Coronavirus, charity and the trolley problem
September 9, 2020 10:06 AM Subscribe
Stuck without enough facts to make an informed decision, I thought about my dad’s old hospital room in Baltimore, the airlock separating his ward from the rest of the building because any mundane microbe could kill the patients on the other side. I imagined a somber-looking doctor walking through those doors to give my vulnerable recipient the news. “I’m afraid there’s been a change of plans,” he would say, removing his glasses. “It seems your donor is a pussy-ass bitch.” I called Heather back and told her to arrange my donation in Boise.
I am so glad you posted this story. I had never thought I would sign up to a bone marrow donor, but now I am going to look more into the process. I was definitely emotional reading this story, but I also found myself thinking about the questions the author raised - about risks and altruism, and the complicated decisions we are making day by day. I appreciate reading more perspectives as I stumble through the personal and family decisions that seem to pile up by the dozens.
posted by dawg-proud at 10:33 AM on September 9, 2020 [2 favorites]
posted by dawg-proud at 10:33 AM on September 9, 2020 [2 favorites]
Yeah this was really nice and reassuring! I registered about two years ago during a local drive at a mall, but I too thought it would be a scary procedure if I ever matched (worth it, of course, "save a life" is high on my bucket list) and it was nice to learn donations have advanced and are mostly a less complicated procedure nowadays.
posted by Cozybee at 10:46 AM on September 9, 2020
posted by Cozybee at 10:46 AM on September 9, 2020
The author, Sarah Lazarus, is a very good writer. There are lines in there that caused me to bark with laughter, and I teared up in other parts. A really affecting story. I hope her recipient lives on for many years to come.
posted by jacquilynne at 10:53 AM on September 9, 2020 [8 favorites]
posted by jacquilynne at 10:53 AM on September 9, 2020 [8 favorites]
That was very well written and moving. Is her last name a crazy coincidence, or a Nom de Plume? I could easily read books by her, if they're out there. Google reveals lots of Sarah Lazaruses, so I'm not sure where to start.
posted by Devils Rancher at 11:03 AM on September 9, 2020 [1 favorite]
posted by Devils Rancher at 11:03 AM on September 9, 2020 [1 favorite]
This Sarah Lazarus, and holy shirt, she was just in Boise less than two weeks ago.
posted by ivan ivanych samovar at 11:12 AM on September 9, 2020 [2 favorites]
posted by ivan ivanych samovar at 11:12 AM on September 9, 2020 [2 favorites]
Lazarus is a reasonably common Jewish surname, though I don't know whether it's hers.
posted by wellred at 11:13 AM on September 9, 2020
posted by wellred at 11:13 AM on September 9, 2020
I can't sign up to be a bone marrow donor (a history of metastatic cancer gets you booted, for obvious reasons); I'm also on the Red Cross's permanent blacklist for blood donation. So I always feel terrible when donation drives pop up, but I'm thankful for everyone else out there who is able to donate. Whoever saves a life, its as if they saved the world, and she should feel real good heading into the High Holidays--may she and her donee be inscribed in the Book of Life.
posted by damayanti at 11:25 AM on September 9, 2020 [4 favorites]
posted by damayanti at 11:25 AM on September 9, 2020 [4 favorites]
A+, best of the Web. Ty.
posted by j_curiouser at 11:51 AM on September 9, 2020 [3 favorites]
posted by j_curiouser at 11:51 AM on September 9, 2020 [3 favorites]
I donated bone marrow a little over a year ago (last May) and haven't heard anything about the status of my recipient. I opted in to be put in contact with them.
When most people think of donating for a bone marrow transplant, they imagine general anesthesia; a very big needle; a painful recovery. That was my experience. I was told apheresis (the other option available, which is akin to donating plasma) wasn't the best option for my recipient.
I registered over a decade ago and never heard anything aside from the occasional followup email to make sure my contact info was up to date. One day at work I sent a call from an unknown number to voicemail, and when I later checked I found out I was a potential match. So the next day they booked a blood draw for me at a clinic near my office. About 24 hours after that blood draw I was told I'm the best possible match, and was asked again if I'd like to go through with the donation process. I was like "yeah, that's why I registered".
