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  cover image: The Gift that Heals

Excerpts from “The Gift that Heals” by Reg Green

The Day They Shot Shafeeq

For four long months Larry Montgomery, a white dentist, 39 years old and a father of three young boys, lay in the intensive care unit at Philadelphia’s Temple University Hospital with a wasting heart. The same disease had killed his father and 35-year-old brother. By now his own heart was beyond repair. Only a new healthy one could save him and he worried that the odds against one becoming available in time were formidably high. “It was very frightening,” he recalls. “Patients who came into the hospital needing a heart transplant, like me, died while they waited.” One man admitted one day to the next bed died overnight. “I only shook his hand once and, when I came back in the room, he was gone.” A few miles away in South Philadelphia, an exuberant 15-year-old African-American boy, Shafeeq Murrell, was bounding out of his front door, headed to a pick-up basketball game. It was the wrong day. Without warning, Shafeeq stepped into a cross-fire of rival drug gangs and was shot in the head. Gail, his mother, just home from using a gift certificate for her son at Eddie Bauer’s, was startled to hear a neighbor pounding on her door and then, almost uncomprehendingly, hearing her cry over and over. “They’ve shot Shafeeq, come quick, they’ve shot Shafeeq.” Shaking with fear, Gail ran into the street. “It’s only a block and a half but it seemed like ten,” she says. “When I got there he was lying on the ground. Everyone stepped back – they all stepped back – it felt as though I was alone with him. I knelt down next to him. ‘You’re going to be okay, Shafeeq,’ I kept telling him. ‘You’re going to be okay.’” But at the hospital he wasn’t okay. “‘We’re trying to get the swelling in his brain down,’ the doctors told us. But they didn’t get the swelling down. They never got the swelling down.” Gail still struggles to describe how a boy as kind and considerate as Shafeeq, with so much to give, should have ended his journey there. “At the funeral, there was an elderly couple we didn’t know,” she says. “They came over to us to tell how one day Shafeeq had seen the lady struggling to carry her groceries home. After that, he went to the store for them once a week. He never said anything to us about it – and he never took anything for it.” He left the same impression on the people at the city housing agency, where he had been a summer intern, but was so well liked that, exceptionally, he was put on the permanent payroll. A woman, who worked with him, recalls how he walked her to the subway most nights because he was concerned about her safety. Now Shafeeq’s parents had another test to face. Stacey, their daughter, was a nurse and had known before they did that he was unlikely to pull through. When the doctors confirmed that he was dead, she braced herself to ask a question even many of the most experienced organ donation professionals find difficult. But it had to be done now or not at all, she thought. Summoning up her courage, she asked them outright. “Shall we donate his organs? It could save other families from what we’re going through.” Shocking though the request can be to people in the depths of grief, their answer was clear. “Of course.” “I’d read about organ donation, seen it on television, but I’d never given it a second’s thought,” Gail says now. “But in my heart I knew it was the right thing to do.” Over at Temple, Larry was thinking about his coming birthday, aware that more likely than not it would be his last, when he suddenly heard these words: “We think we have a heart for you.” His mind filled with a jumble of emotions but among them one somber thought was always there: “Someone had to die to give me this chance.” All he knew about that someone was that it was a 15-year-old, though later he became convinced that it was the 15-year-old from Wharton Street whose death, the day he got his new heart, was reported in the newspaper. The transplant was fraught with more danger than most: he was unconscious for 24 hours and caught a serious infection, which kept him in bed for weeks. Slowly, though, he got stronger, was released from hospital and in six months was living a more or less normal life. Since then he has gone from strength to strength, running in five-kilometer road races, swimming, and teaching at the University of Pennsylvania Dental School. “There’s nothing athletic I’d be afraid of tackling now,” he says. All that time he thought about the donor and his family. “I wrote a letter to them in my mind and every day I said it over to myself. But a fear of hurting them held me back.” Then one day, while driving with a man who had just agreed to buy his car, his heart chilled: he had just passed the end of Wharton Street. “I think my donor lived there,” he said only half aloud. His companion’s response took his breath away. “I was at his funeral. My wife worked with him.” Eagerly, though apprehensively, Gail’s family and Larry’s arranged to meet. They now think of each other as parts of an extended family. Gail joined the board of the Gift of Life Donor Program, the group that coordinated the donation, and has been a force in its multicultural activities ever since. Many times, she and Larry have given talks to increase public awareness of the need for more donated organs. Why did she do it, she is often asked. “You have to help others, whoever they are or wherever they came from,” she says, as though there could be no other possible answer. How did she feel about her boy’s heart going to a white, not a black, man? It went to the person in greatest need, she replies. “The heart has no color.”

