“Adonai, created in your image, I recognize that my body and soul are in Your keeping. I am grateful for the miracles you have given us through medical research and skill and through the generosity of others. Thank you for the possibility of the miracle of life and the relief from suffering that this transplant will bring me and my loved ones. Thank you for the skill of the doctors, nurses and all those whom I do not know who will care for me as I reach new possibilities in life.”
The prayer, taken from Rabbi Mishkan R’Fuah’s 2013 compilation Where Healing Resides, is offered as a suggestion to be recited prior to surgery by the recipient of a donated organ.
On May 20, 2016 I was wheeled into the operating room at the Mayo Clinic in Rochester, Minnesota having neither recited nor ever heard of R’Fuah’s prayer.
I was, instead, shaking from head-to-foot both from the near frozen temperature of the O.R. and the mortal dread of either not waking up or waking up too soon.
“Happy Birthday, Gretchen!” The surgeons and O.R. staff called almost in unison once I was settled onto a table which looked suspiciously like an execution gurney. I managed a grateful smile. “Birthday” by the Beatles began playing from a computer at the far end of the room.
“Good choice,” I told the nurse as she was flushing out the IV in my arm. “Where’s Elvie?”
My eyes followed her gesture to a wall on my left marked by a small window. I strained my head towards it hoping to catch a glimpse of the day’s other participant, Elvie Gibbs-Jordan.
She was a woman who, five months earlier, I knew only as a reader of the Chicago newspaper for which I wrote. Now I was trying desperately to focus my mind upon her. I was terrified. Mayo’s transplant team had stressed and restressed the risks, particularly of Elvie rejecting the kidney I was about to give her. With her eyesight already suffering after months of dialysis, Elvie had also been told by another hospital that there was a risk the procedure would leave her permanently blind.
Although in separate rooms, Elvie and I were locked in a dance we both had to survive. Not only that, but I desperately needed her to keep her sight and accept the kidney.
Up until now and, with the exception of Elvie, I have never told anyone why.
In January 2015, I had gone through a horrendous divorce with a beautiful but self-serving woman to whom I had dedicated four years of my life and my whole heart. A young musician, she thought that just getting up on a stage with her violin would change the entire world. When that didn’t happen, I reminded her that changing the world was also possible “one person at a time.”
She didn’t agree. So, after draining my bank account, she left me in order to change the world by tooling around the country with a guitar player.
I was left a broken person who not only felt like a failure but was utterly cynical and dismissive concerning matters of love or miracles of any kind.
It was then that I first read Elvie’s story.
She and her then-wife Challis were one of the first same-sex couples to be married in Illinois. They had been partnered for over two decades when Challis was diagnosed with terminal cancer. After securing an emergency ruling from a judge, the couple were married in December 2013. Challis died the following February. Devastated, Elvie became sick and, after receiving a bad prescription, went into renal failure. Her prognosis was dire without a transplant.
Her loss in both body and soul immediately hit home with me.
So, on the one-year anniversary of my divorce, I began a long series of tests at the Mayo Clinic. I wholeheartedly believed that, if I followed my own counsel and changed the world one person at a time, four years of my life I believed to have been totally wasted would mean something.
I was so very desperate to heal, donating my kidney to a woman who had suffered far more than I felt like an answer. Although, as “Birthday” was replaced by John Lennon’s “Woman,” an oxygen mask was pressed over my mouth and moments before my awareness vanished under the ominous sensation of fluid going into the vein in my arm, I wondered if I hadn’t gone a little overboard.
At exactly the same time my divorce was finalized, Memphis Tennessee resident Gila Golder got a call from a representative of the international organization DKMS which, for a quarter century, has been fighting blood cancer with the help of bone marrow and stem cell donors.
“He was telling me I was a match,” she recalled. “But it totally came out of left field.”
Golder had registered as a potential donor by performing a cheek swab in her Sophomore year of college during a 2011 DKMS campus drive.
“I had totally forgotten about it,” she said. “I told my husband but, at that point, I had already decided that I wanted to do it. Part of it was because they told me the recipient’s age, gender and diagnosis. I had been matched to this person because we had similar genetic material. I am Ashkenazi Jewish, so I thought he also probably was.”
