Tuesday, June 30, 2009

A Diversity of Blessings

Within the span of a few days before and since my surgery, I received an overwhelming number of well-wishes - far more than I ever imagined. I have recorded each one of them and will reflect on them over the days of recovery to come. Each wish and blessing will be cherished and there are three that particularly made me pause to think.

A few days before my surgery, two different friends - the transplant follow-up nurse, Sharon, and my doesn't-know-how-pretty-she-is best friend, Judy, both sent me a saying from the Talmud, the Jewish book of teachings. Judy and Sharon have never met, but each spoke of the meaningfulness of the gift I was giving and the quote they both shared was "if you save a single life, it is as if you have saved the whole world." I truly appreciated the sentiment, but felt they were overstating the significance.

The night before surgery I received a number of heartfelt e-mails that helped me fall asleep feeling especially well loved and cared for. One of them came from Nancy. I met Nancy through her brother, Bob, who serves on the Community Mediation board with me. Their father was in the hospital with a terminal illness last year. After my first visit to his room, I fell in love with him. He reminded me so much of my own father and I visited him until we lost him at home a few months later. Nancy sent me a beautiful note that included the Prayer of Saint Francis of Assisi. I have omitted portions, but it goes in part as follows:

Lord, make me an instrument of Thy peace;
where there is hatred, let me sow love; ...
... and where there is sadness, joy.
Grant that I may not so much seek to be consoled as to console;
to be understood, as to understand;
to be loved, as to love;
for it is in giving that we receive ...

Nancy highlighted that last line. I had heard this last line many times in my life, but usually as a child when you grudgingly gave a gift you really wanted to keep for yourself.

The first morning after surgery that I woke up at home in my own bed, the reality of it all hit me for the first time. I lay there and thought, "They actually took my kidney out of my body and it lives in another human being now. And I feel perfectly normal just like waking up any other day." It felt other-worldly. I don't know that I have the words to describe it but I will never forget it. A little while later I reached for my blackberry and saw that an overnight email had come from my friend, Hamed, in the United Arab Emirates. Hamed told me that he and his family were talking about my experience and discussing organ donation as a family. That made me feel so wonderful. Then he too went on to talk about my gift and shared with me a saying from the Prophet Mohammad - "You will not believe before or until you wish for your fellow human being and neighbor what you wish for yourself."

I am so fortunate (dare I say blessed?) to have such a wonderful diversity of friends who care enough to share their blessings with me. But I was mostly struck by the fact that these three different religious traditions all hold as basic tenents the importance of giving to others and treating others as we treat ourselves. I am sure that my sister, Sarah, who teaches world religions could give me teachings from the other great religious traditions that are along the same thought.

We have heard all our lives - it is better to give than to receive. I think we all understand this saying intellectually and try to practice it, but do we really believe it? Well, I can tell you beyond a shadow of a doubt that it is true.

I don't know that I have saved the world as the Talmud suggests or have given my fellow being what I wished for myself as the Prophet Mohammad said but I can tell you that I have received back in a few short days far more than my kidney could ever have been worth. As Saint Francis said it is through this giving that I have been the one who has received immeasurable blessings. Thank you to everyone who has reached out to me in so many ways so far during this journey.

Friday, June 26, 2009

Guest Blog: The Gift of Life

Guest Blogger: Jessica Traskey, previous Johns Hopkins patient & a networking colleague of Pamela Paulk

There are few incidents in life which can give you instantaneous goosebumps.

Pamela is a member of the board for a nonprofit at which I work in Baltimore. She has served for a number of years and it was not until awhile ago that I stopped her after one of our meetings. I wanted to let her know how happy I was with the excellent care and fast treatment I was getting from doctors at Johns Hopkins.
I have had a kidney transplant.

I will not forget the brief exchange that we had at that time. I explained my situation and history, Pamela appeared in awe, and immediately said something along the lines of, “Well should you ever need another let me know.” There was something in her delivery of that sentence that I believed.

