A bridge between life and death
IMAGINE leaving your family behind on New Year's Eve to tell somebody that their beloved one just died. Adding fuel to the flame, you ask the relatives to donate the organs of the dead, allowing little time for them to come to terms with the death. For Ms Tong Yuen-fan, one of the seven organ transplant coordinators in Hong Kong, her job means a constant confrontation with death day and night.
"It is essentially a 24-hour task be- cause death has no schedule," said Ms Tong. When she receives a call from the Prince of Wales Hospital informing her of a potential donor, she will need to talk to the relatives about their choices as soon as possible.
Time is a critical factor in organ transplant because the organs will start to deteriorate rapidly once the heart stops. How to convey the imminence of this matter to the grief-stricken families without causing antipathy is a question with no definite answer.
"I would say something in condo- lence with the family. I would not bring up the topic if I feel that they are not ready to accept the death of their loved ones," she said. For instance, people would demand the doctors to resuscitate the patient even after he or she was declared brain-dead.
Ms Tong added that it is important for the family to understand what brain death means and how an organ trans- plant is carried out. The mother of a do- nor kept asking every doctor she visited whether her son's death was real. It is hard to accept the death of your beloved ones when you can still feel the warmth of the body. But they are gone, together with the neural responses and brain functions.
"Sometimes just being a compan- ion is enough. They need someone to be there with them," she said.
Will the procedure be painful to the donor? Will it wreck the body and affect the funeral? The answer to both ques- tions is no. The doctors take good care of the donor and make sure the appearance of the donor remains intact.
More than 3000 patients are waiting for organ transplant now in Hong Kong. Sadly, most of them may not be able to have a second chance at life. Ms Tong has seen patients suffer from chronic kidney disease doing dialysis on a daily basis and patients with liver failure eventually die because they could not receive a liver transplant.
Ms Tong had worked in the intensive care unit before she joined the trans- plant coordinating team 16 years ago. She was happy to see the patients being dis- charged from the hospital and yet there were those whose injuries were so severe that despite the best efforts of the medi- cal staff could not survive. She felt she could do more —— by helping the fami- lies cope with the pain and helplessness when their beloved one dies.
She recalls a case in which a man in his twenties died of serious injuries sus- tained in a traffic accident. His relative was a hospital staff and the family made the decision to donate his organs. Rows of people rose and stood in silence when they took him into the operating room.
"He was the little brother in the family and it was so sad," Ms Tong said. "But it also makes you realise the es- sential goodness of human nature, that people can still make a decision like that even under immense pain and despair."
The parents of a 12-year-old boy who died in a traffic accident decided to donate all of the child's available or- gans. They were hesitant at first but they thought their child was so young and had not yet served the community, this might be the last thing they could do for him and for the society.
"He's got beautiful eyes. It is com- forting to know that he is still able to see this whole extraordinary world," said the mother.
Death is still a harrowing and uneasy subject to many. People seldom discuss how they want to handle their remains with families. Not surprisingly, they may only know the deceased's desire to donate organs by discovering the organ donation card at the last moment. Pro- spective organ donors should make their wishes clear to their families. With the Centralised Organ Donation Register im- plemented in 2008, citizens can sign up easily online or through the post.
"The passing away of a person may become the key to saving another," said Ms Tong.
By Hilary Wu
Edited by Stephen Leung
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