The audience is riled up, rocking its way towards midnight. I am standing on the stage with a microphone in my hand. The band plays behind me. I shout out over the noise, eager to keep going.

“I don’t look sick, do I?” I ask, shaking my head and nodding to the crowd.

“No, no, no,” they shout back.

Turning to my keyboard player, signaling for her to begin the intro, “One, two, three,” I count, as my fingers strum guitar strings.

I have been performing my entire adult life. Now, standing in the club, aptly titled The Bitter End, I have bargained my way out of the hospital to perform this gig. Tomorrow morning at 5 AM, on doctor’s orders, I will re-admit myself to Westchester Hospital to begin dialysis for kidney failure.

Through the years, through travels, music, marriage, and children, a well-worn photograph, always prominently displayed, inspires me from its place on the desk. In the picture, my best friend Pam and I lean against each other, shoulder-to-shoulder, grinning. Her red hair tumbles in curls behind her. I am wearing geeky glasses. We have just completed three interminable days canoeing the Adirondacks in a two-person boat. We are wearing matching denim hats and jeans, beaming victoriously, two sixteen-year-old girl scouts with our whole lives in front of us.

Pam is a soprano; I’m an alto in the high school choir. We go to the same church, believe in the same God, share countless hours revealing our most heartfelt desires. We become blood sisters when I convince her to slice her finger and meld it with mine. After school, she plays flute in a local rock band. I am the band’s groupie hanging out, nurturing a girl crush. Eventually, we go off to college, meet our spouses, and find our ways in the world.

When her fourth child is born, I remember the phone call from the delivery room. “There is something wrong with the baby’s heart,” Pam whispers. “He’s blue.” Doctors temporarily stabilize him, but it’s not a solution. Six years later, when he is in need of a heart transplant, we gather resources and pray. Gratefully, the national organ transplant list yields a donor. The operation is a success, forever impacting our lives.

Because life is crazy and complicated, because nothing is promised, because I am my own biological soup, and because we are all connected, it is not long after that I am hospitalized. Diagnosed with LUPUS, I am quickly crushed by its effects and its treatments. SLE, or LUPUS as it is commonly called, is an immune disorder. The body attacks itself. My kidneys slowly shrivel into two inactive organs the size of walnuts, ceasing to function.

Back home from one of many hospitalizations, Pam visits. The kids are playing downstairs. She says to me, “I want to be the one,” informing me that she has completed preemptive testing and wants to donate one of her kidneys.

“Pam,” I say, “I don’t want you to have to do this.” She laughs at me and tells me it will be fine.

Eight months later, though it seems impossible, we are reborn. The stitches have dissolved, the graft is good, we are healed, and the band is back on stage. “Time to rock!” I shout. Squinting through the darkness, I see Pam in the audience laughing with her family as I place my hand on the slight bulge where her kidney rests inside, just above my hip. The guitar counts us in. The music rises. We begin to sing.

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