The daily trip to get the mail has turned dull, what with the internet delivering our bills and emails dispatching our greeting cards. We open our mailboxes to ads for stores we never patronize and catalogs from companies we’ve never heard of.
Yesterday, I opened a letter offering a free restaurant dinner, except I would have to sit through an hour-long investment pitch. Thanks, but I’m not hungry.
Today, though, something interesting. A mass-mailed jumbo yellow postcard screamed, “Don’t toss me, I’m not boring!”
Indeed, it was not. It was a plea from a Cardiff man asking someone to donate a kidney to a stranger in need — himself.
Rick Elenes is lounging on his bed midday because he’s not feeling well, which he often does not. His multi-level home in Cardiff is terraced on a hillside a couple of hundred yards from the surf. This is land that would be pricey by the teaspoon. Rick is a private real estate investor, which means he operates with his own money. That’s a good thing, to be able to do that.
He’s also the man who sent the postcard.
Rick is 68, and married to Ruth. Both are smiley pleasant. He’s also a worried man, which brings us right back to that mailbox flyer.
Rick has two kidneys of his own, as he’s supposed to; the problem is, neither one works. He was given another one from a deceased man 16 years ago, but that borrowed kidney is starting to wheeze and sputter.
Rick is feeling the degeneration of the transplant every day. He says, “If I walked about 100 yards down the road here, I would have to sit down. You know, I can’t even walk around the block anymore. My distance keeps getting shorter. I can’t even work in the garden now. I’m really big on that. I love plants, and I love to do landscaping.”
He’s not currently on dialysis. That’s where patients lie on a gurney and let a machine cleanse their kidneys. Who wants to do that? But without a new kidney, he knows dialysis will happen, because he’s been on it before. The procedure is not without its health shortcomings, at least in the long term, he says.
He can’t pinpoint the cause of the renal failure that started 20 years ago, except that it wasn’t cancer. He blames high blood pressure, probably genetic, that over the years caused his kidneys to race like a motor without a clutch, making wisps of smoke appear.
Rick is on the United Network for Organ Sharing (UNOS) waiting list, but he says a nephrologist (kidney specialist) told him the chance of his getting a kidney by waiting it out is slim because of his unique characteristics.
That brings us back to the mailer.
Spending $4,000 to send out 10,000 postcards imploring a stranger to cut into their upper abdomen to remove and donate a kidney, is, well, you might call that a long shot, or if you’re inclined, a prayer.
When I read the postcard, my first thought was: What’s the going rate for a kidney? For someone, maybe this is a chance to pay off a car or a year of college. This is the ultimate “What’s in it for me?” question.
(At this point I’ll give you a news flash on something that you may not know if you haven’t been reading my columns regularly: There’s a whole lot I don’t know.)
One thing I certainly didn’t know is that it’s illegal in this country to sell a body part. Too bad in a way, because there are a couple of things I wouldn’t mind trading in myself if the price were right.
Rick’s flyer says, “It involves a minimally invasive laparoscopic surgery, which means quick recovery.”
True, surgery has gotten more patient-friendly, but one of the few things I recall a doctor telling me there’s no such thing as a simple operation.
The flyer also promises reimbursement for all expenses: hospital, airfare for you and a spouse or otherwise, hotels, lost pay, and — this is in caps and red ink — “ANY other expenses you need to have covered.” Hmmm.
Rick says no one in his family or circle of close friends is a suitable match. Frankly, he would be pleased to pull out his checkbook to pay someone for a brand new (to him) kidney, but he knows it’s illegal and he says he wouldn’t break the law. It’s frustrating to him, all the same. He knows there are people out there who need money more than their second kidney.
But that brings us to the reason for the law that I never thought of.
The federal law against selling organs was enacted in 1984 and provides a fine and jail time for violations.
It was based on the reality that people forced into a corner will do anything for money. Going to lose the house? Well, here’s a kidney. Can’t pay a gambling debt? Maybe I can give you an eye. Or how about this one: My wife has to have an operation. What will you pay me to have an operation of my own?
The strongest defense of the law is the creepy feeling one gets when thinking of a mother selling a kidney for her child to stay in college, or any number of other sympathetic reasons.
You see where this could go?
There’s something in the American psyche or mythology that we would be loathe to admit: There are fellow citizens desperate enough to peddle parts of their bodies.
It obviously happens, because some hospital transplant programs will not take non-family donors out of fear of under-the-table payments taking place. Others require tight screening.
Voices have been raised against the 1984 law, saying a managed program that would allow organ sales, especially kidneys, could save thousands of lives because of the current shortage of organs.
Rick is asked if he has looked to other countries where he could pay for a kidney. He says most countries have laws similar to ours. However, anyone who has done well in real estate knows how the world turns. Be assured, when money talks loud enough, ears will perk up and kidneys will change hands — or abdomens.
If inclined, Rick could go abroad and certainly find a place where he could buy one. However, he would also be gambling his health, and possibly his life by letting a stranger of a doctor put an unknown kidney into him.
Dr. Bijal V. Patel is a nephrologist who specializes in home dialysis and kidney transplantation at Sharp Memorial Hospital in San Diego.
Patel says at Sharp, every potential transplant donor goes through rigorous screening from every angle before being accepted. The degree of scrutiny indicates concern about the possibility of donors-for-hire.
He also says the medical profession views the voluntary sale of a body part as not being genuine consent. Even though the donors are willing, the act is viewed as a form of coercion against people willing to sacrifice their own welfare for money, maybe desperately needed money. They would be ignoring that giving up a kidney could put them in medical peril.
However, Patel acknowledges there are people who out of the goodness of their heart, as we say, are willing to sacrifice a kidney for the well-being of a stranger.
“We would have to make sure they’re thinking straight, but you can imagine somebody who donates a kidney (to a stranger) might feel like, ‘You know what, I'm a really good person and good karma's going to come to me.’ People can be altruistic. You have to respect that.”
Patel says there are probably kidneys available on the foreign black market, but if there were complications, physicians at home could be at a severe handicap in treating a possibly flawed organ they know nothing about and which could have severe problems or have been badly transplanted.
I tend to be agog at anything medical beyond a scraped knee, but I’m amazed when Patel says a new transplant would give Rick four kidneys in his body, though only one might be working. He says there is greater risk in taking a useless one out rather than leaving it in. Sounds like it might get crowded in there, but what do I know.
One of the first phone responses Rick’s postcard elicited was from a man who only said, “Shame, shame, shame.” Click.
Rick shrugs, mystified, as he tells of the call. “What? I’m not trying to jump the waiting list ahead of anyone else. I’m just looking for a kind person who will help me.”
Other than the “shame” caller, in the first couple of days Rick received eight or so calls from the mailing, including one from a woman who actually seems interested. But as he points out, there’s a big drop off from being interested in helping on the phone to then being wheeled into an operating room to surrender part of your body.
And then there’s the likelihood of a disbelieving spouse crying out, “What? You want to give some stranger what?”
Rick is a nice fellow and is upfront in what he asks. He wants to live a normal life. That is never too much to ask.
I wish him health, long life and happiness.
Fred Dickey’s home page is freddickey.net
He believes every life is an adventure and welcomes ideas at firstname.lastname@example.org