The Donation

by Robert J. Lanz, LCSW

He was a young Mexican man, just a kid really, nineteen years old and in the prime of life. He had come to the United States, running across the desert like a lot of guys his age, found a job, worked hard and had begun to achieve the American dream.  He made enough money to send some home to his parents in some little town in Mexico every month and he had Sundays off so he could enjoy a game of soccer in the park.  What more could a guy want?  And there he was, without a care, without a worry.  Enjoying a perfect day.  When it happened he wasn’t even moving, just standing there at the goal waiting for the ball.  Then he went down.  Brain aneurysm.

Nobody knows for sure why aneurysms happen.  They just do.  Nature’s little time bomb, just waiting to explode.  On that sunny Sunday when it seemed like nothing could go wrong, the young man’s life began to end, as the part of his brain that made him the guy his friends knew and loved faded away.  When we checked his pupils, they didn’t respond, remaining large and unchanged.  His friends found it hard to understand.  He had just been standing there and then, in an instant, he was gone.  It was too nice a day for that to happen.  He hadn’t done anything wrong.  He was just standing there.

The first night in the hospital was terrible for everyone.  The friends had all shown up with high hopes that the sophisticated American doctors could save him. They didn’t have any idea as to what the outcome to this tragedy could be but were all too aware of the possibilities.  For all intents and purposes, the young man had already died, yet he looked so peaceful.  He just looked like he was asleep, but his brain was dead.

We had two good reasons to use all of our high tech machines to keep the rest of him alive.  Both, in my opinion, very good reasons.  It is in the best interests of the family to have a body to embrace and say good-bye to.  There is a need for closure, especially when there has been a separation of time and space between loved ones.

The second good reason we had to keep the patient alive was because he was the perfect organ donor.  From the neck down, he was only nineteen years old and everything worked perfectly.  Only his head was injured and we couldn’t do anything about that.  But if everything went well, we could save his organs and give them to someone else.

If we can get consent from the family, we call an agency called ROPA and they figure out who will match up with this person’s organs.  Then the “harvesting” team flies in from different parts of the country, goes into the operating room and takes the parts they need.  When they’re done, they fly back to where they came from, straight to their own hospital, where an anxious patient is waiting for their lifesaving skills and a fresh organ.

The nurse called me to the dying patient’s room when the father showed up late that night.  I was in the middle of dinner and wasn’t looking forward to what I knew was going to be a difficult situation, having to face the father who hadn’t seen his son for three years.  When he finally saw him, it was only to watch machines breath for him until he died.  It would be a sad good-bye and I would have to watch it.

Medical ethics and the law say we have to approach every family of a dead or dying patient about the possibility of organ donation.  There’s even a place on the paperwork to be completed for each death in the hospital.  “Was the family approached about organ donation?” “If not, Why not?

There’s no place on the form to explain you just weren’t up to it or you had already done it enough that week and it was somebody else’s turn.  There’s no place to write “I was afraid I’d start crying” or “The patient looked just like my brother or mother or father or someone else I love”.  There was only a box to check.  Sometimes life is just that simple.  It doesn’t matter how you feel, only what you do.  And that night, it was my turn to do.

When I came into the room, the father’s pleading eyes caught mine and there was no place for either of us to hide.  There was only that damn box to check.  Did I do it or not?  It didn’t matter how I felt or what I wanted to do.  There was no way around it, there was only through it.  Everyone else involved in the patient’s life until that time was about life.  Not me, I was all about death.

We knew that neither of us wanted to be there, that both of us wanted to go backwards in time and try the day again and have it turn out a different way.  We knew we couldn’t. I could see the tears in his eyes and he could see the tears in mine.  He didn’t want me to start and I didn’t want to start, this dance of death, this inevitable quest to check the right box, to save some lives and for him, to lose one.

Slowly I explained what had happened.  I told him death was imminent, that even with all our machines we could only keep his son alive a little bit longer.  He seemed to understand that death would come no matter what we did, and his face ever so slightly signaled acceptance. He quickly made his peace with death.  And then he looked me in the eyes again as if to say, “Now what?”

I had to check the box.

“Mr. Lopez,” I said, “how would you feel about letting us take your son’s heart and lungs and some other important parts?”

“What would you do with them?” he asked me.

“Save lives,” I answered.

I explained how that worked and he looked truly amazed.  I could relate.  I’ve been doing this for a long time and I am still amazed by the concept of organ transplantation.  I could see from the way he held his chin in his hand, I was getting close to a yes, and I could almost visualize myself putting that check in the right box.  I knew that he just needed some final piece of understanding, and after thirty years of traveling in Mexico, I knew exactly what it was.  This man would not return to his little village in defeat, sad and grieving.  He would go home the proud, respected father.  We could make his son a hero and send him home in glory.  So we talked.

“When your son came to this country, he had dreams and plans.  He wanted to be a success in America.   He wanted to return to his village in triumph and make you proud of him.  He wanted to come home a hero and a real hero is a man who doesn’t think of himself first.  He is a man who is willing to make sacrifices.  A hero is a man who will give up his own life so others may live.  That is what a hero is.”

The old man looked deep into my eyes.

“I will tell you in the morning” he said and then he left.

The next day when I went to meet with the old man he greeted me with an embrace.  “Let us talk of heroes,” he said, “How many lives can my son save today?”

“He can save two lives with his kidneys, two lives with his lungs and another with his heart.  He can save a life with his liver and help a diabetic with his pancreas. With his skin we can heal the burns that otherwise would be forever painful and with his bones we can help many people walk. And with his eyes he will bring sight to two people who would be in darkness without him.  He will save many lives and change many more,” I said.

“Good, then we can put up a plaque in the church by the plaza so that everyone in the village can see.  My son will come home a hero.  I hope you will do our family the honor of coming to visit the plaque sometime and see the place where my son grew up.”

That night when I filled out the death form, my tears fell on the part that asked if the family was approached about organ donation.  I had never felt so good about putting an X in the right box.  I had never felt better about what I do and who I am.  It just doesn’t get any better than being on a team that saves lives and at the same time, helps ordinary people become heroes.

Some day I’m going down to that place in Mexico. I’m going to see that plaque and meet that young man’s family. I need to tell them again what a hero he was. They all need to know he saved so many lives.

Dividing line


About robertjlanz

Author and health care professional.
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One Response to The Donation

  1. Thomas Hart says:

    Never, ever, envied you that part of the job….

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