Thursday, 8 October 2015

Living on After Death.



            “The same heart,” I said to Sri Husband, “beats in every human breast: boom-pachak-boom-pachak.”
            I added drama: “Red liquid-gold, courses through the chambers, arteries and veins. Truck-drivers and tycoons… have the same biological plumbing. Like air and water, mosquitoes and viruses, blood does its job without bothering about who’s from communities major or minor, a scheduled caste, tribal, Jew, Palestinian or politician.”
            Sri Husband “What have you been reading?”  
            “About blood donation. Saves lives. The blood-cells get replaced in two days and the fluid part in three months. Just imagine, my tambdey-tambdey ragat surging through someone else. It would be fascinating to know mera khoon kiski nassom mein beheta hoga? Just thinking… if an aazaaree manees who has received my blood gets well enough to donate to someone who in turn donates to another someone, etc, will a teensy-weensy bit of me eventually traverse the globe?”
“These days,” said Sri Husband sombrely, turning to his own magazine, “Science is as close to magic as can be. And I’m not talking about the not-so-distant stem-cell therapy but the already-happening organ-transplantation.”
“Means?” I asked, confused by the big-big words.
 He talked like he was telling me a story: “In Goa, we have nearly twelve thousand kidney failure patients.”
“How many have died without diagnosis or treatment?” He doesn’t like to be interrupted so I didn’t really voice this question.
He carried on: “If one’s kidneys fail no medicine, prayers nor visits to holy men will work.”
Me: “Aawaiss.
He: “Dialysis is the answer. Or better, transplantation.”
Me: “Means?”
He: “You have to get another person’s kidney, from parents, siblings, cousins, children. Our law allows the spouse to donate. 
Me: “What happens if their tissue doesn’t match the patient’s? Or a relative is not willing to give a kidney?”
He: “You have to get it from a cadaver.”
Me: “Dead person? How?”
He: “From a brain-dead cadaver.”
Me: “Not heart-dead?”
He: “See-e, there are two kinds of death. One happens when the heart stops beating. Brain-death happens when the brain stops functioning.”
Me: “Like in the case of serious head injuries or bleeds inside the skull?”
He: “Yes. Or in rare cases, of primary tumours that kill the brain yet allow other organs to work under certain circumstances. One can’t predict brain death.”
Me: “Will their kidneys work?”
He: “These brain-dead people, in a well-equipped ICU, can be hooked onto a ventilator to keep blood circulating in their bodies. That way, the heart continues to beat because the doctors artificially maintain it; they also maintain the blood pressure. All the organs in the body are kept perfused.”
Me: “You mean the organs will function even if the patient is declared brain-dead?”
He: “Yes. The instant the ventilator is switched off, the heart will also stop. It can’t keep the heart beating for more than a couple of hours anyway.  Once the blood-flow ceases, the other organs shut down.”
Me: “Is brain death like coma?”
He: “No. A patient in coma is alive… gags if a spatula is inserted into the throat… eyes move if ice-cold water is injected into the ear. There are complicated tests also to make sure the brain is dead. Dead. Maintaining a cadaver-donor for organ retrieval is a complicated process.”
Me: “Who gives the death certificate?”
He: “Two sets of specialists carry out tests at least six hours apart before declaring brain death. Then the cadaver’s family can consider donating organs: 2 kidneys, 1 liver, 1 heart, 2 lungs, one pancreas, the skin, eyes.”
Me: “…so many things?”
He: “The medical team has to run against time to retrieve the organs. Mostly such deaths are accident cases. The family of the deceased has to give written consent.”
Me: “I can write it in my will.”
He: “The funeral might be over before someone reads the will.”
Me: “Then what to do?”
He: “Tell everyone in the family about your wish. And at all times carry a small note in the wallet indicating your wish. In case of an untimely death, it makes it easier for the family to sign the consent form.”
Me: “We can’t do funeral rites on an incomplete body.” 
He: “People have hysterectomies, their appendix and teeth taken out, those bodies can be considered incomplete, too, right? Besides, it’s the ultimate charity: giving life to another.”
“Are such organs sold?”
“Nope.”
“Who gets them?”
“Recipients are carefully chosen. The age of the recipient is considered as also how long s/he has suffered from the ailment. Points are given for each criterion and patients with the highest number of points are called to the operating theatre for the transplant.”
Me: “Then the recipient lives happily ever after?”
He: “Provided he takes the lifelong course of prescribed medicines and is careful about not catching infection. But it’s a good alternative to dying, or in the case of kidney failure, being on dialysis. The quality of life improves. People can earn a living, attend college, have children, participate in sports.”
I peeked over his shoulder to see which article he was getting all the gyaan from and read out the lovely last line: “Don’t take your organs to heaven; God knows they’re needed here.”

Feedback: sheelajaywant@yahoo.co.in

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