Three months after a kidney transplant, Ali Hooks can't go home to Louisiana, a COVID-19 hotspot, so she's still on campus.
Texas Tech University in April is normally a lively place, bustling with activity, echoing with music, laughter and scholarly discussions. Around the residence halls, students often cook out with their neighbors at the barbecue pits, visit their friends' suites or grab a drink from Starbucks on their way to class.
But this isn't a normal April. Thanks to COVID-19, most students are gone. It's quiet. The Starbucks, and even the study rooms, are closed. The residence halls are almost empty.
Almost.
Isolated in her room with just her dog for company, Ali Hooks can't go home – trying to might kill her. She's already beaten death more times in the last two years than most people do in their entire lives.
While COVID-19 seems to disproportionately affect older people, Hooks belongs to a specific class of younger people who are at an elevated risk – those considered "immunocompromised" because of underlying health conditions.
After an extended spring break, all Texas Tech classes were transitioned online in March. Students who went home were encouraged to stay there. In the weeks since, campus has closed to all but the most essential personnel and those students living on campus who couldn't go elsewhere.
Perhaps ironically, the place so many others evacuated is now the safest place for her.
Hooks wasn't always considered immunocompromised. She was a normal kid who took dance lessons and played sports, growing up in the small town of Port Barre, Louisiana. She was on the student council at her high school, Westminster Christian Academy.
When she graduated in May 2018, she was eager to bust out of small-town life and start working toward her dream to become an FBI agent. The first-generation college student had fallen in love with Texas Tech during her visit to campus the previous year, and she couldn't wait to begin the next chapter of her life.
She didn't know then just how scary and unpredictable that next chapter would be. She didn't know that within six months, this normal, healthy 18-year-old would be fighting for her life. She didn't know just how close she would come to losing that fight.
And she certainly didn't know that, just when her life seemed to be returning to normal, a global pandemic would steal normality yet again.
Coming to Texas Tech
Hooks realized fairly early she didn't want to stay in small-town Louisiana. In doing her research, she found that the state of Texas offered significant financial aid for out-of-state students, helping her make her decision. Then, she just had to narrow it down to the right university.
She toured nearly every college in Texas with her grandfather, Dale Hyatt, who Hooks said is her No. 1 supporter.
"I came to Texas Tech, and I fell in love with it the second I stepped foot on campus," Hooks said. "It was summer and the tulips were out, and it was just beautiful. Texas Tech had that homey feeling: it was big, but it didn't feel big – you felt close to everything."
Even though it meant being far away, her grandfather encouraged her to go out of state to pursue her dreams. She had decided to major in sociology, with a concentration in criminology, and double minor in forensic science and American Sign Language. She was excited about her future.
But during the summer between high school and college, she realized something wasn't right. She felt nauseated more often. She felt weak and fatigued. Three separate doctors all said the same thing.
"They just told me, 'You're going to a big university, you're moving 13 hours away from everything you know, you have no friends up there, you're nervous, you're scared and you're stressing yourself out,'" Hooks said.
She arrived at Texas Tech in August 2018. She moved into her residence hall, started to make friends, started classes and started to get acclimated – but her illness only got worse.
She was having headaches. She wasn't urinating, no matter how much water she drank. She told herself she must be dehydrated.
"No matter how much I tried, I could not eat – I went days without eating," Hooks said. "I lost a total of 40 pounds in a month. It was horrible. I became pale as a ghost. I wouldn't throw up, but I would be gagging almost; it was like acid reflux but there was nothing there because my body couldn't handle food. The nausea kept getting to me, and I felt like I was going to pass out."
When she went to University Medical Center, hoping for a different answer than stress, they suggested she might have a stomach ulcer. They scheduled her for an ultrasound.
She didn't make it that long.
The diagnosis
At 4 a.m. on Oct. 5, 2018, Hooks woke up and couldn't breathe. Panicked, but trying to remain calm, she dressed, called her mother and drove herself to the emergency room at Covenant Medical Center.
"I'd never been to an ER in my life," Hooks said. "I was terrified. I was 18, my mom and dad were back home, I had no friends, I was new, and so I walked into the ER and just said, 'I can't breathe.'"