I was told these things normally happen over 60-90 days, but I had my surgery for extraction very soon after this initial contact. There was a quick succession of physicals, blood tests, EKGs, chest X-rays, I'm probably missing things, but I was constantly having to leave work to go to a lab to get a test done. The next day they'd call me and say "how soon can you go to this other lab to have this other thing done?". So I did all the stuff and then they gave me a date that was about 14 days away. They booked a hotel and airfare for me and an assistant (I chose my sister because I didn't want to inconvenience my wife) and they flew us from separate cities to a childrens' hospital.
The next day we checked in for the procedure. Fun fact: adults having bone marrow procedures in childrens' hospitals are treated really well. So I go under anesthesia and woke up with two bandages on my lower back where they extracted 1.6 FUCKING LITERS OF BONE MARROW from my pelvis (how does it even hold that much?). I was really worried about how I'd handle the anesthesia, but I didn't do anything stupid like when I had my wisdom teeth out a couple years prior. We took an Uber back to the hotel, I stayed up and ate horrible sushi and watched a movie. My sister went straight to bed. The next day we checked out, went to the airport, and flew to our respective cities. I was pretty sore in my lower back (felt like I had been kicked pretty hard and also pulled a muscle) but that went away in 3-4 days. I tried (against advice) to resume training (I was training hardcore for an long endurance bike ride at the time) and after about 20 minutes of the easiest pedaling I'd ever done I was completely exhausted. Turns out it's hard for your body to replace all that bone marrow.
I tried to do a ride about a month later and I still felt wiped out. It completely derailed my training plan. It's been over a year now and I'm finally feeling motivated to run/ride again. I'm very out of shape now.
I would love to know how my recipient is doing. I don't know their age or gender, only that they were diagnosed with non-Hodgkin's lymphoma. Would I do it now, during a pandemic? Probably. Without a pandemic? Absolutely. One thing that kept me motivated throughout the process was thinking "what if it was my kid who needs a transplant? How would I tell them we found a match but unfortunately they don't want to inconvenience themselves." Again, this was over a year ago, so well before Covid when all I had to worry about was not waking up from the anesthesia (and this was a couple weeks after there was a well-publicized case of someone dying from anesthesia complications during a donation). So I tried not to think about that, and instead tried to focus on the positive impact my actions would take.
Oh, the weirdest part: about 3-5 days before the procedure I received a call. "Hi! Hope you're doing well. Just calling to let you know that today your recipient is undergoing radiation treatment today to kill all their white blood cells, so they're not going to have an immune system at all. If you back out now, of if you die in an accident, your donor will 100% die a few days later. See ya at the hospital!"
I drove extra carefully after that. I joked for a while that this is my Get Into Heaven card, and for a while I'd say "I bet it's ok if I shoplifted this right now, ya know? Because I saved a life? They'd probably understand." On one hand it's good to know I tried. I did what I could, but that wasn't much. I got on a plane. I stopped eating after midnight, then I passed out and woke up with 2 holes in my back. Big deal. Psychologically what's been getting to me lately is what if my recipient died? I know it's not my fault, but it also means all that was for nothing. And I probably didn't do anything that could have affected the outcome, but what if I did? Could I have done anything differently?
I kinda don't want to know now.
posted by spikeleemajortomdickandharryconnickjrmints at 12:12 PM on September 9, 2020 [77 favorites]
When most people think of donating for a bone marrow transplant, they imagine general anesthesia; a very big needle; a painful recovery. That was my experience. I was told apheresis (the other option available, which is akin to donating plasma) wasn't the best option for my recipient.
I registered over a decade ago and never heard anything aside from the occasional followup email to make sure my contact info was up to date. One day at work I sent a call from an unknown number to voicemail, and when I later checked I found out I was a potential match. So the next day they booked a blood draw for me at a clinic near my office. About 24 hours after that blood draw I was told I'm the best possible match, and was asked again if I'd like to go through with the donation process. I was like "yeah, that's why I registered".
