Opt In, Opt Out, and (Modified) Mandated Choice

The phenomenal success of organ transplantation has created an ever-growing disparity between the number of people waiting for life saving transplants and the number of donors available. The Organ Procurement and Transplant Network (OPTN) and Scientific Registry of Transplant Recipients (SRTR) report current graft survival rates for most organs at 3 years greater than 70-80%. According to Donate Life America, as of 2011, 120,000 people were awaiting transplants but only 28,000 transplants were performed. Every day, 19 people die on the transplant waitlist because there are not enough donor organs. Efforts to increase the donor pool, such as performing more transplants from living donors and encouraging organ donor “swaps”, accepting organs from elderly donors or from donors with chronic diseases (e.g., high blood pressure or—in special cases—hepatitis C or hepatitis B), and “splitting” organs in the case of liver and lung, have proved insufficient to close the gap. Fundamental changes in organ donation technology, including mechanical devices, organ engineering, and revitalization of organs from sudden death victims, are on the horizon (more on this later), but the donor organ shortage problem remains acute here and now. There is more that we as a society can and should do.

The United States practices an organ donor registration policy referred to as “Opt In”. Anoptout individual voluntarily registers to become a donor in the future if he or she wishes. Certain European countries including Spain, Portugal, and France, practice an “Opt Out” system, whereby every citizen is presumed to be a donor unless they specifically say that they do not want to do so. Effective consent rates range from 98-100% in these Opt Out countries compared to 4% (Denmark) to 40% (US) in Opt In countries. I frequently get asked the question, particularly by young people, why we don’t practice an Opt Out system here?

Well, this turns out to be an extremely emotionally charged topic.

There are many passionate and often logical arguments against an Opt Out system here in the US. The most persuasive argument, in terms of swaying public opinion, is that the decision to register one’s intent to become an organ donor upon one’s death is a highly personal one and that governmental “presumption” of one’s wishes would be an unspeakable encroachment on personal liberty.

Fair enough, but I don’t quite buy it.

Opt Out still allows an individual to make a choice. They just have to choose “no” if they wish. Although the vast majority of Americans favor organ donation, too few take the effort to register their good intentions. Why not acknowledge public opinion by allowing everyone to be donors and make it easy for those who do not want to donate by simply clicking “no”? As I’ve said before in my TEDx talk, I’m perfectly fine with someone’s decision not to be a donor. I respect your decision either way. I do think, however, that it needs to be an informed decision.

Some predict that initiating Opt Out would actually decrease current registration rates because so many people would be offended by being “forced” to do something without their permission. This could be the case if adequate and unbiased information is not provided and the point that the individual has a choice is not adequately and sensitively stressed. People need to know that they could make a difference in many others’ lives after they die. They need to appreciate that their decision has meaning beyond their own personal interests, fears, and misunderstandings. They need to know that it is their own, highly personal choice. No one is forcing them to do anything. Just say no if you don’t want to donate.

A more compelling argument against Opt Out is that it wouldn’t make much of a ratesdifference here in the US because our transplant and donation infrastructure is so highly developed and efficient. Organ donor rates per million population are not too different between Spain (32) and the US (25), and the US outperforms several other Opt Out countries in this regard. A corollary to this is the reality that even if everyone were a registered organ donor, this would still not solve the organ donor shortage problem.  Thousands of patients still die on the waitlist even in Opt Out countries with 99% registration rates.

But are these really good reasons to not increase the number of potential donors? We may not be able to completely solve the problem, but thousands of lives could still be saved.

I predict that we will ultimately be able to solve the donor shortage problem with a combination of mechanical devices, biomedical engineering, and revitalization of organs from sudden death victims. “Ventricular Assist Device” (heart pump) technology has advanced dramatically and sufficiently such that implantation of these machines has surpassed the number of heart transplants performed and may offer a long lasting alternative. Research in “growing” organs in the lab with a combination of bioartificial (or organic) scaffolds and stem cell repopulation is coming along and, although nowhere near ready for primetime, will one day result in a viable solution. Closer to reality is the idea of recovering organs from sudden death victims (most people, 16 million per year, die suddenly of strokes, heart attacks, and trauma as opposed to progressing to brain death in the ICU, only 1% of deaths) and “nursing” them back to health in the lab with a combination of artificial perfusion and infusion of growth factors and other protective molecules. This is already being practiced to some extent in lung transplant, where select centers recover the lungs and bring them back to the lab to perform quality checks on a mechanical ventilator to determine which organs are suitable for transplant. The future is bright, but what do we do right now?

