Bud and Judy Anderson barely made a sound as they walked into the empty lobby of the University of Virginia hospital just before 6 on a balmy Thursday morning. The sun, along with most of the town, was still in bed.
With quick, quiet steps and serious, nervous faces, they followed a receptionist to a waiting area. There, they sat next to each other and waited. They read the newspaper and chitchatted with their children, but, mostly, they waited.
For weeks, the Bluemont couple had talked to family and friends about their upcoming surgeries. And for weeks, they tried to prepare themselves for the moment when doctors would take Judy's left kidney and give it to Bud.
Now that the moment was upon them, nobody knew quite what to do, or say.
"Judy Anderson," a man called out.
She rose and headed slowly toward a desk in the middle of the room. The moment had come a little too quickly for her. As the man led her out of the room, she stopped, leaned down and locked Bud in a tight embrace. Neither wanted to let go.
Bud sat alone after Judy left the room. He waited quietly for his moment, which came just a few minutes later.
Bud, 58, began to experience kidney failure in February 1998, after years of neglecting his high blood pressure and diet. With careful attention to what he ate, he was able to stave off dialysis--but it was Judy, 57, who lobbied for a permanent solution before he became ill. And it was Judy who pressed him to make her the solution.
The day before their surgeries, he gave her a card with the printed message: "Blessed are the givers and grateful are the receivers. Just can't thank you enough." At the bottom, he added his own words: "I was blessed when God sent you to me. I love you so much."
And still, he said, nothing could quite capture his feelings. Thankful yet scared. Hopeful yet nervous.
They battled the butterflies Wednesday night by joking and reminiscing with family and friends who gathered at their hotel to help them pass the time. Their daughter, Valerie, 36, and her husband, Dale Reid, came. So did their son Eric, 28, and his fiancee, Linda Shulz. The Andersons' other son, Todd, would arrive the next day.
"We're just glad to be here and do what we can," said Eric, who flew in from Mississippi. "We're very bullish on the outcome. He has the advantage of being healthy going into it."
Until that night, it had been a relatively routine Wednesday for the couple. Judy worked until 5 p.m. at Farm Credit in Leesburg. Bud took care of the cows on his 30-acre farm. The reality of the transplant hit her as she ran several last-minute errands.
"I realized that tomorrow at the same time, I'd be helpless," she said. Bill and Judy Casey, lifelong friends of the Andersons, drove the couple from their west Loudoun County home to Charlottesville. Judy Casey and Judy Anderson have known each other since they were five years old.
Bud said his stomach hurt the whole trip down--maybe from the anti-rejection medication he began taking Tuesday, maybe from anxiety.
With a slight smile, Judy Anderson listened to Bud complain and said, "But he still ate crab cakes for dinner."
"And French onion soup," Bud chuckled.
Laughter filled the room.
Bud sat back, with his hand on Judy's knee. He knows that once he has his new kidney, there will be no more rich food and no more overeating.
"We will exercise, and we will stay healthy," Judy said. "I want him to take care of my kidney."
"I think I'm going to have to be nice to her the rest of my life," Bud added with a smile.
Two surgical teams worked in adjoining rooms to perform the kidney transplant. Judy in Room 8. Bud in Room 9. Judy's operation began shortly after 7 a.m., Bud's about 90 minutes later.
"She's a little bit unusual," Tim Pruett, Judy's transplant surgeon, told two medical students as he fingered the kidney that still belonged to her. It's "scarred up a bit. . . . She's been active in her life, you can tell. This is the sort of kidney you'd see in truck drivers. She probably rides [horses] a lot."
But the scarring, he said, would not affect the kidney's functioning in Bud's body.
At 9:25 a.m., surgeons had freed Judy's left kidney from the fat, muscle and tissue that surrounded it. All that was left to do was cut the tube that connects the kidney to the bladder and disconnect the blood supply by cutting the renal vein and artery.
"How close are they next door?" Pruett asked. "Tell them we're ready."
A nurse left the room and came back with the answer: "Fifteen minutes."
Surgeons in Bud's room worked to cut open a section near his abdomen, where they planned to insert his new kidney. They did not remove his old kidneys, explained nurse Kenneth Fitzgerald. Instead, doctors create a pocket for the new kidney, and the old, nonfunctioning kidneys eventually shrivel up.
That is why kidney transplant patients should avoid contact sports, he said, because the new kidney is less protected than the old.
At 9:40, Bud's doctors were ready, and his surgeon, Robert Sawyer, headed to Judy's room.
"Are you ready, Rob?" Pruett asked.
Sawyer placed Judy's pink kidney into a bowl of cold water, where it turned gray as urine and blood were washed away.
"It's flushing beautifully," Sawyer said.
Using a rolling cart, Sawyer then took the kidney next door, where he began the long, intricate process of connecting the new kidney into Bud.
The other Judy, Judy Casey, waited for news while knitting a blue sweater for her soon-to-be-born nephew. She has never been a worrier. She knew everything would be fine, especially because of the Andersons' deep religious convictions.
"I know she's prayed a lot about this," said Judy Casey, who runs a ladies dress shop in Middleburg.
Valerie Reid filled a photo album with pictures of her children as she waited for news of her parents' operations. After a while, she tried to nap on her husband's shoulder. "I tried to sleep last night," she said. "I slept a little bit, but I kept having these crazy dreams."
It was 10:20 a.m. when Judy was brought out of the operating room--and about two hours later, Reid and her brother Eric were allowed to see her as she emerged from the recovery room.
"Mrs. Anderson, you have visitors," the nurse said gently to Judy.
Judy didn't respond, still groggy from anesthesia. Reid's red eyes filled with tears as she leaned over and kissed her mother.
A few minutes later, Bud's surgeons were through, and at 2:45 p.m., he saw his family again.
Bud and Judy Anderson were doing "really well," according to hospital spokeswoman Marguerite Beck. Judy was recuperating nicely, and Bud's new kidney was functioning normally.
Bud and Judy had asked to stay in the same hospital room but had to settle for separate rooms on the same floor.
If everything continues to go well, Judy will go home tomorrow, and Bud will go home Tuesday or Wednesday. Full recovery for Judy will take about eight weeks, fewer if she heals quickly. For Bud, recuperation will take longer. During the first three months, doctors will have to monitor his kidney constantly for signs of rejection.
Bud hopes that an experimental anti-rejection drug now in the final stages of approval by the Food and Drug Administration will help him. He decided to sign up for the medication out of a desire to help other people.
"I believe in trying anything that could help anyone in the future," he said. "Somebody's gotta do it."
And the Andersons also hope that by sharing their experience with friends and strangers, they can teach people that kidney donations can come from almost anyone, whether related by blood or not.