Authors: Rex Burns
“Well, you might call John Vogel. He’s the public hospitals’ coordinator for the northern Colorado sector. Or Mark Gilbert. He’s transplant coordinator at a small independent firm called Antibodies Research. They’re just getting started in the field, and we’ve done some business with them. But don’t be surprised if they don’t wish to be interviewed. As I say, the issue is a very sensitive one.”
Dr. Amaro told us more about the advances his company was making in areas other than medicine. He was especially excited about superconductor research, and I dutifully filled pages of the steno pad. When I nudged him back to medical applications, I asked if he knew Dr. Morris Matheney.
“Morris? Certainly—a fine person and a fine physician. Very active in transplant research. In fact, he’s consulting with our engineers and designers on a project.”
“What kind of project?”
“Oh, that’s not something I’m at liberty to divulge; it involves patents and security in a highly competitive area. I can tell you this much, however: It’s a model for another transporter unit. An ingenious model, if I may say so.”
“Would it have to do with transporting blood or body tissue, as opposed to organs?”
Amaro’s brown eyes widened and he leaned back against his chair. “Has he talked to you about it?”
“Not in any detail, doctor. But I do know his specialty is tissue rejection, so it just makes sense.”
“Oh, yes—of course!” The man’s round face lost its worry in a relieved smile.
“In fact, I understand you asked him for a rare blood donor not too long ago—someone with Rh null.”
“Why yes! My goodness, you’re thorough in your research. Yes, but I was doing a favor for a potential customer. An emergency call went out for a very rare blood type and I volunteered to query our mailing list. I do that occasionally, since we’re in contact with most of the transplant coordinators and facilities in the region. But it was a long shot and I don’t think anything came of it.”
“Can you tell me who you did the favor for?”
“I could, I suppose. But why?”
I smiled. “As you say, doctor, I’m thorough in my research. I won’t tell him where I learned his name if that worries you.”
“No, no—it’s nothing like that. It just seems an odd request. It was Empire State Hospital in New York City. They specialize in the more difficult transplant operations, and I occasionally go back there to observe their activities and adapt some of our standard models to their more specific needs.”
“Can you give me the name of the person who asked?”
“It just came from their transplant center. An institutional request.”
Bunch took a few more photographs—Dr. Ramon Amaro frowning intently at a document on his desk, Dr. Ramon Amaro gazing with quiet pride toward his laboratory—before we thanked him for his cooperation.
“When will the article appear, Mr. Kirk?”
“That’s up to the editor, sir. Probably within three weeks, though.”
In the car, Bunch sighed and tossed the camera case onto the backseat. “Next time I might even put some film in. And,” he added, “next time you be the photographer and I’ll be the reporter.”
“No, no. That’s reserved for us literary types, Bunch. You just stay with the camera.” I thumbed through the business volume of the Denver telephone directory for the address of Antibodies Research and then through the atlas and street guide for its location. Bunch liked to complain about riding around with telephone books and an atlas shoved under the seat, but they had saved us a lot of time on more than one occasion.
“Her name’s Julie Sandberg.”
“What?”
“The receptionist. Julie Sandberg.” Bunch folded a slip of paper into his shirt pocket. “She’s unmarried and has a telephone.”
“How—?”
He shook his head. “Something you literary types will never master.” Steering the car back toward the Boulder-Denver turnpike, he sighed. “Never underestimate the power of the press, Dev.”
The approach to Antibodies Research wasn’t along sweeping lanes through a landscaped industrial park. Instead, their offices were on the south side of Denver off Santa Fe Drive. The area was industrial, all right, but gritty, cut by the Burlington Northern tracks and strangled with large trucks trying to turn in small streets. We crossed the low, muddy banks of the South Platte, with its strip of thick brush and weeds and snagged trash, and wandered among a variety of one-story brick buildings sheltering everything from printing shops to electronics distributors to the occasional blue-collar bar that snagged homeward-bound workers.
