January 12, 2010 • 36 mins
Tune in as Josh and Chuck take a detailed look at organ donation -- from the earliest organ transplants to the organ black market -- in this episode of Stuff You Should Know.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to Stuff you should know from house stuff Works
dot com. Hey, and welcome to the podcast. I'm Josh
Clark with me as always as Charles W. Chuck Bryant,
who I assume has two functional kidneys. I do, but
(00:22):
I would give one up for your brother. Wow, would
you really? Well? Maybe I think I think that through
Chuck as a living donor. Maybe not. But if I died,
then sure you get thanks. Man. What about your liver,
because I'm pretty certain I'm gonna need somebody's livers. I
don't know that you would want mine either, to be honest.
Oh yeah, yeah, that'd be like getting Mickey Mantle's liver.
I need like a we need a virginal liver, don't I? Yeah,
(00:45):
so I can just start over again, wash it in vodka.
So what are we talking about, Josh? We're talking about
organ donation, Chuck perfect, which I find absolutely fascinating. UM.
Back in nineteen let me take you back a little
bit here, the first successful living human to human organ
(01:07):
donation took place. It was a kidney. Yeah, it was
a great story. Kidneys actually remained the most commonly donated
and UM received organs. But this was actually a couple
of twin brothers, one of whom was dying of chronic nephritis. Yeah,
(01:28):
Richard and Ronald Herrick. And Richard was the one dying,
and Ronald was in good shape right, and Ronald said, well,
you know what, you're my twin brother, and I don't
really want you to die young, so I'm going to
give you one of my kidneys. And um. There have
been uh some other transplants before that. They didn't work
out though, well some of them did, but it wasn't
live human to human um like. For example, the first
(01:51):
I think, the first organ, the first donation or transplant
that ever took place, was way back in sixteen where
they few was part of a dog's skull under a
human's head, crazy and that graft worked. H. We have
taken testicles from monkeys and successfully in playing them into humans.
A pig kidney was successfully transplanted into a human vein transplants, uh,
(02:16):
and a lamb kidney was put into a recipient in
ninety three and that person lived for nine days. But
nineteen fifty four finds the first time a living person
donated an oregon to another living person and it was successful.
And the reason why they think was because they're twins,
there was a very low chance of rejection, right. Yeah.
(02:38):
And the story is great because Richard, you know that
the dying brother had a moment, a clear moment where
he literally, like the day before, said don't do this. Man,
get out of here right now. And the brother said, no,
I'm gonna give you my kidney like it or not, chump,
and he did and it was a great story. Yeah.
And they actually both lived to ripe old ages reproduced,
so they fulfilled their deskin these humans. And since then, Josh,
(03:01):
there have been more than a half a million of
these organ transplants performed. Right, We've gotten a lot better
at it. Yeah. Um, as I was rambling off that
list of stuff that took place before nineteen fifty four,
we have gotten exponentially better. Uh. In two thousand three,
we successfully transplanted a tongue. YEA, I saw that which
I could use A tongue transplanted slightly thinner tongue would
(03:22):
would do me a lot better. I think you had
a fat tongue. Yeah. And do you remember the um,
what do we do the face transplant? Um? That woman
actually remember she got her face from a suicide victim
that was in two thousand five and in two thousand six,
so I know it's coming. A cadaver's penis was transplanted
(03:44):
onto a living human. Yeah, and that man gave it back, Yes,
and I love The reason they gave was because of
it caused psychological problems between the man and his wife,
which I can let your imagination run with that one. Yeah, Yeah,
that's just UH would say the same thing would happen
in my household. So thanks to a better understanding of
(04:04):
how the human body works, of blood type, of the
development of anti rejection drugs, like Chuck said, we've hit
about half a million transplant surgery so far. Right, so
Chuck actually is hot and heavy. Uh to to give
out a stat and this is a very special stat
because it's actually most likely going to change by the
(04:26):
end of the podcast. Yes, these are taking away. These
are current stats. If you go to the website U
n O s dot org, the United Network for Organ Sharing,
they actually have up to the minute statistics on who
needs what and who's giving what and what operations are
being performed. And I didn't realize this, but it's up
to the minute because earlier in the day I checked
(04:47):
on kidneys, and the number actually dropped by three about
an hour later on the waiting list, So three people
got kidneys in that like half hour span. So I'm
just gonna read a couple now and then we'll check
back in for fun in twenty minutes and see if
that's changed at all. Okay, I'm gonna write this down
to check because we'll never remember it. This is the
first time we've ever used a laptop in the studio
and a pen usually just us in our mouths. Uh. Total, Josh,
(05:12):
we got one oh five hundred and five thousand, two
d eight people are waiting for organs, and we'll do
kidney because that's the most popular. Eight three thousand and
twelve people are waiting for a kidney as of two
oh three pm. All right, and we'll check that in
twenty minutes and hopefully those numbers have gone down. Yeah,
(05:33):
because that will mean that either the people on the
waiting list have died or they received a transplant. I
guess we could put those two, we could compare against
one another, and maker we could surmise for So, Chuck,
what are organs? Yeah? I had a feeling you're going
to ask me that, Josh, gohad no, okay. Organs are
(05:54):
systems of cells, josh and tissues, and they all are
in our body for a very specific reason, each one.
And what I like about the organs is that they
are all over equipped, which is what you're looking for
in an organ. You don't want, like the heart to
be like boy, if it beats one beat less, you're
really screwed. So um, our heart. Actually, a twenty year
old's heart beats pumps about ten times more than the
(06:18):
amount of blood we need, and uh, we we have
this reserve capacity in all of our organs as young
lads and lasses. Right. But as Tom Schif, who you
know as my bff, who wrote this article, he points
out that the corneas, when you talk about eye transplants
there they're talking about corneal transplants. Um, they actually don't
(06:40):
necessarily deteriorate like all the other organs. Yeah, that's pretty cool. Um,
So the corneas of seventy five year old donor are
just as good, considering you know, there's not more wear
and tear than say a twenty year old. Yeah, you
could put a seven year old person's cornea inside of
a young person and there would be no difference. Right,
But for organs, they deteriorate with age. Well that's the
(07:02):
bad news, right, Um, so eventually you may need one,
right Well, yeah, because what happens is, let's say one
organ can deteriorate while the rest of your body remains
pretty healthy. That's actually best case scenario, as weird as
that sounds, because that means you can just swap that
sucker out and you'll be fine again. Right. Well, that
that's in a very ideal, utopian world. That's exactly what happens.
(07:25):
The problem is, there is a lot more people in
need of organs than there are organs available, right right,
there's um a waiting list. Some aren't so bad. I
think kidneys go pretty quick, as you're you're talking about earlier.
The longest wait I found, um was the old heart
lung combo. That median wait time was six point seven years.
