Reservoir of Goodness: On Organs, Healing, and Humanity
Depending on which word-origin website you read, “organ” is from the Old French "orgene" or Latin "organum," meaning instrument, implement, or tool. I’ve dug etymologically and still don’t get the relationship between a booming musical pipe apparatus and somebody’s liver.
In early November, my wife missed a phone call from my dad while we were sitting down to dinner with friends at their family’s cabin in rural Kansas, about an hour south of downtown Kansas City. When relatives call at unusual times--when you get a text that says “Call me” or the home phone (used to) ring after 9pm--you’d be wise to place a bet somebody had died.
My wife checked her phone and told me, so I got up and looked at my phone and saw I’d missed a few calls as well.
He had left a voicemail.
“Micah, call me,” my dad said.
“Oh god,” I thought to myself, and started thumbing through the list of who might’ve passed, of which family members were old or currently ailing, of who would do something reckless enough to get themselves killed.
My mind flickered toward my father. He’s had polycystic kidney disease--an illness marked by multiple cysts growing large and painful on the kidneys, ultimately leading to failure--for the past decade. In the last year the disease hit him hard, leading to a variety of other health complications and an overall decline in energy. But he had just been to the kidney doctor for his yearly check up the day before: they told him dialysis was in his distant future, and that he’d remain on an organ transplant list with a couple year wait still predicted.
“A lot of people need kidneys,” they told him.
Our organs keep us alive. Each has a specific vital function, making them integral parts of the miracle that is keeping our body humming, running, breathing. The instrument organ? I’ve never cared much for it--it’s ominous, but not like the brooding, melancholy sounds I enjoy via Spotify playlists like “Deep Dark Indie.” Some organists play sprightly tunes, like Sir Foster, the Atlanta Hawks’ organ player who performs songs like Outkast’s "Southernplayalisticadillamuzik" during NBA games. But most organ songs are sinister, apocalyptic.
I stepped outside and called my dad and he answered after a single ring, at first clear-throated but then with a cracked voice.
“I got a kidney,” he said. “The hospital called and said they have a kidney for me.”
My body felt like all the blood had been drained from it, then new blood spontaneously added: a combination of faintly woozy then needle-of-epinephrine to the heart.
“When’s the surgery?”
“We’re heading to the hospital now to run some tests. It could be as soon as early this morning.”
Our friends prayed hopeful prayers and my wife and I picked at our dinners then drove back in to the city.
A cosmic oddity: we don’t need all our organs to function. Creation appears so meticulous and intricate, especially the human body, in which there are close to 100,000 miles of blood vessels and where nerve cells carry messages at 268 mph. But we’ve also got what are called vestigial organs: parts of our bodies that once served a purpose but have been made unnecessary due to evolution and antiquity. The appendix, for example, which nobody needs and only causes pain when it spontaneously erupts. The gallbladder stores bile, but you can live fine without it. I don’t think it qualifies as a paradox, but there’s at least a sliver of irony in this: our freakish, beautiful, and complex universe gives us some biological grace--we’ve got some parts in us that, if something goes haywire, we’ll still survive.
We get there. His medical home base is a teaching hospital near a hookah bar I used to frequent in college and across the street from a pho spot I really want to try. It was close to midnight, and we were frisked by a security guard and had to pass through a metal detector. Patients milled about the lobby in a dim glow of light. We found him and waited in his room until a member of the transplant team came in and asked a series of questions. We held our breaths because his answers seemed to determine whether or not the deal would go down. The doctor was wearing civilian clothes, not scrubs, and told us she was called in from having dinner with her kids.
“Have you had a fever recently?”
“Any signs of infection?”
“What about a colonoscopy?” she asked.
“Yes,” my dad answered.
“Where?” the doctor asked.
I interrupted here, because I’m an Enneagram Type 3 and couldn’t not.
“In his butt,” I said. Nobody laughed.
After the great medical catechism she left, vaguely hinting that yes, he’d get the kidney as long as blood work came back normal. My parents’ best friends came to sit with him, and my wife and I headed home to get some sleep. My mom said she’d text us when they found out for sure if and when the surgery would be.
There are more organs we need than not, though. Lungs to snag oxygen and expel carbon dioxide, a heart to pump blood, and our skin, a barricade protecting our inner parts. Kidneys are bean-shaped and about the size of a clenched fist, and act as the body’s filter, purifying blood and producing waste and keeping electrolytes stable. You can live with just one, another holy courtesy. But you need at least one to work.
After a fidgety sleep, I woke up to a text that said all things were a go, so we went back to the hospital and sat in the surgical waiting room. My mom’s best friend was there, and so was my dad’s sister. We brought donuts and tried to change the waiting room TV from Fox News to anything else. My aunt bought a Sunday newspaper while I browsed through the Target ad. I looked at deals for Beats wireless headphones as my dad, under anesthesia and the knife, was having a dead person’s kidney anchored to his insides.