Time moved on, and at a board meeting in September last year, she beckoned me to a corner of the room and said, “I have some news to tell you.” Then she announced with a light in her eye that she had made the decision to donate one of her kidneys and that the process was in the works.

Her telling me this gave me the instant goosebumps and, amazing even myself, I was filled with tears. I felt completely overwhelmed, in a positive way. It reminded me of the life-changing changes that someone was about to experience. It reminded me that for someone an end was coming to many complications. It reminded me of the second opportunity of life that someone was to be given.

Jessica's Story
We can survive on one kidney. I do, and have been surviving on a transplanted kidney for 24 years. Yes, I as a recipient take medication daily, and suffer some minor hurdles now – which are closely monitored – mainly due to the two decades of taking the immune suppressant (anti-rejection) drugs. Yet I will be first to holler from the rooftops that life now compared to pre-transplant days is so much better, and at last leaps and bounds away from the illness and weakness that preceded the life-changing surgery.

The Diagnosis

I was two and a half when I first showed signs of repetitive illness, which largely came in the form of excruciating bladder infections. There were years of appointments and visits to and from local hospitals in southwest England, which was home. And, it wasn’t until a family visit to Baltimore in 1981 to spend an Easter holiday with my father's family that I was struck with an infection again. As always, they would hit in the middle of the night, and my parents and brother became all too familiar with the cries of pain that would wake them.

I was taken to Hopkins Hospital. Over a two-week in-patient stay the hospital did every possible test under the sun. The Hopkins doctors did not know me, my history or my insides from Adam, and under the superb care of a Dr. Robert Jeffs (who died in the last year) the picture was clear to him and his team. There was no doubt about it; my kidneys would indeed fail in time and I would need a kidney transplant. There was a double whammy, though: my bladder was causing dramatic reflux and infection, and so would need reconstructive work before I could receive a transplant.

On my return to England I was sent to Guy’s Hospital in London, a high flying city (training) hospital, which seemed leagues ahead of the rural town hospitals that we had been used to nearer home in Dorset. I had excellent pediatric care at Guy’s. In time I was under the care of a urologist, Tony Mundy. He made clear what he wanted to do, and that I would be the first pediatric patient in Europe to have this particular bladder reconstruction, to which a transplanted kidney could be hooked up at a later date. In 1984, my bladder was partially reconstructed from part of my cecum. I was 12 years old. The recovery was long and there was the added difficulty of having to learn to catheterize.

It was in February 1985 that my kidneys finally packed up and I was put on hemodialysis. My mother and I had to live in London five days a week, while my father and brother remained in Dorset – two and a half hours away by train. It was an awful strain all round, although I am sure that (at 12) I was oblivious to their own dealings with the situation.

Brother & Sister

A kidney became available for me in August 1985. I had gone on a ‘Dialysis Holiday’ with the pediatric unit, my parents had been ‘sent away’ for a break of their own and were in France, and I think my brother was staying with friends.

There were 12 of us dialysis children on the holiday with a number of nurses. We were in a caravan park on the Kent coast, and would get the train up to London every other evening for dialysis through the night before, and returning to the park the following morning to get back to our fun fair, beach, and crazy golf-filled holiday.

Over the first few days I think four children were called back to London for kidneys. It was an unreal thing because I just remember that we, as children, were elated for our fellow dialysis buddies. They were being called back to Guy's to get their kidneys. A couple more days passed, and another two were called. By then the rest of us were wondering, “Who’ll be next?”

Then within a few hours a boy called James and I were called – matches had been found. It was an extraordinary time, and even the nurses and doctors were amazed by the sudden availability of donor kidneys that month. It was unusual and rare. James and I were accompanied back to London on the train by a nurse, my parents were called back from France, and James and I were reunited with our parents prior to the surgery due the following morning.

