Two years ago, Dorothy McLean received a call that turned her life upside down. Then, out of tragedy, came hope.
Sunday 14th February, 2016. Valentines Day. Work at Moore Wilson’s was chaos – frantic boyfriends rushed to buy chocolates and candy hearts. By 10am, we’d sold out of roses. Unknown to me, this stressful but ordinary Sunday morning was about to get a whole lot worse.
It began with a phone call: my mother’s voice sounded on the verge of breaking. In an instant, I knew someone must have died. My thoughts turned to my 81-year-old grandfather. I’d never told him I loved him – he isn’t the emotional type.
But I was mistaken. “It’s Michael,” my mother sobbed. “He’s in the ICU. Something happened in town last night. You have to come – they’re telling everyone to come right now!”
I left in a haze, forgetting to inform my manager that I was leaving and why.
Michael Faulkner Boyes, my second cousin, was 25. I had a feeling he would survive; his heart would continue to beat and he’d recover. If anyone deserved a miracle, it was Michael.
Although I didn’t know it at the time, I’d caught a glimpse of the future. Michael’s heart does indeed continue to beat – pumping blood around the body that it serves. His organs were donated. Five people are now alive because of Michael’s death.
More than 550 New Zealanders are waiting for an organ transplant. Of these, 450 are waiting for a kidney. In 2015, there were 53 deceased organ donations.
Few people die in a way that allows their organs to be donated. Deceased donors must be rendered brain dead in a manner that spares the organs. The donor must be ventilated and transported to hospital before organs are compromised.
Brain death is total and irreversible loss of all brain function, due to a traumatic brain injury or inter-cranial haemorrhage. Brain death differs from coma (a state of unconsciousness from which recovery is possible) and from a persistent vegetative state (in which a person is unconscious but has sleep/wake cycles and can breathe without ventilation).
Brain death is defined by an absence of brainstem reflexes. “I call the brainstem ‘the pilot light’,” American neurosurgeon Dr Michael Salcman has said. “That’s because if it goes out… that’s it.”
A brain dead person is unable to initiate their own breath, and will never recover. They are, for all legal and philosophical purposes, dead. The body may be kept alive through intensive medical intervention, but only for a time. This can be a hard concept for family members to grasp: thanks to ventilation, brain dead patients like Michael look deceptively alive.
The best deceased organ donors are young, healthy individuals killed by a sudden trauma. For this reason, motorcyclists are often referred to as “donor cyclists” by ER doctors.
Although anyone may opt to have “donor” on their driver’s license, deciding whether to donate organs is ultimately up to the family of a donor. Often, the wishes of a potential donor are overridden by grieving family members.
Brain dead donors are the best candidates for organ donation. Brain death is the only situation in which hearts and lungs can be transplanted. Other organs such as kidneys may also be harvested after cardiac death, a situation that poses a greater ethical dilemma for the family and medical professionals involved.
Donation after cardiac death occurs when a person suffers devastating and irreversible brain injury that does not meet the criteria for brain death. In such cases, treatment is withdrawn and the person is allowed to die. When the heart stops beating, organs are recovered by transplant surgeons. As organs harvested after cardiac death suffer oxygen deprivation during the process, they are often less than ideal. Hearts and lungs are usually inviable.
Then there are living donations. Living donors are able to give a kidney or part of their liver to a recipient who is a “match”, but cannot donate hearts or lungs. Being a living donor requires invasive and potentially life threatening surgery for the donor, and is only possible if the donor and recipient are a match.
Long wait lists mean hundreds of people die whilst waiting for transplant. Few people are lucky enough to have a healthy family member who happens to be a match and is willing to undergo major, life-threatening surgery in order to donate a kidney.
Thirty minutes later, I arrived at the ICU. It was a beautiful day. How could the sun keep shining as if nothing had happened?
Michael, a blonde Adonis, could easily have been sleeping. A ventilator kept his skin a healthy pink; the cells that made up his body continued to respire.
But Michael was gone. Brain dead. A massive aneurysm had obliterated all brainstem activity. Recovery was impossible: the boy lying in the hospital bed was no longer my cousin.
Beside him, his sisters held his hands, sobbing. The waiting room was packed with friends and family members.
Michael had a beautiful mind. A talented artist and actor, he had performed Shakespeare at The Globe. He loved red wine and women’s shoes. He’d been a debater, an art historian, a musician.
Although Michael didn’t own a driver’s licence, he’d made his opinion on the matter clear during a recent discussion with his older sister. He believed that not registering as a donor was selfish. His family chose to donate his organs, knowing without a doubt that this was the decision Michael would have insisted they make. I’m sure he’d want you to know that it’s essential that your family members know your wishes regarding organ donation.
Michael’s heart continues to beat in another body – cold comfort for those who loved him, but still the only possible good that could come out of the tragedy of his death.
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