It's a long time to wait for a heart and
(07:46):
a long if you need it. Yeah, a long time
because nobody goes I'm probably gonna need a heart and
a long combo. Eventually, I'll just put myself on the
waiting list. Now you need it, like the moment you
go onto that waiting list and you have to wait
six point seven years until you get it. Yeah, and
that's why. Um, the mortality rate while waiting for a
heart is, which is that's not as bad as I
(08:07):
would I would like, and um, the liver actually is
the worst. Oh good, yeah, sorry, Um. There's two ways
you can get organs from a live person or a
dead person. Yes, Traditionally we don't take organs like the
heart from a live donor because they would be a
(08:29):
dead donor. After that, you can take things like, uh,
the liver pancreas uncommonly, but it can be done. A
portion of the intestine, um, blood, blood, stem cells, bone, marrow, bones,
all and bones. Yeah, which giving up a bone that's
really something like, I mean, after that you just kind
(08:51):
of have this floppy arm, but somebody else has a bone,
you know, I mean, that's pretty nice. You Know. What
I thought was interesting about the kidney deal, like why
you can give up one kidney and still be okay,
is that most of the times when your kidneys are affected,
they are both affected at the same time, so one's
never gonna go down. And you'd be like, oh, I
wish I still have my healthy kidneys because they both
(09:14):
would have been unhealthy. And uh, all right, I think
we've arrived at the liver. Chuck. This is fascinating to me.
It is where where should we start? Well, let's just
start by saying that the liver can grow. It's like
the starfish of oregan. Yeah, it can regenerate itself, which
is just freaking amazing. Um. So, for instance, let's say
(09:36):
you wanted to split your liver in half and transplant
that into two different people. You could do that. You could.
And actually, if you're an adult donor, they can cut
off a portion, a child sized portion, uh, which is
I think the same as like a child sized meal
where you get like three chicken nuggets from uh and
(09:56):
give it to a kid, and chuck, this is so great.
It grows along with the kid right to a full
size liver once again, but in step with the kid's maturation. Right,
that's just mind boggling. Let's say you needed a piece
of your liver. Let's say you needed your liver replace
and I cut half of my liver off and gave
it to you. My liver would eventually grow to full
(10:18):
size once again. Yeah, if I live that long, so
mine would grow and yours would grow. And the cool
thing is with the liver, you don't even have to
take out the old liver. You can just put in
the new one. It's like the best organ on the planet.
It really is, and our favorite organ because of the
function that it serves. So Chuck, like I said, you
can neither be a dead donor or a living donor.
A dead donor can donate anything, right, including your yeah,
(10:43):
and your eyes, um, heart, lung, all that stuff that
you can't really take from a living donor. Um. But
there are some exceptions. If you have HIV or disease
causing bacteria in your blood streamer tissue there and I
gonna be taking your organs um. And if you are
(11:03):
a practitioner of the Shinto religion, there's not gonna be
a lot of organ donation going on there either, right. Yeah,
not only that, but if you are Amish, they might
support your donation if there is a certainty relative certainty
of success, but they're more reluctant if it's uh less
probable of success. Right. And Tom actually mentioned why the
Gypsies don't agree with organ donation. They believe that, um,
(11:27):
you need your body for the first year to get
around the afterlife. Apparently after that you got it down
pat and you don't really need it any longer. Um.
But he didn't mention Shinto, but I looked it up. Uh.
They believe that the corps is impure. The body becomes
impure after death. So would be like, here, take this
rotting piece of flesh that will save your life, but
you're going to be impure while you live. Interesting, So,
(11:49):
as a result in Japan, uh doing, donation rates are
like really really low copared to like the USA. Yeah,
and Jehovah's witnessed. We should cover them because we're we
always like to talk about them. Uh, they're not opposed
to it, but they have one rule which I thought
was interesting. You can donate your organ as long as
they drain all of the blood out of the organ
first before giving to someone else. So I guess they're
(12:12):
not big on transfusions. I don't think so that would
be my guess. Yeah, okay, Um, how do you register Chuck? Well,
(12:40):
it's pretty easy. Actually in most states. You can do
it at the d m V, which I always found interesting.
You can do it right with there when you're getting
your new driver's license, and uh, here in Georgia. Actually,
we used to have the one of the highest donor rates,
or I should say, one of the most expansive donor
registries in the country. And the reason was when you
went to go get your driver's licenses. I'm sure you remember, Um,
(13:03):
they'd knock seven bucks off of your driver's license. Love that.
So you were an idiot if you didn't sign up.
The problem is that there's not supposed to be any
kind of compensation whatsoever for being Even though this was
legal under state law. UM. The Georgia organ Procurement Organization,
(13:23):
which we'll talk about a minute, UM, they were very
hesitant to draw from the Georgia donor list because they
weren't sure if the person was just looking for the
seven bucks off or else if they really wanted to
be an organ donor. So actually, the contribution rates were
very low in comparison of the size of the registry
in Georgia until two thousand five when they stopped and
(13:46):
they stopped it, I think to actually give you a
T shirt too that says I've sold my lungs for
seven dollars that's illegal, and all I got was this
lousy T shirt. Yeah. No, under a um law. You
can't have any valuable compensation for organ procurement. Right. Well,
we'll get to that too, the whole black market deal. Okay,
So Chuck, if you're a dead donor, how do you donate?
There's two ways, right, Uh? Two ways sure, two ways
(14:10):
of death, brain death and cardiac death. Yeah, is that
what you mean? Obviously, cardiac death is um a little
trickier because you only have a certain amount of time
to get the organs from the body. Brain death a
lot easier in one sense, because um, there could be
as you know, weeks to find a match and to
(14:30):
prepare the organ for donation and get it carried out.
But there's a wrinkle there. Oh, there's a lot of
wrinkles there. Let me let me say something about cardiac
death first, right, Um this there are there are no
laws really governing organ procurement. It's not a case by
case basis, and basically everybody involved in the organ procurement
(14:52):
process does their best to walk a very cautious line
while harvesting organs to try to of other lives, right, yeah,
because there's families involved greeting obviously, um, with cardiac death,
there was a board I think out of Harvard in
the late nineties that established a five minute wait time
(15:13):
from the cessation of a heartbeat. Right, So, you you
take somebody off the life support, wait for the heart
to stop beating. Five minutes after and while this this
the heart's winding down, you're prepping the patient for surgery.
Five minutes after, Uh, somebody pronounces the person dead and
they cut them open and take the organs. But in
five minutes, the heart is useless pretty much at that point.
(15:36):
Some of the other organs, like the liver, the kidneys,
maybe the lungs can survive that five minutes, but the
heart's gone. So if you have a cardiac death, you
have a useless heart, even though the heart might have
been perfectly healthy five minutes ago. Right. So, there was
this doctor in Colorado that said, you know what, there's
no law whatsoever that says I have to wait five minutes.
(15:56):
This guy did a lot of research and found in
the medical latter sure the longest duration between the cessation
of a heartbeat and the spontaneous regeneration of a heartbeat
ever recorded with sixty five seconds. So he started a
sixty five second rule. Got the pants suit off of him.
It was an unsuccessful lawsuit, and now all of a sudden,
(16:17):
the president has been set and now there's a sixty
five second rule out there that some people adhere to.
That is how organ procurement has been established in the US.
Somebody pushes the envelope, they get sued if they if
the cases uh isn't one by the by the plaintiff,
then you have a new rule. And then weird, there's
like zero guidance for organ procurement except that the person
(16:40):
has to be dead. We don't have any real definition
for death. Well that's where brain death gets really really true. Exactly.
