Ms. Silverstein endured treatment for repeated infections, multiple rounds of skin cancer and a variety of other conditions relating to a weakened immune system, her husband said. The couple found themselves settling in for interminable waits in New York City hospital emergency rooms to deal with one complication or another on a monthly basis.
To check for signs of rejection, she had to undergo frequent heart biopsies in which doctors “run a catheter down through your blood vessels and pluck pieces of your heart out,” Mr. Silverstein said. “She had over 90 of them.”
After “Sick Girl” was published, Ms. Silverstein received reams of fan letters from other transplant recipients, hailing her for her courage in bringing to light the odd mix of joy and misery that can accompany life with a new organ — what she called the “gratitude paradox.”
She also attracted hate mail as a vocal critic of the health care industry. “Organ transplantation is mired in stagnant science and antiquated, imprecise medicine that fails patients and organ donors,” she wrote in her recent Times essay, adding that the daily use of transplant drugs over years or decades can cause a host of other life-threatening conditions, including diabetes, uncontrollable high blood pressure, kidney damage and cancer.
Despite that destabilizing regimen, Ms. Silverstein maintained a vigorous life, returning to finish law school after her first transplant, then practicing briefly before abandoning the profession to raise a son, Casey, and, eventually, to write.
Amid a life of careful regimentation, including regular and intense exercise and adherence to a strict diet, avoiding even the smallest pat of butter or sip of alcohol, she took up the guitar and songwriting. Once, in the late 1990s, she appeared as a solo act at the Bottom Line nightclub in Greenwich Village.
In addition to her husband, Ms. Silverstein is survived by her son as well as her father and stepmother, Beverly Shorin. Her sister Jodie Hirsch died in 2020.
