Introduction

It's November 2004, and I'm in an operating room at the University of Alabama at Birmingham Hospital watching a 57-year-old Alabama school teacher slipping into the emptiness of anesthesia. She's grasping a vision of life, of a grandson nestled in her arms. “I'm holding my baby here,” she says, her voice relaxed and peaceful amid choreographed movements of doctors, nurses, and medical technicians. An anesthesiologist places a mask over her face. She inhales and fades away.

More than six hours later, she awakens in an intensive-care bed and has a transplanted liver, along with the opportunity to again hold grandchildren close and feel love, hope, and humanity. She is among more than 65,000 Americans who have undergone this dramatic operation since 1988. The cost: roughly a quarter million dollars each.