I have to admit that I am on the fence about Opt Out simply because I don’t think our culture is ready to accept this noble notion. We need to continue educational efforts and wait for the younger generation to come of age. At this point, I favor “Modified Mandated Choice”. This an embeddable “nudge” to get people to consider the idea of organ donation without forcing an actual decision. New York State recently passed “Lauren’s Law” that requires visitors to the Department of Motor Vehicles to answer the question “Would you like to register to be an organ donor?” before they receive their driver’s license (or renewal). The answer choices are “Yes” and “Skip this question”. Similar legislation exists in other states and implementation has resulted in increased registration rates. This type of nudge could be incorporated into other environments such as college class registration materials, primary care well visit questionnaires, estate planning documents, and employee benefits forms.

Just ask the question. Think about it. Learn more about it. Talk with your loved ones and friends about it. Registering to become an organ donor is an incredibly kind intention. It’s okay to give it your thoughtful consideration.

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Support NY Bill S.5046 to Improve the NY Donate Life Registry

FINAL BLIFE LOGOv2.5The New York Alliance for Donation (NYAD) is a not-for-profit organization dedicated to increasing organ donation rates in New York State (just like bLifeNY!). New York is currently 48th lowest in the nation in terms of eligible citizens registered to be organ and tissue donors (only 20%), but it has the 3rd highest need for transplantable organs. Every 13 hours, one New Yorker dies on the list while waiting for a transplant. A major reason for this abysmally low registration rate is that it is difficult to actually register here. You need to go to the NY State Donate Life Registry, find the form, print it out, fill it out, then mail it back to them! Why not sign up online via an electronic registry?

Why not indeed. New York Bill S.5046 was recently introduced by Senator Kemp Hannon (hannon@nysenate.gov) that proposes a not-for-profit contractor (i.e., NYAD) to take over administration of the NY Donate Life Registry and facilitate enrollment through its website using an electronic signature. NYAD would also be charged with stepping up the education about and promotion of organ and tissue donation to the general public. NY State Assemblyman Dick Gottfried (GottfriedR@assembly.state.ny.us) will introduce the legislation to the Assembly next week (13 May 2013).

Most of the states with the highest registration rates (60-75%) employ not-for-profit agencies to manage their donor registries. When Texas turned over its registry to Donate Life Texas Inc. in 2012, registration rates skyrocketed. They predict 8 million new registrants within 5 years and will soon surpass New York (in 2011, they had the 49th lowest registration rate at 7%, but no longer).

New Yorkers are good people. The vast majority of New Yorkers support organ donation. Yes we need more education and socially embedded “nudges” such as Lauren’s Law (you will soon have to be asked if you want to register to be a donor when you renew your license at the DMV in NY), but we also need it to be easy to sign up. Please consider writing Senator Hannon and Assemblyman Gottfried a brief note to express your support of Bill S.5046. I’m getting ready to do so myself and I will copy Governor Cuomo, Lieutenant Governor Duffy, Congresswoman Louise Slaughter, and Assemblyman Harry Bronson.

Does anyone see a downside to trying to save lives?

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Gifts of Life in India

Deceased donor organ transplant is a nascent endeavor in India. Most liver and kidney transplants in this country are from living donors. bLifeNY applauds the efforts of organizations such as Shatayu to educate the public about the incredible gifts given when one becomes an organ donor. See this heartwarming story below as well as their wonderful video. Thank you Niksha. Thank you Shatayu. Thank you India.

Brain Dead teacher donates organs, helps 5 live longer 

Late Smt. Niksha Talsaniya

Late Smt. Niksha Talsaniya

Setting an example while undergoing a personal loss, the family members of a deceased school teacher, who was declared brain death after a brain hemorrhage, have donated her organs.

On the 19th of April, while doing her regular household chores, Niksha suddenly started feeling dizzy and fell down unconscious.  She was immediately rushed to V.S. Hospital.  Despite a surgery to save her, she suffered a hemorrhage and was declared brain dead on 23rd of April.

Mrs. Niksha Talsaniya, 47, a primary school teacher at R.M. Advaryu School in Vasna, gave a new lease of life to five others on Tuesday.  Her only dream was to give her son higher education and help him secure an MBA degree.  His son Mr.Gunjan recently got a job in Divya Bhaskar 5 days back.  She was elated with her son’s achievement.

Her son, Mr. Gunjan says, “I will dearly miss my mother.  She was the centre of my life.  But I find solace in the fact that she will continue to live on through others who have received her organs”. 

