Gift Giving

There’s a moment during the transplantation of an organ, where time holds its breath. Just at that point where the clamps are taken off the blood vessels and the organ blushes with the excitement of blood rushing through it again. There is little that is more gratifying than seeing the new organ “pink up” and start picking up where it left off, albeit in an entirely different spot.

Even for the non-religious, it is a true “Hallelujah” moment. There are other milestones along the way that similarly hearten the team implanting a new organ. Never have you heard a room so excited when someone calls out “Bile seen!” after the placement of a new liver. Nor the joy that urine coming from a new kidney can create.

Occasionally I get to be a small part of the transplant team. In fact, the little part I get to be involved with is a very small part of a much bigger whole, as the operation is by far the briefest part of the road leading up to the transplant, and is dwarfed by the care afterwards. Each bit is important though.

It’s also true that it is an exciting privilege to be involved in providing the recipient and their family a chance at a very different future than the one which saw their slowly deteriorating health drawing their orbit ever closer to the hospital.  The one thing that really upsets me about being involved in transplants is when I hear comments suggesting that transplant teams are so focused on obtaining organs, they are predisposed to disregard those individuals, and their families, who donate the organs (this being in the setting of donation after brain death).

I’ve heard this sort of comment more than once, from all sorts of folks. Most recently, some of the comment surrounding this story (with further comment here), was of that nature (and I’ll stress that I’m not suggesting the academics in the story were pushing that angle). It’s that sort of comment that makes me see something beyond red. For to suggest that the teams involved are focused solely on the recipient is akin to saying they are lacking in human compassion.

You don’t get around to being involved in organ transplantation, without considerable experience in looking after people. The surgeons involved will have been training for a minimum of 15 years or so. The same goes for transplant physicians, intensive care doctors, anaesthetists and, most likely, many of the coordinators, nursing staff and other health workers who have decided to get involved in these programs.In that time, we see suffering, grief and death. Is it really conceivable that everyone involved has managed to skip blithely on our way when confronted regularly by the stories of those who pass away, and those who grieve for them? I remember all too clearly how I shook when pinned to the wall by the wounded screams of the mother who had just lost her young son to an accident. I remember all too well the silent, rocking tears of a father cradling his child who had just passed away. We all bear the scars of those moments.

So perhaps you can see how much it offends to suggest that by being part of the transplant system you would have, by default, lost sight of the significance of the life of the donor. Or that you might be so blinded by the desire to save the life of the person on the waiting list that you would seek to pressure the family to agree to a transplantation of which they wish no part. Or that you might have no interest in the integrity of the life of the donor, and would look for any opportunity to cut corners and secure a donation. I imagine it’s the same sort of anger that seizes cancer scientists accused of being part of a global conspiracy to get rich while concealing the cure of all malignancies. Or the vaccination advocate accused of being nothing more than a paid stooge of the big pharmaceutical companies. Those involved in transplants are not exercising some form of lust for organs  that would make a zombie blush.

The pathway to donation is not lightly trodden by anyone in this setting. When considered, it is a discussion undertaken with the greatest care and diligence.  The statement from the Australian and New Zealand Intensive Care Society regarding death and organ donation, including how to go about determining brain death, details the rigour required of those involved in this process.

When the operative team is undertaking the actual procedure, there is no one in the room who is not mindful of the significance of the life that has been lost. There is no one there who does not appreciate the significance of that person in the lives of others and the tremendous gift that the family has also bestowed.

Waiting lists for organ transplantation in Australia are long. There is an acute need for improvements in organ donation rates. Recently the discussion has been much more prominent thanks to the stellar efforts of those driving the conversation, such as the team from Four Corners in this excellent exploration. Efforts such as these will hopefully have people across the country having the all important discussion. What is just as important as having the discussion, is doing so armed with some information (or disabused of disinformation).

For too long not enough people have had the chat. When they do all too often fear and misconceptions can colour people’s thoughts. For those of us involved this makes it even more important to promote accurate and open discussion. Otherwise, there will be less of these amazing gifts, and less celebration of bile and urine in all its glory.


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