No one was coming for his heart or his liver, and it was clear why. No sooner had we taken a scalpel to the skin over his abdomen…my attending starting down by the pubis while I started from up under the xiphoid…we met at the navel…we got through the even poorer protoplasm below it and entered into his peritoneum to find a belly full of ascites fluid. His bowels, thin, pale and filled with air and succus, bobbed up to the surface of the yellow fluid. I placed a suction device deep into his abdomen and watched as the fluid drained out, much like it would from a bathtub with the drain pulled. Liters were drained and what remained were the sad contents of his jaundiced abdomen. The now visible liver did not glisten as expected, and it certainly wasn’t its usual color. It was cobblestoned and knobby, cirrhotic, tortured by this man’s very close and very daily relationship with alcohol. No. We wouldn’t be touching that. Or his pancreas, which was nearly calcified through and through likely from several bouts of alcoholic pancreatitis. His blood vessels, conduits which should be smooth and elastic, were crunchy...hardened by his slavery to cigarettes. Attempts to cannulate them revealed rinds and rinds of yellow, cheesy, calcified atheroschlerotic plaque, filling in the lumen, obstructing blood flow. It was a wonder this man’s legs were getting any blood at all.
We were only there for his kidneys. Kidneys that were risky to take, having come from someone in such poor shape. Kidneys that someone in a nearby state desperately needed. Kidneys that this man’s wife had graciously signed the consent form to donate despite the grief she must have been feeling after loosing a husband who, just three weeks prior, had decided to give up both cigarettes and alcohol. A hypertensive hemorrhagic stroke robbed him of his chance to try out his new life. He was only 51.
Far too young if you ask me.