The relatives were recovering from the shock when they chanced upon Shatayu’s poster on organ donation in the hospital.  They instantly decided to donate Niksha’s organs and called up Shatayu’s helpline number.  The counselors Mr. Maulik Shah and Mr. Kaushal Shah rushed to the hospital and explained the relatives about organ donation, brain death and the entire process of donating organs.  The relatives readily agreed and Niksha was immediately shifted to IKDRC, where her two kidneys, liver and corneas were retrieved.  The kidneys were given to two people of ages 25 and 52 respectively..  The liver was given to 52years old lady.  According to doctors, the cornea retrieved from Niksha’s brain-dead body has been used in two blind patients, and it had positive results.

Her husband, Mr. Akshay Talsaniya says that his wife has given the best gift to humanity by donating her organs.

Always the first to arrive and last to leave, she was known for her punctuality and discipline and had a deep affection for her students.  Mr. Natwarlal Talsania her father in law says, Niksha had a heart of gold and was always willing to lend a helping hand to the needy. 

Shatayu”, a non profit organization, is an organ donation awareness initiative by Govindbhai C. Patel Foundation, which is supported by Ganesh Housing Corporation.  The organization works to dispel all the doubts and myths regarding organ and tissue donation, through awareness and educational campaigns.

 

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Short version of Dr. Barry’s TEDx talk

Here is a 5 minute edit of my TEDx talk on organ donation:

For those of you with tight schedules or short attention spans. It’s all good. Just BE LIFE!

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You will be cared for

Do you think you’ll be treated differently in the Intensive Care Unit if you’re a registered organ donor? You are SO wrong! Check out this video of truth by Finger Lakes Donor Recovery Network:

http://www.youtube.com/user/URMCPR

 

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Comfort and Closure from Organ Donation

I mention in my TEDx talk on organ donation that families and loved ones of deceased

Dr. Christopher Barry

organ donors often experience a profound sense of comfort and closure knowing that the tragedy of death and deep loss resulted in a renewal of life in many others. I had come to know this by talking with donor families. But recently, I experienced these powerful emotions first hand.

My Step-mother Sandy had been a loving and caring wife to my Dad for decades. One day, she was not feeling so well with some vague abdominal discomfort and malaise.  Being raised a tough farm girl, she carried a sense of tenacity and stoicism into her adult life, so she toughed it out for a while until she really got sick. All of a sudden, she was in the operating room where the surgeons removed a short segment of dead intestine that had become trapped around some scar tissue from a previous surgery long ago. Although the surgery was successful, she went into an intense inflammatory state after the operation, requiring mechanical ventilation, medicines to keep her blood pressure up, and broad-spectrum antibiotics. She was critically ill, but she was receiving superlative care and, after 10 long days, things seemed to be getting better.

Then she suffered a massive stroke.

This turn of events was completely unexpected and tragic. There was too much blood and tissue damage in her brain for the Neurosurgeons to be able to fix. She was not expected to have a “meaningful neurologic recovery” (that is, she would never be able to wake up and talk to us and laugh with us). Worst of all, at least as it appeared to me, my father, and my brothers, she was not dead.

Sandy had specifically stated in her living will that she would not want to be kept on artificial life support in a futile situation. I knew very well from my experience, however, that withdrawing care at this point would not result in her passing. Her heart was beating strong without any medical support. The breathing machine was on minimal settings and she was essentially breathing on her own.

The stroke had delivered a cruel non-terminal blow.

So we waited. We made sure that she was not suffering and that she was surrounded by love because that is all that is important in the end. When I was young, I never understood Johann Sebastian Bach’s song “Come sweet death, come blessed rest”, but now I did with all my heart. The only possible good thing that could come out of this horrible situation would be if Sandy could become an organ and tissue donor.  She could live on in others. She could save many lives. She could improve many more lives. We waited until she either progressed to brain death or to the point where she could become a donor after cardiac collapse. We waited several days, not rushing anyone into actions that would spoil her candidacy as an organ donor.

Sandy eventually progressed to brain death and we asked the ICU to contact the local organ donor recovery organization. They compassionately and expertly took over her care and Sandy became a donor. Of note, Sandy was not on the New York State Donate Life Registry, but Sandy, Dad, and I often had conversations together and we knew she wanted to become a donor when the time came. She even sported bLifeNY.org stick-on tattoos in support of donation awareness, striking up conversations with random people in the grocery store check out line.

Imagine if we didn’t have this conversation beforehand and Dad had to make this decision when he was shocked and devastated with grief? We were so grateful that we had spoken about this and we knew exactly how Sandy felt about being an organ donor.

