The Kid Bounces Back

Page 6 of 18

Missy stifled a sob as she and the family got on the elevator. Kathy, her voice wavering, cautioned, "The floodgates, Missy. The floodgates."

When the thirteen-year-old victim's mother gave her consent to Donor Alliance, the care of his body was taken over by one of the agency's coordinators, all of whom are registered nurses. The boy's vital statistics, such as age and blood type, were fed into the UNOS computer, and a regional list was run. There were no Status Level 2A or Status 1 patients who qualified for the liver, so the computer began ranking the patients on Status Level 2B. Chris's name had popped up at the top of the roster, thanks to the three years he'd spent on the waiting list.

Once a heart recipient was located, the other organs could be removed, and the procurement teams moved in. There were two main teams: One would enter the chest cavity for the heart and lungs; the other -- the solid-organ team -- would open the abdomen for the liver, kidneys and pancreas. After the major organs were removed, others would come for the corneas and skin.

The two main teams worked in stages. The first opened the donor's chest but left everything in place -- the heart beating, the lungs rising and falling with the whooshing aid of a ventilator. The abdominal team then moved in, opened the abdominal cavity and got their three organs ready to remove but left them hooked up to the blood supply. The victim was beyond help, but the teams were as precise in their surgery as the transplant surgeons would be. They had to leave large enough segments of arteries and veins for other surgeons to attach to reciprocal places in their new bodies.

When the abdominal team finished its preparatory work, the first team returned to remove the lungs, and, finally, the heart. With that organ no longer supplying blood, the second team quickly removed the kidneys, pancreas and liver. The entire procedure took about two hours.

Once removed, the organs were immediately flushed with a preservative solution and placed on ice. Each of them was then rushed off to a recipient -- the liver to University Hospital and down to the operating room where Chris had been brought.

Chris lay naked on a steel table. His head and shoulders were shrouded beneath a blue half-tent, his face visible only to the anesthesiologist. Electrodes had been placed on his chest to monitor his heart rate; other electrodes were attached to his head to measure his brain waves, which would let Henthorn assess his level of consciousness. Under his careful ministrations, Chris slept.

On the other side of the blue tent was the rest of Chris's body. He was covered from his hips to his feet with another blue sheet, but his torso, from his rib cage to his hips, had been wrapped in a thin, yellow plastic covering called Ioband, which was impregnated with iodine to cut down on the risk of infection. The blue sheets represented areas that were not to be touched by anyone or anything that was not sterile; the yellow was where the surgeons would operate.

Kam stood at Chris's right side wearing an odd pair of glasses called "loupes" that had what looked like microscope lenses attached. To Kam's right was a large tray bearing a wide assortment of instruments -- forceps, scalpels and curved needles already threaded. Surgical nurse Anthony Adams hovered over the tray, counting and recounting the supplies, making sure that all was in order, while other nurses bustled about assisting him. Goldberg, also wearing loupes, stood across the operating table from Kam. Ignored for the moment in a corner of the room was a small plastic basin covered with a sterile blue towel.

There was a momentary pause, like a symphony orchestra between tuneup and that first note of Beethoven's Ninth, then Kam spoke a single word: "scalpel." Adams handed over the instrument and noted the time of the first incision: 7:47 a.m.

Kam started at the middle of the abdomen and made a diagonal cut through the skin toward Chris's right hip. From his original starting point, he then cut up toward the sternum.

Instead of continuing through the next layers with the blade, he handed it over and called for a "bouvie." The penlike instrument, which cuts by using electricity to quickly burn through flesh, has the effect of also cauterizing severed blood vessels. With it, Kam proceeded through the fatty layer beneath the skin -- a very small layer on Chris -- and then through several layers of muscle to reach the abdominal cavity.

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Steve Jackson