The Call, as it has become known, is something that vaguely has hung above the Brown family since Ashley was born more than 17 years ago.

Once it became known the Modesto girl someday would need liver and kidney transplants to live a healthy life, The Call has been the family's hope, their promise of better days. Yes, they assured themselves, someday the phone would ring with news that donated organs were ready for her. The dark side of The Call always has been that it might not come at all, a scenario too heavy to do anything with but shrug aside as an impossibility.

It was that brand of uncertainty that made The Call so difficult to prepare for. That became clear the morning of June 6, when Ashley's mother, Kim, answered her cell phone. A woman from Ashley's liver donor team was on the other line.

"Kim?" the woman said, "Where are you?"

"Modesto," Kim said.

"No, where."

"I'm at home," Kim said. "Why?"

"Are you sitting down?"

"Yes."

"OK," the woman said. "We've got a donor offer for Ashley. It looks good."

The announcement kicked off a chaotic chain of events. Kim tried to stay calm, but emotions flooded her body; the woman on the phone kept talking, but Kim didn't process another word. When The Call ended, Kim's hands were shaking; she immediately dialed the cell phone number of her mother, Barbara Hatton, who was across town dropping off Ashley at the Modesto High School graduation picnic at Graceada Park.

Ashley and a friend had just stepped out of Hatton's pickup when Ashley heard her grandmother scream into a cell phone. Ashley never had heard her grandmother scream like that; instantly, Ashley knew. She started crying and looked at her friend, who was becoming confused at the rush of excitement.

"I got my organs," Ashley said.

"What's that mean?" her friend said.

"It means I'm getting my transplant," Ashley said.

Ashley told her friend goodbye and hopped into the passenger seat. Across town, her mother paced through the house, unsure what to do first. So she walked around frantically accomplishing nothing. Getting nowhere, she stepped outside and nervously smoked a cigarette, trying to collect her thoughts.

She walked back inside and realized for the first time that they had nothing packed. As she stuffed clothes, medicine and other supplies into bags, the voice of one of Ashley's doctors popped into Kim's head. You never know when The Call will come, he said, but count on it happening when you least expect it.

This scenario certainly qualified. The next day was to be Ashley's graduation from Modesto High School. Despite 10 hours of dialysis each night and countless medical appointments that put her well behind her classmates, she had managed to complete a double load of courses during her senior year and make up enough credits to graduate with her class. Instead, at the very hour her classmates would be dressed in graduation gowns to receive their diplomas, Ashley would find herself dressed in a hospital gown and being wheeled into surgery at the University of California at San Francisco Medical Center for a 10-hour operation.

Arriving home, Ashley walked into a room to find her mother packing their belongings.

"I got my organs," Ashley said, smiling.

"I know," Kim said, looking up.

It was then that Ashley first noticed the tears running from her mother's eyes. From the expression on her mother's face, it was easy to see she was both ecstatic and frightened. Ashley knew exactly how that felt.

Thursday, June 7, 10 a.m.

As it turned out, the frantic hours that followed The Call could have been avoided. They arrived at the hospital late Wednesday afternoon for the surgery that had been scheduled for the following morning. But it was postponed until Thursday evening to give the organ-harvesting team more time; the best guess now was sometime around 8 p.m.

Until then, Ashley's home became a private room on the sixth floor of the UCSF Medical Center. The walls were painted beige and contrasted a window view of a beautiful, sunny San Francisco day. But it might as well have been raining outside. On this day, the members of Ashley's family all were prisoners of the indoors in a place where time seemed to pass as slowly as the drops of saline from an IV bag.

In the center of the room, Ashley rested in a bed beneath a white sheet, an IV dripping nutrients into her arm. On a nearby nightstand sat her dialysis machine, covered in smiley faces and animal stickers. If all went as planned, this would be the last day she'd need to see the cursed machine again. Ashley did her best to avoid thinking about the surgery, but it was a tough sell. For her, it was the beginning of perhaps the longest day of her life. And there was nothing to do but wait.

11:30 a.m.

Although organ transplants have become common — roughly 29,000 transplant operations were performed in the United States during 2006 — dual kidney and liver transplants are rare. Last year, 400 people underwent kidney-liver transplants in the the United States, and only seven of those patients were younger than 18, according to the Organ Procurement and Transplantation Network.

Over time, dual kidney-liver transplant patients have a 70 percent chance of surviving five years past their surgery, according to statistics from the U.S. Department of Health and Human Services. However, most of those operations involve older patients. Kidney transplant patients in Ashley's age group have a 96 percent survival rate after five years, and liver transplant patients in the same group survive five years 81 percent of the time.

