So, about that whole kidney donation thing... (Part 1)

I thought about discussing the science and potential risks of being a kidney donor, but that has already been done quite nicely by the organization that shepherded me through the entire process: Matnat Chaim.  They have a Hebrew site as well, but if you follow that link... the information is pretty well organized, and will have enough for someone who is at the 'kicking the idea around' stage.

What I will do is tell the story - in installments - about my personal journey that lead to my decision to donate a kidney.  This will be 'Part 1'.

Aside from the sidelong looks/whispering (yes, I see/hear you), and the excruciatingly embarrassing compliments (which I honestly don't know how to deal with), being a kidney donor - despite how noble and selfless it may seem from the outside - can be fraught with complex personal feelings unrelated to altruism.

Although the reasons for donating a kidney are probably as numerous as there are people willing to consider it... there are a few common milestones that are likely shared by a large proportion of people who start the screening process. 

The entire process - from first toying with the strange idea of letting someone remove a perfectly good part of you, to finding yourself on the operating table - can be a journey of anywhere from a few months to several years; depending on how enthusiastically one embraces the idea. 

Some people jump into the process head-first because a close friend or relative is in urgent need of a transplant.  Others [*raises hand sheepishly*], start with the germ of an idea, and spend several years slowly working up the nerve to even begin the medical screening. 

It's probably not really relevant to anyone else why I, personally, first started thinking about kidney donation.  But I'll talk about it in a bit because it seems to be one of the first questions people ask. 

Before I get to that, though, I want to say that what is hugely important is to get 'buy in' from your spouse / partner (or immediate family if you are single), early in the process.  I'm thankful that I did, because I can honestly say that nobody, even the most supportive person, will fully understand why you want to do this. The best you can hope for is that they don't feel like they've been sandbagged at the last minute to give their okay (which means that you've been planning this for a long time without consulting with the person/people who will have to deal with the consequences if anything goes wrong).

Think about it... if you wait until you are already approved and matched with a recipient, and your husband/wife gives anything but an unconditional, enthusiastic 'yes', it is as though they are saying they're not in favor of saving an actual person's life!  That's a lot to lay on someone who is hearing the idea for the first time. 

Better to talk to them as soon as you start to think about it seriously, so they feel that they've been part of the decision-making process from the get-go.

So... how did I get to the point where I found myself, a person in very good health (it turns out!), in the operating room watching an anesthesiologist with smiling eyes lower a mask onto my nose and mouth?  How does one even begin to contemplate such a monumental decision?!

Like many difficult decisions, I opted to use the 'swimming pool' method in my deliberations over whether to donate a kidney. 

For those not familiar with it, this method is the same used in the difficult process of getting into a very cold pool.  Yes, there are always a few foolhardy souls who jump in all at once.  Most of us first test the waters by putting a toe in... then a foot.. and so on, until we either decide it's too uncomfortable (and we back out), or we find ourselves far enough into the process with manageable discomfort to justify taking the rest of the plunge.

I've described it this way, because I can honestly say that there was never an 'aha' moment when a light-bulb went on and I felt that I could walk around to the diving board and simply jump in head-first.  I always felt that I could allow myself to back out gracefully at any point; and that was crucial!

One of the key factors that allowed me the luxury of knowing I could stop (chicken out of), the process at any time was that I didn't make a big announcement to the world that I was planning on 'going swimming'.  I kept the circle of people who knew about my deliberations to an absolute minimum until I was literally at the point of booking the date for the transplant surgery. 

The reason for this should be obvious.  If you tell everyone you know that you are going to do something difficult (think skydiving or running a marathon), their expectations - and the potential for embarrassment/disappointment if you back out - now become a factor in the decision-making process.  I can't overstate the importance of not letting external expectations influence your decision in so important a decision. 

At the outset I spoke about the idea only with my wife.  Then once I was fairly well advanced in the screening process, I brought my kids and siblings into the loop. I told a few close, trusted friends shortly before the surgery date.   I didn't tell my parents until after the surgery was over and I knew there had been no complications. I didn't feel it was fair to ask them to take part in the decision.  And if I wasn't consulting them, it seemed cruel to tell them in advance and cause them undue worry.  

It wasn't until I was almost finished with the medical testing (a process that took me almost eight months to complete), that I spoke to my boss and the head of my company's HR department.  Obviously, if you are going to be taking anywhere from three-to-six weeks off from work for the transplant surgery / recovery, you are going to need the willing and active support of your employer. 

By the way, in Israel, you don't have to use sick days or vacation time for the workdays you miss due to being a kidney donor.  It is handled by the national insurance in much the same way that they handle military reserve duty.  And all the expenses associated with the medical screening are picked up by the recipient's health insurance.

I think that's enough for one installment.

I'll pick up this thread with at least two or three more installments in the coming weeks. 

I'll respond to reasonable questions in the comments section. But if they deal with things I have't written about (or fully come to terms with), I may ask for your indulgence and patience. 

I'm still working through a lot of the things you're probably curious about.  So bear with me.  I'm using this writing process to enlighten myself, as much as to inform you. 

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[Read Part 2 and Part 3 ]