Long story short, this guy died of a head bleed. He was brain dead by the time I got him to the hospital and probably well before that. I did get a pulse back, and I obviously had no way of knowing he had a head bleed at the time I got him back. Even so, I only had the faintest glimmer of hope that he might have a positive neurological outcome based on how the code went. Hospital staff updated me shortly after finding out that he ruptured an AVM in his brain stem. I went to sleep that night knowing they had called our local organ procurement organization and admitted him to the neuro-ICU; thinking that there would still be a positive outcome with the lives saved from his presumably young and healthy organs.
Come to find out later that there were no lives saved. Why? Because the family declined to donate his organs. Their reasons I'll never know. And maybe they had good ones. But more often than not, I hear things like: "He's been through so much already." Yes, yes they usually have. Frequently, sudden and tragic deaths lead to brain death situations. But if we're at the point of discussing organ donation, they're no longer suffering. Brain dead = dead. No pain. No suffering.
The deceased have no use for their organs anymore. When they're buried, those kidneys and lungs will shrivel up and turn to dust along with their other bits and pieces. But with all of our technology and advances of modern medicine, we can maintain the donor and his/her organs long enough to assemble surgeons and helicopters and recipients. And thanks to said advances, we can keep organs pink and healthy even as their former owner passes on. And if we (surgeons, nurses, the pilot of the helo, everyone...) do our jobs right, those beautiful organs can stay that way and give another person a shot at another 1, 2, 5, even 10 years with his or her family and friends. That's a big deal.
And I certainly understand the overwhelming grief families must feel when a loved one is suddenly torn away from them. I'm sure some see the request for organs as adding insult to injury. At minimum, it's one more decision that has to be made... Something else to think about when all they want to do is cry. There is certainly also a lack of education, compounded by TV shows and movies. (Brain dead is not the same as a coma which is not the same as a host of other neurological states of being. One does not suddenly wake up from being brain dead, as you might believe if you took TV at face value...)
I wish the United States would go the way of some other countries and have an opt-out system of organ donation instead of opt-in. It takes away the decision. It takes away the intrusion into the grief of a suffering family. It makes helping others a matter of course. And still leaves the option of not donating organs if the patient or their family truly has an objection to it, not just a grief-stricken knee-jerk reaction to a stranger's question. Or just let the final decision lie with the patient. If I sign an organ donor card or check the appropriate box on my driver's license (which obviously, by the tone of this post, I have), that should be the final decision. Although I can no longer make decisions for myself, my prior decision should be a binding legal document that my family, with their own opinions or caught up in their grief, cannot overrule. Some states have pushed to make my latter proposal the standard. But even though it is now law, it is very difficult in practice. Who wants to be the person, who, waving the dead teenagers driver's license at his sobbing mother, takes his body away against her wishes? Not meeeeeee!
Now I realize it's no one's obligation to help another person with their own body parts. The recipients are not always cute little dying twelve year olds. Sometimes they're 45 year old former alcoholics who just wore out their first liver. Sometimes they're 100 pack-year smokers who need new lungs. But sometimes they are teenagers with cystic fibrosis or new moms in their 20s who got post-partum cardiomyopathy. You just never know. But really, are you such a perfect person that you should be judging who gets your organs? And overwhelmingly, do you need your organs when you're dead? So why not leave them behind for someone who can use them for a few more years?
Now I realize it's no one's obligation to help another person with their own body parts. The recipients are not always cute little dying twelve year olds. Sometimes they're 45 year old former alcoholics who just wore out their first liver. Sometimes they're 100 pack-year smokers who need new lungs. But sometimes they are teenagers with cystic fibrosis or new moms in their 20s who got post-partum cardiomyopathy. You just never know. But really, are you such a perfect person that you should be judging who gets your organs? And overwhelmingly, do you need your organs when you're dead? So why not leave them behind for someone who can use them for a few more years?
