October 12, 2021

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I am better at writing than putting things into words so I wanted to share some reflections with you all.  One of the things that I’ve been thinking about is this idea that, “there is no benefit at all to you” in doing this.  And it is absolutely true that there is no medical benefit to me (with the exception of being prioritized should I need a liver transplant in the future, which is a pretty cool).  But the reality is that people do a lot of things in life that have no medical or physical benefit to them, and they do these things because they are meaningful and in line with their values.  People climb Everest (which has about a 1 in 100 chance of death).  I’m not entirely sure why people choose to do this, but I imagine it’s because it’s an extreme challenge and an accomplishment that not many can claim.  And then there are the four tourists that Elon Musk recently sent into space – no medical/physical benefit to them, but how many people get to say they’ve been to space?  I would rather do something difficult (and maybe a bit extreme) that has potential to give someone a chance at life. 

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I’m not a thrill-seeker or adrenaline junky, but I have taken a number of risks throughout the course of my life – all in line with my values and sense of purpose in life.  I have been fascinated by science and attracted to medicine from a young age (I wanted to be a “brain surgeon” when I was 3). I was also a very anxious child, terrified of death and illness, afraid of my own body.  My parents, while not the most affectionate or warm people, encouraged me to confront my anxiety, and for this I am eternally grateful.  I began working as an EMT at the age of 16 (in rural Colorado) – a job not low on the scale of riskiness.  I helped people not die, and I also held people as they died.  One particular call sticks with me – a 4 y/o beautiful blue-eyed, blond little girl who had drowned in a lake.  I had a powerful urge to put my mouth on hers and somehow breathe life into her.  But I couldn’t, and she died, and, instead, I stood with my hand on her mom’s shoulder as she screamed.  I tend to be exquisitely sensitive to the pain and suffering of others, and I’ve realized I have two choices.  I can be overwhelmed and scared and hopeless.  And I could drown in my hyperawareness of all the badness in this world (many of my patients do just this).  Instead, I have chosen to use my own privilege and health and skills to alleviate suffering in the ways that I am able.  And this allows me to tolerate and just be present with the pain that I cannot alleviate. Throughout my career, I have been drawn to working with patients who are very ill.  I have learned that the ability to tolerate pain and loss and chaos also provides me with opportunities to provide the most relief of suffering.  And the ability to relieve suffering in some allows me to just be present with those in whom I can’t provide relief.  I’m not a saint or particularly special in any way – this is just how I navigate a life full of “badness” while also finding meaning and purpose (and even joy sometimes).  I’m guessing this is pretty similar to the work you all do in transplant. 

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I have also been thinking about other risks I’ve taken that didn’t offer a concrete benefit.  I traveled to Mozambique shortly after the end of their civil war to work in an orphanage.  Undetonated land mines were everywhere.  We found a dead baby and a decapitated head in a dump where 100’s if not 1000’s of people were living and scavenging for food.  Men with machine guns were everywhere.  I recently traveled to Madagascar with my sister – again maybe not the safest thing for two young(ish) women to travel all around Madagascar by ourselves, but pretty darn exciting nonetheless.  

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Finally, I am grateful at the openness and willingness of your team to consider me as a potential living donor, even in the context of my psychiatric diagnoses.  I knew I was going out on a limb filling out the initial medical history form, and I was prepared to be dismissed.  And I am at a point in my life that I could have tolerated that – I am comfortable enough in my identity.  I would have been disappointed but not devastated or humiliated.  But you didn’t dismiss me.  Instead, you have each been realistic about the potential concerns associated with my psychiatric diagnoses, and you have also been thoughtful about my life context, my ability to function well, and my history of seeking help and support when needed.  My patients (even my high functioning student, resident, and physician patients) often face stigma related to mental health struggles.  Yet, your team has been non-judgmental but also realistic.  I hope you understand that this is still rare in medicine, and I have the highest respect for your team and the way you approached this (irrespective of your decision about moving forward with me or not). 

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All that to say that this opportunity, while providing no medical benefit to me, would provide many other benefits.  The potential to directly contribute to someone’s chance at living is pretty profound and is not something that most people get to experience.  And this is a challenge that I am particularly well suited for – as a science/medicine nerd this is the equivalent of space tourism.  As a physician, I am comfortable with procedures, medical risk, etc. so I don’t find this particularly intimidating    This could be my Everest and would be far more meaningful to me than climbing a mountain.  I would be very proud of my large mid-line scar.  I’d probably appreciate it even more than my full backpiece tattoo. =)