Nelson and Dantzel W. Nelson Presidential Chair in Cardiothoracic Surgery, a professorship awarded to Dr. Selzman. Five years later, President Nelson donated his professional journals to the University. In a meeting with dignitaries from around the world, Dr. Selzman shared what he had learned from President Nelson. Then, in the October 2025 General Conference of the Church of Jesus Christ of Latter-day Saints, Elder Dale G. Renlund, also a retired heart surgeon, shared a story about Dr. Selzman:

“Dr. Selzman recounted that, four days before being appointed to the professorship, after a long day in the OR, he learned that a patient needed to return to surgery. Fatigued and disappointed, he resolved to act differently. President Nelson had been known for his composure, respect, and patience, and Dr. Selzman determined that his actions in the operating room would emulate those qualities. Though already considerate, he chose to be even better, mindful of the impact on his team.”

Almost two years have passed since my transplant, and over a year and a half since my last follow-up with Dr. Selzman. There is a strange intimacy in trusting someone with your life, someone who has held your heart in their hands. Yet, the day-to-day of a surgeon’s life moves on, leaving behind a subtle emptiness for the patient.

Healthcare often makes us feel like a number, not a human being, and our stories can feel invisible. This is not uncommon. I know firsthand the long hours, low wages, and lack of support in the healthcare profession. But feeling unseen can make self-advocacy difficult, and self-advocacy is vital to good outcomes. Feeling safe and valued matters.

Elder Renlund’s talk illuminated this for me. Before surgery, I had understood the professional significance of Dr. Selzman’s award. That was meaningful. But learning about the character lessons he drew from President Nelson—composure, respect, patience—transformed everything. I felt seen, I felt safe.

I realized then that my dream had not been solely about easing anxiety or reassuring me about my choice of surgeon. It was a whisper of love from a Father in Heaven who knows all things and prepares a way. From the start, I had been held in the very best of hands.

His hand is in all things. If you can’t see it, look for it. What you seek, you will find.

And that is the story of a dream that wasn’t just a dream after all.

Jars of Hearts and Fishing Line

Another day, another five-mile walk in the autumn sun. I’ve said it before, and I’ll say it again: what a privilege.

There was a time I would have taken that for granted—not just the walking, but the friendship and camaraderie that comes from spending miles in conversation with friends.

What seems like a lifetime ago, I was a runner. Running was solitary for me, exactly how I liked it. It gave me space for my thoughts. Pounding my burdens into the pavement became my therapy.

I began walking with friends after buying my first home and having a few kids. That’s when I discovered the joy of female companionship, and I learned that doing something hard together—especially something physically demanding like exercise—can strengthen relationships in ways words alone cannot.

But life grew noisy. The demands of motherhood and the endless “more important” tasks slowly edged out those near-daily walks with friends.

In 2012, I suffered a traumatizing miscarriage and fell into depression. Aaron gently suggested I find a hobby to help me recover. I decided to certify in group fitness and began teaching a Pilates-and-yoga-fusion class I called Mix Method. Later, I added High Fitness to reach a broader audience and bring a little cardio fun into the mix.

Putting myself out there wasn’t easy at first, but week by week, my class attendance grew. I had my regular ladies who came faithfully, and others who popped in when life allowed. We spent years sweating side by side, learning from one another, laughing, struggling, and celebrating our progress. I called them my friends, and I hoped they felt the same. Doing something difficult—especially something physical—has a way of bonding people.

But it all ended.

That cursed day in October 2021, my heart could take no more. With my ARVC diagnosis, it was no longer safe to teach fitness classes. I was a literal ticking time bomb. Teaching had been my social life, my way of connecting. Without it, I felt like I had no value outside providing classes.

At one point, I had to write an email to High Fitness to cancel my membership and close my instructor portal. I would never teach aerobics safely again; my heart was broken. I explained my situation—that I needed a heart transplant—and their response was, “That must be scary for you. Have fun in your next adventure!”

I wasn’t sure what response I had expected, but it certainly wasn’t that. I felt dropped like a wet brick by a community I thought I could rely on.

There have been times in the last four years when I felt deeply alone. That feeling is common for people who have gone through something as traumatic as a heart transplant—there are few who can relate, and some distance themselves out of discomfort or fear. I also noticed that my conversations often circled back to my health, which can be boring or isolating for others.