I was told these things normally happen over 60-90 days, but I had my surgery for extraction very soon after this initial contact. There was a quick succession of physicals, blood tests, EKGs, chest X-rays, I'm probably missing things, but I was constantly having to leave work to go to a lab to get a test done. The next day they'd call me and say "how soon can you go to this other lab to have this other thing done?". So I did all the stuff and then they gave me a date that was about 14 days away. They booked a hotel and airfare for me and an assistant (I chose my sister because I didn't want to inconvenience my wife) and they flew us from separate cities to a childrens' hospital.
The next day we checked in for the procedure. Fun fact: adults having bone marrow procedures in childrens' hospitals are treated really well. So I go under anesthesia and woke up with two bandages on my lower back where they extracted 1.6 FUCKING LITERS OF BONE MARROW from my pelvis (how does it even hold that much?). I was really worried about how I'd handle the anesthesia, but I didn't do anything stupid like when I had my wisdom teeth out a couple years prior. We took an Uber back to the hotel, I stayed up and ate horrible sushi and watched a movie. My sister went straight to bed. The next day we checked out, went to the airport, and flew to our respective cities. I was pretty sore in my lower back (felt like I had been kicked pretty hard and also pulled a muscle) but that went away in 3-4 days. I tried (against advice) to resume training (I was training hardcore for an long endurance bike ride at the time) and after about 20 minutes of the easiest pedaling I'd ever done I was completely exhausted. Turns out it's hard for your body to replace all that bone marrow.
I tried to do a ride about a month later and I still felt wiped out. It completely derailed my training plan. It's been over a year now and I'm finally feeling motivated to run/ride again. I'm very out of shape now.
I would love to know how my recipient is doing. I don't know their age or gender, only that they were diagnosed with non-Hodgkin's lymphoma. Would I do it now, during a pandemic? Probably. Without a pandemic? Absolutely. One thing that kept me motivated throughout the process was thinking "what if it was my kid who needs a transplant? How would I tell them we found a match but unfortunately they don't want to inconvenience themselves." Again, this was over a year ago, so well before Covid when all I had to worry about was not waking up from the anesthesia (and this was a couple weeks after there was a well-publicized case of someone dying from anesthesia complications during a donation). So I tried not to think about that, and instead tried to focus on the positive impact my actions would take.
Oh, the weirdest part: about 3-5 days before the procedure I received a call. "Hi! Hope you're doing well. Just calling to let you know that today your recipient is undergoing radiation treatment today to kill all their white blood cells, so they're not going to have an immune system at all. If you back out now, of if you die in an accident, your donor will 100% die a few days later. See ya at the hospital!"
I drove extra carefully after that. I joked for a while that this is my Get Into Heaven card, and for a while I'd say "I bet it's ok if I shoplifted this right now, ya know? Because I saved a life? They'd probably understand." On one hand it's good to know I tried. I did what I could, but that wasn't much. I got on a plane. I stopped eating after midnight, then I passed out and woke up with 2 holes in my back. Big deal. Psychologically what's been getting to me lately is what if my recipient died? I know it's not my fault, but it also means all that was for nothing. And I probably didn't do anything that could have affected the outcome, but what if I did? Could I have done anything differently?
I kinda don't want to know now.
posted by spikeleemajortomdickandharryconnickjrmints at 12:12 PM on September 9, 2020 [77 favorites]
For questions about where you might find more of this writer’s work, here’s her bio from
The crooked media page
The crooked media page
Sarah Lazarusposted by bilabial at 12:17 PM on September 9, 2020 [2 favorites]
ASSOCIATE EDITOR
Sarah is a DC insider who worked at White House Gifts for six pivotal weeks in 2010. Her uniform was a polo shirt with the Declaration of Independence on it. Since then, Sarah has written for the New Yorker, NPR’s Ask Me Another, and McSweeney’s Internet Tendency. Now she writes Crooked’s What A Day newsletter! She lost the shirt in college and regrets it very much.
This is a really great piece. Thanks for posting it, chappell, ambrose.
