He was a rising senior and standout scholar-athlete at his high school. I was the cardiac sonographer on weekend call at the regional trauma center. Answering a mid-afternoon page, I was promptly connected to ICU. "GSW," the charge nurse said flatly. "Harvest."
"I'll be right there."
GSW. Gun shot wound. Someone has been declared clinically brain dead, and the next of kin has consented to donate his or her heart. Organ donation is a tightly choreographed process and every minute counts. My job was to do an ultrasound study of the donor's heart and deliver it stat to my cardiologist, who would assess its viability for transplant.
Guiding my unwieldy machine out of the elevator and into the normally-sterile corridor, I found it teeming with humanity. Mostly teenagers, they were huddled in small groups. Shaking, sobbing, praying.
This was going to be bad.
His cramped room is already packed with family and life support machinery. I introduce myself, scanning their faces. They part silently as I set up my equipment. I know instantly which is his father. I will never forget the look in his father's eyes.
He doesn't look dead. His chest rises and falls with the ventilator; the monitor displays normal vital signs. As I lay my probe on his chest, his skin is warm beneath my glove. His heart springs to life for all to see. Strong. Steady. So much living left to do.
I complete my study methodically, efficiently, as X-ray and lab line up for their turn. His heart function is within normal limits, but I can't tell the family that. Instead, I nod awkwardly and them them I'm so sorry. Mindful of the vigil in the hall, I pause at the door to dab away the rising well in my eyes with a washcloth. It turns out the washcloth is covered with ultrasound gel.
The cold and indignity shock me back into clinical mode. Page the cardiologist. Drive home. The brilliant sun suddenly seems cruel, illuminating a world that doesn't feel beautiful anymore. It feels broken, bleeding about the jagged edges of a piece senselessly and irrevocably ripped from its very flesh.
There was a gun in his home, and there was an accident. It doesn't matter where, or when, or how it happened. In a more perfect world, stories like his would be rare. Instead, he succumbed to the second most common cause of death among children and young people. From the New England Journal of Medicine: (word cloud above)
In 2010, gun-related injuries accounted for 6570 deaths of children and young people (1 to 24 years of age). That includes 7 deaths per day among people 1 to 19 years of age. Gun injuries cause twice as many deaths as cancer, 5 times as many as heart disease, and 15 times as many as infections.
Emphasis mine.
Seven gun-related deaths per day, age 1 to 19. Seven bedside vigils, seven devastated families, seven fathers and mothers with a look in their eyes that stays with you forever. My nursing textbooks tell me to work with measurable quantities. How do you measure heartbreak? How do you quantify the carnage of a single bullet, when its wake is measured in decades and generations?
A year after that unforgettable call, I received a card at work. It was signed by the recipient of that young man's heart. He was doing wonderfully, back at work, and able to play with his kids again.
Only then, far removed from the clinical detachment of the moment, did I comprehend the great gift that young man's family had bestowed in a moment of unspeakable tragedy. Only then did I let myself cry.