Weather Check
It is the first of September. It is ninety-five degrees outside and I am on my second full day of a head cold.
That combination is not supposed to happen. Colds belong to the other end of the calendar, filed alongside short days and dry air and everybody packed indoors together. Heat belongs to summer, which is supposed to be the season when the respiratory viruses take a few months off. The two of them showed up together anyway, and I am keeping a closer eye on this one than I would have a few years ago, because immunosuppression makes an ordinary head cold worth watching.
So much for the tidy version of the year.
I think about the weather more than I used to. Not as small talk. As a variable. And the thing I keep landing on is that the weather did not become dangerous when I got a new heart. The margin narrowed. Those are different claims, and only one of them is true.
The Two Good Seasons
Spring and autumn were always my favorites, well before any of this.
Spring meant the first open windows after months of a closed-up house, rain instead of snow, grass going green, flowers coming up out of ground that looked finished a few weeks earlier, and that first unmistakable smell of things growing again. Animals reappear. The trees leaf out. Everything that spent the winter looking dead turns out not to have been.
Things come back. I have some experience with that now.
Autumn does something different. It is not about beginning again so much as enjoying what is still here. Festivals and cool evenings and soup. Long drives through heavily wooded country while the leaves turn. The first morning cool enough that the jacket comes back out of the closet, and somebody’s woodsmoke on the way home. Walking somewhere without being soaked through ten minutes after leaving the car.
They have one more thing in common these days. They are the two seasons in which the outside world and I are most likely to come to an agreement.
What I Read Now
The forecast used to answer two questions. Do I need a jacket, and can I get the yard cut.
It answers considerably more than that now. Temperature. Humidity. Heat index. The UV index. Pollen count. Air quality. And, in a category the National Weather Service does not cover, whatever happens to be going around.
Heat means hydration, and hydration means kidneys, which matters more when you are taking a calcineurin inhibitor every twelve hours for the rest of your life. Humidity means sweat stops doing its job efficiently—the body sheds heat during exertion largely by evaporating sweat, and the CDC notes that this route becomes minimal once air temperatures climb past ninety-five degrees and the humidity is high. Direct sun means ultraviolet exposure I am no longer in a position to treat casually, for reasons I have gone through at length elsewhere and revisited in a dermatologist’s office.
Dry winter air is not merely uncomfortable; the mucus lining the airway is part of the body’s first line of defense, and animal laboratory work suggests that low ambient humidity impairs both that barrier and the innate response behind it. Spring pollen turns a runny nose into a question rather than an answer. Winter means cold, and it also means everyone moves indoors and begins trading viruses in earnest.
None of this is exclusive to transplant. Ninety-five degrees is hot whether or not you are carrying somebody else’s heart, and ragweed does not ask to see a medication list before it gets started. What changed is how much room I have to be wrong.
The Heart That Answers Late
Here is the part that surprises people who know me.
Heat has never bothered me much. I am the guy who spent whole July afternoons working in the yard in blue jeans and a t-shirt while everyone else retreated to the air conditioning. In most respects I am still that guy. I am simply a little more careful, and the reason is specific.
An ordinary heart responds to exertion almost immediately, through its own nerve supply. Mine was disconnected from that supply during the transplant. A 2024 clinical consensus statement from the European Association of Preventive Cardiology puts it plainly: transplantation produces total denervation of the donor heart, both sympathetic and parasympathetic, and the result is a blunted heart rate increase during exercise. What response there is arrives largely through circulating adrenaline and related hormones rather than a direct nerve signal, so the rate climbs later and often not as far. Some recipients regain part of that connection over the years, and the degree varies considerably from one person to the next.
I spent most of my life gauging hard effort partly by listening to my own heart. That instrument was recalibrated without anyone consulting me.
What replaces it is not complicated, only deliberate. Rehabilitation guidance for transplant recipients sets training intensity by perceived exertion on the Borg scale rather than by targeting a heart rate, for exactly this reason. Something I once felt automatically is now something I have to read on purpose. That turns out to be the whole story of the last two years, compressed into one paragraph.
One caution, because I know how this reads. My heat tolerance is not a virtue and it is not a standard. If you are a recipient who feels wrecked at eighty-five degrees, your discomfort is useful information, promptly delivered. My cardiac response is the one that shows up late. The ordinary reaction is not weakness here—it is the better instrument.