Take it, Chuck, Well, I don't. I mean, you're the
you're the expert here. I don't. I can't weigh in
morally because I don't know what I think. Really Nah,
I mean I know what I might believe for myself,
but I don't know about establishing guidelines for others. But
(17:02):
we need them, though, don't we? Yeah? But I don't
want to make up those rules to you know, and
apparently the federal government doesn't either. Um. Every once in
a while, I think Carter assigned a panel to create
a white paper on this, and I guess George Bush
did right before he left office, because there was one
that came out in two thousand and eight. Either Bush
did right before he left office or it was like
(17:23):
the first thing Obama did when he came into office.
But there was a very recent white paper that came
out that said, Okay, here's how we feel about brain death. Right,
here's the problem. Back in the fifties, I think we
came up with this thing called the ventilator. And with
the ventilator, you can keep somebody who for all intents
and purposes dead, You could keep their organs functioning, so
(17:45):
you're masking death. We have no idea what would happen
if that ventilator wasn't there. Would the person die? And
if the person does die, how long do we have
to wait until we say that that person is dead? Right,
So the ventilator made it so we could procure organs
more easily in brain death because we can keep them alive.
At the same time, it blurred the line between life
(18:06):
and death. Well, now they came out with this recommendation
that said brain death is disengagement of no the um
end of meaningful engagement with the rest of the world,
which really widened the scope of who exactly is dead.
And so when you have a brain dead patient and
you procure their organs, what what you actually do is
(18:28):
you have to run them through this battery of tests
where you are um shining lights in their pupils. Uh,
there's an ice water injection into the ear canal to
see if you move toward or away from the stimulus um.
And there's this battery of tests to establish brain death.
And then here's the clincher. They do an apneas test
(18:49):
where they take you off the ventilator for two minutes
and see what happens. And see what happens. Inevitably the um,
the heartbeat is going to slow down, and then after
two minutes they put the ventilator back on. But that
two minutes where your brain was starved of oxygen was
enough to to create real brain death if you weren't before. Wow,
(19:11):
think about that. This is why they call you supplementary
research man, right, That's why that's your superhero. And can
you hear like people fast forwarding through to get through this, partners,
It's like Josh, josh h Josh. Okay, So we have this,
we have this new definition of brain death. And when
the second apnea test happens, and you're declared brain dead.
(19:33):
What they anesthetize you, they inject you with anti paralytics.
Will you into that hospital room and they harvest your organs,
so you actually die from a lack of organs present
in your body. So that's that it's a ghoulish matter.
And these people who are in charge of making sure
that people donate and keeping the image of organ donation
(19:56):
as a gift of life alive have to battle with
this the fact that it's a very ghoulish process. Right,
you're right, So who's who's in charge of this stuff? Uh?
For what? For that whole soapopsh feel anytime, buddy, Yes, Josh.
That would be called an O p O, which is
an organ procurement organization and they are federally designated nonprofits
(20:22):
and they are local all over the country. There's usually
UM one in the central location of a state and
then different satellite office is obviously because you need to
be close by, you know, you can't be hopping all
over the country to get these organs, although that happens
as well. And they basically responsible for awareness, recruitment, evaluation,
UM organ removal and transportation. So they're the people that's
(20:45):
standing there with a cooler waiting to drop your organ
in there and rush it to the recipient. They're also
the people that talk to the family generally well. Sure,
so anytime somebody dies you, the hospital is legally obligated
to note a by the organ procurement organization. Right, and
you know this, This is a good point to bring
this up. If you want to be an organ downer,
or if you are, you really need to tell your
(21:07):
family the stuff, and you should have it all in
your living will because things can get a little ugly. Um.
For instance, let's say you are from a very strict
religious background. Maybe your family doesn't want you cut up.
They think that would be a bad thing, but you
want it. You gotta have that, you know, in paper
on paper, in writing, right, you need and if you
(21:29):
have a documented um in a lot of cases, even
if you if your family is like, no, we don't
want to donate the organs, the organ procuman organization will say,
you know what, ts sorry, he want he or she
wanted to be an organ owner. So and the last
thing you want after you die is for your spouse.
Let's say, to have to mountain this campaign against your
family like a tug of war like that. You gotta
(21:49):
have it all spelled out. Um, So where are we?
The United Network of Organ Sharing that's another group. This
is where that's where you got the kidney statistics. We're
gonna go back on and look at right. Yeah, they're
in Richmond, Virginia, and they are responsible for placing donated
organs um and maintaining the waiting list like you just said.
And they never close No. Seven three sixty five, which
(22:12):
is how it should be. Obviously, we should try calling
them right now to see if they're open. Let's not
do that. I'm sure they're open. And then chuck, there's
the Scientific Registry of Transplant Recipients right, Yes, the s
R t R. And they basically maintain like every amount
of data you could possibly want on transplants, right, for
like policy makers and doctors and drug makers and that
(22:33):
kind of stuff. Yes, And there was one more called
the organs uh sorry, the Organ Procurement and Transplantation Network,
and they're they're just another network that matches people with
recipients and has waiting list that kind of thing, right,
So this is actually a pretty um lean, mean, streamlined machine. Yeah.
The procurement and donation network. It has to be right. So, Chuck,
(22:56):
you were saying, like they can't be hopping all over
the country, but they have to sometime times. So what
happens with like, let's say somebody dies in Sacramento and
they have the perfect heart that somebody in Tampa needs.
What happens, well, they will put it into a cooler
and fly it to uh what was the destination? Tampa? Tampa?
(23:16):
They fly to Tampa. Apparently like the hospital in Tampa.
Those people will go fly to Sacramento, take possession of it,
and fly it back unless there's somebody in the like
like let's say somebody in Sacramento needed it and somebody
at the Sacramento General Hospital died, that's when that cooler
comes in. Which have you seen the one that's at
the office. We have an organ transplant cooler. Yeah, it's
(23:40):
pretty cool. Roxane keeper tab in it ap probably. Uh.
You know what I thought was really cool is if
you were on the organ donation list as a living donor,
you are actually given consideration if you need an organ
transplant yourself. And they said that they won't like bump
you to the top of the list, but they will
(24:00):
give that a little bit of extra weight, which I
think is that's only right. Did you also see that? Um,
if you are a living donor and you usually your
insurance company won't raise your rates after that. But if
you move to another insurer change like plans, they'll hit
you with a pre existing condition. That's how evil and
(24:21):
seriously you sign up for listening. I will give someone
my kidney as a living human, and the insurance companies
are like, oh, well, you might have to charge a
little extra for that. Don't you think we should start
publicly executing CEOs of insurance companies. It should be part
of the healthcare reform package? Right, of course we don't
mean that. Thanks for the CEO, so Chuck. When when
(24:41):
you're talking about people running around with coolers and all that,
it kind of creates this harried pace right in your mind. Um,
and that's very much true. You have a very short
amount of time for an organ to survive. Remember I said,
like even five minutes can kill a heart once it's
deprived of oxygen, which it stops beating. Right. Um, what
(25:02):
happens when you die too? The body undergoes all these
huge changes. Um, that happened almost immediately, like, um, there's
this uh, parasympathetic flood of chemicals right, um, which is
like kind of fight or flight on steroids. So I
guess it's a sympathetic flood. Like dopamine levels increase eight
(25:24):
hundred percent, epinephrin levels increase, nor EEF levels increase, So
all these chemicals that are meant to like either speed
you up or slow you down or just flooding your body.