My family and I now know that the comfort and closure of organ donation is real. Having been already registered to be a donor would have been ideal, and maybe one day it will be easier and more socially acceptable to register, but the conversation was key. Talk to your Mom and Dad, your kids, your brothers and sisters, your relatives, your loved ones, your friends, and random people in the grocery store check out line. Saving lives and improving lives through organ and tissue donation is miraculous. These miracles start with another miracle: the decision to become a donor.

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I Support the “Organ Donation Driver Education Act of 2013” (Maryland SB 768)

Here is the text of my testimonial to the Maryland State Senate on February 20th, 2013 in support of a bill to link organ donation awareness with driver’s education.

Dear Maryland General Assembly Members: I enthusiastically endorse the “Organ Donation Driver Education Act of 2013” (Maryland SB 768) sponsored by Senator Jamie Raskin and his colleagues Senators Garagiola, Kasemeyer, King, Kittleman, Klausmeier, Montgomery, and Robey. This proposed bill would require the Maryland driver education program to include an online course on organ and tissue donation, thereby providing a continuous source of vitally important information to a broad and influential group of Maryland’s citizens.

I am a transplant surgeon in Rochester, NY with an active commitment to organ donation awareness. Two years ago, we established a grassroots organ donation awareness group, bLifeNY.org, at the University of Rochester Medical Center. BlifeNY is composed of high school, undergraduate, and medical students, as well as transplant professionals and interested community members including transplant recipients, organ donors, and family members of organ donors. Although our focus is primarily on increasing organ donor registration rates in New York State (currently 49th lowest in the nation), we support efforts throughout the country that educate the public about the remarkable success of transplantation, the importance of organ donation, and efforts to encourage everyone to thoughtfully consider registering to become organ donors. We have learned through our experience and through the published literature that the engagement of youth, the establishment of broadly reaching educational efforts, and the identification of suitable environments for thoughtful consideration and conversations are all extremely important components of effective organ donation awareness.

The Organ Donation Driver Education Act is likely to be successful and effective for many reasons. The online education module can be completed at the student’s own pace and should only take about 30 minutes. The course content will be developed by Donate Life Maryland, a nonprofit organization that is highly knowledgeable and devoted to the dissemination of accurate and unbiased information on the subject. Young people throughout Maryland will have an opportunity to learn about organ donation and discuss this sensitive yet important subject with their families. Most importantly, organ donation registration rates are likely to increase and this would result in saving hundreds to thousands of lives and returning previously ill or incapacitated people to fully functioning and productive members of society.

Transplantation is one of the most remarkable successes of modern medicine with long-term success rates approaching 80%. Unfortunately, there is an inexorably growing disparity between the number of people awaiting transplant and the number of organ donors. Nineteen people die every day in the United States awaiting transplants because there are not enough donors. One donor can potentially save up to 8 lives through organ donation and dramatically improve the lives of up to 50 people through eye and tissue donation. Although Maryland enjoys a very respectful 47% organ donation registration rate, this could be better. Senator Raskin’s bill, if passed into law, could save many lives and improve the lives of even more. Success would show the nation that Maryland is a compassionate and forward-thinking land and offer a strategy that could be emulated by other states.

I see this bill as an act of common sense. Just as parents have conversations with their children that smoking is not healthy or that one should not drink and drive, having a conversation whether to give the gift of life should be encouraged and firmly embedded into all aspects of our society.

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A Family, a story of “Organ Donation on both sides of the fence”

Our story begins on March 24, 2002 when our second born son, I’ll call him “Wisdom” who was a 14 year old boy, Captain of his youth hockey team, very active & had no known childhood illnesses.  On that day in March of 2002, Wisdom became ill with what we thought was an upper respiratory infection and was seen by our family Dr. and put on a 5 day antibiotic.  By the third day, our son was not getting any relief from the deep cough he had developed and was very weak and listless.  I called his Dr. to have him seen again.  A mother’s instinct is strong and I heard him in our bathroom coughing uncontrollably and moaning in a way I had never heard come from him before. After seeing the Dr., she advised us that Wisdom be sent to the Hospital for possible “dehydration”, and to get some IV fluids to remedy his symptoms. Wisdom had no strength, he barely had the strength to walk, and get into the car.  When we got to the emergency room, our son was admitted to the Pediatric Unit to be assessed.  After over 3 hours of IV fluids and nebulizer treatments, our son was not getting any better.  He complained of severe abdominal pain, and was complaining of nausea, and a rapid heart rate. The Dr. ordered a portable X-ray of our son’s chest.  After the X-ray was taken, there was a quiet stillness that filled the pediatric unit that I became acutely aware of.  I overheard a nurse outside of his room say two words ~ “Enlarged Heart”.  I called the nurse to the room, and she stated that the X-ray did show a possible enlarged heart, but that they wanted to get a clearer picture of it in the X-Ray Department.  My husband arrived by then, and lifted our son’s weak and limp like body to the X-ray table, kissing him and encouraging him to do as the doctors needed him to do.  

