Wednesday, September 12, 2007

Hollywood Healthcare

Recently, I watched a rerun of CSI. The Las Vegas one, of course, I'm no great fan of either David Caruso or Gary Sinise. But oh, that William Peterson. I just love nerdy guys. Which always gives my husband pause, as in, "hey, that must mean...". Sorry Honey.

Anyway, on this rerun, called "The Organ Grinder", a guy is found dead, yada, yada, bad guys, etc, etc but the guy was poisoned to death and it is IMPERATIVE that his organs be used in the investigation. Except that he was an organ donor. Aaagghhhh! How will we ever catch the criminal? In a scene that somehow manages to combine the trippiness or "Fear and Loathing in Las Vegas" with a graphic Jack the Ripper movie(take your pic), they show a flashback to the organ recovery(they may have said "harvest", I can't remember). "Eight organs in 2 hours," the coroner intones, with organs coming out in quick succession and tossed to waiting surgeons. Then cut to the cadaver, with incisions going up, down and sideways. "A Frankenstein" says Grissom. Oh, Grissom, you're so handsome, but you need to go back to your bugs, baby.

All right, gentle reader, where to begin? First of all, I have never, ever, NEV-AH(as we say in Jersey) seen an organ donor with anything other than ONE midline incision, from the top of the sternum to the pubis. If they're recovering heart valves and other tissue, they make a Y incision for the heart valves and then incisions along the extremities and pelvis to retrieve bones. Just organs, just one incision. And they don't rip out the organs, for goodness sakes. You know, these organs have to be used in a living person, right? Do I need to say they are handled with care? Not tossed around the OR like a live hand grenade. But you, as faithful donorcycle readers, already knew that.

Here's another thing. Many donors require autopsies. They are homocides, suicides, accident victims or sometimes they have just been in the hospital for less than 24 hours, requiring a call to the ME. In NJ, it is ILLEGAL for an ME to deny organ donation because of their investigation. In some cases, they may put limitations on it. For instance, say you were unfortunate enough to be shot in the left lung. The ME might then say that all organs could be recovered EXCEPT the left lung. Which we wouldn't want anyway, seeing as it had a big hole in it.

Here's the other thing. The medical examiner is welcome to COME TO THE HOSPITAL and see the deceased. Either up on the unit and/or in the OR. If they decline, we TC's have a special form, called "The ME operative report" that is filled out with all pertinent info, signed by the surgeon and then passed along to the ME's office, with pictures, blood, bile, urine specimens, copies of the chart and any radiology films, as well. We are a full service OPO, after all. We also call the ME prior to the recovery to set all this up. In this heartbreaking story, the grandparents' hope that their grandson's death would not be completely in vain is dashed by an ME's office that routinely denies organ donations in homicide investigations. A mom in Ohio had the same experience, when the coroner would not allow his organs to be recovered, even though his cause of death was obvious-a gun shot wound to the head. In such cases, it would be within the realm of common sense to deny cornea or eye donation-nothing above the neck. But really, do you need to see his kidneys to know how he died?

I hate to sound like a broken record, but donation is good for the donor's family as well as the recipient. Knowing that someone is going to live on with their loved one's organs is a balm for their wounds.

So where does this leave me with the guys in the crime lab? What would I say if I had an hour alone with Nick and Warrick? Nothing, of course, I'd be too busy staring into their goodness, have you seen Gary Dourdan's eyes? Oh, yeah, organ donation-where was I?

You might think, savvy, innernet-reader that you are, that TV is just a harmless pasttime, a way to unwind after a hard day, to put your feet up and have a nice cold one. Well, that would be true for only 67% of you. Because in 2005, a Gallup poll showed that 43% of Americans got their health info from the TV. Out in Cali, a group of OPO's and transplant organizations has started a campaign called Donate Life Hollywood, They explain that if a show's plot contained such inaccuracies about HIV, there would be an uproar.

Dr. Susan Morgan, of Purdue University and author of "Entertainment (Mis)Education, has published two studies showing that the misperceptions of organ donation portrayed on TV keeps people from registering as donors.

It's true. If I think back to all the story lines I've seen on TV about organ donation, they always seem to involve some urban myth-selling organs, buying organs, mutilating bodies, etc. But never do I see them resolve the problems or clarify the myths. Maybe it's not compelling enough TV. Which may explain why I read a lot.

Now, if you'll excuse me, I have a producer to write to.


BreathinSteven said...

Hey TC!

I've met some awesome coroners from the Northern Illinois area -- they've been commended by Gift of Hope for the lengths they go to help promote and assist with organ donation... The Ohio Mom story you linked to bothered me...

I sent the following letter to the Frankling and Licking county coroner's offices:

September 12, 2007

Dear Drs Lewis, Raker and Lee,

I’m disappointed in the handling of Christopher Grooms’ case as well as the comments justifying the process made to the press. I’m disappointed that Cathy Grooms was not given the chance to wrest some lasting good from this incredible tragedy that will be with her for the rest of her life.

Dr. Lewis was quoted as being concerned about being questioned whether a victim may have had a heart condition that could have contributed to the victim’s death. Beyond the fact that a transplant team wouldn’t accept a damaged heart – perhaps the heart recipient could be called as a witness to show the heart was working just fine… Dr. Lee echoed the need to protect evidence in a homicide. Granted, I’m a layman – but for a gunshot wound to the head, it wouldn’t seem necessary to “protect” the kidneys, liver, heart or lungs. I do not understand how so many other coroners offices can seem to work with organ donation as part of the process.