That's why you have to take the drugs right most times, Well, no,
this is when you die. So when they're trying to
harvest these organs, they're like trying to get them out
(25:45):
of the body before this flood just damages these I
thought you meant as a recipient that would happen. No,
that'd be pretty awesome though, to have your dopamine levels
raised eight percent, right, But it's not as easy as
just throwing the new heart in there either and sewing
you up and say good luck with your life. No, no,
it's not. And uh there's also some expectation that you
(26:06):
lead a very healthy life after that. You're not supposed
to be drinking or smoking or swearing, and um, you
have to stay away from call girls and things like that. Yeah,
you shouldn't get a new liver and then like dive
into the vodka bottle. You're you're pretty much signing a
contract to become ned Flanders after you get your organ donation. Yeah. Actually,
just over Christmas heard of a friend of a friend
(26:29):
of a family member that was a candidate for I
think a liver transplant and they would not do it
because he wouldn't enter um rehab. Really yeah, wow, so
that's hardcore. Yeah, that guy's dedicated to the booze, isn't it. Yeah,
pretty much. Um. And also you're if you are a recipient,
(26:52):
there's some expectation that you pay like for the lodging
and travel expenses of the person who donated. Yeah, it's
kind of an a written rule from what I understand
well and have to be real, you know, it's kind
of against the law really well, but it makes sense though,
because if you're let's say, you want to donate a
kidney to someone that lives across the country and you're
spending money off from work and flying out there and
(27:12):
putting yourself up, it's gonna cost you some dough and
a kidney. Yes, you'd have to be a really nice
person to be in an anonymous living donor. Yeah, that'd
be cool. All right, So Chuck, you want to talk
(27:49):
about the black market? Yes, the black market does exist.
Isn't that crazy? Um? Yeah, but not surprising. No, but
it's pretty interesting. Um. It obviously exists, Um, typically outside
of the United States, although there have been some cases
inside the United States. Usually it's like, and this is
(28:09):
what's so sad. Usually it's impoverished nations. And what will
happen is there will be a couple of countries involved.
You'll take someone out of a really poor country, offer
them like five thousand dollars for their kidney, and then
the middleman will get, you know, a hundred thousand dollars
for that kidney. And you know that it's not like
these are done in professional surgical rooms. It's a lot
(28:30):
of time, it's it's the back room, if you know
what I mean. And that's actually exactly what happened in
two thousand three in South Africa. Yeah, they were importing
people from uh, I guess the city of God in Brazil. Yeah,
slums of Brazil. Yeah, and um, giving them five grand
for their kidney and then turn around selling it for
a hundred k Yep. That's nuts yep. And uh where
(28:53):
else did it happen? Villagers in India so that they
were getting they weren't getting nearly. They were getting about
eight hundred dollars for their organs, which is just unbelievable.
And at one time the Israeli organ brokers were obtaining
these from Soviet Bloc nations and doing the operations in Turkey,
and this one guy made a middleman, made about four
(29:15):
million dollars before he was called, which is not bad
harvesting organs, although I imagine being an illegal organ broker
is a fairly stressful job. Yeah, and it happens in
the US too, although customarily it's um an organ broker
and a nefarious funeral director who harvest organs before cremation.
Did you know this happened? No? I didn't either, And
(29:38):
I saw all the six feet under of course you did. Uh.
Did you see the movie Trista's No, that wasn't very good.
That was the the deal there though kids are like
captured in the jungle. No, but it was like an
Eli Roth movie. It was like hostile, except they were
harvesting organs basically instead of blind torture uh. And speaking
(30:03):
of that, thereristas that actually does happen in the world.
It's not just old wives tales. Kidney theft does happen,
It really does. Mohammed, what do you say. His name
was Selim Khan. Yes, he lived in Delhi, India, and
he was looking for a day's work and agreed to
(30:23):
go to a house under the premise that he would
get about four dollars a day for performing uh work.
Their construction work. All is on the up and up
so far. Then he has held at gunpoint for several
days along with two other day labors. They were taken
to an operating room drugged and they awoke with a
horrific pain in their side and minus one kidney. And
(30:46):
when they took him to the hospital. When he went
to the hospital, he checked him out and he had
indeed been down one kidney. Not an urban legend. That
really happens, although it makes me wonder if the urban
legend gave rise to the actual practice. Oh, yeah, you know,
maybe so. And Josh, the one US case that was
in here was really interesting too. Yes, Michael Master Master Marino.
(31:08):
There's an oral surgeon in New York and he opened
a company called Biomedical Tissue Services with an embalmer, which
should have been a real red flag that he partners
up with an embalmer. And this is in the year
two thousand, not even that long ago. Actually it was
ten years ago. I'm old. Uh. For many years though,
they harvested human tissue provided by funeral homes and sold
(31:28):
it to research facilities. And one of those bodies belonged
to who Alistair Cook Alistair Cook, famous host of Masterpiece Theater.
So he was chopped up and given to unwitting Well,
I don't know about recipients. They did harvest some of
his tissue. Yeah, yeah, how about that? It's pretty awesome.
So where are we now? We are I think we're
(31:50):
at the point where we checked those stats. I have
them written down here as of two oh three pm.
What time is it now? Chuck's gotta get out of
his Josh is one okay? To thirty one? I gotta
telling me disappointed If this number hasn't gone down, I
think all of our listeners will be too. So we
(32:10):
started out Chuck with a total of one hundred and
five thousand, two hundred eighty eight on the waiting list.
What are we at one oh five. Okay, nothing has
changed in twenty minutes with the kidney. We are at
eighty three thousand twelve. Well, it would be the same
because that was the master stat so the kidney didn't
change either. Let's just hope Jerry didn't put a drum
(32:32):
roll in anywhere, right. But I will say though, don't
be disappointed, because, like I said earlier this morning, UM,
three people received kidneys that were in search. That's awesome.
Or else they died waiting. Yeah, let's let's like to
think the other scenario panned out. Are you a donor?
I don't remember. I was. At one point in time,
I was that seven bucks off, But UM, I think
(32:56):
I'm going to go ahead and do it. Yeah, this
article inspired me because I'm a the belief that the
human body after you die is like worm dirt. So
I have no problem with donating my entire body or
all my organs, none of that. Yeah. Well, if you
want to learn more about organ donation, you can read
Tom Sheave's article on how Stuff Works dot com. UH.
(33:19):
You can also check out the UM what is It?
Chuck the Organ Procurement Network UM for their side of
the story. But I think you should also check out
the Life Guardian Foundation. They have a very much opposing
view of organ donation, So such a controversial topic should
probably um get all of the facts before you make
(33:40):
the very um important decision of whether or not you're
going to be a dead donor. And if you decide
that you want to be, like Chuck said, let everybody know,
tell everybody, tell strangers on the streets. Just anytime you
meet a doctor, go I'm going to be an organ donor.
And you may want to make the decision with your
loved ones as well, even though ultimately it is it
is your right. So good luck with being a rag
(34:03):
doll in the afterlife. Which leads us, of course to listener. Now, Yes, Josh,
I am going to call this uh interesting cleptomania story
from Sarah okay um hi, Josh, Chuck and Jerry, And
she even spelled it correctly. Wow. I think that deserves
a T shirt, don't you? Oh? Actually she didn't, Sorry
(34:26):
to ours Okay close though. Uh here's a story that
I always think of when you hear anything about kleptomania.
