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Spiritual Lessons From My Double Lung Transplant

by Cathy Clayton-Botha

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My life was saved by a double lung transplant. This life-changing event led me to a much deeper understanding of Christ's sacrifice and God's plan for me and all mankind.

Victor Kubik
Cathy and her husband Vivien Botha in 2018, after her lung transplant.

I was diagnosed with cystic fibrosis (CF) when I was 12 years old. CF is a progressive genetic disease that primarily affects the lungs. There is no cure. Average life expectancy is 37 years. Medication and health management practices can prolong and improve quality of life, but once the patient reaches end-stage lung disease, double lung transplant becomes the only option.

I reached this stage in 2015, following years of gradual deterioration and irreversible lung damage. Eventually I was in and out of the hospital every few weeks battling severe, recurrent pneumonias. While at home, my daily routine at times involved up to six intravenous infusions, two to three hours of nebulizing and two hours of chest physiotherapy (treatments to assist clearing the lungs). I slept with the help of supplemental oxygen, and used it intermittently to relieve incredible fatigue.

The "burden of treatment" is a medical term describing the time and commitment involved in doing everything necessary to stay alive. This burden often destroys every vestige of the patients' quality of life, and eventually it was consuming me. My circumstances also meant that I had to continue to work, albeit not effectively. Ironically, I felt suffocated by the medical regimen that was keeping me alive.

An urgent prayer

I was barely holding my life together. And my spiritual life was suffering. If I tried to read the Bible, I would just doze off. Concentration became increasingly difficult. I listened to sermons but usually had to rewind them to hear the parts where I had fallen asleep. I would doze off during church services, and because of travel and church commitments, the Sabbath, meant to be a day of rest, was one of the most exhausting.

I felt increasingly frustrated about my lack of spiritual diligence and enthusiasm for God's Word. When I saw others so full of zeal for God, I felt inadequate. I was just barely going through the motions. I also knew I was out of time, with possibly just one year left to live.

I was dying.

At one extremely low point of spiritual discouragement, I knelt and prayed a simple but urgent prayer -- that God would give me more understanding and change my heart completely to be more like Him. According to Philippians 1:6, "He who has begun a good work in you will complete it." I had no idea how God could finish a good work in me when my body was essentially finished. I knew I had not finished my race (as the apostle Paul had in 2 Timothy 4:7), but there was no more race left in me.

Other than God's miraculous instant healing, my only chance to live rested on the slim possibility of finding a donor. The average waiting period is 1 and one half years, during which time most patients die.

Three weeks after my prayer, I received amazing news -- the most unexpected and improbable thing to happen. This colossal life-changing and life-saving event has led me to examine the similarities between my physical salvation and my spiritual salvation, along with God's plan for all mankind.

"The call"

In the donor world, potential recipients are on a waiting list, sometimes literally waiting by the phone for what is known as "the call." When an organ becomes available, and the medical team is finally ready, a designated person makes a critical call to the recipient. There is no prior warning that "the call" is coming.

The recipient is told that the surgery is their choice -- he or she is under no obligation to accept. It is a simple phone call that offers incredible opportunity and considerable risk.

I was asked, "Are you ready and willing?" Some patients do not take the offer. They may feel the disease is manageable and are too frightened to risk death or other problems. Or they may not be emotionally prepared. Some accept it and go on to live significantly better lives. Some refuse it and ultimately die. Some accept it and still die.

Many people never get "the call" at all, but if they do, they are given a choice. Once the decision has been made, they must submit to the process.

I thought of the spiritual parallels of God's calling process. I was reminded of 2 Timothy 1:9, which tells us that God "has saved us and called us with a holy calling, not according to our works, but according to His own purpose and grace which was given to us in Christ Jesus before time began."

I also thought of 2 Peter 1:10: "Therefore, brethren, be all the more diligent to make certain about His calling and choosing you; for as long as you practice these things [that is, elements of good character listed in preceding verses], you will never stumble " (New American Standard Bible).

Life-giving death

The story of Christ's sacrifice is repeated so often in the Christian world that it can too easily become depersonalized. The phrases we hear regarding His death become sadly commonplace. He suffered and died so that I may live. I understood that, but did I really? I may even have allowed myself to think that because Christ knew He would die, He was better prepared to deal with it. Yet the Gospels show that even Jesus experienced deep emotions facing suffering and death.

He told His disciples before He was handed over in betrayal: "'My soul is exceedingly sorrowful, even to death. Stay here and watch.' He went a little farther, and fell on the ground, and prayed that if it were possible, the hour might pass from Him" (Mark 14:34-35).