I’m thinking pretty hard about finding out whether my particular medical realities would allow me to be a donor, and registering if they will. Maybe not until after a vaccine prepares my immune system to respond to coronavirus, though.
posted by Songdog at 1:08 PM on September 9, 2020 [1 favorite]
I’m thinking pretty hard about finding out whether my particular medical realities would allow me to be a donor, and registering if they will. Maybe not until after a vaccine prepares my immune system to respond to coronavirus, though.
posted by Songdog at 1:08 PM on September 9, 2020 [1 favorite]
This is so well written and really thoughtful about what risks we should take.
Some friends and I signed up for the registry in college. Back then, the testing to even join the registry was a blood test that had to be done in person and took some time, and we all stood around in the studios of CNBC in Charlotte waiting our turn. A few years after that, the friend who got us all to do it watched her own dad get diagnosed with leukemia and get a bone marrow transplant through a registry donor. A few years after that, the same group of friends gathered to walk in the Leukemia and Lymphoma Society Light the Night walk in memory of her dad, who recovered well after his first transplant, but ultimately relapsed. A few years after that, I was diagnosed with an auto-inflammatory disease and had to remove myself from the registry. I'm still sad about that.
It's such a simple good thing to be able to do. But I wouldn't want to give an already sick person my malfunctioning immune system. They should get a nice functional one.
posted by hydropsyche at 2:15 PM on September 9, 2020 [4 favorites]
Some friends and I signed up for the registry in college. Back then, the testing to even join the registry was a blood test that had to be done in person and took some time, and we all stood around in the studios of CNBC in Charlotte waiting our turn. A few years after that, the friend who got us all to do it watched her own dad get diagnosed with leukemia and get a bone marrow transplant through a registry donor. A few years after that, the same group of friends gathered to walk in the Leukemia and Lymphoma Society Light the Night walk in memory of her dad, who recovered well after his first transplant, but ultimately relapsed. A few years after that, I was diagnosed with an auto-inflammatory disease and had to remove myself from the registry. I'm still sad about that.
It's such a simple good thing to be able to do. But I wouldn't want to give an already sick person my malfunctioning immune system. They should get a nice functional one.
posted by hydropsyche at 2:15 PM on September 9, 2020 [4 favorites]
I am currently on the list for a match. My own sibling just didn't think he wanted to help me out, so I'm relying on the kindness of a stranger, too. Those people who donate bone marrow and/or stem cells (I'm in line for the stem cell transplant) are the closest thing to saints that I know . The idea that a perfect stranger might be willing to go through these procedures so that I can continue to live and possibly even be well for the first time in years, well it chokes me up with gratitude.
posted by alltomorrowsparties at 2:40 PM on September 9, 2020 [12 favorites]
posted by alltomorrowsparties at 2:40 PM on September 9, 2020 [12 favorites]
Psychologically what's been getting to me lately is what if my recipient died? I know it's not my fault, but it also means all that was for nothing.
Cancer treatment is stochastic. It's all about loading those dice as much as you can. Anything that improves a patient's chances is not for nothing.
posted by rhamphorhynchus at 3:37 PM on September 9, 2020 [7 favorites]
Cancer treatment is stochastic. It's all about loading those dice as much as you can. Anything that improves a patient's chances is not for nothing.
posted by rhamphorhynchus at 3:37 PM on September 9, 2020 [7 favorites]
This was well written and a great read.
Also her tweet from Jan 1 is great use of foreshadowing.
posted by justkevin at 4:00 PM on September 9, 2020 [2 favorites]
Also her tweet from Jan 1 is great use of foreshadowing.
posted by justkevin at 4:00 PM on September 9, 2020 [2 favorites]
What a truly wonderful piece of writing. And oof, that testimonial from her dad...
posted by obfuscation at 4:36 PM on September 9, 2020 [1 favorite]
posted by obfuscation at 4:36 PM on September 9, 2020 [1 favorite]
Thanks for posting this. I've been meaning to register on Be The Match for years, and this was the kick in the pants that I needed.
posted by TheCoug at 5:00 PM on September 9, 2020
posted by TheCoug at 5:00 PM on September 9, 2020
And for non-Americans, a tool to search for organizations in your country is available here at the World Marrow Donor Association website.
