The gift of life
Organ donation comforts those left behind and offers hope to the many awaiting transplants
By Jeremy D. Bonfiglio - H-P Features Writer
February 14, 2010
Contributed photo Frankie Pipkins |
The list came on a Saturday.
Stuck between the bills and junk mail was a letter that would tell Tammy Maynor where her son's heart had gone.
"I couldn't read it at first," she says, "even though I wanted to know."
Maynor's son, 18-year-old Frankie Pipkins, died a month ago.
He was one of two Bridgman High School students killed when their Jeep slid on an icy patch of road along Red Arrow Highway and into the path of an oncoming car. Jeffrey Demko, the other teen, was pronounced dead at the scene. Pipkins would die a short time later at Lakeland Regional Medical Center in St. Joseph.
That's when Maynor decided that someone should have his heart.
"It was so strong," the Stevensville woman says. "I thought that maybe if his heart could keep beating somewhere for somebody, if his lungs were still breathing for somebody, then he would in some way still be alive."
18 deaths a day
The demand for organ and tissue donation vastly exceeds the number of donors. On average, 18 people die each day because the number in need greatly outpaces the organs available. As of Friday, 105,658 people across the country were awaiting an organ transplant, 2,933 in Michigan alone. And while studies have shown that 90 percent of Americans say they support organ donation, only 39 percent have taken the steps needed to become a donor.
"Every 11 minutes another name is added to the waiting list," says Mike Kirby, a Coloma man who works with Michigan's Gift of Life. "Eighteen people are going to die today, and tomorrow, because enough people haven't talked about this. That's heartbreaking to me. It's not because people don't care. People just don't know. For me, I can't think of a better way to go out of this world than knowing that you are helping save someone else."
That's why Gift of Life, the state's federally designated organ and tissue recovery program that serves as a liaison between donors, hospitals and transplant centers, has launched a yearlong campaign to add 1 million names to the Michigan Organ Donor Registry.
The state ranks 42nd nationally in registered donors, well below the 39 percent average, with just 24 percent signed to the Michigan Organ Donor Registry.
Part of the reason Michigan lags behind other states, Kirby says, is because residents aren't aware that signing the back of their driver's license or state ID isn't enough to be a donor anymore. Since 2007, residents must join the Michigan Organ Donor Registry through Gift of Life or by visiting a Secretary of State branch office in a process that takes about 30 seconds to complete.
While previous laws required hospitals to check with surviving family members before organs could be donated, the passing of the Revised Uniform Anatomical Gift Law now allows the registry to serve as an individual's first-person legal consent, overriding the possible objections of family members.
"What it does is make sure your fifth cousin can't suddenly come in and say, 'Wait a minute. I'm not sure about this,'" Kirby says. "By signing up you ease the burden of your loved ones who would have to otherwise make that decision. With the registry, the decision is already made. Your wishes will be met."
A gift of laughter
Frankie Pipkins was born in the same hospital where he died.
He was the long snapper for the Bridgman High football team and, Maynor says, always had a gift for making people laugh.
"He could walk into a room full of strangers, and by the time he left they were all friends," she says. "That's the type of kid he was. He didn't do very good in school, he was 18 and a junior, but he never gave up, and I was so proud of him for that."
Two weeks before the crash, Maynor and Pipkins were in the car talking about his future.
"He told me, 'I'm going to get my diploma, Mom. I'm not going to give up,'" she says. "I just told him that, 'No matter what, I'm so proud of you.' He just looked at me and smiled. I'm so glad I had that chance to tell him that."
Demko and Pipkins were heading to Bridgman High School on Jan. 5 to watch the basketball game against Buchanan when the crash occurred.
"One of his friends from school called me and said there was an accident, a Jeep was involved, and no one could get ahold of either of the boys," Maynor says. "I called the hospital. They were trying to identify him at the time. I gave them a description of his clothes, and they told me I should come down there."
When Maynor walked into Lakeland, she was asked if she could identify him.
