Of all who give and receive gifts, such as they are wisest.
Everywhere they are wisest. They are the magi.
-;O. Henry, "The Gift of the Magi"
Knowing his father's first transplanted kidney would eventually need to be replaced, Bob, a real estate developer from Utah, always expected he might be called upon to donate one of his. But he and the 70 other friends and relatives who applied to be tested as potential kidney donors were not a match for his father, Buzz, whose kidney function was deteriorating rapidly.
After requesting their records be transferred from another transplant facility, Buzz and Bob met with kidney surgeon, Dr. Adam Bingaman, at Texas Transplant Institute in San Antonio, Texas, where they had been referred by Buzz's nephrologist. As Director of the Living Donor Kidney Transplant Program, the largest in the United States, Dr. Bingaman was very optimistic that their extensive database of incompatible donor and recipient pairs would soon provide a match for the father and son.
"Finally being referred to the Texas Transplant Institute was like a breath of fresh air. They are truly heaven-sent folks who work there," says Bob.
To keep family and friends updated throughout the transplant process, and to help crystallize his own thoughts, Bob created an online blog. His posts, and later, during his surgery and recovery, those of his wife, Stefanie, are excerpted below.
Turkey, Thanksgiving and a Telephone Call
[T]he phrase, "we may have found a kidney for your father" electrified my soul. As you can imagine, feelings of joy, elation, cautious optimism, and humility overcame me.
On November 25, 2009, the day before Thanksgiving, Bob got a call from the Texas Transplant Institute at Methodist Specialty and Transplant Hospital. Bob was asked if he would still consider donating his kidney in the Paired Exchange Program in order for his father to get a matching kidney from a compatible donor. Unfortunately, this first couple with whom they were paired turned out not to be compatible. Since antibodies in blood can change over even a short period of time, Bob learned the young man who would donate his kidney to Buzz was no longer a suitable match.
"My heart sank. But in a matter of seconds I went from sheer devastation to sheer elation," Bob says after he learned another couple had already been identified through the database who would be a match and the transplant surgeries would proceed as planned in early January, 2010.
"They are all so wonderful, so proactive. This program serves a big purpose-;without it I'm sure my father would have spent years on dialysis and on the waitlist for a kidney," says Bob.
Monday, December 21, 2009
A Good Man
I was touched by a stalwart kidney patient I met in the waiting room of the Transplant Clinic today. As we discussed this man's condition and his quest to find a new kidney, I learned that he has been on dialysis since January and that his wife is a willing, but incompatible, donor for him. Accordingly, he and his wife are, like us, pursuing a paired kidney exchange.
His attitude was powerfully inspiring to me. He explained that "dialysis is brutal" and that he has "three rough days each week". But, those three rough days are outweighed by "four great days each week". What a marvelous attitude! This man has clearly chosen to live his life through a "glass-half-full" lens and I am certain he will continue to be a powerful influence for good in the world. He further explained to me that his kidney failure has not deterred him from pursuing his goals, including working as coach of a nationally competitive girls' softball team that he coached in the World Series this summer (while he was on dialysis). Unlike some kidney patients who have lost hope, this man, like my father, is driven to return to his normal activities and views the need for a kidney transplant as a temporary setback, and not as a long-term impediment. May God bless him and his family in their pursuit of a new kidney!
Bob didn't know it at the time but this "Good Man" was Orlando, the match for Bob's kidney.
It was a few days later, on December 25, 2009-;Christmas Day-;the fourth anniversary of the day Bob and his wife, Stefanie, brought home two-day-old Elle, whom they had adopted. Bob was reflecting on the similarities between being kidney donor and receiving such a precious gift from Elle's birth mother:
[W]e understood that we would become dependent upon the grace and mercy of others if we were to have children. Accordingly, we submitted paperwork to apply for an adoption, and on December 23, 2005 Elle was born and she was placed into our custody on Christmas Day.
We learned of many miraculous events that had occurred that led Elle's birth mother to choose us to adopt her unborn child. We consider this woman to be an angel and we thank the Lord each day for her. We can never repay this woman for the gift that she provided to us. By selecting us to adopt Elle, she truly provided us with a gift that we could not provide for ourselves.
Bob had originally planned to donate his kidney to his father, so preparing himself to give it to a total stranger was difficult at first. "When I decided to be a paired donor, it required a fundamental shift in my thinking. I had always said I'm going to give my dad my kidney. Now, the outcome would still be the same-;I give my kidney and Dad gets one," says Bob. "I had come to the conclusion that I may be giving my kidney to someone I don't like-;whose lifestyle I don't agree with, and I had to be at peace with that first."
The entire transplant team works hard to keep donors and recipients apart and anonymous until well after the transplant surgeries and all permissions have been granted. Yet, somehow, despite their vigilance and to their constant vexation, Bob and the donor/recipient pair, Orlando and Karen, became friends-;before their surgeries!
"A week before the transplants, Orlando mentioned something about a softball game-;I think it might have been a hint. Without telling them beforehand, we all just showed up at the game. I think his wife was nervous about us being there, but it was so fun to see Orlando in his element. When he saw us Orlando admitted, ‘I hoped you would come!'" Bob says.
On January 6, 2010, and, as one friend noted on the blog, the feast of Epiphany-;the day when many people of faith celebrate the visitation of the Magi, the transplant surgeries were successfully performed. Dr. Luke Shen performed Bob's nephrectomy and Dr. Francis Wright transplanted Karen's kidney into Buzz.
Bob's wife, Stefanie, takes over the blog:
Reflections on today
I am blessed. Truly blessed. I have literally witnessed a miracle. Wait. That's not right. Not only have I witnessed one miracle, I have witnessed 4 miracles today!
It is very humbling to be here watching it all go on around me. To literally see the hand of the Lord bless and protect 2 donors, 2 recipients, 4 surgeons and countless family members. Two men have a new lease on life as of today as two selfless donors have given the gift of life. It really is beautiful to be part of it all.
Today, Orlando and Karen are in Utah to visit Bob and Buzz and to celebrate the arrival of the newest member of Bob's and Stefanie's family-;six-week-old Brennan.
On President's Day, February 15, 2010, just five weeks after donating his kidney, Bob got a call from a young pregnant woman in Chicago who had chosen him and Stefanie to be the adoptive parents of her unborn baby boy. Brennan was born on May 5-;Cinco de Mayo-;a day of celebration for those of Mexican heritage. Orlando told Bob that if he ever brought Brennan to San Antonio on May 5 he would show him the best birthday ever!
Besides sharing a kidney, Bob and Orlando seem to share a friendship that neither one could have predicted. "He's so funny. He calls me whenever he reaches a new milestone in his recovery, like ‘Hey, Bob, I'm lifting weights today for the first time!' I don't want him to feel obligated to tell me everything, but he says he's so excited he just has to share!" Bob says, laughing.
As he reflects on the astonishing number of coincidences, both sacred and secular, that connect these four kidney donors and recipients, Bob, a profoundly religious man, admits the experience has further deepened his faith, and often tested the limits of incredulity. "If all of this hadn't happened to me, I would never have believed it," Bob says.
Adam Bingaman, MD, PhD, Francis Wright, Jr., MD, Director of Organ Transplantation, Preston Foster, MD, FACS, Juan Palma-Vargas, MD, and Luke Shen, MD, are transplant surgeons with Texas Transplant Physician Group. They serve patients at Texas Transplant Institute's Kidney Transplant Program on the campus of Methodist Specialty and Transplant Hospital in San Antonio, Texas.