posted by mosst at 5:37 PM on September 9, 2020
posted by mosst at 5:37 PM on September 9, 2020
Can we have a chat about you all posting things that make me cry?
posted by medusa at 7:20 PM on September 9, 2020 [2 favorites]
posted by medusa at 7:20 PM on September 9, 2020 [2 favorites]
I’m actually donating in a few days - I found out that I anonymously matched in July and have been going through the process ever since. I’m also trying to sign up 500 people as new members of the registry before I donate: join.bethematch.org/melody
Even before the donation, this has been one of the most meaningful and humbling experiences of my life. I’m very grateful to be taking part in it.
posted by melodykramer at 12:09 AM on September 10, 2020 [16 favorites]
Even before the donation, this has been one of the most meaningful and humbling experiences of my life. I’m very grateful to be taking part in it.
posted by melodykramer at 12:09 AM on September 10, 2020 [16 favorites]
melodykramer - I just signed up using your link, so you're one person closer to your goal!
posted by SeedStitch at 7:27 AM on September 10, 2020 [4 favorites]
posted by SeedStitch at 7:27 AM on September 10, 2020 [4 favorites]
I registered on Be The Match a few years ago, and just updated my contact info with them last week. I haven't been asked to donate yet. I'm Ashkenazi too, so if I ever do get called it'll likely be for someone hard-to-match, and it's something I've thought about once in a while -- will I actually be able to go through with it? This made me feel a lot more confident about saying yes.
posted by nonasuch at 10:20 AM on September 10, 2020 [2 favorites]
posted by nonasuch at 10:20 AM on September 10, 2020 [2 favorites]
melodykramer - you got me to sign up, too!
posted by Ink-stained wretch at 10:54 AM on September 10, 2020 [5 favorites]
posted by Ink-stained wretch at 10:54 AM on September 10, 2020 [5 favorites]
Oh wow, her father's message at the end. Too beautiful.
I had been signed up with Be The Match after listening to a poignant Radiolab episode, but after moving back to Canada I recently went through the process to join via Canadian Blood Services. They have some cutoffs which differ - most interestingly, you must be 35 or younger to register (so I just squeaked into eligibility): you can donate if you're older, but only if you registered before the cutoff age. They also report that men are more likely to be asked to donate if multiple matches are found, apparently because they produce more cells on average.
posted by Paper rabies at 3:51 PM on September 10, 2020
I had been signed up with Be The Match after listening to a poignant Radiolab episode, but after moving back to Canada I recently went through the process to join via Canadian Blood Services. They have some cutoffs which differ - most interestingly, you must be 35 or younger to register (so I just squeaked into eligibility): you can donate if you're older, but only if you registered before the cutoff age. They also report that men are more likely to be asked to donate if multiple matches are found, apparently because they produce more cells on average.
posted by Paper rabies at 3:51 PM on September 10, 2020
I really appreciated this essay - thank you for sharing. I also appreciate all the perspectives everyone has shared in this thread: a number of my young, healthy friends refused to get swabbed for the registry. They mostly talked about being scared of the obligation if they were found to be a match, and about being scared of the donation procedure.
I spent an afternoon last year exhorting people to sign up for the registry in order to help find a donor for a local biracial man. BIPOC are underrepresented among donors, and people with biracial backgrounds are even rarer, I imagine. I didn't have a personal connection to this man, so, prompted by this essay, I went and checked the hashtags we were using for his campaign.
He passed away earlier this year.
.
posted by invokeuse at 5:31 PM on September 10, 2020
I spent an afternoon last year exhorting people to sign up for the registry in order to help find a donor for a local biracial man. BIPOC are underrepresented among donors, and people with biracial backgrounds are even rarer, I imagine. I didn't have a personal connection to this man, so, prompted by this essay, I went and checked the hashtags we were using for his campaign.
He passed away earlier this year.
.
posted by invokeuse at 5:31 PM on September 10, 2020
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posted by marfa, texas at 10:19 AM on September 9, 2020 [2 favorites]