It was a whirlwind after the X-Ray was taken.  It was true, our son’s heart was enlarged, and now he was surrounded by a fast acting medical team; Doctors, nurses, respiratory therapists, and the pediatric cardiologist coming together at once to move our boy upstairs to be better evaluated.  Our son Wisdom ryptonite was now fighting for air and was starting to panic, which increased his respirations, making it harder for him to breathe.  I felt helpless, and I was led out of his room as the medical staff tried to calm him and give him oxygen. Our son was fighting the oxygen mask until the nurses told him that they would have to intubate him if he didn’t take the oxygen this way. Wisdom calmed down, and took the oxygen and tried to sleep.

 My husband and I were asked by the pediatric cardiologist to come and sit down to talk to us.  We sat down and the words that came next will forever be burned into our memories.  “Your son is in critical condition, he is in severe congestive heart failure, and his heart is enlarged four times its normal size.”  The cardiologist went on to say “Your son’s only chance for survival at this point is a Heart Transplant!”  The doctor went on to state “we are not a pediatric heart transplant center, so get ready, because your lives are going to change forever.”  He stated “you will have to relocate to another area that has a Pediatric Transplant Center.”

I watched the Doctor’s mouth move, and the words did not make any sense to me.  I was in shock, how could my perfectly normal 14 year old son who was just playing hockey last week be in “Congestive Heart Failure”?  The Doctor went on to explain that Wisdom had severe “Dilated Cardiomyopathy” of unknown cause.  He explained to us that a virus inside his body for a long time could have very well caused the horrible destruction of his heart.  It was also possible that it was also inherited known as “Hypotrophic Cardiomyopathy.”  We as a family would need to all be tested.  Our oldest son, I’ll call him “Peace” who was only 23 months older, 16 years old, would also need to be tested to see if he also carried a gene that could be the cause of this horrible and rare disease.  I myself was born with a congenital heart defect called “Patent Ductus Arteriosus
and it was not detected until I was 12 years old by a Doctor during a school physical.  I was operated on at the same hospital and during the surgery something went terribly wrong and I had a sudden aortic aneurysm. I was in surgery for 12 hours, and the Doctors could not stop the bleeding. That same Pediatric Cardiologist, now older, was the same Doctor present during my own life & death experience, and went on to tell a fellow working with him that I had emptied the hospital’s blood bank.  I had used 70 units of blood during my 12 hour ordeal. At last, the surgeon was able to put a graft into my aorta and the bleeding finally stopped. My parents were told I may never talk, walk, or ever be the same again because of the long period of time I was under anesthesia, and the huge amount of blood loss.  It would be 3 weeks later on my 13th Birthday that I would walk out of the hospital to go home.  After several years of follow-up by my Pediatric Doctor, it was determined that I was growing normally, and had no restrictions at all in my young teen-age years and the years following.  These memories will always be with me in detail to this day in my mind.

Within 4 hours, our son was moved to the “Pediatric ICU”.  He was surrounded by so many medical staff, sticking him with blood draws, taking orders from the Cardiologist to start a “pic line”.  In addition, he was hooked up to a cocktail of at least 8 different IV medications to keep his weak and damaged heart pumping to supply enough blood to the rest of his body.  I never left his side, only to go to the bathroom, or go to the waiting room to fall apart in pure terror and exhaustion. But fortunately, I was surrounded by many family members and friends.  For two weeks our son was in our local hospital when it became an emergency situation after he experienced a “heart attack”. He looked up at me and said “Mom, I’m going to die!”  I’ll never forget the look of terror in his eyes!!  Within seconds there were several nurses, respiratory therapists, & cardiologist running into his room.  After lab tests were drawn to determine if he had indeed experienced a heart attach, it came back clear that he had, and now his heart was even more severely damaged.  It was time to move him to a Transplant Center immediately!!!  We were flown by a Lear jet to Boston Children’s Hospital.  About a 6 hour drive, that took us only 22 minutes on a very fast jet. 