What I Actually Want
I want to be outside. That is the honest starting point.
I want to be camping. I want to be hiking. I want to be at a day game at Great American, which is a real problem, because a Reds day game in July is three hours of direct sun over most of the seats, concrete radiating heat back up at you, a crowd measured in the tens of thousands, and no practical way to step indoors for twenty minutes. Four separate problems stacked onto one pleasant summer afternoon. That one is a no, and I am not happy about it.
But look closely at what actually went missing, because it is narrower than it first appears.
I did not lose the activities. I did not even lose all of the spontaneity—I could get in the car this afternoon and drive to the Smokies, and I wrote elsewhere about how strange it was to notice that I could. What I lost is impulse where exposure is involved. Crowds, heat, and sun now require a decision made in advance rather than one made in passing.
I can still go to the festival. I cannot decide to go to the festival while driving past it.
That is a real loss and some days it is genuinely aggravating.
It is also not seasonal affective disorder, which is an actual diagnosis tied to a recurring seasonal pattern, most commonly the shorter days of fall and winter, and I would rather not borrow a clinical term I have not earned. What I am describing is a year with fewer uncomplicated days in it. If that ever stops being aggravation and turns into something persistent, that is a different matter, and it deserves the same attention as any other complication.
The Advance Work
So I do reconnaissance now.
I drove up to Yellow Springs in June, on the Sunday morning after their street fair had emptied thirty thousand people out of a village of thirty-six hundred. I found swept brick and open parking and a town that looked like nothing had happened there in years. I had not gone for the fair. I had gone to see what I would be getting into. I expect to be back on the tenth of October for the fall one.
Coming home from Gethsemani I drove through Bardstown and paid attention to the layout, because the bourbon festival is on my list and I would rather know where things are before I am standing in the middle of them.
Harvest Home is coming up here at home. I intend to go early, before it fills, with a mask in my pocket in case it fills anyway.
And there was a morning at the Cincinnati Zoo in a hat, out the gate after about two hours, when the temperature started its afternoon climb.
The pattern is simple enough. Scout the ground, learn where the shade and the exits are, arrive before it fills, carry what I might need, and decide in advance what will send me home. Then go.
Morning Outside, Afternoon In
A good friend and I spent a weekend out and about not long ago. We did the outdoor things in the morning and moved to indoor things once the afternoon heat set in. It was a good weekend. Nobody had to call it a strategy.
A couple of weeks back I drove up to Yellow Springs again for photographs I had failed to take in June. We walked around town. We had lunch. Somewhere in there a small carved statue was bought for me, and it rode home on the passenger seat. On the way out we stopped at Young’s, where the tray came out with two shakes, a burger, a BLT, and a pile of fried cheese curds, on a red steel table in the sun.
There was also a week of silence at the Abbey of Gethsemani in the heat of August, which costs the body nothing and pays elsewhere. And a weekend camped at Big Bone Lick in the last week of July, in Kentucky, which is not a place that moderates in July. That one was not my first trip out, but it was close, and the first one nearly did not happen at all—not because of heat or crowds or any real obstacle, but because I had talked myself into believing I needed to be ready first.
Which is worth admitting in a piece about planning.
The advance work has a failure mode, and the failure mode is never going.
Here is the part worth stating plainly, once, without decoration.
I am doing more now than I did in the years leading up to the transplant. In the last stretch of that decline the world contracted a little every few months, and I let it, because there was not much choice. Now I am immunosuppressed, more careful than I have ever been about heat and crowds and sunlight, planning things I used to do without thinking—and I am out in the world considerably more than I was.
Both of those are true at once. I have stopped trying to make them argue.
Two Cruises
The same friend has been suggesting cruises.
The Caribbean first, in January. January in the Caribbean is precisely the weather I have spent this entire piece describing as ideal. Getting there is two American airports in the first week of January followed by several thousand people sharing a floating building for a week. The reward and the risk arrive on the same boarding pass.
And then Alaska, which is the one I actually want.
The Alaska cruise season runs May through September—the exact months I have been writing off here. Sixty degrees, long daylight, outdoors from morning until it stops being worth it. Spring weather hiding inside my summer. The high-latitude sun coming off water and ice means the hat and the sunscreen will still be earning their keep.
Both are on the list. Neither has been decided.
The season isn’t lost. It’s just somewhere else.
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