The small office was behind a security fence and showed a closed-off brick wall that offered few entrances. In fact, the only one we found was a single door with a half-panel of glass bearing the company name. It led to a tiny reception area that had a potted ficus and no chairs. In an office opening off the entry, a woman sat clicking a computer keyboard. When she looked up, it was with some surprise to see us standing there.
“Yes? Do you need something?”
She was severe. Brown hair pulled back severely into a knot, dress severely unornamented, face severely clean of cosmetics. Her eyes, dark and large, dominated the scrubbed face, but if she was aware of any dramatic effect, she didn’t show it. Rather, she seemed one of those people bent on erasing themselves with noticeable vigor.
“We’d like to speak with Mr. Gilbert.” I explained that we were reporters doing a story on transplant technology.
The dark eyes stared at us for a long moment. Somewhere in the small building a man’s voice called unintelligibly, and the sound echoed on tile and brick. “Just a moment, please.”
She went through the door and we waited. Down the hall a stocky figure in brown coveralls, intent on balancing a box of something, walked—soft shoes squeaking on the waxed floor—toward a more distant door. The secretary came back and, with a curt nod, aimed us to a short, heavyset man with a red face and clipped, sandy hair.
He didn’t invite us into his office but got right to the point. “I’d rather not be interviewed about our business. We don’t seek publicity.”
“The article will be in good taste, Mr. Gilbert.”
“Nonetheless, we try to avoid embarrassing all parties concerned.”
Right. Tell that to the doctors who described their transplant successes on national television. “Do you know or have you ever worked with a Dr. Morris Matheney?”
“Good day, Mr. Kirk.”
His hand urged us through the door, and after it slammed, I heard the tiny click of the lock. “So much for the power of the press.”
“Some of us have it and some don’t, Dev.” Bunch gazed up the solid facade of brick that faced the busy street. “Be tough to get in here.”
“We don’t intend to try, Bunch.” But Gilbert’s shyness did pique my curiosity. “Vogel’s office is over at the University Medical Center. Maybe he’ll be more help.”
Red brick dominated there, too, but the cluster of high-rise buildings had that emphasis on horizontal lines, rows of windows, and ground-level access that spelled hospital. John Vogel’s name on the directory was followed by an address that didn’t tell us how to find his office in the confusing spread of hallways and connecting ramps. It took a good twenty minutes of wandering through the antiseptic-smelling corridors before we located the door, on the crowded basement level and just down a concrete tunnel from one of the cafeterias.
“Mr. Vogel?”
The single room was jammed with filing cabinets and computer ware, and the small desk littered with pamphlets, directories, and papers. A bumper sticker pasted over the terminal said, “Don’t take your organs to heaven; heaven knows we need them here.” Vogel, about my age, had a triangular face dominated by a large nose, and bushy, straight brown hair that fell down the sides thickly enough to hide his ears. His eyes lay deep under heavy brows that made a straight line across the top of that nose; his mouth made a parallel line beneath it.
“You’re the one who called earlier? The reporter?”
The gag had worked so far. “Yes. Devlin Kirk.” I smiled and shook hands. “Can you tell me a little about your business?”
Vogel was cautious. “A little, I suppose. But I don’t want to sensationalize—”
“I assured Dr. Amaro I wouldn’t do that, before he mentioned your name. And I promise you I won’t, too.” I glanced at the bumper sticker. “But it’s possible that some favorable publicity might incline more people to become donors.”
He considered that and nodded. “You understand I can’t go into specific cases. Not without the families’ consent.”
“I understand. Can you sketch your role in the transplant process?”
He did, hesitantly at first, then—with the excitement of anyone fully immersed in his work—more freely. The state had perhaps ten or twelve transplant coordinators; some worked for individual hospitals, a few for private firms, but most for charitable organizations that specialized in specific types of organ transplant—the Lions eye bank, for instance, or a bone bank, or University Hospital’s skin bank. To prevent families of accident victims from being hounded by several representatives, the major groups had created a consortium with one spokesman, and that’s what Vogel did for his geographical area.
The way it worked, member hospitals in the coordinator’s region notified his office when a suitable donor was admitted. Suitable meant young, healthy, and fatally injured. “Visiting their families is the hardest part of the job,” he said. “And sometimes I wish the donors could see what wonders the organs do for people who had no other hope of living a normal life.”