"Then I could see his head and feet behind the curtain, and they were using one of those bags for breathing," she says. "I knew it was him."
A neurosurgeon arrived a short time later, but the damage was too severe. Pipkins' spinal cord was severed from his brain.
"He told us that there was nothing he could do," Maynor says. "We even called Bronson (Methodist Hospital) and Borgess (Medical Center in Kalamazoo), and they said he was just too critical. He wouldn't even survive the move. That's when we knew there was no way he would be fixed."
Pipkins was pronounced brain dead sometime after midnight on Jan. 6, but his body was kept on mechanical support.
"His heart was still beating," Maynor says. "Even if Frankie couldn't use it anymore, I wasn't going to let it stop."
No age limit on donors
Despite efforts to educate the public about the process of organ donation, fears based on misconceptions still contribute to the number of people willing to give such consent.
"Some people think that if you're a donor they won't try as hard to keep you alive," Kirby says. "Well, that's murder. Hospitals are required by law to do everything they can to keep you alive. By law, the medical team treating you also must be completely separate from the transplant team. We also get people who think they're just too old to donate or that their religion won't accept it. That's simply not true."
Michigan has successfully transplanted the organs of donors in their 90s, and, while some medical conditions could make a donor's heart or kidneys nontransplantable, Kirby says, a pancreas or liver could still help someone on the waiting list. Even donors with medical conditions such as hepatitis or HIV are able to save or prolong the lives of patients with the same diagnosis.
As for the religious argument, Kirby says, all major religions in the United States support organ, eye and tissue donation. Gift of Life has even provided a list of religious affiliations on its Web site, listing the views expressed on the topic by each doctrine.
Maureen Bishop, clinical nurse specialist at Lakeland and the hospital's liaison for Gift of Life, says fear and the cultural stigma surrounding death may be the largest obstacle facing potential donors.
"We need a change in our culture," Bishop says. "Dying is part of our life cycle. It's part of the process. Death is the end of that process. It's never too early to talk about the kind of death you want and if donation is a part of that."
One donor can help dozens
One of the more staggering statistics, Kirby says, is the number of people who can be treated from a single donor. One person can provide organs for up to eight different people, while tissue donation could help another 50.
Organs that can be transplanted include kidneys, heart, lungs, liver, pancreas and intestines. Because organs cannot be stored, they must be used within hours of removing them from the donor's body. Corneas and tissues such as the middle ear, skin, heart valves, bone, veins, cartilage, tendons and ligaments can be stored in tissue banks and are used to restore sight, cover burn victims, repair hearts, replace veins, and mend damaged connective tissue and cartilage.
Most of the organs used in transplants come from people who have suffered brain death as the result of an accident, heart attack or stroke. Brain death is the total cessation of brain function. There is no oxygen or blood flow to the brain, which will never function again.
When a person is declared brain dead, a referral is made to Gift of Life to evaluate the patient for donation. The Michigan Organ Donor Registry is checked, and, if the patient is a registered donor, the donation can proceed. If the patient's name is not on the state database, his or her family is asked for consent.
"Gift of Life works with the medical staff, and if they feel there's a potential organ donor they are the ones who approach the family for consent," Bishop says. "Legally, hospital personnel can't do that."
After consent, the donor is kept on mechanical support until the organs can be matched and surgically removed. Tests determine whether each organ is healthy and suitable for transplantation, and potential recipients are identified through the United Network for Organ Sharing, a national organization that handles the organ matching and placement process.
"Patients who are brain dead, we're treating them like any other patient," Bishop says. "We're making sure they are receiving the same medications and care until the transplant teams come in and harvest any viable organs. That can be anywhere from 12 to 48 hours after brain death."
The same transplant teams that will put donated organs into a new patient are also the ones who come in to remove them. Organs are removed, cooled and preserved at the same time, and teams immediately return to their transplant centers to perform the transplant surgery.