Almost exactly two years ago, I sat in my car, tucked inside the garage, feeling utterly destitute. My health was failing, and I knew my days of driving were coming to an end. That morning, while taking my daughter to school during a dizzy spell, I had driven directly into the path of a dump truck, narrowly avoiding disaster with the next turn. I had to admit: I was no longer safe behind the wheel. By that time, I had been waiting for a heart for more than a year. I realized that in order to get better, things were going to have to get so much worse. I needed a miracle. I cried. I prayed. I cried and prayed again.

And I felt so alone.

I asked God to send me someone, anyone, to help me—someone to ease my burden, to distract me from the crushing loneliness. The answer was clear: no.

Surprised? I was. It seemed like such a simple request. I wasn’t asking for an earth-shaking miracle. I wasn’t asking for the heart I needed. I was asking for someone to reach out and ease my loneliness.

The answer was no because I had lessons to learn—one of which was to notice and appreciate the ways people were already showing up, even in small ways.

This is one reason I collect heart-shaped rocks.

On my kitchen counter sits a jar of heart rocks. Most are collected from nature—small gifts from a loving Father in Heaven, reminders to see miracles every day. Some are gifts from people in my life, accompanied by notes that say, “I saw this rock and thought of you.”

My son, Aiden, served a mission in Ghana. Fishing is a big part of life there in Cape Coast. Fishermen take large nets from the beach and cast them into the ocean. At the end of the day, they pull the nets ashore to see what they’ve caught. The nets are huge, and they cannot be hauled in by one man alone—so others step in to help.

One day, Aiden and his companion came across such a scene. They began to help pull for an hour before two of the fishermen began arguing. To Aiden’s surprise, everyone else dropped the line and walked away. No fish were hauled in that day.

In life, we all have our own lines we’re pulling, our own responsibilities and messy challenges. At the same time, we are called to show up for others. We don’t have to haul in the nets alone.

Recognizing how people show up—big or small—makes a difference. A sincere, “How can I pray for you?” or “You’re in my prayers” goes a long way. Faith-filled prayer, followed by acting on promptings, is one of the most charitable things we can do. After all, in the final hours before His death, that is exactly what Christ did for all of us.

I am blessed to see these acts in my life: God’s angels taking up my line, helping me haul in my nets. Offering a prayer, silent or spoken. Noticing a heart-shaped rock, cloud, or even a Pringles chip. Sending a morning text: “Walk at 9?”—and then filling the miles with our words and laughter.

What a privilege.

Witness Marks

My husband loves old clocks. I’ll admit, it sounds romantic—but when he brought his first antique clock home, I was a little perplexed. The thing was beautiful: a mantel clock made of ebony hardwood, engraved with delicate filigree. Built around 1910, it required care in the form of weekly winding. He was instructed to turn two keys—one clockwise, the other counterclockwise. If he kept to a disciplined schedule, the clock kept remarkably good time and chimed faithfully on the hour. If he forgot to wind it, well… she sat uselessly on the piano where she was meant to mark the passage of time.

Aaron is disciplined, and he wound the clock regularly. On the rare occasions he forgot and the clock fell behind, he would patiently work the keys and gently move the hands back to where they belonged. One Sunday evening, Aaron went to wind the clock only to discover it was broken. The hands no longer responded to the turning of the keys. When we removed the back and exposed the inner workings, we found the problem: the coiled mainspring—an essential piece—had fractured. We had no idea how to fix it or where to find someone who could. Aaron was devastated. He was so proud of that clock and of the care he had taken to keep it running, and his disappointment made me deeply sad.

Eventually—by what means or after how long, I don’t know—Aaron found a repairman. The shop was tucked into a small, rust-colored brick building on a crowded corner of Main Street in Holiday, Utah. Inside, the space was filled with clocks of every kind: towering grandfather clocks, noisy cuckoo clocks, delicate pendulum clocks under fragile glass domes, and even a few whimsical Felix-the-Cat clocks with their tails swinging back and forth to keep time.

The clerk took our beautiful-but-broken mantel clock and warned us that repairs could take up to a year. “You have to understand,” she said, “we don’t have an owner’s manual for clocks this old. The clock will need to be completely taken apart and examined before we can even know what repairs it needs.”

Then she added, “And sometimes, we simply can’t find the parts. When that happens, the only option is to rebuild.”

In the art of clock repair, when instructions don’t exist, repairmen rely on what are called witness marks—tiny clues like faint scratches, screw holes, tool marks, or even missing pieces. Sometimes these marks are intentional, left by builders or previous repairmen. Other times they’re the result of damage. But to a trained eye, they tell a story. They guide the repair.