As encouraging as statistics can be, they don't always have a calming effect on the mind of a 17-year-old girl. And, looking forward to at least nine more hours of being confined to a hospital bed, Ashley's battle became a mental one.

1 p.m.

Sitting up in bed, Ashley held her cell phone in front of her. She hadn't moved or spoken to anyone for the past 20 minutes. The only motion and sound in the room was the tat-tat-tat of her thumb as it madly pattered the keypad. With unbelievable speed and precision, she sent a flurry of text messages to her boyfriend, Joey. One hundred miles apart, it was their best line of communication.

When she finished writing, Ashley raised the phone in the air to get a signal strong enough to send the message. She lowered her arm, looked at the screen and saw that it had gone through.

"This is how she passes the time," Kim said. "She just tries to stay positive."

Ashley looked up and got ready to say something, then returned her attention to the phone. She began typing out a message to another friend. Tat-tat-tat. Tat-tat-tat.

She'd been sitting and lying in the hospital bed for 19 consecutive hours now. Keeping busy helped keep her mind from wading into scary waters, but ultimately it was a losing battle. She put the phone down and glanced at the clock hanging directly in front of her on the wall. Seeing the time, she did some quick math. Then she sighed loudly.

"One o'clock," she said. "Seven more hours."

Ashley has been in tune with UCSF her entire life. The transplant surgery was to be her seventh overall, each being performed at UCSF. The endless string of hospitalizations and recoveries has led her mother to call Ashley her "miracle baby."

The first surgery came when she was 2 weeks old. Her stomach became bloated and her blood pressure wouldn't stabilize, so Modesto doctors sent her to specialists in San Francisco. A full day of tests revealed she had polycystic kidney disease, a progressive disorder that affects one in 20,000 babies and leads to kidney failure. Of those who survive the first month, about one-third require dialysis or transplantation by age 10. The disease puts added strain on other organs and can lead to liver failure.

Ashley's surgeries have included placement of a catheter, a hernia repair and two upper endoscopies. She had the TIPS procedure, which involves placing a tube in the liver to reroute blood flow; she underwent a reverse TIPS procedure when the initial one didn't work. There have been countless other visits to UCSF because of complications from her kidney disease, which has required her to take as many as 14 medicines at once. Her condition also recently led to hepatic fibrosis of the liver, necessitating the dual organ transplant.

5 p.m.

As the day wore on, Ashley's thoughts floated everywhere at once, occasionally returning to the bittersweet reason for her chance at a better life: Somewhere in California, a family was mourning the loss of a young woman who died the day before, the result of some type of accident.

7 p.m.

One hundred miles away, thousands of people gathered at Modesto Junior College for the graduation ceremony of Modesto High's Class of 2007. At one point, Principal Hugo Ramos told the crowd about Ashley, whose primary mission in life the past year had been earning the right to graduate with her class. A never-ending chain of doctors' appointments and sick days during her early high school years had left her short of credits, well off the pace of being able to graduate on time.

Yet, early in her senior year, Ashley approached her mother and told her about the new goal. It was a monumental wish. It meant essentially taking a double load of classes and finishing each day early enough to be in bed for 10 hours of dialysis at night. Her senior year had consisted of mostly two constants: school and dialysis. And more than simply achieving her goal, she shined.

Kim said Ashley held a 4.0 grade-point average her senior year until a B knocked her down a notch from perfection. In March, the Modesto City Schools District presented her with an "Eddies" award, which recognizes students of outstanding character. In May, Ashley was chosen to be on the cover of the district's tab for college-bound students. Also in May, she received two college scholarships, The Truman & Frances Hand Scholarship and the Applied Communications Scholarship.

In the mind of a determined young woman, there had been only one thing that could have stood in the way of her dream to graduate with her class. And, at 9:15 that night, as a new crop of Modesto High graduates headed to various celebrations, a nurse walked into Ashley's room and told her it was time.

9:15 p.m.

One by one, Ashley nervously told her family members goodbye as they wished her well. She hugged her father, and two of her grandmothers, and Kim's fiance. After 25 nervous hours spent passing the time in her hospital bed, the moment she had simultaneously hoped for and feared all her life was upon her.

A nurse wheeled Ashley's bed out of the room and into a long hallway. As Kim walked beside the bed as it moved toward the operating room, she noticed the frightened expression on her daughter's face. Kim melted inside but tried not to show it.

"Ashley, you can cry if you want to," Kim said. "It's all right to be scared, honey."

The bed stopped moving. Ashley, Kim and the nurse had reached the last set of doors. The nurse walked away to give the mother and daughter some time alone. As they held hands, Ashley started to cry.

"It's going to be OK, Ashley," Kim said. "I'll be right outside the door the entire time."

