Footprints

I planned to write a blog at least once a week and then I went back to work. What a whirlwind that has been! I was given six weeks of leave, but felt fine after four weeks and returned to work then. While I felt fine, I did tire more easily and found myself going to bed early. Then the days got back to normal and I just ran out of time to blog. But I am back.

It has been six full weeks now since my surgery and I feel great. I do not feel like I ever had surgery. I said to a physician in the hall yesterday that it just didn't seem right that it was so easy. She said, "you didn't suffer enough." That's right. I thought I would have suffered at least little. Don't get me wrong, I am happy and grateful that it was so effortless.

On my last day at the beach before I returned to work, I got up early to take one last walk on the beach. If you get out early enough, you feel you have the whole world to yourself. The Gulf is usually calm with the waves lapping in a slow steady rhythm. The water is a beautiful shade of green that is only seen in nature. Since I was nearing the end of my official recovery period, I was feeling particularly philosophical.

I am strong now, so it was a nice long walk. I thought about the experience I had just been through and how it had impacted me. I felt very joyful having finally done something I had wanted to do for so long.

When I turned to head back, I could clearly see my own footprints in the sand. I stopped to watch the inevitable process I knew was coming. My recent steps were distinct. When the first wave hit, I could still see them clearly, but they were fading. The next wave left them faintly visible. By the time the third wave washed over my footprints, they were erased from all memory.

As I walked toward home, I thought about the impressions we make in life. We have an opportunity to make a clear and distinct imprint on the people we come in direct contact with - our siblings, friends, neighbors, co-workers. The next generation of relationships is like my footprints after the first wave - we make an impression but it is not as deep. By the time we are three degrees removed, we are a faded memory at best.

The first time I saw the Tibetan Buddhist monks painstakingly make an intricate colored sand mandala only to watch them sweep it into an urn and pour it into a flowing stream, I did not understand their lesson of impermanence. My walk on the beach that last day reminded me of that lesson.

We do not live forever. So the mark we leave is not in things, but rather in the deeds we do and the lives we touch. And for most of us even our best will be unknown or unseen in three generations removed. So maybe our intention should be to do the best we can anyway with those we touch directly. Maybe they will then "pay it forward" with kind words and deeds to those they touch. We can start a wave of words and deeds that will ripple far beyond our touch. Maybe then our footprints will make a deeper and longer imprint in the world.

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.

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.

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!

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.

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.