It was past midnight in a very cold winter of December 2009, I remember rushing out of the hospital doors in the dark night into the waiting van, to get a liver for a patient in ICU who was battling for her life, she was so unstable that this was her only window period to survive.
Any delay for more than 24 hours Mrs R would not make it or become too sick to transplant. She was on top of the Super Urgent List for Transplant in the State. Luckily for her a donor had consented in a remote area of Michigan. As I quickly glanced at the bags to ensure we had everything I saw the patient’s husband Mr R, come running through the hospital doors to our van. I had been taking care of his wife for the past 10 days, with her fluctuating health, a touch and go situation, reviving her at times in the middle of the night, hoping she makes it until her transplant. With tears streaming down his eyes, He said, ‘Doctor all those prayers day and night, are with you, Godspeed!’ That early morning, we returned with a good healthy liver and transplanted his wife. Mrs R is now 10 years post-transplant and I have a family photo postcard for every Christmas since then, with a ps. message underneath by Mr R, remembering that fateful night and their gratitude and prayers for their saviour - the donor family who said ‘Yes”
If that donor family had decided against organ donation that night, there would not be a family Christmas each year for Mr and Mrs R. A difference of existence present today - alive tomorrow, only because someone said ‘Yes” for organ donation.
Researchers have tried to understand what makes some families say ‘yes’ and why at the same time with similar environment, some may refuse. A group from Boston studied factors which influenced organ donation, and found that among other factors, families without any college education were more likely to donate (83.3%) versus those with formal education (58%).
In India, too, we see a similar pattern. Every year there is an organ donor celebration day when families of organ donors are felicitated and honoured for the gift of life. Majority of the donor families fall in the group with less formal education. The ‘belief ’ of doing good to others even in death, leaving a legacy of their loved one - an act of pure altruism was the foremost thought in their minds. They didn’t debate much on it. The one common thing they often wish is, that they hope the recipient’s live long and healthy and enjoy a blessed life. It is what they would want for their loved one, whose organs they had donated.
Why some land in organ failure and why others lead a healthy life? One can reason it out with scientific explanations, but why me, is a hard question to answer. Organ donation rates are improving but the rates are very low. There are about hundreds of people competing for one organ. The waiting is a tough trial, many fall of the list – too sick to transplant or could not survive. Doctors, medical teams try very hard to stabilise patients until the transplant. We have the facility, the infra structure, the expertise, the capacity, the medications but without an organ donor, the effort is null. A life cannot be saved.
Not too long ago I had travelled to a medical college for a talk on Liver transplant. I had finished my talk when a coordinator approached me. She introduced me to a couple. They were farmers and lived the rural area, 2 hours away from the medical college. Their young son had died a year ago and they had donated his organs. They had read in the newspapers that his liver was transplanted by me and when they read the news of my lecture at the medical college, they had approached the coordinator to meet me. The father said, I have not met the recipient, but you transplanted my son’s liver so a part of him was with you in this journey. I came to say Thank you for making my son’s life immortal. I was overwhelmed with emotions and couldn’t speak. His wife smiled with tears in her eyes said- my son saved 4 lives. Our family, the whole village is proud of him. She continued- we have not garlanded his photo as is the tradition, because he didn’t die, he continues to live on, bringing light into others’ lives. We all had tears in our eyes as we talked. Our hearts filled with gratitude; we said our good byes.
It had been a few months since my medical college visit when a woman in her 40s walked into the transplant clinic, she was in a rush, today was her son’s PTA meeting and she had to be in the school, plus there was this ‘Satyanarayana puja’ to attend to, her job had become so busy and she was really looking forward to her vacation and then this clinic appointment. She was laughing and mischievously grumbling about it at the same time. I smiled and remembered the day when she was battling her life, and a young donor had donated a liver -the farmer’ son! This was the same liver transplant patient. I said a small prayer for the farmers family. A family lives on because of them.
Studies have found that people were favourable towards organ donation when there had been a prior family discussion about organ donation. An expressed intention in the form of a donor card or conversation to be an organ donor was strongly associated with the decision to donate. We need to have the conversation with our families. What would we want, when we came to that last stage of our life? As Rear Admiral (Ret.) Kenneth Moritsugu, said, ‘It is the human aspect of donation and transplantation—helping people. It is the right thing to do.’
‘August’ is Organ Donation Month, as we renew our pledge of being an organ donor.
I hope maybe you will too. It is the circle of Life.