Her recipient was Mitchell Blivaiss—a pediatrician and father of four from Evanston, Illinois. His diagnosis of Myelodysplasia (a blood cancer with an average survival rate of between five months and seven years) came following a routine physical.
“I was shocked,” he said. “I’d always been very healthy. In 35 years of work, I’d only missed two days. The variant I had isn’t really amenable to chemotherapy. The only effective treatment is a stem cell transplant. My brothers were tested and they weren’t matches so they told me they would search the registries.”
Golder’s information was found after six-weeks.
There were two possible options for saving Blivaiss’ life: surgery during which bone marrow cells are collected from the donor’s hip bone or a less invasive but longer procedure designed to collect a donor’s stem cells through a blood draw and filtering process.
In March 2015, Golder was able to donate via the blood draw—something she described as “uncomfortable but painless. I was just really tired afterwards. I went home and slept for two days straight. After that, I was pretty much back to normal.”
“It was difficult for me to be the patient and not the doctor,” Blivaiss said. “But I sailed through the treatment and the recovery period. Now I’m pretty much back to normal.”
For the next year, per Federal law, Golder was permitted to receive updates on how Blivaiss was doing but not his name. When she finally received the information via a DKMS email, she googled his name and found it on a Chicago synagogue newsletter.
“I called him that night,” she said. “On the one hand, he was a complete stranger but, on the other, we had this intimate, physical connection. He has my blood-type now and, if they test a sample of his blood, it comes up genetically as female.”
“I was overwhelmed,” Blivaiss said, his voice cracking. “It was her stem cells that got me through this.”
The pair talked for 15 minutes initially and then kept in touch via email but, after finding out she was pregnant, Golder wanted to do more. Given a choice of destinations for one last vacation before the arrival of her baby, she and her husband opted for Chicago.
Last month, Golder and Blivaiss met for the first time at a Kosher restaurant in the city.
“I was just expecting to meet Mitchell and his wife,” she remembered. “But he had brought all four of his daughters with him.”
“There was a lot of emotion,” Blivaiss said. “Without a successful stem cell transplant my three-year survival rate was only 50 percent. The fact that I am still here is because of her.”
“There was a lot of laughing,” Golder said. “We discovered how much we had in common. It was surreal because it felt like a big family reunion. I feel like Mitchell and I have that connection now. I feel like I have gained a new family.”
Last week, Elvie and I got together at a restaurant a few blocks away from her North Chicago home. I had just recovered from a cold so, ever conscious of transmitting any germs to her fragile immune system which is kept from rejecting her kidney by a long list of unpronounceable medications, I didn’t hug her.
I wanted to though. I always want to whenever we meet. As far as we are both concerned, we’re family.
“How’s Kitten doing?”
I was asking after her kidney which received a mutually approved name the day after our surgeries when I hobbled down the hospital hallway to her room and found her, not only able to see clearly, but with far more energy than I was able to summon.
I named my remaining kidney “Oddball.”
“She’s fine,” Elvie smiled reassuringly and we reminisced over a typically hedonistic breakfast together.
“The waiting list for a new kidney was really long,” she said. “You wait for a call. I had to pretty much forget about it. As I was suffering under dialysis I kept thinking ‘I want to die’ but then a voice in my head said ‘no, you don’t because you’re trying to live’.”
After I passed the last barrage of tests at the Mayo, I found Elvie’s number and called her to let her know “I’m going to give you a kidney.”
“I was in my car picking up my daughter, her husband and my granddaughter from the airport,” Elvie said. “You were on speakerphone. I think it was serendipity. I wasn’t terrified when we had the surgery because I had put my faith in the fact that it was probably going to work. Mayo had assured me that I would keep my sight. But, I remember when I woke up, my daughter was on the phone and she yelled “Mom sees me!”
Since the surgery, there have been two rejection scares.
“A doctor explained that African Americans can have a higher resistance to our body accepting the transplant,” Elvie said. “The anti-rejection meds they were giving me were not enough.”
Meanwhile, she pushes on. While trying to build her hair replacement and handmade clothing businesses, Elvie dreams of becoming a snowbird during Chicago’s vicious winter months.