Much is a blur, yet some memories are as fresh as yesterday. James and I became ”kidney” brother and sister. We both had a kidney from the same cadaver - in the 1980s receiving a kidney from a live donor was, I think, very rare - and through surgery and recovery we were toe to toe in ICU rooms; our bond seemed destined to last forever. But it was a tough few weeks following. My kidney needed a jump start with some dialysis, and I was still getting bladder infections. James, who had other complications, unfortunately died of septicemia. It was an awful time, and very scary for a 12-year-old.

New Life

I am a kidney transplant patient. I was fortunate to receive a kidney. The donor was a young man, — a son, a brother, a grandchild — who was killed in a motorcycle accident. His family made the decision to donate so that I and others could live. I owe it to that family to look after this kidney for as long and as best I can.

To receive a live donation is also a staggering privilege and honor. That someone makes the decision to give a part of themselves so that another can be free of debilitating illness, a life led by machines, and separation from family and friends, is an almost incomprehensible gift.

Now, nearly 24 years on, I’m living in the U.S. and leading a productive life, thanks to that gift and to the doctors at Hopkins and elsewhere who monitor my progress.

The Gift of Life

Pamela’s decision and her journey really begins this week. She will be giving someone a second chance at life, and that person will have the very special honor of saying that they know their donor. Above all, may others understand and be inspired by this extraordinary, selfless gift of life.

Thursday, June 25, 2009

TMI - Too Much Information

I have worked my whole career in and around hospitals and doctors. We administrators joke affectionately about how nurses talk about bodily functions like we talk about spreadsheets. Very matter-of-factly, no sugar-coating.

Early the first morning (Tuesday, Donate Day +1) the transplant fellow checked my dressings and then she listened for bowel sounds. Hmmm? I wonder why she cares about my bowels? She knows they took my kidney, right?

After breakfast, I took a lap around the unit and came back to sit in a chair. The nurse came in and said I was looking good and then "Are you passing any gas yet?" Passing gas? I sound like a motor boat. It was so embarrassing. I asked Mack to talk real loudly when I had visitors so I could time my "episodes" to coincide with his talking. If I looked in pain, it wasn't pain - rather it was his queue to say something - anything. And say it now! I proudly reported my progress to the nurse. From her pleased expression, I knew I had passed the test - no pun intended.

Early the second morning (Wednesday, D+2) the fellow visited me again, removed the dressings and I saw my amazingly tiny incisions for the first time. As she again listened to my bowels, she said, "Have you had a bowel movement yet?" Wait a minute. Are you upping the ante? You didn't tell me I had to do that! I haven't eaten solid food since Saturday! I think my exact words were, "It ain't happening." I think I begged her to not make that a prerequisite of discharge. She said, "Well, we'll see how you do today." I was left unsure if I had to pass this new test before discharge.

Shortly after shift change, my new nurse came in and boldly asked, "Have you had a bowel movement yet?" OK enough already! What's up with the bowel movement?

She patiently explained that anesthesia slows your bowel functions and sometimes it takes a while for them to "wake" back up. They want to make sure everything is working again before I go home. She explained that getting constipated could be a very bad thing. Hello! You don't have to tell me that twice. I have four incisions in my belly.

When Mack and my sweetest best friend, Vicki, started texting each other about my "number 2" I knew it was time to take action. I asked for a peanut butter and jelly sandwich (purely psychological) and walked up and down the hallway several times. Late in the afternoon, I asked Mack to guard the door and say I was napping if anyone came to visit. I emerged a little while later and gave my nurse two thumbs up. Shortly after that I was on my way home. I guess I had successfully passed all their discharge criteria.

Thanks to the great transplant fellow and all the staff on Marburg 2. You made my stay very easy and pleasant despite the requirement to provide waaaay too much information about my bodily functions. Want to see a really cool spreadsheet?

Wednesday, June 24, 2009

Milk of Amnesia

There is a drug that anesthesiologists can give you that makes you forget all the unpleasant activity around the surgery. You are awake and able to respond and cooperate, but you don't remember a thing. If you have had it, it is pretty cool. It is a white, milky fluid and one of my wonderful doctor friends, Connie, told me they like to call it Milk of Amnesia.

