The Paradox of Organ Donation

One family’s tragedy becomes another family’s miracle

Photo by Samuel Zeller on Unsplash

It is never a pleasant situation.

From time to time, as a Critical Care physician — especially in the midst of the opioid crisis — I am called upon to assess if a patient has suffered from brain death. During one shift, I had to do this for two patients at the same time. The implications are great: once I declare brain death — after all the criteria have been met — the patient is legally dead. It is almost always a shock for the patient’s loved ones, who now — all of the sudden — have to deal with the fact that their son, daughter, brother, sister, husband, wife will never wake up again.

Many times, when the situation of brain death arises, the issue of organ donation comes up, especially if the patient is otherwise healthy. If the patient has previously indicated that they wish to donate their organs, then the process occurs automatically. If the patient has not made such a wish, then a possibly very difficult conversation follows to convince a family, already stung by the loss of their loved one, to consent to organ donation. The conversations can be heart-wrenching and emotional. I have seen them firsthand.

All of this gets me thinking: inevitably, there has to be a tragedy for someone — slowly dying while they wait for their organ — to get a transplant. Whether it be a heart, or liver, or lung, or kidney, or a pancreas, one family’s tragedy is another family’s miracle. It is such a paradox, and it is indicative of the reality that is earthly life.

At the same time, organ donation is so important, and I urge everyone to think long and hard about becoming an organ donor.

For the longest time, I was afraid of signing up to become an organ donor. At the risk of sounding silly and selfish, I was always afraid that I was going to die as soon as I sign up. Hilarious, I know, but that was the reality. I have since overcome that silly fear. It was super easy to do, and it felt so great to do so. Now, I proudly have the sign on my driver’s license that I am an organ donor.

True, it is absolutely necessary that, almost always, one has to die — many times a tragic death — in order to become an organ donor. At the same time, to be able to give another human being who is suffering from a life-threatening illness the gift of life is something that is truly indescribable in its beauty and generosity. It is the ultimate story of human connection, something which we so desperately need in these very divisive times.

Of course, for some people, organ donation is something that may be against their moral or religious beliefs. If this is the case, that is totally acceptable. One must be completely comfortable with a decision that has major implications and may delay a funeral and burial for perhaps several days.

That said, many of us do not have such moral objections to organ donation and simply do not, or have not wanted to, think about death and what we want done in case it comes up unexpectedly. We need to start thinking about it — now, when we are healthy — so that our families do not have to be burdened by speaking on our behalf during such a difficult time.

It is never a pleasant situation — having to tell a family that my testing has confirmed the brain death of their loved one. And while I am not the one having the conversation with the family about organ donation, it is still an extremely important conversation to have. All of us should think long and hard about becoming organ donors. It could save someone’s life.