A while ago, I was working in a large independent
bookstore that had been a city institution for years. Like
any retail establishment, they had experience about ten theft loss
a year, nothing too unusual. However, one day in the
late eighties they received a thick, densely written journal which
(34:48):
detailed to the day, our moment, weather condition, et cetera,
every single book this person ever stole from the bookstory.
But this guy turned it in. Uh. They showed it
to us in sales training. It was written in a
cramped hand and all pages front and back, which is
really creepy. When you're writing on front and back, you're
either really green or you're like a serial killer. That's
what I think. Uh. Sometimes a clipping or a picture
(35:11):
from one of the stolen books is taped to it. So,
of course the bookstore said, huh, maybe we should prosecute.
Since they confessed basically to stealing over a period of
twenty years, adding up to thousands of dollars is recognition.
They contacted the people that returned address, and it turned
out the person who wrote in was a son or
daughter the very prominent local family active in politics and
(35:31):
big charities and the like, the kind of family they
named Wings of Hospitals after food Sarah say, so, of
course they didn't want their good name, dragted the mud,
and apparently settled out of court for an undisclosed Some
money can do that. I guess that journal was something
to behold though, So, um, that's what Sarah says. That
is definitely that's awesome. Yeah. Cool, Well, if anybody's ever
(35:55):
sent you a cryptic or disturbing journal and you want
to tell us about it, or if you just want
to say hi, you can send us an email at
stuff podcast at how stuff works dot com. For more
on this and thousands of other topics, is it how
stuff works dot com. Want more how stuff works, check
(36:17):
out our blogs on the how stuff works dot com
home page. H
Welcome to Stuff you should know from house stuff Works
dot com. Hey, and welcome to the podcast. I'm Josh
Clark with me as always as Charles W. Chuck Bryant,
who I assume has two functional kidneys. I do, but
(00:22):
I would give one up for your brother. Wow, would
you really? Well? Maybe I think I think that through
Chuck as a living donor. Maybe not. But if I died,
then sure you get thanks. Man. What about your liver,
because I'm pretty certain I'm gonna need somebody's livers. I
don't know that you would want mine either, to be honest.
Oh yeah, yeah, that'd be like getting Mickey Mantle's liver.
I need like a we need a virginal liver, don't I? Yeah,
(00:45):
so I can just start over again, wash it in vodka.
So what are we talking about, Josh? We're talking about
organ donation, Chuck perfect, which I find absolutely fascinating. UM.
Back in nineteen let me take you back a little
bit here, the first successful living human to human organ
(01:07):
donation took place. It was a kidney. Yeah, it was
a great story. Kidneys actually remained the most commonly donated
and UM received organs. But this was actually a couple
of twin brothers, one of whom was dying of chronic nephritis. Yeah,
(01:28):
Richard and Ronald Herrick. And Richard was the one dying,
and Ronald was in good shape right, and Ronald said, well,
you know what, you're my twin brother, and I don't
really want you to die young, so I'm going to
give you one of my kidneys. And um. There have
been uh some other transplants before that. They didn't work
out though, well some of them did, but it wasn't
live human to human um like. For example, the first
(01:51):
I think, the first organ, the first donation or transplant
that ever took place, was way back in sixteen where
they few was part of a dog's skull under a
human's head, crazy and that graft worked. H. We have
taken testicles from monkeys and successfully in playing them into humans.
A pig kidney was successfully transplanted into a human vein transplants, uh,
(02:16):
and a lamb kidney was put into a recipient in
ninety three and that person lived for nine days. But
nineteen fifty four finds the first time a living person
donated an oregon to another living person and it was successful.
And the reason why they think was because they're twins,
there was a very low chance of rejection, right. Yeah.
(02:38):
And the story is great because Richard, you know that
the dying brother had a moment, a clear moment where
he literally, like the day before, said don't do this. Man,
get out of here right now. And the brother said, no,
I'm gonna give you my kidney like it or not, chump,
and he did and it was a great story. Yeah.
And they actually both lived to ripe old ages reproduced,
so they fulfilled their deskin these humans. And since then, Josh,
(03:01):
there have been more than a half a million of
these organ transplants performed. Right, We've gotten a lot better
at it. Yeah. Um, as I was rambling off that
list of stuff that took place before nineteen fifty four,
we have gotten exponentially better. Uh. In two thousand three,
we successfully transplanted a tongue. YEA, I saw that which
I could use A tongue transplanted slightly thinner tongue would
(03:22):
would do me a lot better. I think you had
a fat tongue. Yeah. And do you remember the um,
what do we do the face transplant? Um? That woman
actually remember she got her face from a suicide victim
that was in two thousand five and in two thousand six,
so I know it's coming. A cadaver's penis was transplanted
(03:44):
onto a living human. Yeah, and that man gave it back, Yes,
and I love The reason they gave was because of
it caused psychological problems between the man and his wife,
which I can let your imagination run with that one. Yeah, Yeah,
that's just UH would say the same thing would happen
in my household. So thanks to a better understanding of
(04:04):
how the human body works, of blood type, of the
development of anti rejection drugs, like Chuck said, we've hit
about half a million transplant surgery so far. Right, so
Chuck actually is hot and heavy. Uh to to give
out a stat and this is a very special stat
because it's actually most likely going to change by the
(04:26):
end of the podcast. Yes, these are taking away. These
are current stats. If you go to the website U
n O s dot org, the United Network for Organ Sharing,
they actually have up to the minute statistics on who
needs what and who's giving what and what operations are
being performed. And I didn't realize this, but it's up
to the minute because earlier in the day I checked
(04:47):
on kidneys, and the number actually dropped by three about
an hour later on the waiting list, So three people
got kidneys in that like half hour span. So I'm
just gonna read a couple now and then we'll check
back in for fun in twenty minutes and see if
that's changed at all. Okay, I'm gonna write this down
to check because we'll never remember it. This is the
first time we've ever used a laptop in the studio
and a pen usually just us in our mouths. Uh. Total, Josh,
(05:12):
we got one oh five hundred and five thousand, two
d eight people are waiting for organs, and we'll do
kidney because that's the most popular. Eight three thousand and
twelve people are waiting for a kidney as of two
oh three pm. All right, and we'll check that in
twenty minutes and hopefully those numbers have gone down. Yeah,
(05:33):
because that will mean that either the people on the
waiting list have died or they received a transplant. I
guess we could put those two, we could compare against
one another, and maker we could surmise for So, Chuck,
what are organs? Yeah? I had a feeling you're going
to ask me that, Josh, gohad no, okay. Organs are
(05:54):
systems of cells, josh and tissues, and they all are
in our body for a very specific reason, each one.
And what I like about the organs is that they
are all over equipped, which is what you're looking for
in an organ. You don't want, like the heart to
be like boy, if it beats one beat less, you're
really screwed. So um, our heart. Actually, a twenty year
old's heart beats pumps about ten times more than the
(06:18):
amount of blood we need, and uh, we we have
this reserve capacity in all of our organs as young
lads and lasses. Right. But as Tom Schif, who you
know as my bff, who wrote this article, he points
out that the corneas, when you talk about eye transplants
there they're talking about corneal transplants. Um, they actually don't
(06:40):
necessarily deteriorate like all the other organs. Yeah, that's pretty cool. Um,
So the corneas of seventy five year old donor are
just as good, considering you know, there's not more wear
and tear than say a twenty year old. Yeah, you
could put a seven year old person's cornea inside of
a young person and there would be no difference. Right,
But for organs, they deteriorate with age. Well that's the
(07:02):
bad news, right, Um, so eventually you may need one,
right Well, yeah, because what happens is, let's say one
organ can deteriorate while the rest of your body remains
pretty healthy. That's actually best case scenario, as weird as
that sounds, because that means you can just swap that
sucker out and you'll be fine again. Right. Well, that
that's in a very ideal, utopian world. That's exactly what happens.