The last thing I remember was the nurses unlocking the wheels on my stretcher and saying, "Here we go to the OR." According to Merrie, I was wide awake just talking up a storm. I like to talk. I apparently moved myself from the stretcher to the operating table and cooperated with all their instructions while bombarding them with questions of my own. Happily, I don't remember a thing!

The next thing I remember is a vague recollection of people coming and going from the recovery room. To me, only a second had passed, but it was really about 4 hours, I think. I have visions of Mack and Chris and Gail and Carol. I think I remember Greg and Pickle, too. My best doctor friend, Kristy, stood at the foot of my bed for a long time and then said, "She won't remember any of this. I'll be back in a little while."

I had no pain and no nausea (thanks Anethesiology, Merrie and Jeff). All I wanted to do was sleep a little longer.

Finally, I was ready to go to my room. I had two lovely ladies transporting me. When we got to the elevators I asked them if Robert was in surgery yet. They said his surgery was a little delayed and he was still sitting in the pre-op area. When I asked if I could see him, they did a quick u-turn and headed back. Everyone along the way just stared at us with quizzical looks wondering why we were coming back.

They pushed my stretcher in to the room where he was and I met his wife for the first time. He looked so happy. I think he was relieved to see me safe and well. We had a brief chat and I could feel how eager he was to see this day finally come.

I would not have traded that u-turn for anything. I am also glad that the Milk of Amnesia had worn off so that I can hold that memory forever.

Sunday, June 21, 2009

Monday, Monday ...

In about eight hours I am having a nephrectomy. I am voluntarily having my kidney removed to donate to someone else.

WHAT!? They are going to poke holes in my belly, blow it up with air and pull my kidney out through a little slit. I MUST BE INSANE!! WHAT WAS I THINKING??

Last week my old best friend, Mindi, and I went to dinner. I told her that I didn't understand why everyone was making such a big deal. It couldn't be worse than a hysterectomy or a C-section. My kidney is only about the size of my fist and that is much smaller than a baby. Mindi, in her dry way, said, "And just when have you had a hysterectomy or a baby?" I admitted that I had had neither. So she said, "So, Pamela, you have no idea what you are talking about."

My mother used to say that all the Paulk kids had the unique ability to speak with great authority about subjects we know absolutely nothing about. Well, except my older brother, Keith, who actually does know something about everything. We have yet to stump him.

Mindi is right. I don't know what donating a kidney is like, but the staff have done a great of preparing me. I go in tomorrow morning at 5:30 a.m. My brother, Mack, my nephew, Chris and two of my best friends, Gail (new best friend) and Carol (best friend from work) will be there. They will sit watch in the waiting room for the next several hours.

Merrie from Anesthesiology kindly called me yesterday to talk about anesthesia. When I explained that I am claustrophobic, she said she would make sure I was warm and comfortable and that nothing would be put over my face until I was asleep. That was incredibly reassuring. She even said she could put me to sleep in a comfortable sitting position. She did warn me that my side would get stretched a lot with my arm over my head, so not to be alarmed. Hooray, mentor Kathy, for encouraging me to stretch.

I will wake up about four hours later that will feel like two seconds with one less kidney. I will stay in the hospital for a couple days and go home to recuperate. My recovery will take 4 - 6 weeks. I measure full recovery when I can get back to the gym and my pilates and yoga classes. They say a full six weeks before I am allowed to do that. I have a wonderful support system of family and friends who have volunteered to check on me, walk with me and feed me.

Thanks to everyone for all their notes and words of support. It has already been an extraordinary journey and it really hasn't even started yet.

I am ready for tomorrow - Monday.

Saturday, June 20, 2009

I Know She Needed Fish

We lost our Dad early. I am the fourth of six kids and I was 17 when Dad died at the age of 56 - heart disease. Before he got sick he was full of energy and loved life. He and Mom loved nothing more than their six kids and he shamelessly bragged about us to anyone who would listen. But their love for fishing was a close second. We ate what they caught.