Through heart transplant surgery and thyroid cancer, surgeons have left plenty of visible witness marks on and within my body. Fifty years of living have left even more on my soul. I’ve been brought, many times, to what I believed were my breaking points. Life is full of them.

I don’t believe God gives us trials. I believe life is inherently hard—sometimes brutal, and for some, unspeakable. But I do believe that these hard, brutal, and unspeakable things can be used for good. They can become blessings.

In a recent conference talk by President Henry B. Eyring titled “Proved and Strengthened in Christ,” I was drawn to Philippians 4:13. Most of us know it by heart: “I can do all things through Christ who strengthens me.” What a beautiful promise.

But when I returned to the King James Version, I noticed something subtle yet profound:
“I can do all things through Christ which strengtheneth me.”

Which—not who.

That distinction matters.

I can’t count how many times I’ve felt so low, so devastated, that in the darkness I’ve wondered: Where is He now? If Christ is the one who strengthens me, why does He feel absent when I need Him most?

It is in those moments—when we feel alone—that we are given a choice: to turn away from Christ, or to turn toward Him. And in the act of turning, in the choice to believe, we find strength.

It is in the doing that faith is strengthened. It is believing still—choosing Christ again—that fortifies us. He is with us, always, inviting us: “Take my yoke upon you, for my yoke is easy and my burden is light.”

This is the great initiation. This is the school where we learn to consecrate what feels entirely unholy into something redemptive. In trial—when we are stripped bare, opened up, and taken apart—we can be strengthened. Our grief can be met with love and wisdom.

And when Christ has healed us, like a master clock repairman, He will have left His witness mark.

The Five Mile Trail

Today I walked five miles.

The sun was shining, and the air held that perfect autumn-day crispness. We had the trail mostly to ourselves—Christine, Millie, and me—and we talked freely, filling the miles with whatever drifted into our minds.

Five miles. What a privilege.

At one point, we passed a neighborhood friend, Megan. She commented on how fast we were—and we were, moving along at a pace of fifteen or sixteen minutes per mile. Without missing a beat, Millie and Christine both said, “Well, Fiauna has a new, young heart. It wants to go fast!”

I have a 21-year-old heart.

That’s a fact that still brings me to tears. My donor was only nineteen years old when her life ended and her heart was donated to extend mine.

After my transplant, while I was still in the hospital, the social worker came to my room during a rare moment of privacy and asked if I wanted to know what little information she was allowed to share about my donor. Surprisingly, I had to think about it.

Did I really want to know?

It seems like such an obvious question, but after everything I had been through, I had to ask myself how much I truly wanted to carry. That information felt sacred somehow. Holding any knowledge at all felt like a responsibility I wasn’t sure I was capable of bearing. It’s hard to explain exactly why. There are good things and hard things that come with knowing. We are all just human, after all, and sometimes the magic you hope and pray for can also break your heart.

While I was waiting for transplant, I heard all the anecdotes about organ transplants and personality changes—believe me. My father-in-law shared, more than once, a story about a man in his church who received a heart from a thirteen-year-old girl and went on to develop her personality traits, right down to an uncontrollable case of the giggles. While I understood there were logical explanations—medications, trauma, the body adjusting—it still colored how I felt in that moment when I was given the chance to learn about my donor.

When the social worker told me my donor was female and between the ages of eighteen and twenty-four, I couldn’t stop the immediate cascade—no, the deluge—of tears. My own children were that same age.

Who was I to take a heart? To take life, opportunity, learning, and growth from someone so young?

I still haven’t found an answer.

Nine months after my transplant, I wrote a letter and sent it to my social worker, hoping it would eventually reach my donor’s family. I didn’t need a response; I simply wanted to say thank you. It felt like the right thing to do.

Then, the following February—ironically, on the very day I learned my thyroid cancer had returned—I received a letter in return. It was from my donor’s mother.

My donor was Ella.

She was a medical assistant and a nursing student. A dancer. A lover of music. She and her mother were very close. Precious.

There’s something that happens when someone comes close to dying—or, in my case, receives a heart transplant. You feel a responsibility to live an extraordinary life, to somehow make the second chance, the gift of an organ, worth it. I’ve wrestled with this more than I care to admit.

I don’t want to go back to college and complete a nursing degree in her honor. I don’t feel healthy enough to run a marathon or climb a famous fourteen-thousand-foot peak. Maybe someday I’ll create a charitable trust or do something meaningful in the realm of organ donation.

But for now—for today—I will walk five miles.

I will breathe in the crisp autumn air and feel the steady rhythm of this 21-year-old heart. And that will be enough.