"When they found a match for Frankie's heart, they prepared him for surgery," Maynor says. "They started at 3 in the morning and at 7:30 (a.m.) they called and said it went well. They said his intestines were too damaged to be used. They were too bruised from the accident. They could still use his kidneys, his liver, his lungs, his pancreas and his heart."
A recipient
For every Frankie Pipkins, there's a Corey Smith waiting on the other side.
Smith, who grew up in St. Joseph and now lives in Portage, Mich., had a double lung transplant on March 16, 2009. The 21-year-old Smith was diagnosed with cystic fibrosis, a disease that causes thick, sticky mucus to build up in the lungs and digestive tract, when he was 5 months old.
"He turned 18 and started going downhill really fast," says his mother, Tamara Smith, who works in the pharmacy at Lakeland. "From the time he was diagnosed, we knew this could be a possibility. His lung function was down to 20 percent. That's when they start talking about either getting a transplant or have hospice come in and wait to die. That was never an option for him."
Corey Smith says he knew it was time to get on the transplant list when he suffered seven collapsed lungs within a six-month period. Becoming a viable candidate for surgery was much more complicated than signing a piece of paper.
"He was turned down the first time because they didn't think he would survive the surgery. He was so sick," his wife, Brittany Smith says. "He only weighed 87 pounds. He had to be completely off his pain medications and gain a lot of weight; that's when we put a feeding tube in."
Corey Smith went through another series of physical and psychological screenings a few months later. He was off his pain medications and up to 125 pounds when he made the transplant list. Nine months later, he got the call.
"I had been waiting for so long that by the time the call came it took me by surprise," Corey Smith says. "When they said, 'We don't usually call people on a Sunday unless it's pretty important,' that's when I knew it was happening."
He was scheduled for surgery at 11 p.m. but was still waiting when a Gift of Life representative gave him the news.
"The family on the other end were having a hard time letting go," Tamara Smith says. "Corey just looked at the Gift of Life people and said, 'You tell them that I said I'll wait. Take as long as they need.' I don't know if they ever got that message, but the lungs were there two hours later."
Corey Smith went into surgery at 6 a.m. and emerged nine and a half hours later with new lungs.
"The first thing I noticed was that his cheeks were so pink," Tamara Smith says. "It's because he was finally getting enough oxygen."
"Immediately when I woke up, even with all the inflammation, I could breathe better than I ever have in my life," Corey Smith says. "Within 24 hours I was walking laps around the hall."
In the year since his surgery, Corey and Brittany Smith have bought a house together. He's working on completing his GED and hopes to attend college next year.
"I don't even know how to thank someone for such a thing," Corey Smith says. "Even if my lungs stopped working tomorrow, the months they have given me is such a gift. How do you thank someone for that?"
"Working at Lakeland I see Gift of Life come in," Tamara Smith adds. "I see the families in the waiting room. As a mom, I can't imagine, even now, making that decision, but as a mom of someone whose son is alive because of a family just like them, I'd love to be able to say what an amazing gift they are giving someone else."
A heart still beats
Five hundred and sixty five people attended Frankie Pipkins' funeral, and he was buried next to his grandmother, Gaye McKenzie, in Mount Pleasant Cemetery in Sodus.
For Tammy Maynor, the past month has been filled with grief and empty condolences. But it was on a Saturday, between the bills and the junk mail, when she received some solace.
There were no names, no addresses on the list. Laws and protocols kept such details private. But it did tell her that her son's death helped five other people live. One man received Frankie Pipkins' kidney. His pancreas and other kidney went to another man. Two people each got a lung. And his heart was now in a young woman's chest.
Frankie Pipkins heart was still beating, somewhere, in someone.
"I've always known my son would do great things in his life," Maynor says. "And he did. He's a hero. He will always be my hero, and now he's a hero to those five people. I wish he was still here with me, but if he couldn't be, this is the gift he'd want to give."
Copyright © 2010 Herald Palladium.
This article posted February 18, 2010.