They went fishing every chance they got and if Mom couldn't go, one of us kids would go along with Dad. I did my share of fishing, but my younger brother, David, loved it the most and he and Dad spent many hours fishing together. David has Dad's same joie de vivre and when he walks into a room the volume goes up and people smile. David shared a story with me a few years ago that stuck with me.

He and Dad had been fishing when David was probably 9 or 10 and had a good catch (probably bass or brem). Dad drove a 1969 Volkswagen automatic stickshift - I learned to drive in that car. On the way home, Dad pulled off the road in front of a very modest house. Hearing a car drive up, a woman walk out on the porch. Dad yelled, "Get a pan. I've got some fish for you." She said, "I can't pay you for them." "No, I don't want money. I'm giving them to you. We caught more than we can eat."

When Dad returned to the car David said, "Dad, how do you know that woman?" He replied, "I don't, son, but I know she needed fish."

If you don't believe in legacy, here is the rest of the story. Years later, David pulled up to a modest house on the way home from fishing and gave an elderly woman some fish. She said, "You know, years ago a man in a Volkswagon used to stop every now and then and give me fish. I remember that there always a young boy with him." David's answer, "I was that boy."

People ask me why I would give my kidney to someone I am not related to. I just don't have a good answer. I just know he needed a kidney.

Though he has been gone 38 years next week, rarely a day goes by that I am not reminded of him in some way. He never knew me as an adult, but I hope he would be proud of the woman I have become.

Happy Father's Day. I wish you were here.

Friday, June 19, 2009

Starting the Conversation

As I walked across the Nelson-Phipps bridge this morning I could see a coworker and her son walking into the hospital entrance. I have worked with her for 9 years and have known her son since he was in elementary school. He is now taking college classes and works full-time here as well. He is a handsome young man with a beautiful spirit just like his mom.

She and I arrive on our floor at about the same time. She said, "Hey, funny to run into you. We were just talking about you. On the drive in this morning, my son said that he had read your blog last night and he asked me, 'Mom, could you do that? Could you give someone your kidney?'"

I don't know how the conversation ended, but I know that it started. Here is a young man who likely never would have had a conversation with this mother or anyone about organ donation. Now he has thought about it - thought about it enough to raise the question with his mother. A seed has been planted. Organ donation is now something real to him. That can never be erased.

It would be great if all families had this conversation. Signing your donor card and having it designated on your license is the first step. But make sure your loved ones know your wishes firsthand. If a tragedy strikes and your organs are available, even if you have that little heart on your driver's licence, the hospital will consider the wishes of your family. At their time of lose, this may be a painful decision. If you have told them your wishes, then just maybe they can find some comfort that your wish was to help someone else.

Later today, someone pulled out their wallet, pointed to the heart on their driver's license and asked me, "This does mean that if something happens to me, they will use my organs, right?" I said, "It tells the healthcare providers that that is your wish. Please go home tonight and tell your family so that they know it, too."

It may be an awkward conversation at first and I am not sure how to start it, but please start the conversation somewhere, anywhere. And please sign a donor card if you have not already.

Thursday, June 18, 2009

My Inspiration

Is it a coincidence that I want to be a donor and I have two friends who have kidney transplants? Probably not. More than likely their friendship planted the seed in my mind without me or them even knowing that the seed was being planted.

My old best friend - I also have a new best friend, a best friend at work, a best friend at the gym, a best guy friend - you get the idea. Anyway, my old best friend moved to Baltimore a few years ago with her husband and they called to get a recommendation for new doctors. Specifically, he needed a nephrologist. That was when I learned he had a transplant. He had a rare condition as a child that caused both kidneys to stop functioning. Luckily, both his parents were a match and at the age of 21, he received his dad's kidney. You would never know that he has a transplant. Hmmmm... people with transplants look and act just like people without transplants.