(07:25):
The problem is, there is a lot more people in
need of organs than there are organs available, right right,
there's um a waiting list. Some aren't so bad. I
think kidneys go pretty quick, as you're you're talking about earlier.
The longest wait I found, um was the old heart
lung combo. That median wait time was six point seven years.
It's a long time to wait for a heart and
(07:46):
a long if you need it. Yeah, a long time
because nobody goes I'm probably gonna need a heart and
a long combo. Eventually, I'll just put myself on the
waiting list. Now you need it, like the moment you
go onto that waiting list and you have to wait
six point seven years until you get it. Yeah, and
that's why. Um, the mortality rate while waiting for a
heart is, which is that's not as bad as I
(08:07):
would I would like, and um, the liver actually is
the worst. Oh good, yeah, sorry, Um. There's two ways
you can get organs from a live person or a
dead person. Yes, Traditionally we don't take organs like the
heart from a live donor because they would be a
(08:29):
dead donor. After that, you can take things like, uh,
the liver pancreas uncommonly, but it can be done. A
portion of the intestine, um, blood, blood, stem cells, bone, marrow, bones,
all and bones. Yeah, which giving up a bone that's
really something like, I mean, after that you just kind
(08:51):
of have this floppy arm, but somebody else has a bone,
you know, I mean, that's pretty nice. You Know. What
I thought was interesting about the kidney deal, like why
you can give up one kidney and still be okay,
is that most of the times when your kidneys are affected,
they are both affected at the same time, so one's
never gonna go down. And you'd be like, oh, I
wish I still have my healthy kidneys because they both
(09:14):
would have been unhealthy. And uh, all right, I think
we've arrived at the liver. Chuck. This is fascinating to me.
It is where where should we start? Well, let's just
start by saying that the liver can grow. It's like
the starfish of oregan. Yeah, it can regenerate itself, which
is just freaking amazing. Um. So, for instance, let's say
(09:36):
you wanted to split your liver in half and transplant
that into two different people. You could do that. You could.
And actually, if you're an adult donor, they can cut
off a portion, a child sized portion, uh, which is
I think the same as like a child sized meal
where you get like three chicken nuggets from uh and
(09:56):
give it to a kid, and chuck, this is so great.
It grows along with the kid right to a full
size liver once again, but in step with the kid's maturation. Right,
that's just mind boggling. Let's say you needed a piece
of your liver. Let's say you needed your liver replace
and I cut half of my liver off and gave
it to you. My liver would eventually grow to full
(10:18):
size once again. Yeah, if I live that long, so
mine would grow and yours would grow. And the cool
thing is with the liver, you don't even have to
take out the old liver. You can just put in
the new one. It's like the best organ on the planet.
It really is, and our favorite organ because of the
function that it serves. So Chuck, like I said, you
can neither be a dead donor or a living donor.
A dead donor can donate anything, right, including your yeah,
(10:43):
and your eyes, um, heart, lung, all that stuff that
you can't really take from a living donor. Um. But
there are some exceptions. If you have HIV or disease
causing bacteria in your blood streamer tissue there and I
gonna be taking your organs um. And if you are
(11:03):
a practitioner of the Shinto religion, there's not gonna be
a lot of organ donation going on there either, right. Yeah,
not only that, but if you are Amish, they might
support your donation if there is a certainty relative certainty
of success, but they're more reluctant if it's uh less
probable of success. Right. And Tom actually mentioned why the
Gypsies don't agree with organ donation. They believe that, um,
(11:27):
you need your body for the first year to get
around the afterlife. Apparently after that you got it down
pat and you don't really need it any longer. Um.
But he didn't mention Shinto, but I looked it up. Uh.
They believe that the corps is impure. The body becomes
impure after death. So would be like, here, take this
rotting piece of flesh that will save your life, but
you're going to be impure while you live. Interesting, So,
(11:49):
as a result in Japan, uh doing, donation rates are
like really really low copared to like the USA. Yeah,
and Jehovah's witnessed. We should cover them because we're we
always like to talk about them. Uh, they're not opposed
to it, but they have one rule which I thought
was interesting. You can donate your organ as long as
they drain all of the blood out of the organ
first before giving to someone else. So I guess they're
(12:12):
not big on transfusions. I don't think so that would
be my guess. Yeah, okay, Um, how do you register Chuck? Well,
(12:40):
it's pretty easy. Actually in most states. You can do
it at the d m V, which I always found interesting.
You can do it right with there when you're getting
your new driver's license, and uh, here in Georgia. Actually,
we used to have the one of the highest donor rates,
or I should say, one of the most expansive donor
registries in the country. And the reason was when you
went to go get your driver's licenses. I'm sure you remember, Um,
(13:03):
they'd knock seven bucks off of your driver's license. Love that.
So you were an idiot if you didn't sign up.
The problem is that there's not supposed to be any
kind of compensation whatsoever for being Even though this was
legal under state law. UM. The Georgia organ Procurement Organization,
(13:23):
which we'll talk about a minute, UM, they were very
hesitant to draw from the Georgia donor list because they
weren't sure if the person was just looking for the
seven bucks off or else if they really wanted to
be an organ donor. So actually, the contribution rates were
very low in comparison of the size of the registry
in Georgia until two thousand five when they stopped and
(13:46):
they stopped it, I think to actually give you a
T shirt too that says I've sold my lungs for
seven dollars that's illegal, and all I got was this
lousy T shirt. Yeah. No, under a um law. You
can't have any valuable compensation for organ procurement. Right. Well,
we'll get to that too, the whole black market deal. Okay,
So Chuck, if you're a dead donor, how do you donate?
There's two ways, right, Uh? Two ways sure, two ways
(14:10):
of death, brain death and cardiac death. Yeah, is that
what you mean? Obviously, cardiac death is um a little
trickier because you only have a certain amount of time
to get the organs from the body. Brain death a
lot easier in one sense, because um, there could be
as you know, weeks to find a match and to
(14:30):
prepare the organ for donation and get it carried out.
But there's a wrinkle there. Oh, there's a lot of
wrinkles there. Let me let me say something about cardiac
death first, right, Um this there are there are no
laws really governing organ procurement. It's not a case by
case basis, and basically everybody involved in the organ procurement
(14:52):
process does their best to walk a very cautious line
while harvesting organs to try to of other lives, right, yeah,
because there's families involved greeting obviously, um, with cardiac death,
there was a board I think out of Harvard in
the late nineties that established a five minute wait time
(15:13):
from the cessation of a heartbeat. Right, So, you you
take somebody off the life support, wait for the heart
to stop beating. Five minutes after and while this this
the heart's winding down, you're prepping the patient for surgery.
Five minutes after, Uh, somebody pronounces the person dead and
they cut them open and take the organs. But in
five minutes, the heart is useless pretty much at that point.
