Billy Snyder, a Lifesharing organ procurement specialist, relates brain death to pregnancy.
“Either you’re pregnant or you’re not. Either you’re brain dead or you’re not,” he says. “There’s no wiggle-worming gray area. When someone’s brain dead, they have complete cessation of their entire brain system and all those functions that go along with it: respiratory drive, pupillary response, cornea response, any pain response, any receptor in the body.”
After brain death has been declared, Lifesharing first tries to place all organs locally. Today, over 1600 people in San Diego are waiting for organ transplants. Because the length of time an organ can live outside the body differs, the allocation varies. For example, hearts and lungs tend to stay local because they have only four or five hours of viability. Kidneys, on the other hand, can last as long as 48 hours with the use of a perfusion pump, which stimulates optimal body function for the kidney and increases the success of its transplant. If someone on the list is a perfect match, that kidney will bypass local transplant centers because it has the best chance of functioning in the body of a person with “zero mismatch.” In other cases, if Lifesharing can’t find a suitable match for organs in San Diego, they expand the search to Los Angeles, Northern California, Arizona, Nevada, and so on.
∗ ∗ ∗
Outside the doors of the conference room, past the reception desk, a narrow hallway leads to the Lifesharing staff offices. The walls of this hallway are hung with five “donor quilts,” each bearing 20 squares dedicated to the dead, whose organs and tissue live on in the bodies of strangers like those around the conference room table.
Crystal, We miss you is embroidered in white thread on a red square.
Sarah Elaine Schonhoff is stitched in green above a picture of a smiling, thin-haired baby, along with the dates 1-21-2004 and 2-10-2006.
The right half of the backside of a pair of jeans (including belt loops to just below the pocket) fills the square next to little Sarah’s. Poker chips and pictures of dice, running shoes, and a tool belt create a collage of significant mementos, along with the words “husband” and “father” spelled out in tiny Travel Scrabble letters.
Mario Gerardo Pinedo does not yet have a quilt square. The 39-year-old owner of a National City auto-detailing shop died of a massive brain aneurism in 2006, and his sister, Letty, who sits next to Rita at the Lifesharing volunteer meeting, says the square is something she and her four sisters have been meaning to get around to. During a recent conversation, they did come to a couple of decisions. They want a Chargers background, and something about the Padres, for sure — maybe a picture — and also, perhaps, a couple of lines about Pinedo.
In July 2005, a few days before his 39th birthday, Mario went to the Chula Vista DMV to renew his driver’s license.
“They asked him if he wanted to be an organ donor, and he said yes,” Letty said on the evening we sat together with Rita, Michael, and two of Mario’s other sisters in the Pinedo siblings’ childhood home. “He comes home all excited because he was going to be a donor. My parents were telling him, ‘Are you crazy? You’re 38 years old. What are you thinking?’ And he was, like, ‘When I die, what are they going to do with it? Everything’s going to turn into a worm. I’m going to be eaten up. No. I’m going to give it to somebody. You never know, Mami. You never know whose life you can save.’”
Seven months later while at a Friday-night barbecue, Mario suffered a massive brain aneurism and was admitted to Scripps Chula Vista Hospital around 10:00 p.m. Two days later, he died.
“We all ran to the hospital, though my parents weren’t here. They were in Mexico,” Letty says. “Pretty much right away, [the doctors] told us he was brain dead. At that point, it wasn’t even what are we going to do, it was how are we going to tell our mom, and who’s going to make that call?”
It was at this point that Belen Bell, family-services specialist at Lifesharing, introduced herself to the Pinedo family. The now 57-year-old Bell, fond of brightly colored sweater sets, establishes and maintains eye contact when she explains her job to me one afternoon in another, smaller conference room. It’s been a week since the volunteer meeting.
Although Bell has several responsibilities, one of them is to obtain consent from family members for the procurement of organs. She had been at the hospital following Mario’s case but did not approach the family right away.
“We follow from a distance,” she says. “We check their labs, and we check their neurostats, to see if they’ve worsened or gotten better. We don’t go near the families until the right moment. Never do we want a family to feel that we’re hovering.”
Once a family has been informed by physicians that their loved one is brain dead, they need time to grieve, Bell says.
“What we normally listen for is ‘What is our next step? Should we be looking for a funeral home? What should we do now?’” she explains.
In the case of Mario Pinedo, this happened around 5:30 on Saturday morning, when his sisters began to discuss how they were going to tell their parents that Mario was gone. The first thing Bell did after introducing herself to Mario’s family was to ask after his mother. When his sisters informed her that their mother was in Mexico and didn’t yet know what had happened, Bell told them to call her and tell her that he was ill, not that he was dead, so she wouldn’t go into shock before the long trip home. Bell then helped the sisters decide who would drive to Tijuana to pick their parents up from the airport and drive them back into San Diego.