The ER staff initially thought she had broken a rib, but they began running tests to rule out anything more serious.
"I literally could not lay down because at that point, my lungs were 96% fluid," Hooks said. "They were amazed I was even breathing at that time. They said if I would have waited a couple more hours, I would have died in that dorm room."
Instead of ruling out a serious condition, the results of her bloodwork confirmed it.
"Everything was out of whack," Hooks said. "They said I was a dead man walking, basically, because none of it made sense."
At age 18, Hooks was diagnosed with end-stage renal disease, meaning her kidneys were no longer able to properly filter her blood. Because she wasn't able to urinate, dangerous levels of waste had built up in her body. She needed immediate dialysis or a kidney transplant to stay alive.
"They told me I had a few hours to live, so my first phone call was to my mother," Hooks said quietly. "It was 6 a.m. I told her what they told me: I was in end-stage renal disease, I literally had a few hours to live and I was about to go into immediate dialysis surgery and get a heart catheter put in me, trying to save my life.
"I just remember my mother shrieking and dropping the phone."
On the home front
For Hooks' mother, Misti Hyatt, it was like reliving a nightmare. She'd had to watch as her own mother suffered from the same disease years earlier.
"I remember trying to tell her to calm down because I know that triggered a lot, but my phone was on 2%," Hooks said. "I said, 'Mom, I'm at Covenant. I don't know what's about to happen, but I love you. I hope I'll see you soon.' And then my phone died and that's where everything ended."
While Hooks was rushed into surgery, Hyatt was putting out the word to friends and family. Within half an hour, nearly the whole town knew the situation.
"My favorite high school teacher called her sister, who lives in Lubbock, and said, 'Get to the hospital and find Ali Hooks,' so when I woke up from surgery, her sister was sitting there," Hooks said. "She was an angel, honestly. I'm 18 years old, I just went through surgery and there's all this stuff happening around me, and she just sat there so calm, like she's known me forever."
In the meantime, Hyatt, Hooks' father, Toby Hooks, and stepmother were making their way to Lubbock as fast as they could. When Hyatt arrived that afternoon, Hooks was already undergoing her first dialysis treatment – a process where the blood is pumped out of the body, filtered and pumped back in.
"There were just no words," Hyatt said. "The smell and sound of that dialysis machine was all too familiar. But to see Ali laying there, hooked up to it, was the most awful, helpless feeling. I watched my mom on dialysis. I never in a million years thought I'd see my child go through it."
She was about to see worse.
In the hospital
Hooks continued dialysis for the next week, living in the intensive care unit and receiving blood while doctors worked to discover the reason behind her mysterious blood loss.
In kidney failure, she explained, whatever a person drinks stays in their body because they are unable to filter and pass it. When fluid suddenly began to build up around Hooks' heart, doctors told her they needed to do open-heart surgery immediately. With the surgery, they said, she had a 50-50 chance. Without it, she was likely to die within the hour.
"I didn't know what else to say, so I said, 'Go for it,'" she said. "I don't really remember much about it because I was severely sedated at that point, but I woke up a couple of days later, finally fully awake, and it had worked.
"I had about 20 pounds of fluid on my heart, and it was smothering me. They were able to drain it all."
As Hooks' hospital stay lengthened, her care became increasingly expensive. That's when a childhood friend of Hyatt's stepped in. Bambi Polotzola, executive director of disability affairs for Louisiana Gov. John Bel Edwards, started a GoFundMe account for the family, but her biggest contribution was yet to come.
Still focused on school
Hooks, who'd then been in the hospital for a week and a half, suddenly realized where she wasn't – in class. She begged for someone to call her professors and let them know the situation so they didn't think she was skipping class or just blowing off her assignments.
"One teacher emailed me, like 'Ali, get well; don't worry about this,'" she said. "I have pictures, actually, of me sitting in the hospital a day after open-heart surgery. We have all this going on, and I'm sitting there typing a report, doing homework, working on my studies.
"I can laugh about it now – it was so crazy to do that. But my main concern was, how are my grades?"
She's proud to say that, even with everything she was facing, she didn't drop any classes. She returned to campus about a week after her heart surgery and picked up where she left off. Living in the dorms. Going to classes. Enduring dialysis five hours a day, three to four times a week.
