A Walking, Talking Miracle

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It was a normal working day, and I received a very normal phone call. A new patient needed to be admitted by a doctor, and that task would obviously fall to me, as the newest and most junior member of the surgical team. I looked at the clock – half past four. This would hopefully be my last job of the day.

Up on the ward, I glanced at the patient’s details. His name didn’t mean anything to me, but I saw that he had come in for a hernia repair the following day. Most hernia repairs are done as a daycase, so I guessed if he needed to come in the night before the operation he must be quite frail. I looked across at his age. 42. Odd.

He didn’t look frail or sick. We ran through the surgical details quite quickly. When it came to asking about his past medical history, he answered the question quite oddly.

“I don’t have any health problems now” he told me, “but I used to have cystic fibrosis”.

I learnt about cystic fibrosis at school, and again at medical school. It’s a genetic disease, caused by inheriting two faulty copies of a specific gene. People with the condition suffer from a build-up of mucus in the lungs, and tend to suffer from repeated chest infections. Antibiotics and physiotherapy help, but I had thought the underlying condition was incurable. I asked for an explanation.

He told me that during his teenage years and as a young adult, he had spent almost half of his time in hospital on heavy duty antibiotics. He was not expected to live many more years. After a particularly bad infection, during which he nearly died, he was offered a lung transplant. He pulled through the operation, and had never looked back. Since he had been discharged after his transplant, he told me, he hadn’t spent a single night in hospital. “Each morning” he told me “I wake up, take a deep breath in, and feel lucky to be alive. I’m a walking, talking miracle”.

transplant

Modern medicine is pretty amazing. We have drugs that can render you unconscious so you don’t object to being opened up and fixed. We have (for now) drugs that can get rid of unwanted bacterial freeloaders. We have drugs that kill off cancer cells, but spare their healthy neighbours. We have telescopes that can peer into pretty much any orifice and take samples of your internal organs. We can feed wires into your arteries and open up blockages. Often, we can fix damaged organs with medicines or with surgery.

But if we can’t fix what is broken, we now often have the option of giving you a new one. Kidney failure..? Have a new kidney. Liver failure..? A liver transplant. Severe burns..? A skin graft. Your pancreas, heart, lungs, even limbs can be transplanted.

Of course the surgery, in someone who is usually pretty sick to start with, is dangerous. Transplants usually require the recipient to be on life-long medication to prevent the new organ from being rejected, and the new organ may not last forever. But it is still one of the most amazing things that modern medicine is capable of. I left hospital that day with a renewed sense of wonder at my job.

You might donate a kidney to a loved one, but in the world of transplant living donors are the exception rather than the rule. Each transplant might represent a miracle for the person receiving a new organ, but many transplants are born from tragedies. In England, only about 60% of people who could donate an organ actually do so. Often, if they haven’t expressed any advance wishes, the decision is left to their families. It must be an agonisingly difficult decision to make.

In Wales, the law recently changed so that consent for organ donation is assumed, unless someone has chosen to opt out. Opt-out rates are very low, and the number of transplants has jumped up by around a third in the six months since the new law came in.

It’s a small good news story, at a time when they are rather hard to come by.

 

If you live in the UK, sign up to the organ donor register here. Unless you live in Wales, in which case there is no need! Don’t forget to discuss your decision with your next of kin.

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