“Harvesting” Part 3 by Gary Edgar Grist RN CCP Emeritus

The Quality Of Mercy

I looked through one of the windows in the double doors leading to the eight-bed open ward. The donor was in the third bed on the right.  The ward was empty except for her. She was on a ventilator; a young woman in her mid-twenties. The hospital had no intensive care unit, which was still a relatively new idea in the late ‘60s.  Besides, this was a general hospital, which meant that most of its patients were indigent and the hospital had no money to upgrade its facilities.  Above the main hospital entrance, engraved in stone, was this quote from William Shakespeare’s The Merchant of Venice:

 “The quality of mercy is not strained. It droppeth as the gentle rain from heaven upon the place beneath. It is twice blest: It blesseth him that gives and him that takes.”

 The Man With Crossed Arms

I was there for a different kind of “give” and “take”. The donor’s husband stood at the foot of the bed, silently gazing at his wife. He stood perfectly still, just as still as she was, lying in the bed.  He was in his mid-twenties, about 5’10”, slightly balding but with a full beard.  He wore a wrinkled flannel shirt, khaki pants, and slippers without socks. The untidy dress was probably the result of the rush to the hospital. His image was seared into my mind and I can still see him clearly today, over fifty years later. Their story was that the wife suddenly fainted while in bed and could not be revived. The husband called for an ambulance.  At the hospital, the husband was told that his wife had a massive hemorrhagic stroke, probably from a ruptured cerebral aneurysm.  The stroke caused irreversible damage to her brain. The husband then agreed to organ donation, which was why I and the harvest team were there. We were impatiently waiting outside the ward doors for the husband to say his goodbyes. He just stood at the foot of the bed with his arms crossed; not in the surly way that arms are normally crossed, but more like he was hugging himself.  It was as if he was trying to hug her to his body, and in his mind, for the final time.  We waited outside the doors for perhaps 30 minutes. No one on the harvest team was willing to approach the husband about the urgency of our mission. Harvest teams need to remain emotionally detached from donors for their own emotional well-being. But I pictured our team as vultures lurking over their carrion. The image unsettled me. Suddenly the husband turned and walked through the doors and passed the team members without a glance or a word.  He walked down the corridor to whatever grief-filled life awaited him, the soft echoes of his slippers quickly diminishing.  The man with the crossed arms received no mercy upon the death of his wife, but he showed great mercy by giving her up for organ donation, even though all hope was gone.

I Had A Problem

The team descended on the pitiable donor, quickly transporting her to the OR for the harvest without any problem.  But I had a problem. Even though I had participated in organ harvests for over a year, this time I experienced an intense feeling of shame. I didn’t know why.  I did not think organ harvesting was wrong or immoral.  And I was just doing my job.  But I kept asking myself “How can a human being be harvested? It doesn’t seem right somehow.” Maybe this was when the term “organ harvest” became antithetical to me. The mission of the donor hospital may have been one of mercy, but I was not sure my mission was a merciful one. So, I learned what real, adult shame feels like for the first time on this harvest. Not the kind of shame a child feels when caught in the cookie jar by a parent, but rather the uncomfortable gut sensation of feeling small and guilt-ridden.  But guilty of what? I did not know, and I would not learn why I felt that way until 40 years later.