When we arrived at the Children’s Hospital in Boston, our son was immediately put through another round of testing to get a good look at his damaged heart.  We were immediately met by the Pediatric Cardiologist and head of the Pediatric Transplant Department.  She had a beautiful down to earth and calming personality, and she insisted we call her by her first name: “Betsy”!  She was worried about us, and social workers and other support staff approached us to help us navigate the whole crisis our family was now experiencing. 

It would be two weeks of extensive testing for Wisdom to go through to evaluate his other organ systems to see if he was sick enough to go on the transplant waiting list, or if he was too sick and not strong enough to survive a transplant and not be put on the list.  We found out on April 12th, that he would be placed on the “United Network of Organ Sharing” list.  He would be at the top of the list as a “Status 1A”, which meant he was in desperate need of a heart quickly.  We were given a pager by the Doctor, and told, “This could take days, weeks, or even months, to find a suitable donor that would save our son’s life.  

Twenty Six hours later, Wisdom’s cardiologist bounced into his room and sat at the end of his bed and said; Wisdom you’re not going to believe this, but we’ve found the perfect donor”! Wisdom’s first statement was of concern for another young girl “Marissa” who was in the hospital for the same condition, and he stated “What about Marissa, she’s been waiting longer than me”?  Betsy explained gently how the matching process worked, and that this heart would not match Marissa’s criteria. 

We again were numb and didn’t know how to feel at first knowing that our son was now going to go into an operating room and have his heart removed from his body and another’ person’s heart put into him to beat normally and give him a second chance at life.  After the announcement of the donor match for Wisdom the nurses on the unit were dancing, bringing balloons into his room, hugging him, hugging us.  Excitement and joy filled the unit.

We immediately called our other son “Peace” to tell him of the good news, and that if he wanted to see his brother before the surgery, he would need to get a ride to Boston to see him before he went through the surgery. Peace and an older friend drove through the night for 6 hours, but unfortunately missed the opportunity to see his brother prior to the surgery. 

The memory after this for me is very fuzzy, I remember the wonderful nursing staff & Doctor’s updating us every hour on how things were progressing.  They would say; “OK, we’ve prepared Wisdom for the new heart, but we have not removed his sick heart yet, he’s on a by-pass machine now and stable as we wait for the donor heart to arrive”.  Next update was;  “we’ve got the heart in the bucket and now we are ready to proceed to take Wisdom ‘s sick heart out and replace it with a beautiful healthy heart”.  It seemed like eternity until the next update.  The nurse came to us in the waiting room & said; “OK, they are now doing the transplant and your son is stable”, everything is going beautifully!!” The next update was a miraculous one!!  “The heart is in and now beating beautifully inside your son’s chest!!!” 

Wisdom recovered quickly, not without bumps in the road, but he did very well, and was out of the hospital within two weeks.  We stayed in the New England Area with a good friend, so that the Doctor’s could keep track of our son’s recovery, and check him three times a week at the hospital to ensure that all was going well. 

My husband was unable to stay with us in New England after our son’s surgery because of his job, and of course our older son Peace needed his Dad to be close and support one another until we returned home.  K Wisdom was given the green light to go home by his Doctors in Boston.  He was so very happy, and actually was able to attend the last week of school in the 8th Grade.  He was welcomed back home by family, many friends, and a wonderful community that ran fund-raisers to help our family get through our crisis living in two locations, with all the costs involved. 

Today, Wisdom is a 25 year old young man, healthy, happy, adventurous, and living life to the fullest!!  He will graduate from Nursing School this May ~ 2013 and will be getting married this July to the “Love of his Life”!!!  

Wisdom is our hero, and a very loving and witty, smart young man that wants to give back by working as a Nurse & future Education as a possible Nurse Practitioner.  He is a sign to others ~ a living happy young man that got a second lease on life because someone decided to go through with their loved one’s wishes and donate their organs after death, to save another human being.  The decision to donate a loved one’s organs, tissues, & corneas during the most horrific time of their life is nothing less than heroic and shows all of us that there are still more good people in the world than bad!!! 

