Being an organ donor is like quietly looking away when you see teenagers smoking pot -- it's just something you do if you're not super religious and/or an asshole. But the reality of organ donation can be much less heartwarming. It literally requires putting hearts on ice, for starters. We spoke to three professionals of the organ bank industry, and they told us ...
"People think that the helicopter rushes over with the cooler, someone runs the organ to the ER just in time for the doctor to save the patient, everyone high-fives, and the credits roll," says "Richard," who works for a trucking company that hauls human tissue. But in real life, as always, it's much less exciting, much more gross, and features many more grumpy service employees. Here's what really happens when Richard gets called in:
"The organs are put in a bag, then into a Styrofoam cooler with ice, then a cardboard box, labeled, and set in their entryway. They call a broker and get the load set up. The broker calls us, we get the box and take it to the airport. We take it to the airport, where people flying out see us lugging a box labeled 'Human Tissue - Handle With Care,' give us weird looks, and take a step back. Then ... another company retrieves the box and takes it to its destination ... Some family members I've told about the organ stuff were surprised that precious, possibly life-saving donations are sent out in a box of ice like a Christmas ham."
"Who ordered the honey-baked ... pancreas? Shit, I need to make a phone call."
"GM" knows that the tissue she harvests and transports is going somewhere it's needed, so "the process is somewhat time-sensitive, but not as much as you would think. Especially since the majority of removals I do are corneas, you can plan out your day a little bit according to what needs to be done."
You wouldn't think the transportation of eyeballs could be a boring errand run, but GM's average afternoon doesn't look too different from your mom's, minus all of the sex with us. "Let's say you just removed some corneas," she continues. "They are preserved in chemicals to keep them fresh, plus they are in an ice cooler. You get a call from a hospital nearby that you need to remove another pair of corneas, and it's on the way to the airport anyway. You can literally leave eyes in your car, go do the other removal, preserve the second pair, pack them up in an ASAP shipping container, and take them to the airport." It's a weird day from the eyes' perspective, but same old, same old for GM.
But make sure to hide 'em under the seat. You don't want to explain to a blind kid how their new eyes were stolen and sold for Oxycontin.
"Here's a fun fact: Deep inside your eye is a yellow, gel-like tablet," GM says. "It's right in the center of your eye, and looks like a fish oil supplement." We're not totally on board with GM's definition of "fun," but let's see where this is going. "Part of the dissecting process to do a cornea removal is to score a line around the iris to know where to make an incision using a metal cylinder to create a perfect perimeter," she continues, unfunly. "If you press too hard, this tablet will shoot right out of the pupil and land with a wet splat on your face guard. You can't flick it off, though, because when you operate, you're sterile. If you try to remove it, you have to re-sterilize and scrub up all over again. I had to work with eye-goo sliding down my face mask like a bug smeared across with a windshield wiper. Not one of my more glamorous moments."
Yeah, that was our reaction too.
That's only one of the fun surprises in store! "I would say weight is a big issue," adds 'Tucker,' an organ bank worker. "We just had one where a guy was over 500 lbs., and that's a big problem for a technician, because we can't physically move them. Sometimes they can't fit into a vehicle, or they can't get into storage." Despite all the potential for wackiness, Tucker insists it never devolves into a Chris Farley skit. "It's a gruesome process, but it's done with care," he says. "I know that, I've seen it."
For all the wacky eye goop stories, you don't lose sight of how serious the end result can be.
So you want to be an organ donor. You've done the thing, checked the box, and gotten the little sticker on your driver's license. Now you can feel all fuzzy, knowing your worthless carcass is going to help save someone's life! Oh, but maybe not. Tucker still has to call your mom and make sure she's cool with it, because even in death, you can't escape her meddling.
"We have to call [the next of kin] and say, 'Hey, this person was registered, we're trying to follow up with their wish and some paperwork needs to be done,'" he says. "The thing is, a lot of people don't know. We call up a husband and say, 'Your wife was registered,' but she never talked to him about it, and he's on the spot and doesn't feel comfortable with it, even though that's what she wanted. So that's one of the more frustrating things we encounter."
"Please sir, open your heart!"
"Oh, so now you want my heart too? No deal!"
Tucker still tries to convince them, because it's kind of his job, but he approaches it from a more spiritual perspective: "It's basically like we're speaking for the dead sometimes, is how it feels, when you're speaking to an argumentative family member. It's like, we're trying to honor their wish, we're speaking for them at this point." So like The Sixth Sense, but without all the puke monsters or Donnie Wahlberg.
Also the big twist is how many people get Bruce Willis' internal organs.
"If they're not registered," Tucker says, "we don't tell them they're not registered, but we say, 'Hey, we know what happened, and we want to let you know that they're eligible to donate.'" Shockingly, this is a lot easier than dealing with the hostile family of an actual registered donor. "I thought a lot of people would be angry, but a lot of people are really happy to get the call," he says. "That happens a lot with suicides: Someone kills themselves and they're not registered, and the family says, 'We want something good to come out of this.'"
Whatever the case, there's a lesson here: Talk to your family about what you want to do with your body parts. Especially the squishy ones. In excruciating detail. Over dinner. Use props.
"... so to summarize, my rotting corpse does not require a perfectly good set of kidneys."