“The permission of the families is always required? Even if the victim signed a donor card?”
“Always. If the family doesn’t consent, the donation doesn’t happen, card or no. But I tell them that whatever decision they make is the right decision for them. And it is.”
He illustrated with the story of a young man killed in a car wreck who gave organs to four people. The heart was flown to Baltimore where a sixteen-year-old boy was hours from death, the corneas went to a woman in Colorado who had been blind for fifteen years, one of the kidneys went to a New Mexico man who’d been on dialysis for nine years waiting for a suitable donor. The liver gave life to a father of four predicted to die within days. “He gave me a letter for the donor’s parents, trying to tell them how their generosity saved his life and let him stay with his children.”
“Why didn’t he write them himself?”
Vogel shook his head. “We have to ensure confidentiality of all parties involved, donor and recipient. It’s just better that way.”
“A donor’s family might take the organ back?” asked Bunch.
A slight smile. “Not exactly. But sometimes a donor’s parents transfer their sense of loss to the recipient. A bit of their child is still alive, for instance. Or, even, they feel they have some claim on the person whose life was saved. Psychologically, it can get very complex, and as a rule it’s just better all around that the parties don’t identify each other.”
After receiving a family’s permission, Vogel arranged for the hospital to remove the organs as quickly as possible and then, while that was going on, started calling transplant centers across the country to find matching recipients. Hotlines, computer networks, and pager systems operated twenty-four hours a day, and occasional calls would be broadcast nationwide for especially difficult matches or critical cases. Once the organs were harvested, they had to be transported quickly and safely to the recipients’ hospitals where they were already being prepped for the operations. “With the right environment, a heart has about four hours of life on its own, livers about twelve.”
“The right environment is a transportation unit?”
“A cooling and perfusion unit, yes.”
“Do you deliver the organs?”
“Sometimes. But not often. Usually, the hospitals—especially the big ones—have their own transplant teams that fly out and escort the item back to the hospital. Pittsburgh, Chicago, places like that.” He added, “They don’t say it, but they don’t like to trust locals handling the item.”
“It must cost a lot,” said Bunch.
“Most of the centers are nonprofit. They only cover expenses.”
“Yeah. Sure. But those expenses run pretty high, right? A day’s pay for the doctors and nurses, their airplane, the specialists … .”
Vogel nodded reluctantly. “It’s not an inexpensive endeavor.”
“How much demand do you have for organs and tissues?” I asked.
More than he could satisfy, was the answer, and he rattled off figures. “Nationwide, around thirty thousand patients are awaiting transplants at any one time. Those nearest death are highest on the list, but many have to wait too long—they never do get an organ.” To help distribute items, the National Organ Transplant Act of 1984 organized the harvest and delivery system and expanded the number of donors, but suitable organs were still in critically short supply.
“It sounds as if the procedures and safeguards are pretty well established.”
“Well, yes and no. Transplantation is a relatively new field and a rapidly expanding one, too.” He gestured toward the coffee machine steaming in a corner of his crowded office and raised his eyebrows. Bunch and I shook our heads.
“In a lot of areas, state and federal laws are only now being considered. Generally, it’s illegal to sell organs, but for example, just last year Colorado established a law that attending physicians can’t participate in recovering organs and that hospitals are required to have trained transplant coordinators on their staffs.”
There was a note of satisfaction there, and I guessed he had something to do with that legislation. “What’s that about attending physicians?”
“To avoid any possible conflict of interest. And it also protects the attending physician from possible lawsuits by the family—charging undue influence, for example. It mandates a second opinion about the patient’s state.”
“Whether the guy’s dead,” said Bunch.
“Whether the victim has any possible chance to survive,” corrected Vogel.
“You harvest the guy before he’s dead?”
“Ideally.”
Hospitals were now required by law to ask for donation under certain circumstances or lose their Medicare/Medicaid eligibility. Moreover, progress had been made in establishing regional clearinghouses for information about suitable donors, Vogel told us.