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After reading the message in our long-running WhatsApp family chat, I dropped my iPhone in the bed, covered my face and sobbed: “Dear family, there is very sad news. Our dear brother, Guillermo, has died.”
It was 10:45 p.m. in London, where I recently moved from Houston, and six hours earlier back home in Quito, Ecuador.
All the hope and happiness I had experienced only a few hours ago, when my 63-year-old brother Guillermo Ordóñez urgently flew from Quito to the coastal city of Guayaquil to receive a long-awaited liver transplant, was instantly crushed that February evening earlier this year.
It was the type of message every immigrant dreads when you are thousands of miles away from family. No matter how much success we have in a different country, every expatriate knows there is no way to escape this: being unable to hug loved ones back home during life's darkest moments.
This dread is all too real for so many in the Houston region, where 1 in 4 people are immigrants.
In the face of death, I was wracked with grief. I begged for it to just be a dream. There must be a way out of the horror; some way to reverse time. I just wanted to hug my beloved oldest brother again.
I was accustomed to seeing Guillermo at least once, sometimes twice a year, when I would fly from Houston to Ecuador. It was always a big deal to return and join everyone for holidays. And as the youngest of eight children who are now parents or even grandparents, our gatherings were always large.
I broke our family’s tradition by being the first to immigrate to the United States. I was a competitive track and field athlete in my youth and went on to become a sports journalist. I later won a fellowship to work in the U.S. where I earned a master’s degree and went on to writing about business before joining the corporate ranks, where I am now based in London for a U.S. energy company.
Guillermo became a father figure after we lost our dad many years ago. As a public health doctor, he led a nonprofit that creates homes for street children in the poorest, most dangerous shanty towns across Ecuador. He is guided by the philosophy that unconditional love provides hope to even the most abandoned and neglected youth.
He dedicated his life to helping those who had the least. He lived with them.
Guillermo set an example of selflessness and giving to others, but he has flaws as we all do. His health had its ups and downs over the years but liver problems had finally caught up with him and the vital organ simply could not go on much longer.
After almost five hours of surgery, doctors transplanted the liver of a young man who died a few hours earlier in a car accident to Guillermo’s exhausted body.
When they pumped blood through the new organ, which was so much stronger and flexible than my brother’s hard-like-a-rock damaged liver, blood flowed without obstacles. It overwhelmed his heart. It halted his beat.
After crying for about half an hour, I found the strength to grab my iPhone. I scrolled through the chat, usually lengthy with the reactions of eight siblings and dozens of nephews and nieces, and now raw with so much grief splayed open.
As I progressed, what I soon found, instead, was what many would call a miracle.
“He is still alive,” a follow-up message exclaimed. “But the doctors said we shouldn’t have a lot of hope because he was clinically dead for a long time.”
The main surgeons, Cristian Arias, 41, and Carlos Bermello, 41, and two assistant surgeons would not let their patient go so easily. Not without a heroic, physical fight.
When Guillermo’s heart stopped, the four doctors took turns compressing his heart for about 30 minutes to resuscitate him. But there was no heartbeat.
Dr. Arias then grabbed a scalpel and enlarged the incision they were using for the transplant by 4 inches, to use his full fist to grab my brother’s heart in his own hand and pump it. He and Dr. Bermello took turns massaging his heart for 15 more minutes. They finally stopped because too much time had passed. Guillermo’s heart didn’t respond.
Exhausted, the doctors walked to the waiting room and asked to talk to our family. Dr. Arias told my sister-in-law, Rocio, that the surgery had been going well, but that Guillermo’s heart didn’t respond, and there was nothing else they could do. “We are very sorry, but he has passed away,” Dr. Arias told her.
Rocio wailed with pain. Other family members at her side began making calls and sending messages. Arrangements were being made to return Guillermo’s body to Quito, where he was born and spent his entire life.
At the same time, the anesthesiologist who was disconnecting my brother from the respirator and the nurses preparing his body, which still had the open incision, saw that the heart monitor had begun beeping again. At first, they thought the machine was malfunctioning, but soon realized his heart was beating again by itself.
