Joy Comes In The Morning

This has been an incredible summer at work-- I feel like I hear of a new heart transplant recipient every other week. Because I see heart failure patients, I am used to seeing the same patients over and over again... as their hearts get worse, they need hospitalization to readjust medications and (temporarily) reverse other organ damage from their ill-equipped heart. In addition to that, new devices have been released that help heart failure patients survive longer on the heart transplant list. Between these exacerbations in their heart failure and the placement of these heart-helper devices, I see these patients and their families relatively frequently. It's one of my favorite parts of my area of medicine-- I love that there is the potential for me to see patients go through their whole heart failure course, and come out healthier.
That's what Ms. X is to me. She came into the hospital because her heart stopped suddenly. The rescue squad was able to revive her, and in her stay at the hospital she received a pacemaker with a built-in defibrillator (in case her heart stopped again). That was the first heart issue she'd ever had-- completely out of the blue! And she got her money's worth of that defibrillator-- hospitalization #2 was because of multiple shocks from her implanted defibrillator. So many shocks, in fact, that it nearly drained the battery in her pacemaker (the average pacemaker battery lasts YEARS and her lasted maybe 3 months). Her heart kept stopping because it was failing-- the muscle just didn't want to function anymore. She had cycles like this for a while-- she'd get shocked, she'd have medications adjusted or pacemaker settings adjusted, and she'd go home only to be shocked again a while later. Finally her heart wasn't able to maintain this mode, and she needed an artificial heart device to sustain her while she waited for a heart transplant. She had the intense surgery to place the device, recovered in the hospital, and was sent home to wait for a new heart to become available.
That's the language we use-- "wait for a new heart to become available"-- as though we were waiting for the iPad to be restocked at Best Buy. What we really mean is that we're waiting for a relatively healthy person to die in such a way that their heart can be preserved and then be given to Ms. X. We're waiting for a tragedy to enable a miracle.
And it's always a tragedy that makes hearts available. Kidneys and livers and lungs can come from healthy living (consenting) people. Hearts can only come from healthy deceased persons ("healthy deceased"? Even describing the process is difficult...). It can't come from someone who has been ill for a while, so the families have had time to prepare and make arrangements. It comes from a diving accident that destroys the spinal cord, or a motorcycle accident that damages the brain, or a bleeding in the brain that was totally unforeseeable and unable to be remedied. These are the families that are approached for organ donation-- families in the midst of calamity are being approached with an opportunity to offer hope to someone else.

I have recently been focusing on God's faithfulness in my life. I've been taking time to remember the processes that got me to where I am now-- boarding school, nursing school, the unit I work on currently, and how I happened to meet some of my best friends. It's amazing how easy it is for me to be totally ignorant of how God arranged these events in my life. While focusing on God's faithfulness, I heard a sermon called "Praying God's Faithfulness" about Psalm 30. I won't print it all here, but the message is basically about how there are times of trouble, but looking back at when God provided before helps David have hope and confidence in God's presence even in the midst of the present pain. Past (memory), future (confidence) and present (hope).
Psalm 30:5 For his anger lasts only a moment, but his favor lasts a lifetime; weeping may remain for a night, but rejoicing comes in the morning.
That is what we are hoping people will understand when we approach them with organ donation. We hope, for their sakes and for organ recipients, they'll remember that joy comes in the morning.

Ms. X received her new heart this summer. While caring for her one day, I asked how she felt about having a new heart. Most patients feel an ocean of emotions-- fear of organ rejection, anxiety over the intense anti-rejection pill regimen, hope of returning to a semi-normal life... and oftentimes a little bit of guilt over getting someone else's heart. She said she felt selfish praying for a heart transplant because she knew someone had to die in order that she can live. I reminded her her that her heart transplant didn't kill anyone-- it just kept that heart from being buried in a coffin or cremated into dust. The tragedy would have happened anyway, but organ donation gives families an opportunity to see a silver lining in the tragedy. I'm struggling to accurately describe how families report feeling about this... silver lining sounds too simple and almost making them content. Basically, families are given an opportunity to see the disaster as being more than just futile pain-- there can be a purpose after the tragedy that they can take part in. I've seen a family receive news that the patient was unable to be an organ donor (due to other health issues), and it sincerely looked as though they were receiving the stamp of futility on what was an already barely-bearable circumstance.

I love organ donation for many reasons, but seeing hope in the midst of heartbreak is the foundation of my passion. It challenges our culture's selfishness and focus on the present circumstances and asks us to consider others and the future... the look to the morning.