Our family’s story does not end here in regards to “Organ Donation & Tissue Donation” 

On August 30th, 2010 I would be awoken by a knock on my front door at 2:25am.  I was asleep on my couch waiting for my oldest son “Peace” to come home safely.  He and his father had just both bought brand new Harley Davidsons!!  Peace and his father were very close, and did a lot together in life. I walked to the door to find two Deputy Sheriffs at my door.  They asked me if this was the home of Peace and I replied “Yes”.  Still asleep, and groggy, I was almost positive I had heard my son come home already, and heard him do his normal routine of getting a cold drink from the refrigerator & then hearing his footsteps going downstairs to his room.  I then thought that perhaps he had been chased by the police and was in some type of trouble.  The Deputies asked to come into my house and I said “NO”!!  I was in “Mother Lion Protective Mode” and again I was convinced my son Peace was already home, bike in the garage, and he was asleep.  The Deputies stood at my front door, and then I walked out to them, and started to feel the hair on the back of my neck stand up.  I said “Where is my son?, they just looked at me very uneasily, by then I was screaming “WHERE IS MY SON?”.  Then from the mouth of one of the Deputies came the words: “He’s at the Medical Examiner’s Office, he’s gone!!! “He crashed his motorcycle tonight into a guard-rail and was killed”!!!  I screamed “Did he suffer, oh GOD did he suffer?”  The Deputy replied “No he didn’t”.  After that I went into shock walking in circles screaming, and yelling “NO, NO, NO, NO”.  I told my husband to drive to my other son’s apartment and tell him and bring him home.  My husband did and Wisdom came home to the awful sound of grief, with its pain & moaning.

Our first born son was a beautiful gift from GOD & at the age of 5 years old picked up his Daddy’s guitar and started strumming it with precise timing, as he sang along in perfect pitch.  It wouldn’t take him long to learn many songs he would hear, and play by ear.  Peace also learned how to teach himself how to play the banjo, and harmonica, all at the sweet tender age of 5 years old.  We knew by now, that our son had a GOD given Gift of raw musical talent!!  We would often remind him of his gift from GOD.  As the years passed by, Peace played in many local bands as lead singer, and lead guitarist, he had an amazing energy on stage, and people were mesmerized by his amazing guitar leads.  As parent of a gifted musician, we became his “roadies” and we loved it! Peace also composed his own music and had his own recording studio in our basement that would soon become a legitimate recording business.  Peace just loved playing music, and many of his friends from high school went on to study music at well-known music schools, and would always come home and reunite with what they described as one of the most talented and diverse musicians they had ever played with.

When Peace left this earth, we made the decision to donate some of his tissue & his cornea’s to help others in need of life changing anatomical gifts.  Shortly after his passing, we were told that our son’s corneas had given the “Gift of Sight to two different people”! We knew Peace always gave 110% of himself in his life here on earth.  He was also an excellent savvy auto mechanic with computer skills that often would puzzle many others in the shop he worked in. Peace was humble, loving, giving, and a beautiful young man of 24 years young.  Peace touched so many hearts in his life with his music and giving ways to others. He once cut his long beautiful black hair and donated it to “Locks of Love” to give something to a sick child who had lost their hair during their sickness.

We are profoundly changed as people after the loss of our son.  We are now on “Both sides of the Fence”!!  We have now experienced both the recipient’s experience with the “Gift of Life” for our youngest son Wisdom, and the profound experience of “Giving the Gift of Life” as the parents that tragically lost a son.

We know the JOY, we know the agony!!

Recycle yourself!!!  Organ Donation saves lives!!

Kahlil Gibran – “Out of suffering have emerged the strongest souls; the most massive characters are seared with scars.”

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Are Transplant Surgeons “Money Grubbing Vultures”?

So I’m in the operating room the other night getting ready to start an organ recovery operation (news alert: the term “organ harvest” is old school and demeaning. Teach everyone to say “organ recovery” instead) when one of the nurses got all cranky. She said she hated these operations, that she would never become an organ donor herself, and that we were all a bunch of “money grubbing vultures”.

Ouch.

At the time I was very polite and reiterated my belief that organ donation is a highly personal decision and anyone can decide not to be a donor should they wish. But the inappropriateness of her remarks (hello, filter please!) really got to me after a short while. The donor was a young, vibrant person who had decided long ago to donate her organs to those in need upon her death. Her family and loved ones (including two who are health care professionals) understood and strongly supported her wishes. Other people’s lives were saved that night. She gave precious gifts.

So I’m a money grubbing vulture?

I suppose that my livelihood does to an extent rely on death. There just aren’t enough living donors out there and tissue engineering is not yet at the point where we can grow organs in the lab and pull them off the shelf as needed. But I don’t think that’s the correct perspective. I look at the end result first: tens of thousands of Americans each year are given a new lease on life with successful transplants. This is a transformative experience for these recipients because they have known health and have experienced illness, often life-threatening illness. So when they return to how they were before they ever got sick, their lives are all the more precious and meaningful. They are true spiritual warriors and real-life miracles in this world.