Blind for 48 Years, He Can See Again

On the day after Christmas 1944, in a corner of what became one of the most fiercely fought battles of World War II, a German mine blew up in Sergeant Harold Urick’s face. It left him totally blind and he stayed that way for 48 years. Harold’s unit, the 303rd Engineers, had just crossed the redoubtable German defensive barrier, the Siegfried Line, when they were ordered to dig up and defuse mines. He remembers every detail. “It was a bitterly cold day and the ground was frozen hard. There was a man on each side of me as we moved forward. I saw the mine – it was one of the small ones they used, just about a quarter pound -- and began digging it up very carefully with my bayonet. Suddenly I slipped on the icy ground. There was an explosion and everything went dark. I put my hands on my face. ‘My God, I thought, what am I going to do now?’ “Most of all in those early days, I worried about Jean. I was 21 and we’d been married just over a year. I thought of it over and over. Instead of the life we’d dreamed of when the war was over, I was going to be a burden to her all her life.” He was flown to a military hospital in Valley Forge and then back home to Cleveland. One eye was so badly damaged that it to be taken out and a prosthetic one put in its place. With the other he could see just a patch of light. He spent two years in a therapy school and then, with the dogged courage that has defined his life, started a physical therapy business of his own. “But people weren’t as affluent then and it didn’t take,” he says. He worked for several years at the Cleveland Clinic and then for another 15 at a snack bar managed by the Cleveland Sight Center. In the meantime, he and Jean had five children and seven grandchildren, none of whom he had ever seen. The family was central to his life. He went to almost every high school and college football game his son, Jeff, played in. “My wife would tell me what was going on. I just wanted to be there.” But his sight didn’t improve. “I went to three or four ophthalmologists over the years but all of them said they couldn’t do anything for me. Then one day in 1992 I was listening to a television program and I heard a doctor talking about transplanting corneas. I didn’t know what to think but I went back to the eye doctors. They weren’t encouraging until one of them said, ‘I know a doctor who does these. I think you should go to him.’ “That’s how I met Dr. Philip Shands at Kaiser Permanente. ‘Yes,’ he told me, ‘I do these. Do you want to try?’ ‘You bet,’ I said. ‘What do I have to lose?’” Shands had then been in practice for only a year or two and was unsure himself about how much he could help. “The prosthetic eye we could do nothing about, of course. But when I examined the other one, I could see a small bit of the iris which, when we shone a light on it, constricted a little. Then, using ultrasound and other tests, it appeared as though the retina and other structures inside the eye were intact.” With this encouragement, Harold was put on the waiting list and told it would probably take three or four months before they had a cornea for him. “You might think I’d be on pins and needles all that time but I wasn’t. Most of the time I didn’t think about it, probably because he exuded so much confidence,” he recalls. Just before Thanksgiving, he was called in and, with great care, Shands removed the badly damaged cornea and other scarred tissue, implanted an artificial lens to focus the light and sewed in the donated cornea. In about an hour it was all over, Harold remembers. “‘Are you done?’ I asked him. ‘Yep,’ he said ‘but you’ll have to wait until tomorrow morning when we remove the bandages.’ “The next day, when he began to take them off, I was lying face down on the bed and the first thing I saw were his shoes – the first things I’d seen in 48 years – then his pants. I looked up and saw he was wearing glasses. It was still a bit fuzzy, but they’d warned me it would take a while. “Then I looked down the bed and there was Jean, looking as pretty as she did when I first met her. Then I looked at Yvonne, my oldest daughter. It was the first time I’d ever seen her face. And she was beautiful, too.” He had some shocks too, such as how big airplanes had become and how fast cars went. In a few months his sight had improved so that he could pass the driver’s test and read just about anything he wanted. “Since then we’ve only had to fine-tune the prescriptions for his glasses, just like any normal aging person,” Shands says. “With them on he has 20/25 vision. Like all corneal recipients, he takes small amounts of immunosuppressants but has never had a period of rejection.” The other patients Shands treats have much less dramatic stories. “This was a once-in-a-career case,” he says. “But vision is the faculty people fear losing most and, with success rates of over 90 percent for those who are legally blind, cornea transplants reopen a world they thought they had lost forever.” All his life Harold has treasured the little things. Now it’s being able to walk through a restaurant to find a table or waving at friends across the street. He can still see with only one eye but goes to baseball games regularly and doesn’t need a running commentary. And at 86, he still bowls and plays golf. “But best of all is being able to see the whole family,” he says. “That was the hardest thing all those years. Now I have everything I want.”