The emotion grew until Kim could barely stand it. She and her daughter said a small prayer together. When they finished, Ashley looked at her mother and bravely tried to smile through the tears.

"I feel a real strong presence here," Ashley said.

"I do, too," Kim said.

Ashley told her mom the presence felt like Papa — Ashley's grandfather, who had died about four years ago. Kim smiled and wiped away more tears. The two held onto the moment with all they had.

The nurse returned and told Kim the surgeons were waiting. The mother and daughter hugged tightly and kissed. Then the doors opened, the wheels rolled, and the doors closed. And the miracle baby was gone.

Suddenly, standing in the hallway, Kim felt incredibly alone. She sobbed as she moved down the hallway. The hardest part was leaving Ashley's side when she was crying and afraid to be alone, knowing there was nothing she could do to help her daughter. Needing a cigarette to calm her nerves, Kim hurried to the elevator. Once inside, she pushed the button for the bottom floor. She held it together until the doors finally closed. And then she sank against a wall and began to wail, her brave face melting into the throes of a mother's grief.

Friday, June 8, 2 a.m.

The waiting area outside the UCSF operating room is a heart-wrenching place.

Families gather closely, helplessly waiting on matters of life and death. The hours pass in a tedious, slow-motion calm. The rigid couches and chairs that line the waiting area's walls conspire with worrisome circumstances that make sleep next to impossible. And there is no privacy in the most private of times.

In the early morning hours, as Ashley's family waited for news about her liver transplant, the anguished mother of a 9-month-old baby girl sat in a chair, clinging to thin hope. The girl had been rushed into emergency surgery after swallowing some type of screw. Kim watched as a hospital worker walked over to the mother and asked her to come to the ICU. Moments later, Kim heard the mother's horrible, anguished cries that left no doubt the baby girl had died. A while later, the family of a 10-year-old boy was told their son had not survived surgery.

Those developments only intensified the restlessness brewing within Ashley's family members. Around 2 a.m., Kim managed to get herself comfortable enough to fall asleep on a small couch. A couple of hours later, she awoke when her fiance touched her arm.

Kim opened her eyes and looked up to see Dr. Chris Freise, the surgeon in charge of Ashley's liver transplant, walking toward her. The years of waiting-room experiences had taught Kim that the results often could be tipped off by the expression on the surgeon's face. Earlier that night, she had seen serious expressions when the news was grim; and, as with all of Ashley's other surgeries, Kim always had noticed the smile well before the surgeon had uttered a word.

As Dr. Freise approached, Kim spotted a pleasant smile on his face. She took a giant breath and exhaled in relief. She cried as Freise said he'd never had a liver transplant turn out better: The liver started working immediately upon being placed into Ashley's body. Everything was going well, he said. So far.

7:30 a.m.

Knowing the liver was the more difficult of the two transplants didn't do much to allay Kim's fears. She spent the next three hours alternating between rushing downstairs to smoke and rushing back upstairs to see if there had been any word. The black of night slowly gave way to the blue sunrise, but still there came no word. By 7:30, Kim fidgeted on a couch, nervous and — having slept only two hours — exhausted.

Then Kim saw the figure of a short man wearing hospital garb, walking down a hallway that led to a waiting room. Instantly, she recognized it was Dr. Sang-Mo Kang, the surgeon in charge of Ashley's kidney transplant. Kim and the doctor made eye contact as he moved toward her. Then she glanced down at his mouth. Instantly, she knew.

He was wearing the friendliest smile she'd ever seen.

Epilogue

Predictably, Ashley's days immediately after the surgery were wrought with terrible pain and a never-ending series of tests. She spent more than two weeks at UCSF, followed by another month at a San Francisco home near the hospital as doctors monitored her progress daily.

To date, her blood tests have shown no signs of her body rejecting her new organs. She still has 14 vials of blood drawn per week for tests, but she is considered healthy and no longer requires pain medication.

As her pain has receded, an entirely new and welcome feeling has taken hold.

"My life just feels so different because I have all this energy now," Ashley said Thursday. "Before, I was tired all the time, but that's gone. I just feel so much better."

Ashley returned to her Modesto home for good on July 19. However, she hasn't stayed there much. Last week, Ashley took college placement tests. She plans to enroll in junior college this fall, either in Modesto or Santa Rosa.

Even though all signs show her daughter's recovery is on track, Kim said she still hasn't stopped worrying about Ashley's health. After 17 years, it's a hard habit to break.

"I've lived so many days worrying about her, it's hard to let it go just like that," Kim said. "I haven't figured out how to relax about it yet. But everything has been great so far. We really couldn't have asked for it to go any better than it has."

Story reprinted and modified for the Web site with permission from the Modesto Bee.