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  • Writer's pictureLisa McIntire

The Last Birthday

Updated: Oct 31, 2022

It's November 17, 2019.


It's Sunday, my favorite day of the week. But today I dragged out of bed, my soul already swimming in a sea of emotions—sadness, gratitude, anger, contentment, fear. I reach for my toothbrush and glance in the mirror, willing myself to shake off the anxiety my aging face reveals. But I know deep down that any attempt to move through today like any other typical day is in vain. Because today is also my 49th birthday.


The last birthday.


Mine was a good life – a standard-issue middle-class Midwestern life, simple and sweet. I was 31, happily


married and busy nurturing our blended brood of five – two boys and three girls, ranging in age from 16 to six weeks. Each weekday, I put my CPA license to good use with a big firm in a big building downtown, and on the weekends, we played outside with the kids and worked in our garden.

Nothing special, just an ordinary life – until that is, one hot, humid day in August 2002 when everything I thought I knew about my life changed in an instant.

I was still on maternity leave and underwent a routine outpatient surgery. I was healthy and young, and I’d be back on my feet in a couple of days. Nothing to worry about, the doctor said.

But that was before her tiny camera revealed significant unexplained liver damage, which set in motion an exhausting whirlwind of blood tests, ultrasound scans, a liver biopsy, a referral to a GI specialist, and ultimately a “diagnosis by elimination” of autoimmune hepatitis. I surmised that this is the medical way of saying,

“We’ve tested for everything else, and all we can figure out is that your immune system is attacking your liver.”

No theories, no explanations. Just the gut-wrenching news that my 31-year-old, otherwise perfectly healthy body was systematically destroying itself.

One thing was for sure: I was sick – very sick. We needed to start treatment right away, a brutal combination of steroids and a chemo drug used to suppress the immune system, which proved to be the most physically punishing five months of my life.

Nausea, dizziness, and headaches pounded me all day every day. But if the days were long, the nights were longer. I slept at most two to three hours, tossing and turning as my heart raced, and my arms and legs shook with tremors.

I clung to faith in God and relied on my love for my family to push me forward, and finally, mercifully, I completed the course of treatment. And now, all that was left was to wait for an update from the liver specialist.

His office was sterile and cold, but he looked official and intelligent in a white lab coat and black-rimmed glasses. Dr. T was an expert in all things gastrointestinal, and Exam Room B was the last place on earth I wanted to be.

I needed answers I didn’t want, and I needed a plan of action.

I was tired of the tests, the fear, the headaches, the mounting medical bills. I just wanted to get back to normal – being a mom, and my job and my life, the life I knew and loved only a few months ago. But alas, it was not to be.

Immediately, I sensed that Dr. T was somber - that the news he was charged with delivering this time was no better than the other times we had met. The treatment had failed, he said, averting my urgent eyes and looking down at the chart. He was sorry, he didn’t have any other solutions to offer me.

My head fell forward, and tears slid down my cheeks as my new reality closed in. I had fought so hard, prayed so hard, done everything they told me to do. How could all those drugs and all those prayers have failed? How can a young, healthy body that had just birthed a big, healthy boy fail?


Through the fog that was enveloping my brain, I managed to choke out two words…” How long?”

I’ve heard his answer a million times since that fateful day.

“You might have six months; you might have five years; you do not have 20 years. It will be a miracle if you live to see 50.”

And there it was, my death sentence, communicated so succinctly on a regular Tuesday morning, the words as sterile and cold as Exam Room B. The judgment had been pronounced; court adjourned.

I nodded slowly and picked up my purse. Numb, I half-walked half-stumbled out of Exam Room B, through the packed waiting room and across the parking lot to my car, blinded by salty, stinging tears, trying at once to come to terms with this death sentence yet somehow also determined to learn how to live.

This is that journey— from a death sentence on a regular Tuesday morning to the last birthday and beyond.

These are the fears I’ve faced, the lessons I’ve learned, the mistakes I’ve made. All of it together, like lots of little gifts just waiting to be unwrapped and experienced.

Life is fragile, life is sacred, and life is good - even when you’re living on borrowed time, and (spoiler alert!), we are all living on borrowed time.

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