This miracle takes a second miracle in order to manifest: an organ donor. It is an incredible act of compassion to give a part of one’s very physical being to another human being. This altruism emphasizes that we are all one tribe, one family, and that we’re all in this together. I can’t imagine a more meaningful or selfless act.

From this perspective, there is still the tragedy of death and the profound sadness of loss. But it gives this very real and inevitable thing called death meaning. There are all the newfound hopes and joys in others. The cycle continues as it does and must. There exists the opportunity to continue celebrating the lives and memories of those passed.  I can’t imagine a more meaningful way to die.

Perhaps I’m idealistic or I’m simply rationalizing my own existence. But I truly feel that I’m a part of something much greater than me (yes, we surgeons can be humble). I’m here to help and do my part the best I can. It is an awe-inspiring privilege to do so. Maybe there are some others in it for the money, but if I really wanted tons of money, I never would have become a doctor.

I do know that I’m not a vulture. The operation I perform to recover the organs for transplant is compassionate and is not disfiguring. Donors do not suffer and they are treated with the utmost respect and dignity. Surgery is not for the faint of heart, but at its best, it is a glorious and elegant act.

I really don’t know what to say to that nurse, other than what I’ve just written. She will likely to continue believing what she believes. What really troubles me is there is an undercurrent of fear and disdain for transplantation and organ donation among a minority of health care professionals. It’s hard to quantify this, but I’ve witnessed it first hand and heard about it second hand a number of times. Even if it’s just a few people out there with bad experiences, it’s enough to poison or otherwise misdirect public opinion.

For those of us who support organ donation and transplantation, the best we can do is to share our experiences and our truths with others. We need to educate and encourage compassion. This takes time and energy, but we help save lives each time we take action. So take it from this money grubbing vulture: live to celebrate life, live to share life, and live to love life.

ctb

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Priyanka’s Stardom Brings Light to URMC Transplant Gala

PC's red carpet walk at URMC's Transplant Gala

On October 5th, 2012, the University of Rochester Medical Center celebrated the 20th anniversary of its Liver Transplant Program at a fabulous Bollywood inspired Transplant Gala. The sold out crowd of 500 guests were treated to an evening of Indian dance, food, and the presence of a very special guest, former Miss World, Bollywood film superstar, and emerging pop diva Priyanka Chopra. The Gala’s main focus was to raise awareness on the miracle of organ donation, but also honored were the Liver Transplant Program’s founding father, world famous surgeon Dr. Seymour Schwartz, and the entire local Indian community for their contribution to medical and scientific excellence throughout the Rochester area.

Priyanka and her father Dr. Ashok Chopra

After a glamorous red carpet entrance by Miss Chopra to adoring fans, she then met with several VIPs and gave an interview with the evening’s emcee, local television personality Doug Emblidge. Priyanka and her parents, Drs. Ashok and Madhu Chopra, were treated to performances by local Indian dance troupes from Cornell University, the University of Rochester, and Pittsford. She delighted the enthusiastic young dancers by joining in the fun at the very end of their performance.

 

David Omdahl, Priyanka Chopra, and Dr. Chris Barry

The program continued over dinner with speeches by transplant surgeon Dr. Chris Barry (who briefly touched on the major points of his recently released TEDx talk on organ donation, including the memorable line: “If you’re not an organ donor when you die, then you’re taking a lot of people with you”), Transplant Division Chief Dr. Mark Orloff (who honored Dr. Schwartz and bestowed upon him a shining Ganesha statue), donor mother Helene Ehmann (who delivered a touching reminiscence of her son who became an organ donor), URMC CEO Dr. Brad Berk (who celebrated URMC Transplant, the Indian community, and introduced Priyanka Chopra), and the special keynote address by “PC”.

 

Priyanka’s address on organ donation was heartfelt and moving. She thanked URMC for providing expert and compassionate care to her father, who came all the way from India to receive his treatments, and then shared her personal reasons for pledging to become an organ donor. Here are some memorable quotes:

Priyanka Chopra's keynote address

“I hope to God that when I die that I will be able to have so many people live on because of me.”

“No amount of charity that you’ve done all your life will equal donating your organs.”

“(Pledging to be an organ donor) is one of the things you will always be proud of all of your life because you know your life will be worth something.”

Drs. Brad Berk, Mark Orloff, Priyanka Chopra, and Anil Sharma

The evening carried on with festive dancing by all, sumptuous Indian desserts from Tandoor of India, a book signing by Dr. Schwartz, and opportunities for everyone to learn more about organ donation and take action to register as donors. All in all, it was an incredible success, especially thanks to Priyanka Chopra!

 

 

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