Dialysis was filtering Hooks' blood and buying her time, but it didn't change the fact that her kidneys had completely shut down and, without a transplant, she was dying. Her blood pressure was off the charts, and because of it, she had a stroke in her residence hall the first month of the spring 2019 semester. After her stroke, she developed a type of epilepsy, which gave her seizures, and then pneumonia. Some days she was unable to even get out of bed.
"That really hindered my classes, and, sadly, that semester, I failed every class just because I was too stubborn to drop out," Hooks said. "That was the worst semester."
Still determined not to give up, Hooks returned to Texas Tech in August. But while driving, she got a call with some unexpected, but very welcome, news: Polotzola, Hyatt's best friend, was a perfect match for a kidney transplant and was willing to donate one of her kidneys to Hooks.
"I was hysterical, crying on the side of the road," Hooks said, "So many emotions."
But as the news sunk in, she had one request: "Can we wait until after the semester so I can finish my grades?"
After Hooks assured Polotzola and Hyatt that she fully understood the urgency and still wanted to wait, they accepted her choice. On Dec. 23, she received a new kidney and, with it, a new chance at life.
A new normal
Ready to finally have a normal college experience after everything she'd been through, Hooks began this semester. It wasn't entirely normal of course – there were still good days and bad days. Her blood pressure was still high, and she was now taking about 50 pills a day to suppress her immune system so her body would accept her new kidney.
"Not every day can I just roll out of bed and get to class," she admitted. "I'm only three months with a new organ in my body. I still struggle to walk sometimes, even just up stairs."
Let alone walking across campus. But Hooks was sticking with it and doing her best. Her emotional support animal, a French bulldog named Chester James, was by her side through highs and lows.
And then came COVID-19, and every student's "normal" college experience came to a screeching halt as spring break was extended, classes were transitioned online, campus was limited to essential personnel and then only those who couldn't go elsewhere.
"It was like I finally got my life back, I got to be a teenager and go to college and finally attend class, and COVID-19 took it all away again," Hooks said. "I felt like, 'Oh my goodness! I just want to go sit in class and learn. Let me do that!'"
But she couldn't. If classes hadn't moved online, she wouldn't have been able to attend them. In her case, because of her transplant and the immunosuppressants she's now taking, she falls into the category of immunocompromised people who are at a higher risk of death if they contract COVID-19.
At the same time, she can't go home to Louisiana, which has now emerged as one of the country's COVID-19 hotspots. For Hooks, the safest place to be was in the place nearly everyone else was evacuating: campus.
"I've been in self-isolation for a long time, for about five weeks," she said. "I am not allowed to go home yet. It's just too risky to drive home or fly home or go anywhere else. So I'm just here in my little room, where no one else enters or goes out. It's very quiet and quite lonely at times due to the lack of neighbors."
Without Chester, she says, she would have gone stir crazy, but she's OK.
"Yes, I'm sad because this was supposed to be my big comeback," Hooks said. "This was going to be a semester where I didn't have to sit on a machine three times a week. I get to be that normal kid who goes to class, takes the notes herself and takes the test in person, and I don't get that. And, yes, it aggravates me and it makes me mad, but it's not Texas Tech's fault. It's nobody's fault."
'All I could ask for'
As much as she dislikes the situation, Hooks believes Texas Tech has handled the situation as well as possible. The extended spring break gave her time to stock up on food and the supplies she would need to wait out the virus. She's venturing out as little as possible.
Hooks is particularly grateful for the people at Texas Tech who have continued to monitor her needs and well-being, like her adviser with TRIO Student Support Services and Student Health Services, which called to see if she needed a blood-pressure cuff to monitor herself.
"That made me feel very safe that they still look at the students in their computer and make sure they're still doing well, whether they're on campus or off," she said. "I love that about Texas Tech. I really appreciate that I'm not just another face in the crowd, that they actually truly care about me and want to see how I'm doing."
So while this wasn't the semester Hooks had hoped for, she's making do with what she has and looking forward to "normal" whenever it returns.
"I have everything I need," she said. "I'm back in classes. I have perfect grades right now. I'm going to get my credits. That's all I could ask for."
