E takes fourteen pills a day. Eight in the morning and six at night. These aren’t drugs which treat symptoms like arthritic stiffness or iron poor blood. If he doesn’t take these pills as prescribed, his body will reject his new heart. Toss it out like the town drunk at last call. In addition to the normal risk of rejection for transplant patients, the disease which killed his first heart has a 25% chance of sneaking in and getting this one. It can’t be given even the smallest window of opportunity. 

There are items E can’t consume like grapefruit juice and pomegranates because they conflict with the medications. Years ago when he returned to rec hockey after his transplant, he began drinking Five Alive juice post game in the locker room instead of beer. We noticed his stamina started to weaken and his health worsened. We figured out that one of the juices in the Five of Five Alive, was grapefruit. He went back to beer.

These pills don’t go through our extended health plan they come directly from the pharmacy at the hospital every three months. We keep them in a plastic case which could be transported easily if there is a earthquake or zombie apocalypse. If we had to bug out, I wouldn’t care so much about passports or papers, we would be grabbing that case of drugs.

Probably four or five times a week, I ask E if he has taken his pills. It’s a force of habit. He usually assures me that he has. On occasion we have broken our routine, maybe gone to town early or stayed out late with friends and he has forgotten to take his pills. We keep a three day supply in the car just in case.  

 We have three down quilts of varying quality and in graduating weights. The heaviest and best is on the bed now. Even  half price at a black Friday sale we paid a couple of hundred dollars for it. This morning we can see the first snow on the mountains across from our window. The winds are howling and the rain is falling. The wood fire is out and the house is cold. But we are warm and snug in our bed under this amazing quilt.

We were out late last night and I didn’t see E take his 9 PM pills. At five am when I woke up, my first thought was to ask him if he took his pills. Behind the pillows and under the flannel sheets and giant down comforter I heard his muffled response ” hmph, I don’t remember” and he rolled over back to sleep.

 I thought that was a fairly casual attitude towards the regimen which keeps him alive.  After a couple of minutes reality had kicked in and I heard him get up to go and check. He returned with a “Yes, I took them”. We both snuggled deeper under the heavenly quilt and went

back to sleep