1. Scheese, Carolyn H. DNP, RN, NE-BC, CHSE, CPPS


A son's loss and the healing power of giving


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As a high school wrestler, my son, Karl, was often called "pretzel man" because he was so flexible. He could slip out of positions that would have pinned most wrestlers, but that elasticity and extraordinary range of motion came at a cost. The hyperflexibility of his right knee resulted in several episodes of spontaneous dislocation, which were both extremely painful and disconcerting.

Figure. Illustration... - Click to enlarge in new windowFigure. Illustration by Janet Hamlin.

Thankfully, a solution was available: using a cadaveric tendon, his surgeon stabilized the knee, making it completely trustworthy. Following rehabilitation, Karl was thrilled to be able to participate fully in sports and other physical activities without worry.


Three years later, Karl died unexpectedly. Even in the fog of this senseless loss, one of my first thoughts was to donate his tissues. I knew this was something Karl wanted. I remembered several conversations through the years, particularly on his completion of the paperwork for his first driver's license. Looking over at me with a thoughtful expression, he asked, "Should I sign up to be a donor?"


Karl listened as I shared with him my experiences as an OR nurse on the transplant team, restoring function and improving quality of life. I had seen donor kidneys "pink up" and begin to produce urine immediately after the clamps on the blood vessels had been released. I had seen severely diseased livers replaced with smooth, healthy livers; a new heart restore vitality to a young mother; a donor vessel restore blood flow to a severely injured leg.


I particularly recalled participating in surgery on a young boy with a tumor that had invaded his tibia. Removing the tumor meant removing a three-to-four-inch piece of bone, nearly half the length of this young boy's leg. Donor bone was used to replace the missing section of bone, allowing the boy to keep his leg instead of undergoing an amputation.


I shared many experiences with Karl, ending by telling him that I had signed up to be a donor, but he would have to choose for himself. He did so quickly. "Mom, I want to be a donor. If something ever happens to me, and someone else can use my heart or other things, I want them to have it."


So, there was no question. Karl wanted to be a donor.


As clear as our direction was, my mind was anything but. In a daze, I waited to hear from the organ procurement organization; when the phone call came, I answered the many questions about Karl's health and gave consent. I was numb. None of it felt real. Because Karl had sustained cardiac death, he did not qualify for organ donation. However, he was a good candidate for tissue donation.


Confidentiality is maintained with all tissue and organ donations, and the name of the donor and the recipient are not disclosed unless both parties agree. All communication goes through the procurement organization.


Within a matter of days, we received notification from the eye bank that Karl's corneas were used to restore sight to two different people. Several months later, we received notification from the organ procurement organization that Karl's tissue donations had passed the rigorous testing and had an impact on nearly 100 people. We wouldn't know the far-reaching impact of all his tissue donations: the patient who received cortical bone to aid in spinal fusion, the burn patients who received his skin to help in the healing process, the heart valve recipient who was restored to health.


We received only one letter from a recipient, about 18 months after Karl's death. But it was the one I needed. The letter read in part, "Please know your loved one had a profound and positive impact on my life. Prior to my surgery, my knee function was very limited. It was becoming increasingly difficult to walk and maintain a normal life. This surgery was the last option to rebuild my knee and try to regain normal knee function. I'm happy to say my knee is working normally again, and my quality of life has improved."


That letter was enough to let me know we had come full circle. Karl had benefited from a generous donor, and now it was only fitting that he had given this gift to another.


As a nurse on the transplant team, I had been given insights and made to examine my beliefs about life and death, and how in moments of despair organ and tissue donation can help bring a sense that something good can come from tragedy.


My son died. The heartbreak of this still affects me. But thanks to that conversation we'd had long ago, I knew what he wanted. In life, he had always been generous and giving. His tissue donations cannot replace him, but the generosity of these gifts and his spirit reaches beyond death to help others in need.