They called Dr. Arias. He and his team rushed back into action. They closed him up and again fought to keep him alive. They finished the surgery in an hour.
I was stunned when I learned he was still alive. My emotions were swirling as I wondered how it is possible he is alive when I was just told he was dead?
As the news of his resurrection spread among family and friends, there was joy, but also uncertainty.
What shape would he be in after being technically dead, including the last 15 minutes when he stopped receiving the heart massage?
Thinking of the worst-case scenario, I could not imagine a man so full of life, a leader of our family, and the selfless guardian of so many others reduced to a vegetative state.
Guillermo was moved to intensive care. When his wife was allowed to visit him for a few minutes the next day, she reported he was opening his eyes, identifying her with a thumbs up. Then, when his daughter visited in a few days, and he was not intubated anymore, he quietly proclaimed with a raspy voice: “I’m OK.”
He left intensive care after two weeks, weighing 125 pounds, 40 pounds less than his normal weight, and unable to stand due to his weakened muscles. He stayed in the hospital until early September, going through numerous ups and downs, including scares about transplant rejections.
But he was finally released from the hospital and allowed to return to Quito in September. His brain and body are intact. He can walk, talk, drive, tell jokes. More importantly, he can share his story. He is starting on the unfinished projects of his life, like writing a book about the power of love to change the lives of children in the most dire circumstances. He values every moment.
When I visited Guillermo at the hospital in June, I found him with an enormous appreciation for the outpouring of love and support of friends, family and even strangers, many who donated to help with living expenses. But he was particularly thankful to God for his second chance at life. For decades he was an atheist, but in the last few years had slowly become a person of a strong faith. What happened that night of Feb. 7, only strengthened his faith.
He told me that at some point during the surgery he saw himself out of his body and observed the team working on him. He then saw a bright image with a shiny hood, like a scarf or hoodie pulled over one’s head. He saw a light projecting moving images of many people, including our father who died 30 years ago. He felt warm, he said. Then, the bright figure started walking away. He began following him, but then the image turned and asked him to stop and go back. After that, he only remembers nightmares and deliriousness from being in intensive care. He became fully conscious weeks later.
“I’m happy and immensely grateful I’m alive,” Guillermo said. “But I’m no longer afraid of dying. I felt peaceful and happy when I was dying that night.”
What happened that night also touched Dr. Arias.
“I have done more than 50 surgeries of these in my more than 20 years of practice, and I have never seen anything like this. I’m not a strong believer, but this is what people call a miracle,” Dr. Arias said.
“Your brother is able to describe things that were happening in the operating room that are physically impossible to know when you are under general anesthesia,” Dr. Arias said.
For me, it also changed many of my beliefs, many at the very practical level, including the assumption that the best medical care is always in the developed world.
After living for 15 years in Houston, I would have expected this miracle only to happen in the Texas Medical Center but not in the operating room of a public hospital tucked away in my tiny underdog Andean country, where tragedy and tough times fueled by difficulty are a part of daily life.
I also would not have expected our family’s heroes to be Dr. Arias and Dr. Bermello, two doctors operating in a severely underfunded government hospital, whose entire medical education was done in Ecuador, with specialization in Argentina and Spain, respectively.
Dr. Arias and Dr. Bermello’s professional lives are likely as demanding as any surgeon in Houston, but their lifestyle is different. They have a middle-class income, working for a government-funded hospital, and they don’t need much more to love their jobs and to fight for their patients.
I have also been amazed that the hospital and transplant costs were zero to my brother, that the liver became available in less than six months because he was qualified to receive the transplant thanks to a law in Ecuador that makes it a default for people to be organ donors. In other words, everyone is a potential donor unless they opt out.
“I will forever be grateful to the anonymous young organ donor and the medical professionals who saved my life,” Guillermo said while tearing up.
What happened Feb. 7 made me wonder what gives us the power of life and what takes it away? What are life’s biggest mysteries and how much we really know about life and death?
The surging love I felt when I was able to hug Guillermo during my visit in June while I listened to his story, that is all I need to know for now.
Contact Isabel Ordóñez at [email protected].
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