“I’m still lost without Challis,” she admitted. “But you’re almost the other half of me. You’re the reason I’m breathing. I’d say we’re related by blood.”
Now enjoying his renewed life with Golder’s stem cells, Blivaiss teaches part-time at the Chicago Medical School and recently helped with a campus bone-marrow drive.
“I was very fortunate,” he said. “Hashem gave me Gila and my doctors the wisdom to get me through this, a strong family and community around me.”
In a country which outwardly presents itself as bitterly divided, it is hard to imagine that the numbers of people like Elvie and myself or Golder and Blivaiss who have become family through organ or bone marrow transplants are rising.
Jaclinn Tanney has been the DKMS Chief Development Officer for the past four years.
“The last few years have been tremendous for us,” she said. “Globally, DKMS has registered more than 7.7 million people. Approximately 65,000 have gone on to donate and save a life. Whenever someone goes on to donate, we actually ring a bell in our office in their honor because it means that another life is being saved. Every single day we’re ringing a bell in celebration.”
Dr. Charles B. Rosen, MD, Director of Mayo’s William J. von Liebig Center for Transplantation and Clinical Regeneration, has seen the same upward trend.
“There’s been quite a change,” he said. “A big uptick in the number of deceased donations in the past couple of years which, sadly, is due to the Opioid epidemic. The opportunity to designate oneself as a potential donor in the event of death is very helpful. We’ve also noticed a steady increase in living donors. It now is about 15-20 percent of our overall practice at Mayo Clinic.”
“The techniques have improved for kidney procurement such that it’s more comfortable for the donor with a much smaller incision, a reduced length of stay in the hospital and a quicker recovery afterward,” Rosen added. “A living donor kidney is better than a deceased donor kidney. They tend to last longer and function better.”
Living liver donations remain much riskier by comparison but the benefits of a shorter wait time and thus a decreased risk of death for the recipient are the same.
A Reform Jew with a son in Rabbinical school Rosen reminded me that, in terms of deceased donations, there are more spiritual complications in Judaism.
Rabbi David Wolkenfeld leads the Orthodox Anshe Sholom B’nai Israel Congregation in Chicago.
“Living donations are an act of tremendous kindness and those in community who make a decision to do so receive tremendous encouragement and admiration,” he said. “When it comes to organ donations from cadavers there is a great deal of controversy and it all circles around determining a definition of death. There are a diversity of opinions within the Orthodox community about what the definition of death is. There are major figures on both sides of that question. There are some Orthodox Rabbis who do accept modern definitions. If you follow those opinions, if a patient is determined as brain dead then it would be permissible to harvest their organs.”
Wolkenfeld added that he is “personally convinced that a position in favor of organ donation is sensible and has the advantage of enabling many lives to be saved. It’s something I’m public about and that my community knows.”
He noted the Halachic Organ Donor Society (HODS) as a go-to resource for community education.
“I do encourage people to sign up as an organ donor on their driver’s license,” he said. “But HODS has their own cards which you can keep in your wallet. They’re a little more precise. So, I encourage people not only to sign up but tell their families that they are willing to be donors and that it is consistent with their religious principles.”
“The magnitude of donation is in the hands of anybody,” Tanney said. “Everyday people can be heroes. The donor feels a real sense of being and pride knowing that they are providing time and hope to not just the patient but their family. It’s about having more moments. There’s no greater moment than when [donor and recipient] meet.”
“In simple terms, adding life to your years and years to your life is what we’re all about,” Rosen said.
“When we’re successful doing that, it gives me tremendous satisfaction. Fortunately, in transplantation, our successes are in greater number than our failures.”
Elvie closed another morning together with talk of Thanksgiving plans. There is a new meaning to the day for both of us and R’Fuah’s prayer has just as much substance for me as a donor as it does for a recipient.
Before I fell into darkness to the sound of John Lennon echoing through the Mayo Clinic’s O.R., I was suffering and life’s possibilities seemed extremely limited. But every time I see Elvie and we slip into each other’s company like a pair of loving sisters, I’m reminded that, out of failure, came life. The truth is, we saved each other’s.
Gretchen Rachel Hammond is an award-winning journalist and a full-time writer for Tablet Magazine.