Thursday, December 01, 2005

A Very Happy Thanksgiving

Last year, at Thanksgiving, the whole family of Birds came to our little house in our 'rural oasis' of a town. I was bloated with ascites, which swelled my ankles and my belly and was as yellow as SpongeBob SquarePants or - with my bald pate - Homer Simpson. From the jaundice, which turned the whites of my eyes yellow, to my dizziness from a coincidental and unfortunately timed case of vertigo, I was, in a word: Scary. Several family members urged Nancy to cancel, but it was vitally important for everyone to come. It was just weeks after we had learned that I needed a liver transplant and I had a message for the whole family. Before eating off a plate elevated by a riser, so I wouldn't have to dip my dizzy head too much, I vowed that I knew that I - that all of us - would beat ''this liver thing'' and that life would be better than ever. My spirit and attitude - I called myself ''Yellowman'' after the reggae artist and we played some of his music - eased the unspoken fright of my siblings and Nancy and we had a joyful time. We all prayed then - and every day since - for a wonderful outcome.
And with much joy again, remarkably, we all managed to assemble again here for Thanksgiving - Maryann in from London, neices and nephews flying in from far off colleges and my brother's whole crew down from Boston. I reminded them of my pledge, and this time we prayed for continued health and happiness for all we know and for folks awaiting transplants, for their generous and wonderful donors and their families, and for their doctors.
There's one pledge I made at Thanksgiving last year that hasn't been carried out, but purely on a ceremonial basis. I pledged that Nancy and I would renew our vows - we will - and in our own way, we do so every day.
Thanksgiving Day brought extra happiness, with an amazing story in that morning's paper. Two elderly men in our nearby area needed kidney transplants. Both of their wives were interested in donating to them, but were found to be incompatable. By a stroke of luck, the two wives were perfect matches for the others' husbands. The operations were successful, all are in good health and these strangers brought together by fate were planning to celebrate a very special Thanksgiving.
The papers have been full of transplant news recently. I was very proud to read an item sent by my sister, Kathy, that one of my NYU doctors, Devon John, is visiting African-American churches to promote the great need for organ donation in that community.
The New York Times recently had two pieces dealing with organ donations from live donors. In one, a doctor found herself using a pay-service which matches altruistic donors with folks needing transplants. There are strict guidelines about how this can be carried out - it is illegal - and quite rightly so - to pay for organs. The doctor had no qualms about using the service, which basically connected her with a total stranger, who was altruistically willing to give the gift of life.
This website started last November to promote my need for - at the time - a partial liver. I later got too ill and required - and, miraculously - received a full liver from a deceased donor. Several people, some we knew, some we didn't know at all, came forward to express an interest in being a donor. Nancy and I are still blown away by the level of interest and just flat-out blessed commitment from these folks - who were willing to undertake a risky and incredible procedure to save my life. In my view, each of them - though we never got to proceed with the preliminary testing - saved my life just by being there for me. I wrestled with the notion of putting someone through such an incredible, elective operation and was tremendously relieved when I got too sick and the decision was taken out of my hands.
In the second story, the NYTimes ethics column dealt with a letter from a woman who is estranged from her sister - she described their childhood together as torturous - at least as I recall it. Now, the sister is in need of a kidney and the writer of the letter is the only living relative. Should she donate, or stick to her wish not to do so? The ethics adviser noted that such issues are fairly common and that doctors can often find a convenient medical excuse, if needed, to overcome family politics. In our brief involvement with the living donor, it was repeatedly stressed that donors must be acting of their own free will and purely on an altruistic basis. With a family match not possible in my case, the motivation threshold for a donor would likely be even greater. Since my situation has been relayed to many people, we've heard of people in similar situations - often self-employeed and with few health benefits that would cover required recovery time - or sole breadwinners in the family that can't afford not to be putting in extra hours. Family pressures of parent or other siblings who aren't matches add to the strain and stress. God bless those people who have to struggle with such matters. May we never have to be put in such a situation. As the ethicist said - aren't families great?
The fabulous HBO show Curb Your Enthusiasm, the funniest thing on TV, though certainly not everyone's cup of tea, has been dealing with this issue lately, in a way that only it can. The dispeptic Larry David (the brain behind Seinfeld) is expected to donate a kidney to his best friend. But, true to form, he's trying to scheme his way out of it. As luck, and great scriptwriting would have it, the friend's only blood relative ends up in a coma - remember this a comedy - and Larry stakes out his bedside waiting for him to pass. In the meantime - and this is where I thought it goes beyond the pale - the plot has Larry attempting to bribe the head of the local organ donation organization to use his influence and move his moderately sick friend higher up the list so that Larry gets off the hook.
The organ donation community is extremely sensitive - and rightly so - to any suggestions of favoritism. The story line even brings up the old item about how Mickey Mantle supposedly justed the queue to get his liver - true or not then - the rules - at least as I chose to see it from my experience - are never bent. The guidelines are clear and simple - with so few organs available - they are distributed on the basis of the most critical need.
Hopefully, Larry will find a way of the situation that does justice to his comic talents and to the integrity of the organ donation community everywhere.


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