(15:36):
Some of the other organs, like the liver, the kidneys,
maybe the lungs can survive that five minutes, but the
heart's gone. So if you have a cardiac death, you
have a useless heart, even though the heart might have
been perfectly healthy five minutes ago. Right. So, there was
this doctor in Colorado that said, you know what, there's
no law whatsoever that says I have to wait five minutes.
(15:56):
This guy did a lot of research and found in
the medical latter sure the longest duration between the cessation
of a heartbeat and the spontaneous regeneration of a heartbeat
ever recorded with sixty five seconds. So he started a
sixty five second rule. Got the pants suit off of him.
It was an unsuccessful lawsuit, and now all of a sudden,
(16:17):
the president has been set and now there's a sixty
five second rule out there that some people adhere to.
That is how organ procurement has been established in the US.
Somebody pushes the envelope, they get sued if they if
the cases uh isn't one by the by the plaintiff,
then you have a new rule. And then weird, there's
like zero guidance for organ procurement except that the person
(16:40):
has to be dead. We don't have any real definition
for death. Well that's where brain death gets really really true. Exactly.
Take it, Chuck, Well, I don't. I mean, you're the
you're the expert here. I don't. I can't weigh in
morally because I don't know what I think. Really Nah,
I mean I know what I might believe for myself,
but I don't know about establishing guidelines for others. But
(17:02):
we need them, though, don't we? Yeah? But I don't
want to make up those rules to you know, and
apparently the federal government doesn't either. Um. Every once in
a while, I think Carter assigned a panel to create
a white paper on this, and I guess George Bush
did right before he left office, because there was one
that came out in two thousand and eight. Either Bush
did right before he left office or it was like
(17:23):
the first thing Obama did when he came into office.
But there was a very recent white paper that came
out that said, Okay, here's how we feel about brain death. Right,
here's the problem. Back in the fifties, I think we
came up with this thing called the ventilator. And with
the ventilator, you can keep somebody who for all intents
and purposes dead, You could keep their organs functioning, so
(17:45):
you're masking death. We have no idea what would happen
if that ventilator wasn't there. Would the person die? And
if the person does die, how long do we have
to wait until we say that that person is dead? Right,
So the ventilator made it so we could procure organs
more easily in brain death because we can keep them alive.
At the same time, it blurred the line between life
(18:06):
and death. Well, now they came out with this recommendation
that said brain death is disengagement of no the um
end of meaningful engagement with the rest of the world,
which really widened the scope of who exactly is dead.
And so when you have a brain dead patient and
you procure their organs, what what you actually do is
(18:28):
you have to run them through this battery of tests
where you are um shining lights in their pupils. Uh,
there's an ice water injection into the ear canal to
see if you move toward or away from the stimulus um.
And there's this battery of tests to establish brain death.
And then here's the clincher. They do an apneas test
(18:49):
where they take you off the ventilator for two minutes
and see what happens. And see what happens. Inevitably the um,
the heartbeat is going to slow down, and then after
two minutes they put the ventilator back on. But that
two minutes where your brain was starved of oxygen was
enough to to create real brain death if you weren't before. Wow,
(19:11):
think about that. This is why they call you supplementary
research man, right, That's why that's your superhero. And can
you hear like people fast forwarding through to get through this, partners,
It's like Josh, josh h Josh. Okay, So we have this,
we have this new definition of brain death. And when
the second apnea test happens, and you're declared brain dead.
(19:33):
What they anesthetize you, they inject you with anti paralytics.
Will you into that hospital room and they harvest your organs,
so you actually die from a lack of organs present
in your body. So that's that it's a ghoulish matter.
And these people who are in charge of making sure
that people donate and keeping the image of organ donation
(19:56):
as a gift of life alive have to battle with
this the fact that it's a very ghoulish process. Right,
you're right, So who's who's in charge of this stuff? Uh?
For what? For that whole soapopsh feel anytime, buddy, Yes, Josh.
That would be called an O p O, which is
an organ procurement organization and they are federally designated nonprofits
(20:22):
and they are local all over the country. There's usually
UM one in the central location of a state and
then different satellite office is obviously because you need to
be close by, you know, you can't be hopping all
over the country to get these organs, although that happens
as well. And they basically responsible for awareness, recruitment, evaluation,
UM organ removal and transportation. So they're the people that's
(20:45):
standing there with a cooler waiting to drop your organ
in there and rush it to the recipient. They're also
the people that talk to the family generally well. Sure,
so anytime somebody dies you, the hospital is legally obligated
to note a by the organ procurement organization. Right, and
you know this, This is a good point to bring
this up. If you want to be an organ downer,
or if you are, you really need to tell your
(21:07):
family the stuff, and you should have it all in
your living will because things can get a little ugly. Um.
For instance, let's say you are from a very strict
religious background. Maybe your family doesn't want you cut up.
They think that would be a bad thing, but you
want it. You gotta have that, you know, in paper
on paper, in writing, right, you need and if you
(21:29):
have a documented um in a lot of cases, even
if you if your family is like, no, we don't
want to donate the organs, the organ procuman organization will say,
you know what, ts sorry, he want he or she
wanted to be an organ owner. So and the last
thing you want after you die is for your spouse.
Let's say, to have to mountain this campaign against your
family like a tug of war like that. You gotta
(21:49):
have it all spelled out. Um, So where are we?
The United Network of Organ Sharing that's another group. This
is where that's where you got the kidney statistics. We're
gonna go back on and look at right. Yeah, they're
in Richmond, Virginia, and they are responsible for placing donated
organs um and maintaining the waiting list like you just said.
And they never close No. Seven three sixty five, which
(22:12):
is how it should be. Obviously, we should try calling
them right now to see if they're open. Let's not
do that. I'm sure they're open. And then chuck, there's
the Scientific Registry of Transplant Recipients right, Yes, the s
R t R. And they basically maintain like every amount
of data you could possibly want on transplants, right, for
like policy makers and doctors and drug makers and that
(22:33):
kind of stuff. Yes, And there was one more called
the organs uh sorry, the Organ Procurement and Transplantation Network,
and they're they're just another network that matches people with
recipients and has waiting list that kind of thing, right,
So this is actually a pretty um lean, mean, streamlined machine. Yeah.
The procurement and donation network. It has to be right. So, Chuck,
(22:56):
you were saying, like they can't be hopping all over
the country, but they have to sometime times. So what
happens with like, let's say somebody dies in Sacramento and
they have the perfect heart that somebody in Tampa needs.
What happens, well, they will put it into a cooler
and fly it to uh what was the destination? Tampa? Tampa?
(23:16):
They fly to Tampa. Apparently like the hospital in Tampa.
Those people will go fly to Sacramento, take possession of it,
and fly it back unless there's somebody in the like
like let's say somebody in Sacramento needed it and somebody
at the Sacramento General Hospital died, that's when that cooler
comes in. Which have you seen the one that's at
the office. We have an organ transplant cooler. Yeah, it's
(23:40):
pretty cool. Roxane keeper tab in it ap probably. Uh.