The phrase “organ transplant” conjures up images of an unsuspecting hitch hiker waking up in a Motel 6 bathtub full of ice with ominous scars across his stomach. I don’t know why my mind goes directly to organ harvesting, but it occurs before the reality of the relocation of a deceased human’s now not-needed body parts. The process of transplantation is rigid and executed like a military mission: first, a team of doctors assesses the organs of a deceased organ donor. After letting immediate family know about the death and determining which organs are viable, the deceased’s physical statistics are entered into a database to find good matches. Then, transplant doctors from the various recipients travel to wherever the corpse is to retrieve the organs--you might have multiple doctors from many miles away meeting at the same corpse, then dispersing to generate life wherever they’re from. Retinas and livers and hearts flying all across the country in different directions. A nationwide organic dispersal.
There was a TV screen meant to give surgical updates, like airport departure/arrival boards, but my dad’s number wasn’t listed, so we didn’t know if they’d even started digging. Among the other apprehensive families holed up waiting to find out their loved one’s fate, I overheard a woman’s phone call and gleaned that her boyfriend was in the OR because of an accidental gunshot wound. After hours of jitters and nervous pacing, my dad’s surgeon came in and said that the procedure couldn’t have gone better. I had Googled the doctor before the surgery and found out he went to Harvard Medical School, which gave me some peace. The kidney was a perfect match.
“It’s like it came from a twin,” a nurse told my mom, which sent my mind down a fan-fiction rabbit hole where I imagined it actually was my dad’s long lost twin who gave him this kidney.
There’s a Minnie Driver movie, Return to Me, about a woman who gets a heart transplant and consequently falls in love with a man whose wife died in a car accident. It’s a rom-com, so you know what happens next: it turns out the heart she got was that man’s deceased wife’s heart. There’s a cringe worthy line where someone says "Grace has Bob's dead wife's heart!" but, of course, they wind up falling in love. In the real world, you’re not supposed to know whose organs you get, not unless it’s a voluntary transplant, like a cousin offers you a lobe of their lung or something. Recipients just trust that the transplant team isn’t going to give them faulty parts, and families of the deceased donor get the unsettling satisfaction of knowing their husband’s eyes are in the sockets of someone who can now see, that their daughter’s pancreas went to somebody who’s going to get to spend more time with their grandchildren.
A nurse let it slip that the man who gave my dad a kidney had actually died in the same hospital we were at; he had been in there for a checkup earlier that week. As I wandered the halls waiting for my dad to wake up from the anesthesia, I wondered about that man’s last visit. Did he get coffee from the same cafe as I had? If so, what did he order? What magazine did he read in the waiting room?
We saw my dad briefly in the post-recovery ICU an hour after his surgery. I don’t think he remembers because of his cocktail of anesthesia and pain drugs. I leaned over and gave him a hesitant hug, trying not to get tied up in the plethora of cords running from ports all over his body to an IV stand and monitors that looked like something you’d find at NASA mission control in Houston.
“I can’t believe it,” he kept mumbling.
Neither could I. Except, when I started thinking about it, I really could.
Marilynne Robinson has a phrase, “reservoir of goodness.” In her words, it's “that reservoir of goodness beyond and of another kind that we are able to do for each other in the ordinary cause of things.” She means this: we are humans, and humans best live out their humanity by being humane to one another. By doing good toward one another. The expansiveness of the circumstances that allow for an organ recipient to live are such evidence of the goodness humans can do. Countless biologists worked tirelessly to discover how organs function, and a horde of doctors spent years of their lives figuring out how to medically facilitate the transplant of those organs, and each day thousands of people on transplant teams work exhausting hours to engineer organ swaps. And, all the time, human beings make the choice to be proactive about doing good to one another by entrusting the instruments that gave them life so another human can have more of it.
My dad’s alive and should be for a while, God-willing. There’s at least another surgery to take out his old kidneys, and a lifetime of anti-rejection drugs that make him extra sensitive to the sun. But with his new kidney he’ll live better, faster, stronger. He can eat chocolate again, and the monotonous pain and inconvenience of dialysis is now just an unpleasant what-might’ve-been.
He’s always been a crier--one of my favorite qualities about him. Give him 15 minutes of a Hallmark movie and he weeps like a baby. He cries more frequently now, though, and all it takes is the smallest of sweet gestures. Maybe it’s a chemical in the anti-rejection drugs. Perhaps it’s that he has a new lease on life: a lot of sand was just added to his hourglass. It’s kind of like he’s living his own Hallmark movie.
During his few months of convalescence, my son Lewy, a frisky and bright-eyed toddler, spent a lot of time at my parents’ house.
“You’ll never understand it…” my dad would say when I’d call and ask how Lew was behaving, “But that boy is the best therapy for me.”
And can’t we all be for one another. I can believe that.