My name is James Nerlinger. For 22 years I managed congestive heart failure through diet, discipline, and sheer stubbornness. In the fall of 2024, that stopped being enough.
I arrived at the hospital unable to walk more than ten feet on my own, one leg swollen to twice its size, my ejection fraction at 5%. That number, for context, means the heart was functioning at a small fraction of what it should. The doctors stabilized me with an Impella device and began evaluating me for a heart transplant — something I never expected to be considered for, given my age, my weight, and my diabetes.
On November 9th, 2024, I received a donor heart. The surgeon called it a good heart. He was right.
This blog 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 — the recovery, the complications, the medications, the second chances, and the moments along the way that changed how I understand what it means to be alive.
I am not a religious man. But I have been visited by things I cannot explain and offered exits I chose not to take. More than once. What I can say with certainty is this: there is something more than what we see on this mortal plane, and I intend to spend whatever time I have left figuring out how to live well within it.
One more beat. And then one more after that.
More of My Work
One More Beat is one of several projects I write and build. If you want to know more about who I am beyond this story:
Infobin.com — General bio, background, and a full picture of what I do
Deep Dark Abyss Productions — Independent software. No ads, no subscriptions, no nonsense
Many Lamps, One Flame — Interfaith writing exploring Torah, Gospel, Kabbalah, and contemplative traditions
Rooted Hearth — Writing about real food, practical living, and the quiet work of keeping a home in order
A Note on Medical Content
One More Beat is a personal narrative. I am a heart transplant recipient, not a physician, pharmacist, or medical professional of any kind.
Everything written here reflects my own experience, my own research, and my own understanding of my own care. Where clinical studies or medical literature are cited, they are included for context and transparency — not as recommendations. A study that applies to my situation may not apply to yours. A medication I take may be contraindicated for you. A protocol my transplant team uses may differ significantly from yours.
Nothing on this site should be interpreted as medical advice. Nothing here should be used to make decisions about your care, your medications, or your treatment without first consulting your transplant team.
If you are a transplant recipient or candidate, your transplant team is your primary resource. Talk to them. They know your case. I don’t.
If you are a caregiver, the same applies. Bring what you read here to your loved one’s team and ask questions. That is exactly what this kind of writing is for.
One More Beat is intended to inform, to share experience, and to make the road a little less lonely — not to replace the medical professionals who are keeping you alive.