You are all medical professionals – you know how fragile life is. Imagine your precious daughter accidentally ingesting a toxin or allergen that puts her into liver failure. Imagine watching her life circling the drain, and feeling her suffer, while the only answer is an immediate liver transplant. Imagine victim brain dead due to massive trauma from a gunshot wound to the head, with a viable liver for your daughter who is ill enough to be at the top of the list for the entire region.

Imagine a coroner saying no one touches the victim as you watch your daughter fight for her last breath.

Someone beyond your daughter may have died because of your actions.



Steve Ferkau
Chicago, IL

I liked your post on Hollywood and organ donation -- it never ceases to tear me apart when I see some of these things... I waited almost three years for my beautiful lungs -- when I saw something goofy, I imagined my potential donor family watching the same program and suddenly deciding that maybe organ donation wasn't the right thing to do... As you pointed out, these folks have influence...

Hope your letter to a producer went well...



Lisa said...

Love your blog! Was wondering if you would mention this case from OH b/c I unfortunately am all too familiar with this ME office. These MEs are also invited into the OR. Our organ procrument people are constantly working with them and I hope this is the last case you hear about from Ohio!

Anonymous said...

After years of being annoyed with TV shows and movies for getting the donor process so spectaculary wrong, I've taken another perspective. Donor cases are boring. I did a lot of them. They aren't anything that will keep the butts in the seats in front of the tv. Producers are after ratings. I'm just glad that they're bringing up the conversation. The public is seeing and hearing a lot more about donation and transplantation today, than in the past. Not long ago, I remember doing many approaches for donation and the predominant reaction was the same. "We never talked about that. I have no idea what they would want." Today, people are asking more questions and then getting the straight story. I sincerely hope there aren't a large percentage of folks out there that believe anything that David Caruso portrays. He's just not that good of an actor. Remember, any publicity is good publicity.

BreathinSteven said...

The email to the Franklin County Cororner's office was bounced -- I'm guessing his email box may be overflowing... I did receive a response from the Licking County Coroner's office that made me feel a little better about life:

It read:
Mr. Ferkau,

Thank you for the e-mail concerning the Christopher Grooms case. From the tone of your letter I can tell you must have had a personal experience involving organ donation and a loved one. But, you have some of the facts incorrect and I wish to correct them. Dr. Raker and I (Dr. Lee) work at the Licking County Coroner's Office in Newark, Ohio, the city in which Christopher's incident occurred. We are only a medium sized county and have no hospital with a Trauma Center, so Christopher was taken by helicopter to one of the large Trauma Centers in Columbus in Franklin County (our immediate neighboring county to the west).

While on life support, the Newark detective investigating the case called me for advice regarding the possibility of donating Christopher's organs, especially because his mother was very interested in this. I then volunteered to call the Franklin County Coroner's Office in Columbus where Dr. Lewis works. I spoke to the doctor who was Directly handling the case
(not Dr. Lewis) and he was not willing to allow the donation.

The information in the Columbus Dispatch newspaper article quoted me saying that "coroners have to protect the evidence in a homicide." This is what I
said, but the author did not print what I said next which was that
protecting evidence and allowing organ donation are not mutually exclusive acts. Also, the reason I said that "it is rare for (our) office to consent to organ donation in a homicide case" is because it is extremely rare for
the opportunity to arise for organ donation in our county because we do not have a Trauma Center. As you may know, organ donation requires a beating heart, which requires a level of medical care that our small hospital cannot

Since you were able to read the Columbus Dispatch newspaper article online, I suggest you also read the Letter to the Editor written by Christoper's mother printed in the September 6 edition of our local newspaper, the Newark Advocate (

Dr. Jeff Lee

Licking County Coroner's Office
Newark, Ohio

I did not look up the article as it is archived and I wasn't willing to pay for it -- but I have to imagine that it exonerates the Licking County office. And, it was nice of Dr. Lee to take the time to respond to me. My response back to him:

Dear Dr. Lee,

Thank you very much for your response -- I'm in a bit of a rush and I'll write more later. I will look up the letter to the editor that Mrs Grooms sent -- thank you for guiding me in that direction. At the moment, I'm rather pleased that I did not have the full story.

Yes, I've had a personal experience -- A mother like Mrs. Grooms successfully saved my life. My donor had voiced her strong opinions in favor of organ donation twice in the month before she passed away. She did not die as senselessly as Christopher -- she died of a intracranial hemorrhage -- but her parents had the opportunty to pull some good from a devastating situation by donating the organs of their 17-year-old daughter, Kari. I have Kari's lungs.

I'm a strong advocate of donation and I speak for Gift of Hope in Illinois and Iowa Donor Network frequently -- I have met hundreds of donor families -- I understand the benefits they've received from the gifts they've been allowed to give.

Thank you again for getting back to me, and helping me understand your position... I will address this further after the weekend...


Steve Ferkau
Chicago, IL

Miles said...

What is your take on "Heartland"?

Miles said...

Ah yeah.. found your take. Thoroughly enlightening. Thanks.

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