I am on the board of a local non-profit that works on policy, legislation and programs to help remove barriers for lower wage and lower skill workers to open avenues for them to get and keep jobs with good pay and benefits. (I am doing them a great disservice by not explaining further, but it is Donate Day - 4 and I can only write so much.) I became close with one of the staff. I am not sure when, but somewhere along the way she told me that she had a kidney transplant. I never asked her the details, but I know that she received a cadaveric kidney when she was only 12 years old.

He is 43 and she is 36 now. They both have transplants that are over 20 years old. Without these kidneys, they would have died tragically young.

They are my inspiration. Whenever I get the least bit uneasy, I think of them. I felt the need to reach out to both of them this week when I needed a little dose of reassurance. They are the living proof that kidney donation gives back life. I value them in my life and know my life and others' lives would be less complete without them in it.

Everyone Needs a Mentor

Shortly after I volunteered to be a donor, the Transplant Office at Hopkins asked me if I wanted a mentor. I know and promote the value of mentoring in career development, so it sounded like a great idea. The coordinator said they would try to connect me with someone who I could relate to. Well, they weren't kidding!

In a few days they called me and gave me her number. They said she was about my age and had donated her kidney to her husband 3 - 4 years ago. The following Sunday I called the number they gave me....

"Hi, this is Pamela, Hopkins Transplant Office gave me your number as my mentor. I am considering donating a kidney and was wondering if we could talk."

In a loud, distant voice I hear. "Oh, Hi! I was expecting your call! But I am in Snow Mass! Right now I am at the top of the run about to come down! Can I call you when I get to the bottom!?"

The coordinator had hit a home run. Here was a woman full of life who had just donated a kidney. Her response was better than any brochure I could read.

We did talk when she got back to the lodge. She gave me some great practical advice including to do as much side stretching as possible before the surgery. She said she did not know why but her mentor (her uncle if my recollection is correct) had warned her that you would be very sore because your arm is over your head for most of the operation. She said she had not stretched as much as she should have and was definitely sore.

She said to walk as much as I can after the surgery even if it is only around my apartment. In a week, she could walk a block. She reminded that for the first few weeks I would have good and bad days and not to get discouraged. She emphasized over and over that my life would not be harmed in the least after the recovery period. And she is living proof of that.

I called her again last night to tell her I had a date scheduled for this Monday. First thing she said was, "Have you been stretching." I have! I got lots of encouragement and support and repeated cautions about following doctors orders to rest from her. Hmmmm....I wonder why she thinks that would be a problem for me?

I am learning that the donor/recipient community is larger than I expected. As I talk about it publically I hear of more and more people in my own extended circle who have given or gotten kidneys. I also hear too often of people who are waiting for a kidney or of people who have died waiting.

Thank you to my mentor for her encouragement. I need to go stretch now!

Tuesday, June 16, 2009

My Co-Worker Needs a Kidney

Robert reminded me today that we first met in 1996 or 1997 when I was a consultant working in his department. I was managing a re-engineering project at the time and I doubt that the workers there were particularly happy to see me. (If it were relevant, I would explain that it was not really re-engineering, but that is the easiest way to describe it that most will understand.)

But I really got to know Robert in 2000 when I negotiated my first union contract at the Hospital. I came to Johns Hopkins in 1998 as an employee and moved into the Vice President role in 2000. One month after I was officially appointed to that job, our bargaining union contract expired. I led the Hospital’s negotiation team and Robert was one of the union delegates who “sat across the table” as they say. I remember him being strong, persistent and representing the needs of his fellow union members well. I developed a great respect for him.

After the negotiations were over, I learned that he was also on our employee recognition committee and served as the photographer at all our employee events. In that role, I got to know him even better. He even was the photographer at my assistant’s wedding. On one of my work-days, I shadowed him and we painted a patient room together. That day, he went out of his way to make me feel welcome and to introduce me to as many of his co-workers as possible. I was impressed at how well liked he seemed to be and how many people he knew by name. He is a very quiet, hard-working person. He is liked by everyone – seriously, I don’t know anyone who has ever spoken ill of him.

