The First Harvest
First responders arrived at the home initially, followed soon
thereafter by paramedics. We picked up the dispatch over the
radio scanner and prepared our minds and equipment in trauma
room one. This one was a long time coming which surprised us all
since the scene was within five minutes of the ER by car. 45
minutes passed before the call came telling us they were
inbound.
The ambulance pulled up to the doors and he was brought in on a
stretcher. He was SOA- smurfed on arrival, or perhaps I should
say cyanotic for the sake of the purists, which really means
that his skin was a most unappealing shade of blue. No IV line
had been started, and the rescue team were bagging as they
hurried him into the ER. 45 minutes on scene, four paramedics
accompanying him - the focus of the time on scene had been
concentrated on CPR alternating with unsuccessful attempts to
intubate.
My heart leapt into my throat as the stretcher was rolled into
place beside where I stood waiting, under the saucer shaped
overhead exam light, with IV catheter in hand & fluid hung ready
to get a line started. With his face partially obscured by
venti-mask this bare-chested man lying on the stretcher was the
spitting image of a man I deeply cared for- was it... ? No time
to pause to know that instant- other things took priority and
the IV was started, the ER doc tried to intubate, the parameds
kept up CPR and the theater became a whirlwind of fast working
professionals, some drawing blood for lab, taking x-rays,
connecting the lines for cardiac monitoring etc...
Very quickly I became busy pushing medicines through the IV
line, atropine, bicarb, epi, we drained the crash cart in short
order and had the house supervisor dashing for more. As I paused
between each administration I was able to see the man more
distinctly and know he was not the person I thought him to be at
first glance, although he could surely have been the man's
brother.
All efforts to intubate were unsuccessful as were the medicines
we were giving and the jolts from the defibrillator The
patient's wife had arrived and we learned that he was on the
waiting list for a new heart. With sadness, and after an hour of
all out effort in the ER we knew his name would be off that list
this night.
The doctor called the code. The patient was pronounced. We
removed the signs of our interventions and made him presentable.
His wife grieved. The ER physician returned to his call room and
the nursing staff began the mountain of tasks and paperwork that
follow an unsuccessful code.
My partner had recently been certified for organ harvest and she
noted on his driver's license that he had agreed to be a donor
and so after providing his wife a bit of time to cry, we had the
task of approaching this subject with her. I remember how his
wife handled it- she was a hero that night. We watched the time
and let her know when we would have to begin at the latest. A
wonderful trooper, she departed leaving her husband in our care.
It would be the last time she would look upon his features as he
was to be cremated.
"K" and I studied the manual closely, assembled all the
necessary items and got started. We worked together and by
carefully retracting, snipping and cutting delicately, removing
first one eye, and then the other, being sure to get as much
optic nerve as possible, pin it, cage the specimens and pack
them properly. It's a highly emotional feeling, the first time
you actually perform a harvest, and as nurses a scientifically
interesting change of routine as well. "K" and I remained high
on our experience the remainder of our tour of duty.
That was the first time I participated in a harvest. There have
been others since that night, but no matter how many chance and
circumstances will bring me to participate in or perform over
the course of my nursing career I will never forget Mr. "S" or
his brave wife. I am left filled with awe every time I think
about the contribution Mr. "S" made.
If I were to write a blockbuster movie or a best-selling novel I
would never come close to leaving a more meaningful contribution
than that of Mr. "S" and all those who like him donate their
organs. My mother had cataracts from an early age and her
quality of life was greatly improved by being able to have lens
implants. My father, still flying his private plane at age 82,
recently had a lens implant done and passed his FAA flight
physical. I hope it comforts Mrs. "S", as it should, to know
that her husband gave of himself so that others would be enabled
to lead better lives. What finer contribution can any of us hope
to make? I remember Mr. "S" with great respect and reverence and
every once in a while speak quietly and smile while telling him
... Mr. "S", you're a hell of a man. Somehow I think he looks
down and smiles back...
I hope that the next time you renew your driver's license, or
otherwise come across the question of whether or not you would
like to become a designated organ donor you will remember Mr.
"S" too and all of the fine people like him and consider
checking the box that says yes.
Written as I smile, remembering Mr. "S"