Only through my transplant experience could I truly begin to understand the reality of receiving His death in my place and God's plan in a visceral way. I have come to better appreciate Christ's humanness, and what He gave up for me to receive the opportunity of an eternal and vastly better life.

After my operation, I found out my donor was a little child. Nothing could have prepared me for this news. His life ended abruptly, leaving his loving parents devastated. He had a full life ahead of him -- he was healthy and full of promise. He did not deserve to die, and his precious life certainly was not an equal trade for mine. My body was aged, tired, beaten up. My life was full of wasted opportunities and failures. Surely his little life was filled with so much more light and hope. Yet he died, and I was saved. I understand he was not sacrificed for me, but it was his death that enabled me to live on. And not only do I live, I have a far better quality of life.

When I think about Christ and my young donor, and the ripple effects their deaths have had on my life, I am overcome with emotion. Each one's gift helps me understand the other. The comparisons between these two sacrifices have compelled me into a deeper, more gratitude-based relationship with God the Father and Jesus Christ.

Christ actually chose to die for me. He was more innocent than any human being who has ever lived. Yet He suffered horribly for my near-worthless life. I think of Romans 5:7-9: "For scarcely for a righteous man will one die: yet perhaps for a good man someone would even dare to die. But God demonstrates His own love toward us, in that while we were still sinners, Christ died for us. Much more then, having now been justified by His blood, we shall be saved from wrath through Him."

A parent's sacrifice

I often think about my donor's parents and the incredible gift they gave me at their time of unspeakable grief. They donated his lungs to save me, and other organs to other desperate patients. I imagine them having to watch their son die and making the choice to turn off his life support. And then, willingly and generously, through the fog of their own pain and suffering, they offered others a life-giving gift. This was a mindful decision, not an impulsive reaction to their own suffering.

I owe my donor family my physical life. But far greater than that, I know that through God's plan of salvation, I have gained an elder Brother and an eternal Father. Only through the planned sacrifice and impossible-to-fathom death of Christ do I have the prospect of being grafted into the eternal family of God. "For this reason I bow my knees to the Father of our Lord Jesus Christ, from whom the whole family in heaven and earth is named" (Ephesians 3:14-15).

Hebrews 2:10 summarizes this process: "For it was fitting for Him, for whom are all things and by whom are all things, in bringing many sons to glory, to make the captain of their salvation perfect through sufferings."

"Without blemish"

As with all transplants, the days and hours preceding are critical. The donor's organs must be healthy and a suitable match for the recipient. Many donors are rejected due to infections or organ damage. The batteries of critical tests and the analysis take 24 to 48 hours. Recipients are oblivious to this behind-the-scenes work. They are usually mired in the daily struggle for survival, totally unaware that somewhere, usually far removed from their reality, a plan to save their life is being meticulously worked out.

This plan can succeed only if the donor's organs are healthy. Despite the mockery of justice in the judicial proceedings Jesus went through, He was nonetheless found to be morally spotless by the human authorities of the time, Pilate even pronouncing Him a "just Person" (Matthew 27:24). But more importantly, God's assessment is found in 1 Peter 1:18-19: "You were not redeemed with corruptible things ... but with the precious blood of Christ, as of a lamb without blemish and without spot."

Similarly, after all the medical scrutiny, my donor's organs were found to be physically perfect.

Christ living in me

I now have a redeemed-from-certain-death life. Yet I carry around in my body the lungs of a child that I've never physically met. His lungs work to keep me healthy -- breathing for me as mine no longer could. He has made me a better version of myself than ever before. This is something that, when I try to think about it, my mind refuses to engage. It's too hard to contemplate. The apostle Paul, in 2 Corinthians 4:10, notes that he was"always carrying about in the body the dying of the Lord Jesus, that the life of Jesus may also be manifested in our body."These lungs live on in me -- giving me so many unexpected opportunities.

I know I will meet my young donor one day when God resurrects all people to give them an opportunity for salvation. I can only imagine how humbling this meeting will be for me. I wonder if he will like me, the person I've become. Would he approve of things I've done with his gift of life -- of my speech, my empathy, my marriage, my family, of how I treat others? How would my life choices and attitudes stack up to what he would have done with his extra time if it had not been cut short?

This meeting applies with greater magnitude to my spiritual life. The real question is, What am I doing with my life? Am I allowing old habits to continue, old ways of thinking and behaving? Do I reflect the life of Christ in me? Am I being submissive to His will and in tune with His Holy Spirit to help move my life forward in His direction?