About two years ago, I didn’t see Robert for a long while. When I did finally run into him in the hallway outside my office, I mentioned that I had missed seeing him around the hospital. He told me that he had been ill. The way I remember the rest of the conversation is that I asked if there was anything I could do. He jokingly said something to the effect of “Only if you have a kidney.” I told him that I happened to have an extra one and that he could have mine. In retrospect, I don’t think he believed me. (I asked him today if he believed me that first day. He said, "Well, I didn't not believe you." Ever the diplomat!)

I went straight to the transplant office and told them I had found my recipient.

Note: Robert gave me his permission to share this part of the story. He even jogged my memory about when we first met. It is important to me not to violate his privacy without his support and in the healthcare world we would not violate the privacy of a patient.

Monday, June 15, 2009

Getting Approved to be a Donor

I knew that being approved as a kidney donor would be a lengthy and detailed process of medical examination, but I was completely wrong about the reason for the scrutiny.

I work in the medical field. For thirty years, I have been in and around hospitals. But as I went through this process, I began to realize how naive I was. I thought the tests to approve me as a donor were to determine if I had a kidney healthy enough to be of value to a recipient. I worried that I was too old and no one would want a 55 year old kidney. Would my kidney be big enough? I could be described as petite.

So I first met with the Social Worker. I am a Social Worker so that was comfortable for me. She asked about my emotional makeup and living arrangements. She seemed to be determining if I had the resources and support to aide me through the surgery and recovery. I met with the Psychologist next who I assume was making sure I wasn't a wacko. Just kidding. He seemed to be determining that I was stable and was not being coerced in anyway. There also was an ethical issue to consider in my case. My designated recipient was a co-worker. Was there anything I might gain from giving my kidney to this person? For example, if the recipient were my supervisor, I might think by giving my kidney, I could get better hours or raises, etc. But since, I hold a higher position in the organization than my recipient, I have nothing tangible to gain.

I actually found these interviews helpful and not at all intrusive. It was really the first time I had talked about donation in detail. By talking about it, I was able to clarify for myself my concerns and motivations.

Then the medical tests started. Twenty-four hour creatinine - every drop of urine for 24 hours has to be collect in a jug and refrigerated. That was gross. There was lots and lots of bloodwork, but our phlebotomists are the greatest. I had a CT scan with contrast of the abdomen to get a clear look at my kidneys. Two interesting things happened with the CT. The technician had my same birthday (though years younger) and his first and last name where my younger and older brothers' first names. I love discoverying silly connections like that and I will not forget him. And, my left kidney has two arteries. That is not so unusual, but most kidneys only have one artery enering it. If my recipient has only one artery, then my two arteries will have to be joined into one so that it can be sewn to the recipient's one artery.

The most challenging test was the cardiac stress test with an echocardiogram. I hate doing cardio exercises in the gym so I was afraid I would not do well. I had never had an exercise stress test, so I didn't completely know what to expect. I knew I would walk on a treadmill but that was about it. Yes, you walk on a treadmill, but at certain timed intervals, I think it was every 3 minutes, they not only increased the speed, but they also increased the incline. You start off nice and slow and flat. After about 12 minutes you are running up a steep hill!! When you absolutely can't go anymore, you jump off the treadmill and roll onto the exam table on your side as fast as you can so that they can get an echo image while your heart is at its most stressed. Oh my gosh, it was stressful and I'm glad there are no video cameras. I guess I passed.

Once all the tests were complete, I met with Dr. Hamid Rabb to go through the results. That is when my eyes were opened. His job was to look at my current health, the health of my parents and siblings, my lifestyle and my tests. Then to look into a crystal ball and predict my future. Was there any reason to think that my remaining kidney would fail? Was there any reason to believe that my health would deteriorate and place stress on my remaining kidney? Would I develop hypertension or diabetes?

Dr. Rabb said, "My job is to make sure we end up with two healthy people. The worst thing would be if you, the donor, went from healthy to unhealthy." At that moment, I was blown away. All this was not just to make sure I had a healthy kidney to give to someone, but to make sure that I would remain healthy. No matter how badly someone needs a kidney and how willing someone is to give them theirs, they will not jeopardize the donor's health.

