Thursday, July 13, 2017

The Second Call ... Who Does This?

So Monday morning, I was sitting at my desk with a new trainee.  We'd been talking about ten minutes ... barely getting started in the whole training process ... when my cell phone rang.

The Transplant Coordinator said she had an offer for me ... and here she hesitated ... "But I don't think this is the one for you.  This is a high risk kidney."

Now ... high risk can mean a lot of things.  When you first get on the transplant list, they ask if you would be interested in a high risk kidney.  They encourage you to say yes ... and tell you that, when the time comes, you can always say no without it being held against you.   About 10% of deceased donor kidneys are classified as high-risk for infection with HIV or with hepatitis B or C (HBV or HCV) based on CDC criteria.  To get tagged as high risk, the situation could be as serious as a drug user ... or as simple as just being a homosexual.

I told the coordinator that I was open minded ... to go ahead and give me the news.

A young 20 year-old man had just died of a heroin overdose.  They were offering me his kidney.  The kidney had been tested and already had decreased urine output and a higher than usual creatinine level.  She said it wasn't optimal ... but that legally she had to give me the choice.

I sighed and sat there shaking.  So much information in such a short period of time.  You're elated to be getting a call.  You're horrified that a young person just died of a heroin overdose.  You're sick to your stomach ... because you know you're going to have to say no.

The coordinator explained that I'm (relatively) young ... that I'm doing really well on hemo ... and that I haven't been hospitalized with issues yet.   She thought there was still time to get a better offer ... and I reluctantly agreed.  I hung up the phone so she could call the next name on the list ... and I walked calmly to the bathroom where I crumpled in a ball and cried.

I managed to text the news to Stoney ... who called me just as I was pulling myself together and walking back to my desk.  He comforted me and said it was alright ... but I think he sounded just as "gut punched" as me.   Neither of us sounded sure of what we'd chosen ... but he surprised me and picked me up for lunch so we could talk more about it.

He's held me and told me over and over it was the right decision ... and my nephrologist and mother have strenuously agreed.   But I feel so guilty.   I turned down a kidney.   A young person died and I turned down his kidney.  It's just so terrifying.  If he took any other kind of drugs I would've thought about it ... but heroin?  How do I know if he shared needles?  If he had unprotected sex?   The kidney tested negative for HIV and HEP ... but those things can be undetected for months.  So months after a transplant, when you're taking anti-rejection meds and have no immune system left ... you could find out you have HIV?   How horrific would that be?

I've even hesitated to write this here ... because I don't want anyone to read this and think, "Wow, ThirtyWhat is STUPID!"  Because, believe me, I think that enough myself.  

But this is where we are.  Second call received ... waiting on the "real call."  Third time's a charm?

Mr. Telephone man
There's something wrong with my line
When I dial my baby's number
I get a click every time
Mr. Telephone Man
There's something wrong with my line
When I dial my baby's number
I get a click every time

New Edition - Mr. Telephone Man

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