A Life-Giving Choice Best Thought About In Advance

David Bly

Calgary Herald

Several years ago, I went to visit my aunt who was waiting out her remaining days in the Brooks hospital. Her mind was sharp but she was weakened by a heart increasingly reluctant to do its job.

"They tell me I could be a candidate for a heart transplant," she said, "but I told them I'll keep my hard old heart, thanks. If they have a good heart to spare, they should give it to someone who'll get more miles out of it. Like a young mother, perhaps."

A few weeks later, she was gone. I wish she had been given a new heart so she would have had a few more years to dispense her wit and wisdom and gentleness, but I understand her decision.

A couple of years ago, Rod, a friend from college days, phoned to bring me up to date with what was happening in his life. Over the years, we had talked about working together on some writing projects, but we had never gone beyond talking about it. Now, his kidneys had failed and he didn't know how much longer he would be alive. He was eager to follow our dream while there was still time.

When I went to visit him, he didn't look good. He still had the wry sense of humour I had enjoyed, but he was not quick with his replies. He said his disease made it difficult to concentrate and to focus on concepts and ideas.

He spent three days a week hooked up to a dialysis machine. He talked of how easy it would be to let go. He could simply not show up for dialysis. He would become increasingly tired until his body simply shut down.

But he had no intentions of following that route. His family and his future mattered too much to him.

Then he was put on the list for a transplant. He carried a pager which could signal him to show up at the hospital at a moment's notice. He wrestled with conflicting emotions, hope and dread, knowing that for him to live, someone had to die.

Last spring, I received a short e-mail.

"The call came," he wrote. "I'm headed for the hospital."

I visited him a couple of weeks ago and found a healthier, happier man. He's struggling with weight problems and diabetes, both side effects of the anti-rejection drugs, but the surgery occurred with no problems and his recovery is on schedule. He has excellent prospects of seeing his children progress in their careers. He can look forward to being a grandfather.

We spent a day walking through busy city traffic, seeing the sights, talking. It left him tired -- he's still on the mend -- but it was something he couldn't have dreamed of doing a few months ago.

Miracles take various shapes. This is one. The fact that I understand, in general terms, how a kidney transplant works, does not make it any less a miracle for me.

Rod was right -- someone had to die so he could live. He and another man received the kidneys from a young woman who had been killed. It's possible other organs were taken from her to save other lives.

From one family's tragedy came new life for at least two other families. Rod said he hopes that knowledge will help ease the pain of those who lost a mother, a sister or a daughter.

A procedure exists whereby Rod can write a letter of gratitude which will be forwarded to the survivors of the donor. He intends to do that, but not yet. It may be too soon to remind a family still in mourning that someone else's rejoicing is partly a result of their loss.

And Rod is still trying to come to terms with the idea that a piece of another human being lives in him, giving him life.

I believe there are times to let go. My aunt knew that. Her mother -- my grandmother -- knew it years before when she had declined to let doctors do a biopsy and subsequent surgery on what was, without doubt, rampant cancer. The doctors had little hope of doing anything that could extend her life. "There are worse things than dying," Grandma said.

What a gift it is, though, when medical science can offer extra years of meaningful, useful life. It's a gift that requires more than medicine, though -- it requires the generosity and foresight of potential donors.

Medical personnel are under pressure to be more aggressive in approaching families for permission to harvest organs. Since the organs need to be taken at the moment of death, the permission often needs to be given before the patient is actually dead.

I've signed an organ-donor card and I carry it in my wallet, but the card has no legal standing -- it's entirely up to the next of kin. I need to let my family know now what my wishes are.

If the decision is made before it's necessary, it will ease the suffering of all involved.

David Bly is deputy editorial page editor and can be reached at 235-7550 or by e-mail: blyd@theherald.southam.ca

Copyright © 2000 Calgary Herald New Media.

This article posted October 29, 2000.