WHITBY FREE PRESS, TUESDAY, DEC. 30, 1986 PAGE 5 I have sworn upon the altar of God eternal hostility against every form of tyranny over the mind of man." - Thomas Jefferson Advise and Dissent OF DEATH... AND LIFE... AND TRANSPLANTS New Year's is an appropriate time to talk of endings and new beginnings. For one Whitby family, this week marks the first anniversary of an abrupt and tragic death - and for several total strangers scattered across the province, the an- niversary of a new beginning. In the' wee hours of the morning of Dec. 28, 1985, Greg Boyer was playing hockey with some of his buddies at Iroquois Arena. He collapsed and was rushed to Dr. J.O. Ruddy Hospital and then to St. Michael's in Toronto where he was pronounced brain dead. Within hours, his death had given new life and hope to others through the donation of his heart, kidneys, eyes and bone to other patients. At the time, I was chief technologist of the laboratory at J.O. Ruddy Hospital, and I was summoned to the hospital on that cold December night at 2 o'clock in the morning to play my small part in the ensuing drama. Hospital workers tend to become hardened to suffering and death but on those occasions when the vic- tim is a young person in the prime of life, a pervasive chill reminds everybody of the fragility and fleetingness of life. Greg's breathing had stopped yet his heart pulsed on. X-rays and blood tests revealed nothing out of the ordinary. Since the hospital lacks sophisticated neurological facilities, he was hooked to a respirator and transferred to Toronto. His parents, Wendy and Rick, followed by car. At St. Mike's, they were met by neurologist Dr. Chris Wallace who told them that Greg had suffered a spon- taneous cerebral hemorrhage - a time bomb waiting to go off. He was brain dead - would they consent to the transplant of his organs to other patients? À Death and brain death are the same thing. They are the irreversible cessation «all brain function. In the absence of modern resuscitation equipment, brething woùld cease and the heart would stop as soon as it ran out of oxygen; lìbwever; the concept of brain death recognizes that a body can now be kept fun- dtioning mechanically for many hours. This time is used by transplant teams to match the organs and prepare the recipients.Y ,The moment when grieving relatives have just been informed of the death of a loved one is a very awkward one at best and asking in the same breath for the donation of organs may seem callous and indiscreet - yet if others are to live, it must be done and the procedures cannot wait for the sensitivities to soften - the organs deteriorate too rapidly. Al too often, the question is not asked and the suffering of those waiting for organs goes on. Robert Smith, transplant coor- dinator for MORE (Multiple Organ Retrieval and Exchange), a clearing agency for organ donation and matching, told me that less than half of the families of potential donors are.ever asked. He added that many relatives have expressed resentment tliat they were not given the opportunity to turn a tragic death into a positive contribution to someone else's health. Fortunately, Greg; who liked motorcycles, and his mother, who worried about him, had discussed organ donation only weeks before. His parents agreed to donate his organs without hesitation. They were also asked by MORE if the operations could be filmed for broadcast by the CBC on the Journal - they agreed. The donation of organs is intended to be anonymous, indeed MORE is specifically prohibited from revealing names of donors and recipients; never- theless, members of the media put the pieces together and within hours, the Boyers' private grief became public. At the time, Wendy Boyer resented this in- trusion, but in retrospect, she has no regrets. Greg's death and the publicity that surrounded the transplant of his heart to an Ottawa youth has given Wendy's life a new purpose - she has become an active spokesman for organ donation and is called on regularly by MORE and others to tell the transplant story from the grieving relatives' point of view. * The success of organ transplants over the last five years is in sharp contrast to the early years. - After an initial bandwagon rush to do heart transplants following Dr. Christian Barnard's pioneering 1967 operation in South Africa, reality reasserted itself as it became clear that virtually all of these hearts were èejected and death was usually postponed for only a few months. Kidney tran- splants continued but their success was dependent on very close matches and asually the organ came from a (living) blood relative. Indeed many kidney patients were considered better off on dialysis than risking a kidney transplant. Eowever, these pioneering efforts focused attention on the need for new drugs to nhibit the body's defenses. Such drugs were developed by the early 80's and lave made transplants the treatment of choice for many chronic conditions. )nly about 20 percent of transplanted organs are now rejected and tranplants vlch are not particularly good matcare nre now attempted. Greg Boyer's heart vas not considered a good tissue match