In the pre-operating room on the third floor of Tampa General, the two nurses lay in hospital beds, side-by-side.
Their husbands had pushed them close enough for the women to hold hands.
"It's going to be fine," said Pam Mizerany, 48, squeezing her friend's fingers.
Debbie Ismer, 56, smiled. "They said you're going to feel bad. But I'm going to feel so, so good."
Debbie's husband snapped pictures. Pam's husband smoothed her white sheet. Then the chaplain came in and folded the women's clasped hands into his.
Both nurses bowed their heads. They have prayed with this chaplain for years, for their patients.
On Wednesday, he prayed for them.
The nurses met 15 years ago, two floors up, on 5A. They were working in the cardiac unit, side-by-side.
"I remember Debbie was wearing all white scrubs," Pam said. "But she had on these crazy, colorful socks."
"I just remember watching Pam," Debbie said. "I kept thinking, 'Now there's a nurse who really puts her patients first.' "
That winter, Debbie invited Pam and her family to a Christmas party. Debbie was a single mom whose only daughter was grown. Pam had married her college sweetheart; their daughter was a young teen. Over the years, the women shared spaghetti dinners, took their families camping together at Fort DeSoto, paddled canoes side-by-side.
Debbie was there 11 years ago when Pam found out she was pregnant with her second daughter. Pam was there that same year when Debbie met her husband, a transplant patient waiting for a heart. "They're so much alike, in personality and spirit," said Bill Ismer, Debbie's husband and a retired police captain. "Those two share an unusual bond."
Pam knew Debbie had a genetic disorder called polycystic kidney disease. She knew her friend had cysts in both kidneys.
But it wasn't until the women bumped into each other two years ago, on Mother's Day, that Pam realized how sick Debbie had become.
• • •
That night, the Florida Orchestra was playing a benefit for the LifeLink Foundation, a nonprofit that matches donated organs with patients who need them.
Pam went to support the cause. Debbie went because of Bill. At least that's what Pam thought.
But during the concert, as the nurses sat picnicking with their families, Debbie told Pam, "The doctor says my kidneys are failing. I need a transplant."
Without hesitating, without thinking, Pam turned to her friend, "Well I've got two. I'll just give you one of mine."
Debbie laughed. "All kinds of people will tell you that," she said. "But they don't really mean it."
By then, the women had moved to different floors of Tampa General. Debbie records EKGs during patients' stress tests. Pam cares for premature babies. But every week, for two years, they met in the hospital chapel.
"Heavenly Father," they would pray. They always said the same prayer. "Please help me find the right donor," Debbie would say.
"Please," Pam would add. "Help the right donor find Debbie."
By spring, Debbie's kidneys were functioning at 10 percent. By summer, 8 percent. Debbie kept working. Kept going to church, taking care of her grandkids, making birthday cards for everyone.
In July, Bill told Pam: Debbie is going to have to go on dialysis. If she doesn't find a donor soon, it might be too late.
• • •
Every day in the United States, 18 people die while waiting for an organ transplant. In Florida alone, 4,000 people are on waiting lists. About 70 percent of them need kidneys.
Most donated organs come from people who recently died. But about 25 percent of transplanted kidneys come from living donors, according to LifeLink spokesperson Betsy Edwards.
At Tampa General, from January through October, surgeons transplanted organs from 51 living donors.
Kidneys that come from live people have a better chance of success.
• • •
The RV trip was Bill's idea. In August, he drove Debbie to Yellowstone National Park, while she was still strong enough to enjoy the ride.
When they got back to Florida, Pam called. "It's a match."
Debbie didn't understand.
"Me. I'm a match for you."
She had taken all the tests at LifeLink: The two nurses share the same type of blood, O-positive; they're close in age and size; and, most importantly, their five genetic markers line up.
"I want to do this," Pam told Debbie. "Please, let me do this."
They started researching online, asking doctors in the transplant unit: What's involved in the procedure? What's the incision like? What could go wrong?
A surgeon will take Pam's left kidney — the one away from the liver — and attach it to Debbie's right kidney. Eventually, Debbie's own kidneys will wither and die. Pam's kidney will keep Debbie alive.
Both women will have 4-inch scars along their bikini line. Both will be home within a week. And, as with every surgery, anything could go wrong.
But even though Pam had never had any type of surgery; even when doctors told her she would be in much worse pain than Debbie; even when she heard about an organ donor bleeding to death, Pam never considered backing out.
"People keep asking me why I'm doing this," she said. "For me, it's more like, 'Why wouldn't I do this?' I have a chance to give her another chance. Debbie has blessed so many people's lives. I want that to go on."
• • •
The pre-op room was cold. Pam and Debbie tugged on matching tan socks.
Another nurse took their pulse, drew their blood, planted IVs in their arms.
"Our success rate is very good here," the surgeon said. "The chance of rejection is 10 percent."
Pam pulled her hair into a loose ponytail. She would go first.
After her three-hour operation, the doctor would prepare her kidney and transport it in a triple-layer bag, on ice, to another operating room.
There, during another three-hour procedure, the same doctor would implant it in Debbie.
The IV began to drip into Pam's arm. She turned to Debbie, smiling fuzzily:
"He better not drop my kidney."
Debbie squeezed her friend's hand. "That's my kidney now."
By midafternoon, they were both in recovery, groggy but fine, side by side.
After Christmas, the surgeon said, both nurses can come back to work. They plan to meet at the hospital chapel. And say a new prayer.
Lane DeGregory can be reached at firstname.lastname@example.org or (727) 893-8825.