Transplant Team Copes with Child’s Tragedy Amid World-Shaking Event

At 10 p.m. on September 10, 2001, Bruce Zalneraitis, then clinical director of Life Alaska Donor Services, was called to Alaska Regional Hospital in Anchorage to help with a tragic case. A 13-year-old boy, Will Dean, had just shot himself in the head and seemed likely to die at any time. When Bruce arrived, the emergency room team was still giving the boy large quantities of fluid and blood products to replace the blood lost from the wound and had placed intravenous drips in both arms. But it soon became clear that not only could they not save him but also that, in his highly unstable condition, they would have a difficult time just keeping his heart beating. Will’s mother and father, Jill and Tim, are divorced – and at the time she was in Saipan and had to be reached by telephone -- but when told their son was a candidate to be a donor both said they were in favor. It was something they had discussed while they were still married. It seemed fitting that a boy known for his patient and gentle touch with small children and pets should at the end still be helping others. At 2:30 a.m., no brain activity could be discerned and Will was given the full range of tests to put all doubts to rest. Bright lights were shone into his eyes and sharp pins were used to prick his arms. He was given a gag test and taken off the ventilator for 10 minutes to see if he would breathe spontaneously. There was no response to these or any other tests and at 3 a.m. he was officially declared dead. By 5 a.m., Bruce was telling his organ donation colleagues at LifeCenter Northwest in Seattle, the organ procurement organization that covers Alaska, that potentially seven organs and two corneas had just become available from a boy weighing 140 pounds and blood type O-positive. At their end, the Seattle team accessed United Network for Organ Sharing’s computer system to match the donated organs to the sickest candidates with the best genetic matches. Once the organs were allocated, calls were put in to book the two corporate jets that are always kept on standby at Boeing Field to take the specialist surgeons to the hospital where the donor was. The long distances between Alaska and anywhere make time even more critical than elsewhere. For livers, kidneys and pancreas, timing is always a concern but for hearts and lungs everything has to go right. Bad weather or even a slight mechanical problem can unravel the donation and everyone’s hopes. Arrangements are dovetailed to save seconds. While the planes are in the air, bringing the transplant surgeons, the organ procurement team is providing them with updated information about the donor. When they are on their way back, the crews are reporting progress to their own hospital: “30 minutes out, 15 minutes out, we’re in the ambulance.” Even before they land, the operation on the heart and lung recipients is under way – their chests are opened and the lines are in. In Bruce’s words, “the recipient is placed on the bypass pump when the surgeon comes through the OR door carrying the heart in the ice chest.” On the day of Will’s donation, the donor team at Anchorage was doing its part, maintaining the oxygen supply and blood pressure and reducing the dependence on drugs, to make sure the organs were working as normally as possible. But at around 5 a.m. they were interrupted by a nurse who came in to say that a terrible accident had happened in New York. It was four hours later on the East Coast on the morning of September 11 and a plane had just crashed into the north tower of the World Trade Center. Two hours later, word reached Bruce that the FAA, acting on orders from the military, had grounded all civil aircraft in the United States. The schedule put together with such speed would have to be scrapped and, with it, the donation itself. Among the confusion and disbelief of that day, Bruce still remembers the special pain he felt hearing that news. “Here we were, witnessing the enormity of one of the worst things that has ever happened to this country and yet struggling, in a small way, to bring some good out of the terrible loss of a child,” he says. “We decided that, even if we couldn’t move Will’s organs by air, we would at least take his kidneys to Seattle by van, because they can last longest outside the body. It’s 2,300 miles but we would have saved something.” A hectic series of phone calls from Alaska and the clinical director of LifeCenter Northwest followed and, in the end, the FAA granted a special exemption for the jets to fly. At 6 p.m. they took off from Seattle into eerily empty skies – the first civilian planes, Life Alaska was told, allowed to fly in all American airspace since that morning. At 9:15 p.m., the surgeons were in the operating room in Anchorage. At 12:22 a.m., the cross clamp went on and Will’s blood stopped flowing. Minutes later, his heart and lungs were removed and the first team left, while the second team continued its work to remove the other organs. Twenty minutes later, the first team was in the air and all was going well. As they approached Seattle in the black of night, however, fighter planes that had apparently not been informed of the exemption intercepted them, declined to accept their explanation and forced them to land at Bellingham, Washington, close to the Canadian border. There they were surrounded but, to their great relief, quickly established their identity. But now another worry took over. They were 90 miles from the University of Washington Medical Center and already dangerously close to the time when the organs would no longer be viable. Conveying the urgency of the situation to the base commander, they were bundled into a helicopter and flown directly to downtown Seattle. As the new day began, Will’s young heart was transplanted into a 21-year-old man and both lungs into a 52-year-old. His liver and a kidney went to a 29-year-old man, his pancreas and another kidney to another 29-year-old, a father of two, and the corneas to two other patients. Back in Anchorage, the team completed its work, carefully suturing Will’s chest and abdomen, just as if he were still alive, applying dressings to the incisions and washing his body, returning it as much as possible to the state it was in prior to the donation. Then Will was put gently into a shroud, having just saved the lives of four people it’s hard to imagine he would ever have met.