I was ready.

Am I Nervous?

Everyone keeps asking me if I am nervous. I am not – at least not yet. I have been going through a weird process of putting my life in order. I feel like I have to have everything organized and complete just in case ... I really do think that everything will be fine, but I like to think that I live with no regrets. A surprising inner calm has come over me since I got the date; although you would not know it if you were around me manically trying to get things done before D-Day – Donate-Day, June 22.

I was approved for donation a couple of months ago. It was a very extensive process and I was very happy to be deemed healthy enough to donate. They asked me when I would like to have the surgery. That seemed strange to me - that I got to give the time of donation - within a range, of course. They said that the donor had a lot of say in what happened next. So I told them my preference was to do it over the summer because I teach at Johns Hopkins University in the spring and fall and wanted to sandwich this in between my classes.

As the days passed, I began to think that it was not going to happen this summer. And then, out of the blue, they called and asked if I was free on June 22. I did not even look at my calendar. I knew I would make myself available.

So suddenly I had a month to prepare to take off from a demanding job for up to six weeks and to arrange for someone to come and stay with me. Oh, did I say that I had my kitchen gutted a week before the call I was so sure the surgery would not happen?

But with all the activity, an inner peace has come over me. I am not sure where the calm is coming from. This certainly isn’t a calm event. Maybe it is because I am at peace with this decision. I hold the ability to save another's life or at least restore some of their health. The miracle of medicine. I don’t see how I could not do it.

Oh, just to prove that I am not just in denial - I had some tests run today and my blood pressure was 127/76 and my heart rate was 58. So biometrics support my sense of calm!

Why I Am Donating A Kidney

In about a week, I am donating my kidney. It will be transplanted into a complete stranger, but in doing so, one of my co-workers will get a kidney as well. There was not a single event that brought me to this decision, but rather it was more like a journey - a journey that began 10 years ago in a Fell's Point bar with a phone number on a napkin.

I am the vice president of Human Resources at The Johns Hopkins Hospital and Johns Hopkins Health System. It is an extraordinary place in the heart of Baltimore. My job brings me in contact with many of the over 9000 people who work at the hospital. So I was in a position to hear about one specific employee's need.

How Did I Make This Decision

About 10 years ago, ABC did a documentary called Hopkins 24/7. I was invited to the wrap party and started a conversation with one of the physicians featured in the series. The physician was Bob Montgomery, Director of our transplant programs. I told Bob that I had spent time in the operating rooms and would love to see a transplant. He took a napkin from the bar and wrote down his beeper number. He said that most Tuesdays they did a live donor transplant and I could come and watch. (Observers are discourage in the ORs, but at that time, it was allowed). He said I could beep him when I found a free Tuesday and he would arrange it. So the week between Christmas and New Years that year I beeped him and was able to watch this extraordinary procedure.

I remember that day in great detail. I literally cried when I saw the transplanted kidney "pee" for the first time. I was even more impressed when I passed the recovery room and the donor was already sitting up talking while Bob was still closing the recipient. I still remember asking how the donor was related and hearing them say that he was a friend of the recipient. I always thought of donors as being a family member.

It made a big impression on me that a friend would give his kidney.

A few years later, I was asked to be the speaker at a minority donors' celebration. In order to write my remarks, I had to do some research. For the first time, I learned about the extreme need for kidney transplants and the lack of donors. So I mentioned to Bob that I might be interested in being a donor. He said that I would make a good altruistic donor. An altruistic donor is one who gives their kidney to anyone who needs it without designating anyone as their recipient. Altruistic donors give in the purest way imaginable.

I thought about it, but decided that I wasn't ready for that. It was important to me to have some connection to the person to whom I was donating. So I began to wait and wait and wait. I am not sure how I thought I was going to find someone who wanted my kidney. Maybe I wasn't truly ready yet.