Our transplant service carried a very high profile and consumed the lion’s share of our health center’s OR time and other resources. Their star status imbued the transplant surgeons with the sort of smarmy, menacing charm exuded by bandidos in old westerns. During my residency years, transplant stories became daily fare on the local television news programs, making the senior transplant surgeons into celebrities and hailing every permutation of donor, recipient, organ, and disease as a medical landmark (“Girl becomes first Asian to receive an African-American lung for the treatment of pulmonary hypertension…film at eleven!”). Our center was, and still is, a transplant center of unequaled excellence, but I grew irritated by the news media’s perception that saving a life with an organ transplant is more admirable than saving a life by draining a subdural hematoma or reversing a diabetic coma. When one popular liver-transplant recipient, who had been tracked for years by local journalists, died suddenly, the mayor declared a day of mourning. A tragic death, yes, but aren’t they all? When would the city declare a Sarah Clarke day? Heart and liver transplants are indeed heroic affairs, requiring consummate skill to perform and extraordinary fortitude to undergo. But when viewed from a national health-care perspective, such transplants equal zero-sum games: a life saved is a life lost. Our city coaxed people into signing donor cards, although no one really wants to think about ending up young, healthy, and brain dead. Transplant programs survive on a constant diet of good-looking cadavers—people in the prime of their lives with brains extinguished by senseless catastrophe. In adults, our donor supply flowed from auto accidents and gunshot wounds; in children, donors were victims of parental shakings and beatings. By definition, a donor organ flows from some tragic and eminently preventable event. Although transplant patients now do quite well, few recipients survive as long as the donor would have had he dodged a bullet or missed a telephone pole and kept his own organs a while longer. I support organ donation wholeheartedly—it makes the most of a bad situation—but we shouldn’t lose sight of a larger objective: preventing people from becoming donors in the first place.
Vertosick Jr., Frank. When the Air Hits Your Brain: Tales from Neurosurgery (Kindle Locations 3111-3128). W. W. Norton & Company. Kindle Edition.