Nurse Still Shocked by How Sick Some Children Are

“I wanted to be a nurse when I was five years old. When I was 12, and one of my sisters went into a hospital, I was certain I was going to be a pediatric nurse. At nursing school, I concentrated on children’s diseases. But none of that prepared me for how sick children really get.” Emily Jackson, now 27, has been a nurse at the UCLA Medical Center’s pediatric intensive care unit and sedation room for five years and what she sees still shocks her. “We get babies in ventilators who can’t be touched because their hearts can’t handle it. They don’t have the oxygen supply or vascular structure to tolerate anything other than simply being kept alive. We have to heavily sedate, or even paralyze, them or they couldn’t live at all. “In nursing school you learn about alcoholics who kill their livers but hardly anyone talks about the babies who are born with bad livers and bleed everywhere: they throw up blood, their diapers are bloody, they can bleed into their heads and die in a matter of seconds.” She treats children with kidneys that never develop and have to be put on dialysis from birth. Some with liver disease are so jaundiced their eyes are a glowing yellow. The 20-bed unit is always close to being full of critically ill patients ranging from brand-new babies to 21-year-olds. “Most of them are candidates for an organ transplant and for them there’s no other choice.” Emily says. “But when we tell the parents that, we never know how they are going to react. Some are frightened, some refuse to believe it, some simply won’t listen. But for most it’s a relief that there’s a way out of the suffering and, for some, the first hope they’ve had since the child was born. “We get many very young parents and, as we know, it’s hard for a child to bring up a child. But to bring up a sick child is a hundred times harder. They don’t know what to think or how they are going to manage. “Children are very resilient, however. If they can get a new organ, they usually can be fixed. I’d guess about 80 percent of the children who come to the ICU get to go home. But it’s a waiting game and, with donated organs from babies so scarce, many of the smallest ones don’t make it,” she says. “I’ve been to a lot of funerals. It’s always very hard. I fall in love with almost every child I take care of so, although it’s the parents who ask you to come, you go for yourself. When children have spent practically their whole life in hospital, it’s the nurses who know them best.” Emily remembers one baby girl who was bleeding from multiple incisions from previous surgeries, was on a breathing machine and on multiple blood products to strengthen her liver and blood factors to help with clotting. “Her liver enzymes were through the roof. They were at toxic levels. She was so yellow she looked liked a yam. When he saw her, the surgeon said flatly, ‘I can’t transplant this baby until she is stronger. As she is now, she won’t survive the surgery.’ None of us expected her to live. “But she was a fighter, and every day she got a little better. Eventually she sat up and we tailed off the medicines until she was healthy enough for a transplant. There were complications and for 24 hours it was touch and go. But now she’s four years old and, unless you knew, you couldn’t tell she’d ever been that close to death.” The work can be emotionally draining. “But when these children come back to see us, dressed in their best clothes, laughing and full of energy, it’s the happiest feeling I know,” she says. “I can’t imagine doing anything else.”

The Gift that Heals: Stories of hope, renewal and transformation through organ and tissue donation, which is published jointly by the Nicholas Green Foundation and United Network for Organ Sharing, can be ordered online at www.authorhouse.com or through booksellers.


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