
I chose life three times….
The Story
For more than two decades, I lived with congestive heart failure. I managed it through diet, discipline, and stubbornness—and for a long time, that was enough. Then it wasn’t.
In the fall of 2024, I arrived at a hospital unable to walk more than ten feet on my own. My ejection fraction was 5%. Death came to my bedside more than once. More than once, I told it no.
On November 9th, 2024, a surgeon removed my heart and replaced it with someone else’s. This is the story of what led to that moment, what happened in the OR, and what life looks like on the other side of it.
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November 9th
The nurse came through the door differently. It was 10:15 on Thursday evening, November 7th. The ward had settled into its overnight rhythm—the particular quiet of a hospital after the last shift change, monitors steady, the corridor outside moving slowly. The day had been ordinary by the standards of that room: a walk outside, pork
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The Waiting
Tom Petty said it as well as anyone ever has. The waiting really is the hardest part—but not for the reasons most people assume. It isn’t a matter of patience. Patience implies something you can summon—a discipline you can practice. This is something else entirely. The runway is short, and the solution to a successful
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Dignity
There is a transaction that occurs the moment you are admitted to a hospital for a serious, extended stay. Nobody explains it to you in advance. Nobody sits down and walks you through the terms. It simply happens, quietly and completely, from the first hour. You surrender agency over your own body. Not partially. Not
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Standing On Your Own…With Assistance
The room at 7am looked the same every day. Lines in, lines out. The Impella running its quiet mechanical rhythm in my chest. The monitor glowing green behind my head, numbers I had learned to read the way you learn to read a dashboard—not alarming anymore, just information. The ward coming to life outside the
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Out of the Frying Pan
The listing came through on a Friday afternoon. October 11th, 4:02 in the afternoon, Niles in the room. I had been officially listed for transplant—Status 2 at The Christ Hospital in Cincinnati, on an Impella heart pump, waiting. I posted to Facebook from the hospital bed. I HAVE BEEN OFFICIALLY LISTED. Three days of relative stability followed.
About James Nerlinger
I’m a writer, developer, and home cook living in Cincinnati, Ohio. I spent twenty-two years managing congestive heart failure before receiving a donor heart on November 9th, 2024. This blog is the story of that journey — and everything that comes after it.
Choosing life, one beat at a time.
Contact
Thoughts? Comments? Discussion?
JNJ@OneMoreBeat.com