to Jean-Pierre Guidon, the youth who 'eceived it, yet it bas been successful. New drugs bave also opened the way to ew procedures - lung and liver transplants are nowattempted with reasonable uccess where previously rejection and death were inevitable. The drug that has mad e big difference in eart transplants is cyclosporin. >atients remain on this medication for the rest of their lives, but apart from Ibis convenience and some minor side effects that require regular monitoring a atient can expect to lead a normal life. Robert Smith of MORE told me tha't a eart transplant patient who survives the first few months without rejection cn w expect a near normal life expectancy. Now that most of the technical problems of transplantation have been solved îe problem of supply remains. Tragic deathis occur daily le which organs are p pst. In most cases, the fault lies with medical practitioners wlio bave enoughi dif- culty just informing relatives let alone asking consent to use various parts for e :her patients. In some cases, family members refuse because they feel the dead rsonwould not avewanted it. Wenyou die, the fate of your body lies entirely ith your family and even if you bave signed the donor consent portion of your iver's license, there is no obligation for your reatives to honor it. •s SEE PAGE 18. WITH OUR FEET UP .By Bill Swan, Time: the day òf New Year's Eve. Place: the mayor's office in Beaver, Ont. Since no sane person does business on this day the waiting room is empty. Mayor Johnny Cannuck got to the office today only because Mrs. Cannuck is cleaning house before their annual New Year's Eve party. Hadhe stayed home, he would have ended up with a vacuum cleaner in his hands. So he ends up at the office. And that's how lie meets Gertrude Gerund. The mayor is sitting at his chair building a paper clip chain. In barges -Gertrude, flowered hat and all. She shakes her umbrella, the point pressing hard against Johnny Cannuck's chest. "After all, I voted for you and I expect a little more from you," she says, the point of ber umbrella slipping off the mayor's.slipping chest and ending up two degrees south of his adam's apple. lWell, are you going to do anything about it?" she says. "Do anything," replies the meyor, "about what?" "About what," she replies, Tinally lowering the umbrella. "Isn't that just like a man? About everything, that's what. About...postal service and...and...smoking. There's one thing. What are you going to do about smoking." "If it would help you, I would quit smoking this minute. But I don't smoke." "Sure, sure. Then pass a law making smoking illegal. Shoot people who smoke in elevators and restaurants, the way they do in Toronto." "Madam... whoever you are..." "Gertrude Gerund. Well, the least you could do is remove that ash tray from your waiting room. The one right under the'No Smoking sign. That would be a start." The mayor turned that funny shade of purple behind the ears, the way lie does when his blood pressure goes up. Gertrude continues: "What about hanging? We elected you to bring back hanging and we're still waiting." "Hanging, madam, is a federal matter." "Darned tootin". That's why you should do omething about it. And give us free trade, then. Let's be nice neighbors. If them tourists come up here in July with skis strapped to their cars, then let's turn on the snow-making machines." "Agood idea..." "And jail all those feminists for running around getting all abortions and telling everybody else they should, too? Why even my daughter is one of those feminists. I told .her the other day, I said, 'You should join a group the way I did,' I said. That's what I did. We really get involved. But my daughter..." . "Your daughter is a feminist?" "A libber. She wants men to change diapers and do dishes ad wants women to get jobs and abor- tions and balance cheque books. If God had wanted us to balance cheque books he would have made us goodinmath." "And you voted for me?" says Johnny Cannuck. "And, we don't expect our politicians to hide behind the constitution. Look at Ronald Reagan. When he wants to get at those Contraltos, he don't let no constitution get in his way." "And you..." "We want.you to bring back traditional values. Back the right-to-life movement. Bring back capital punishment. Tax day care centres. Put the woman back in the home. Make heart at- tacks once again purely a male phenomenon. Bring back male-only beverage rooms. Restore ignoran- ce to its rightful place in the schools. Ban all those dirty books by Margaret Laurence." "I suppose," says the mayor, "that next you'll. want equality for everyone." "Except for those people who want to put all those poor people in condominiums in our neighborhood. Imagine, using our tax money to subsidize people to lower our property values. You'd think anyone would have the sense to keep poverty south of the expressway." With that, Gertrude Gerund looks once at ber watch. "Heavens, I'm late. We're meeting to get Shakespeare banned from schools. Must go." At the doorway she. turns once. "Happy New Year," she says. "The same to you," mumbles the mayor. But he doesn't believe a word of it. 3%