“Procurement tonight” — a text
I’ve been anxiously awaiting with both excitement and dread,
for on transplant service this means
a life must be lost to save another’s.
I’m not prepared for the mid-20s man awaiting us,
a donor after cardiac death, he will be extubated
with his family by his side and allowed to die first before we procure.
The teams set up in the room for
lungs, kidneys, and liver and a prayer
is said out loud in honor of our donor.
We prep the abdomen and thorax for surgery,
and cover him up for his family.
A drape behind him hides the empty basins
awaiting his multiple organs.
The harsh operating room lights are turned down,
and a single soft light illuminates his innocent face.
We step out of the room and wait.
With his family surrounding him he is extubated —
away from our partial eyes.
Minutes begin to pass and nurses trickle out of the room in tears.
I imagine the grief on the other side of the door,
and I pray — for a miracle or that his death not be prolonged —
Either way, a very ill person will have life after tonight.
Ten minutes pass — then twenty —
another team’s surgeon paces back and forth —
back and forth,
weighing organ ischemia with the vitals we are given
At thirty minutes we have lost the liver —
somewhere a notified recipient was waiting
with bated breath and will now continue to wait.
Minutes later the donor is deceased
His family leaves, the lights come on,
and the teams flood into the room to procure;
With nearly forty minutes ischemic time
there is no time to spare.
Chaos ensues as the countdown is on
and I can’t help but think how awful we look,
descending like ravenous vultures,
and yet how absolutely amazing
everything happening in front of me is:
The freshest anatomy I have ever seen —
a young life lost just under our drapes —
and I, the medical student,
am overcome with joy and grief all at once.
Sarayna McGuire is an Emergency Medicine PGY1. She is a former Certified Pharmacy Technician and veteran of the United States Air Force. Sarayna earned her B.S. in Environmental Studies from American Military University. She enjoys traveling, photography, and gardening in her free time.