He and his parents will ask me what I did with my extra time. God will ask me. I think of 2 Corinthians 5:9-10:"Therefore we make it our aim, whether present or absent, to be well pleasing to Him. For we must all appear before the judgment seat of Christ, that each one may receive the things done in the body, according to what he has done, whether good or bad."

How will I answer?

In Romans 12:1 Paul urges, "I beseech you therefore, brethren, by the mercies of God, that you present your bodies a living sacrifice, holy, acceptable to God, which is your reasonable service." To be a living sacrifice for Him, I need to do what He would do. I need to allow Christ to really live in and through me.

I have this hope that when I finally get to meet my ultimate Savior, Jesus Christ will be able to say to me, "Well done, good and faithful servant; you have been faithful over a few things, I will make you ruler over many things: Enter into the joy of your lord" (Matthew 25:23).

Lifelong commitment to discipline

Concerning life after a successful transplant, organ rejection is a real and ongoing threat for all survivors. I must live a disciplined life -- being mindful of what I eat, carefully avoiding specific foods and certain situations, taking extra precautions to prevent infections, being diligent to take my medications and undergoing regular medical testing and follow-ups. People are surprised to hear that I must take immunosuppressive drugs for the rest of my life.

Receiving donor lungs is not a once-off life-saving event. I am saved in an ongoing way principally by taking the anti-rejection drugs without fail, every single day. Daily disciplined actions and obedience to a regimen are keeping me alive. And the same applies to one's spiritual life.

Compared to my previous "burden of treatment," which included many grueling hours each day just to be able to breathe, "My yoke is easy, and My burden is light" (Matthew 11:30).

Paul says in Ephesians 4:1, "As a prisoner for the Lord, I urge you to live a life worthy of the calling you have received" (New International Version). I realize that both my physical and spiritual salvation are not totally secure. I must do my best to maintain them and give myself the best possible opportunity to endure.

I also find it spiritually significant that organ rejection occurs when the recipient's body overcomes the medication and rejects the new lungs -- not the other way around. My body will try to attack and destroy the new life-giving lungs if it has a chance. The Bible reveals that "the mind-set of the flesh is hostile to God" (Romans 8:7, Christian Standard Bible).Only by accessing and stirring up God's Holy Spirit, which is given to us at baptism, can we practice what Paul refers to in Romans 8:13: "For if you live according to [the old, corrupt nature of] the flesh, you will die; but if by the Spirit you put to death the misdeeds of the body, you will live" (NIV).

Hope for all

Reflecting back on the days immediately following my transplant, I remember lying in the Intensive Care Unit (ICU). I became acutely aware of other patients and their families in the cubicles around me. We were all surrounded by numerous drips, drains, beeping machines -- mankind's valiant efforts to prolong life. The ICU is a place of protracted suffering and extreme grief, of unending perseverance by medical staff to save lives. It is a place of pain, confusion, fear, hope and joy -- emotions jumbled up together, experienced all at the same time.

My lung transplant involved all of these for myself and my family. Although it entailed extreme discomfort, I received a new opportunity for life. Conversely, my young donor died, and his family experienced utter devastation. One life passed, but another was preserved.

Since my transplant, I have experienced a wonderful quality of life. But when I look at old friends still battling to breathe -- their days a painful struggle against despair -- it appears unfair. I know that but for the grace of God go I. And I feel so incredibly blessed to understand that unlike this physical life today, hope and salvation are not ultimately offered to only a select few. In the great plan God is working out, everyone will have the opportunity for a wonderful future without end.

As valiant as mankind's efforts are to bring healing, peace and prosperity, they will always fall short of God's perfect plan. One Man, Jesus Christ, died for all those people in that ICU where I was and for everyone else as well. He died that they might live again, and live better.

The ancient patriarch Job expressed this hope through his great suffering:"I know that my Redeemer lives, and He shall stand at last on the earth" (Job 19:25). I now better understand Job's words. In that hospital ward, the true hope and longing for God's perfect, peaceful and joyful Kingdom dawned on me more forcefully than I could have ever imagined before. There was hope for all those despairing people moving in and out of that ICU, even though they did not know it.

Someday my young donor will be reunited with his family. Someday my struggling friends will breathe easy. Someday all human beings who have ever lived will have the opportunity to experience love, health and peace in God's family. Someday soon Revelation 21:4 will become a reality: "God will wipe away every tear from their eyes; there shall be no more death, nor sorrow, nor crying. There shall be no more pain, for the former things have passed away."

God speed that day!

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