Once they've gotten permission from both you and your crazy family, that's only the beginning. "Probably the most time-consuming part of the job is combing through people's medical paperwork," Tucker says. "Not everybody can be a donor ... People assume they're going to be a donor because they're registered, and that's not the case -- it just makes it easier for us."
The reasons for turning down a perfectly good corpse are predictable. "The largest ones would be high-risk issues: HIV, hepatitis, drug use, IV use," Tucker says. "[But] age is a big one as well. I believe the eye banks and tissue banks from state to state vary on criteria, but usually after 80, you can't be a donor. If you live after 80, that's great for you, but you can't be a donor." No one wants your vintage organs, grandpa.
"What?! I'll have you know my lungs have a good 10-20 months of use left."
"One of the things people don't realize is that travel history can play a part in whether you can be a donor," Tucker continues. "There was the mad cow scare in the UK, so if someone has had a lot of travel, that's something we have to investigate. Now, that's just eye and tissue -- if it's organ donation, they might not care about hepatitis. They might just say, 'You might get a liver with hepatitis C,' and [the recipient] can decide if they're okay with that." Organ beggars can't be organ choosers, after all.
Hard to turn down a functioning liver when jaundice has you a spiky haircut away from looking like Bart Simpson.
"There are so many things that can go into it," Tucker says. "Dying on a holiday can affect you being a donor. Dying in [the wrong part of a state] can affect you being a donor, if it's not safe for us to get out there. Living a long and healthy life can affect you being a donor. The way you die can affect you being a donor -- if you get hit by a car, you may be too damaged, they may need to do an autopsy." All in all, even if you sign up, Tucker concludes that "the odds that you're going to be a donor are slim."
The whole process involves talking to your family about a lot of uncomfortable things. Sexy things. "A lot of times, families know things hospitals don't know," Tucker says. "They know travel history, they know who they live with -- if you live with someone with hepatitis, that can be an issue. You have to ask about sexual history." Yes, they have to ask. "Even one question, if it's missed, we can't move forward."
"Bearing in mind this may save a child's life, I need to know if your father was into raw-doggin' it."
If your beloved spouse of 20 years was your high school sweetheart, your donation will go as perfectly as the rest of your life. But if you've ever made a mistake, be prepared for a person with a clipboard to grill your children about it. "Just last week, I had one come up where I was talking to a son, I believe, about his father, and his father saw prostitutes every once in a while," Tucker says. "And that's a problem. That's considered a high-risk activity. So unless we can interview those prostitutes -- which we won't -- we won't be able to do that transplant. We usually have to preface it with, 'We mean no disrespect, and this is just to the best of your knowledge, obviously.' Like, it's pretty hard to ask a child about their parents, but usually you'll be able to ask a spouse, and they're pretty forthcoming."
Everyone has that aunt who will gladly fill the entire checkout line in on your uncle's latest extramarital activities. Turns out she's the backbone of organ donation. Who knew?
"That's very informative, ma'am, but we try not to use the term 'rouge-smeared hussy' on official forms."
Now, some of these guidelines stretch the meaning of "mistake." "I know one of the more controversial issues is if you're talking about a male, you have to ask if they've had sex with a man," Tucker says. "The FDA is slowly starting to go in a smarter direction, I think. It's going from whether it's been in the last five years to the last year, I think, and eventually it won't matter at all, I think." In the meantime, though, "sometimes we have to tell people that that's unfortunately a problem. It's an issue with the Food and Drug Administration." Tough luck, little girl who needs a kidney; the dead guy's beloved spouse of 20 years happened to have the wrong pee parts.
But don't worry, kiddo, these rules are there to protect you ... from a disease we've been able to test for decades.
It might seem, based on everything we've talked about so far, that the little sticker on your driver's license is about as useful as a Lisa Frank original. Why bother registering if you might be too fat, or too gay, or too ... uh, rich in experience?
Because when it does work, it saves lives. Plural.
"Depending on what the organ folks can place, it can save a few lives," Tucker says. "With eye and tissue donation, if the person is young enough and healthy enough, they can help up to 50 people. Some of it even is life-saving, like with skin donation ... There are lots of burn victims out there whose lives that would save. It's life-changing, too ... There are people who are blind from birth who can say, 'I can finally see, I can get my driver's license, I can do all these things.' It really gets you sometimes."
That's why Tucker is so frustrated with a system that requires him to spend most of his resources on cajoling, and why he's a proponent of the opt-out system of organ donor registration. "I think opt-out would be better for everybody," he says. "Just put it on their license. 'I do not want to be a donor.'" That's already the policy in lots of other countries, and some states are trying to make it so.
The fact that about six times more people donate under that system is a really good reason.
"It would save hundreds of thousands of dollars in man-hours, simple as that," Tucker continues. "If it was an opt-out program, I wouldn't have to be calling families at all. If we see someone has opted out, boom, we're done, we don't have to do anything else." It would make an enormous difference: "Sometimes you'll spend your whole 12-hour shift working on one person, only for the family to say, 'No, we don't want them to be a donor.' And there's your whole 12 hours." Sure, the change might result in the desecration of a few corpses (mostly of people who hated children with cancer, but couldn't be bothered to say so at the DMV), but is that such a loss?
Manna won't steal your kidneys if you follow her on Twitter.
For more inside looks at working with expired meatbags, check out 5 Horrifying Things Real Dead Bodies Do (Too Weird For TV) and 5 Horrific Things You See Collecting Dead People as a Job.
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