Some pre-op teaching...

After working at one of the world's top transplant centers for over four years now, I've had to come to the realization that, even though transplantation is mostly associated with life, it involves more death than I could have ever imagined.  Sure, we can think of an eager team of surgeons coming in and harvesting organs from some unfortunate cadaveric donor, snipping and picking kidneys, corneas, lungs, heart, liver, pancreas, skin, and bowel, leaving the OR with coolers and turning their backs on the now worthless corpse, still open and empty.  But, that scene becomes much more palatable and justified when one thinks of the lives that can be saved.  Donate life.  Put it on your drivers license.  And that's where the thinking stops. 

No one thinks of the patient that actually received a liver transplant but his portal vein keeps mysteriously clotting off and his bowel keeps spontaneously perforating, spewing shit all over his insides, requiring him to go back to the OR for surgery after surgery.  His abdomen actually needs to be kept open with only a fine layer of mesh covering his liver and intestines, exposing him to more infection in a body that already has a suppressed immune system.  His loving family that has been at the bedside for weeks with him--puffy, yellow, and sedated on mechanical ventilation--finally agreed yesterday that "comfort measures only" (or "CMO" in the industry) is the way to go.  A perfectly good liver into such a deserving candidate.  Sometimes life and death just aren't fair.  And this is an example of the stories about transplant that no ones knows. 

I am writing this blog because there is value in what a transplant nurse experiences and it indisputably deserves a voice.  While sharing stories at the bar of the grotesque aspect of transplant nursing will probably never cease, there is more to it than that.  There is beauty in being intertwined in the fine line between life and death.  There are inspiring patients and heartbreaking patients and annoying patients and patients that you want to suffocate with a pillow but can't and each and every one of them deserves to have their story told.  There are surgeons that play god and value human life above all else, even to the point where it becomes unethical.  There are nurses that give up on patients too quickly and single-handedly act as the death panel the media blew out of proportion circa 2009.  Truthfully, the possibilities for material are endless.   

Everyone always tells me I should write a blog.  So, here are my stories of transplant nursing, just for you.