In Practice: Father's decision makes a hero of his dying son

[Karol]

In Practice: Father's decision makes a hero of his dying son

Talking to a family about harvesting organs for transplant can be painfully difficult. But one father looked beyond grief to his son's legacy.
January 16, 2012|By Robert Lanz, Special to the Los Angeles Times

He was a young Mexican man, just 19 years old and in the prime of life. He had come to the United States, found a job, worked hard and had begun to achieve the American dream. He made enough money to send some home to his parents, and on Sundays he could enjoy a game of soccer in the park. And there he was, standing there at the goal waiting for the ball. Then he went down. Brain aneurysm.

Nobody knows for sure why aneurysms happen. They just do. And so the young man's life began to end as the part of his brain that made him be the guy he was faded away.

The first night in the hospital was terrible for everyone. His friends had all shown up with high hopes that sophisticated American doctors could save him. But for all intents and purposes, the young man was already gone. His brain was dead.

We had two good reasons to use all of our high-tech machines to keep the rest of him alive. First, it is in the best interests of the family to have a body to embrace when they say goodbye. There is a need for closure.

The second good reason was that this patient was the perfect organ donor. From the neck down, everything worked perfectly. We could save his organs and give them to someone else.

If we can get consent from the family, we call the regional organ procurement agency and they figure out who will match up with the donor. Then the "harvesting" teams fly in from different parts of the country, go into the operating room and take the parts they need. When they're done, they fly back to their own hospitals, where anxious patients are waiting.

The nurse called me to the dying patient's room when the father showed up late that night. I wasn't looking forward to what I knew was going to be a difficult situation. This man hadn't seen his son for three years, and now he would be watching machines breathe for him until he died. It would be a sad goodbye.

Medical ethics and the law say we have to approach every family of a dead or dying patient about the possibility of organ donation. There's even a place on the paperwork we fill out when patients die in the hospital: "Was the family approached about organ donation?" "If not, why not?"

There's no place on the form to explain that you just weren't up to it or that it was somebody else's turn. There's no place to write "I was afraid I'd start crying," or "The patient looked just like my brother or mother or father or someone else I love." There was only a box to check. Sometimes life is just that simple. It doesn't matter how you feel, only what you do. And that night, it was my turn to do.

When I came into the room, the father's pleading eyes caught mine and there was no place for either of us to hide. There was only that damn box to check. Everyone else in the patient's existence until that time was about life. Not me — I was about death.

Slowly, I explained what had happened. I told him death was imminent, that even with all our machines we could keep his son alive only a little bit longer. He seemed to understand that death would come no matter what we did, and his face ever so slightly signaled acceptance. He quickly made his peace with death. And then he looked me in the eyes again as if to say, "Now what?"

I had to check the box.

"Mr. Lopez," I said, "how would you feel about letting us take your son's heart and lungs and some other important parts?"

"What would you do with them?" he asked me.

"Save lives," I answered.

I explained how that worked, and he looked truly amazed. I could relate. I've been doing this for a long time, and I am still awed by the concept of organ transplantation.

I could see from the way he held his chin in his hand that I was getting close to a yes. I could almost visualize myself putting that check in the right box. I knew he just needed some final piece of understanding, and after 30 years of traveling in Mexico, I knew exactly what it was.

This man would not return to his little village in defeat, sad and grieving. He would go home the proud, respected father. We could make his son a hero and send him home in glory. So we talked.

"When your son came to this country, he had dreams and plans. He wanted to be a success in America. He wanted to make you proud of him. He wanted to come home a hero, and a real hero is a man who doesn't think of himself first. He is a man who is willing to make sacrifices. A hero is a man who will give up his own life so others may live. That is what a hero is."

The old man looked deep into my eyes.

"I will tell you in the morning" he said, and then he left.

The next day, when I went to meet with the father, he greeted me with an embrace. "Let us talk of heroes," he said. "How many lives can my son save today?"

"He can save two lives with his kidneys, two lives with his lungs and another with his heart," I said. "He can save a life with his liver and help a diabetic with his pancreas. With his skin we can heal the burns that otherwise would be forever painful, and with his bones we can help many people walk. With his eyes he will bring sight to two people who would be in darkness without him. He will save many lives and change many more."

"Good, then we can put up a plaque in the church by the plaza so that everyone in the village can see. My son will come home a hero. I hope you will do our family the honor of coming to visit the plaque sometime and see the place where my son grew up."

That night, when I filled out the death form, my tears fell on the part that asked if the family was approached about organ donation. I had never felt so good about putting an "X" in the box. I had never felt better about what I do. It just doesn't get any better than being on a team that saves lives and at the same time helps ordinary people become heroes.

Someday I'm going down to that village in Mexico. I'm going to see that plaque and meet that young man's family. I need to tell them again what a hero he was. They all need to know he saved so many lives.

Robert Lanz, a retired licensed clinical social worker, spent 30 years working the night shift in Huntington Hospital's emergency room in Pasadena. He is now president of Giving Music, a nonprofit that arranges concerts for hospitals, nursing homes and other healthcare facilities.

In Practice is a forum for doctors, nurses and others in healthcare to write about their experiences on the job and lessons they have learned from them. Please send submissions (800 words or fewer) to health@latimes.com.

http://articles.latimes.com/2012/jan/16/health/la-he-practice-organ-donor-20120116