You know what I thought was really cool is if
you were on the organ donation list as a living donor,
you are actually given consideration if you need an organ
transplant yourself. And they said that they won't like bump
you to the top of the list, but they will
(24:00):
give that a little bit of extra weight, which I
think is that's only right. Did you also see that? Um,
if you are a living donor and you usually your
insurance company won't raise your rates after that. But if
you move to another insurer change like plans, they'll hit
you with a pre existing condition. That's how evil and
(24:21):
seriously you sign up for listening. I will give someone
my kidney as a living human, and the insurance companies
are like, oh, well, you might have to charge a
little extra for that. Don't you think we should start
publicly executing CEOs of insurance companies. It should be part
of the healthcare reform package? Right, of course we don't
mean that. Thanks for the CEO, so Chuck. When when
(24:41):
you're talking about people running around with coolers and all that,
it kind of creates this harried pace right in your mind. Um,
and that's very much true. You have a very short
amount of time for an organ to survive. Remember I said,
like even five minutes can kill a heart once it's
deprived of oxygen, which it stops beating. Right. Um, what
(25:02):
happens when you die too? The body undergoes all these
huge changes. Um, that happened almost immediately, like, um, there's
this uh, parasympathetic flood of chemicals right, um, which is
like kind of fight or flight on steroids. So I
guess it's a sympathetic flood. Like dopamine levels increase eight
(25:24):
hundred percent, epinephrin levels increase, nor EEF levels increase, So
all these chemicals that are meant to like either speed
you up or slow you down or just flooding your body.
That's why you have to take the drugs right most times, Well, no,
this is when you die. So when they're trying to
harvest these organs, they're like trying to get them out
(25:45):
of the body before this flood just damages these I
thought you meant as a recipient that would happen. No,
that'd be pretty awesome though, to have your dopamine levels
raised eight percent, right, But it's not as easy as
just throwing the new heart in there either and sewing
you up and say good luck with your life. No, no,
it's not. And uh there's also some expectation that you
(26:06):
lead a very healthy life after that. You're not supposed
to be drinking or smoking or swearing, and um, you
have to stay away from call girls and things like that. Yeah,
you shouldn't get a new liver and then like dive
into the vodka bottle. You're you're pretty much signing a
contract to become ned Flanders after you get your organ donation. Yeah. Actually,
just over Christmas heard of a friend of a friend
(26:29):
of a family member that was a candidate for I
think a liver transplant and they would not do it
because he wouldn't enter um rehab. Really yeah, wow, so
that's hardcore. Yeah, that guy's dedicated to the booze, isn't it. Yeah,
pretty much. Um. And also you're if you are a recipient,
(26:52):
there's some expectation that you pay like for the lodging
and travel expenses of the person who donated. Yeah, it's
kind of an a written rule from what I understand
well and have to be real, you know, it's kind
of against the law really well, but it makes sense though,
because if you're let's say, you want to donate a
kidney to someone that lives across the country and you're
spending money off from work and flying out there and
(27:12):
putting yourself up, it's gonna cost you some dough and
a kidney. Yes, you'd have to be a really nice
person to be in an anonymous living donor. Yeah, that'd
be cool. All right, So Chuck, you want to talk
(27:49):
about the black market? Yes, the black market does exist.
Isn't that crazy? Um? Yeah, but not surprising. No, but
it's pretty interesting. Um. It obviously exists, Um, typically outside
of the United States, although there have been some cases
inside the United States. Usually it's like, and this is
(28:09):
what's so sad. Usually it's impoverished nations. And what will
happen is there will be a couple of countries involved.
You'll take someone out of a really poor country, offer
them like five thousand dollars for their kidney, and then
the middleman will get, you know, a hundred thousand dollars
for that kidney. And you know that it's not like
these are done in professional surgical rooms. It's a lot
(28:30):
of time, it's it's the back room, if you know
what I mean. And that's actually exactly what happened in
two thousand three in South Africa. Yeah, they were importing
people from uh, I guess the city of God in Brazil. Yeah,
slums of Brazil. Yeah, and um, giving them five grand
for their kidney and then turn around selling it for
a hundred k Yep. That's nuts yep. And uh where
(28:53):
else did it happen? Villagers in India so that they
were getting they weren't getting nearly. They were getting about
eight hundred dollars for their organs, which is just unbelievable.
And at one time the Israeli organ brokers were obtaining
these from Soviet Bloc nations and doing the operations in Turkey,
and this one guy made a middleman, made about four
(29:15):
million dollars before he was called, which is not bad
harvesting organs, although I imagine being an illegal organ broker
is a fairly stressful job. Yeah, and it happens in
the US too, although customarily it's um an organ broker
and a nefarious funeral director who harvest organs before cremation.
Did you know this happened? No? I didn't either, And
(29:38):
I saw all the six feet under of course you did. Uh.
Did you see the movie Trista's No, that wasn't very good.
That was the the deal there though kids are like
captured in the jungle. No, but it was like an
Eli Roth movie. It was like hostile, except they were
harvesting organs basically instead of blind torture uh. And speaking
(30:03):
of that, thereristas that actually does happen in the world.
It's not just old wives tales. Kidney theft does happen,
It really does. Mohammed, what do you say. His name
was Selim Khan. Yes, he lived in Delhi, India, and
he was looking for a day's work and agreed to
(30:23):
go to a house under the premise that he would
get about four dollars a day for performing uh work.
Their construction work. All is on the up and up
so far. Then he has held at gunpoint for several
days along with two other day labors. They were taken
to an operating room drugged and they awoke with a
horrific pain in their side and minus one kidney. And
(30:46):
when they took him to the hospital. When he went
to the hospital, he checked him out and he had
indeed been down one kidney. Not an urban legend. That
really happens, although it makes me wonder if the urban
legend gave rise to the actual practice. Oh, yeah, you know,
maybe so. And Josh, the one US case that was
in here was really interesting too. Yes, Michael Master Master Marino.
(31:08):
There's an oral surgeon in New York and he opened
a company called Biomedical Tissue Services with an embalmer, which
should have been a real red flag that he partners
up with an embalmer. And this is in the year
two thousand, not even that long ago. Actually it was
ten years ago. I'm old. Uh. For many years though,
they harvested human tissue provided by funeral homes and sold
(31:28):
it to research facilities. And one of those bodies belonged
to who Alistair Cook Alistair Cook, famous host of Masterpiece Theater.
So he was chopped up and given to unwitting Well,
I don't know about recipients. They did harvest some of
his tissue. Yeah, yeah, how about that? It's pretty awesome.
So where are we now? We are I think we're
(31:50):
at the point where we checked those stats. I have
them written down here as of two oh three pm.
What time is it now? Chuck's gotta get out of
his Josh is one okay? To thirty one? I gotta
telling me disappointed If this number hasn't gone down, I
think all of our listeners will be too. So we
(32:10):
started out Chuck with a total of one hundred and
five thousand, two hundred eighty eight on the waiting list.
What are we at one oh five. Okay, nothing has
changed in twenty minutes with the kidney. We are at
eighty three thousand twelve. Well, it would be the same
because that was the master stat so the kidney didn't
change either. Let's just hope Jerry didn't put a drum
(32:32):
roll in anywhere, right. But I will say though, don't
be disappointed, because, like I said earlier this morning, UM,
three people received kidneys that were in search. That's awesome.
Or else they died waiting. Yeah, let's let's like to
think the other scenario panned out. Are you a donor?
I don't remember. I was. At one point in time,
I was that seven bucks off, But UM, I think
(32:56):
I'm going to go ahead and do it. Yeah, this
article inspired me because I'm a the belief that the
human body after you die is like worm dirt. So
I have no problem with donating my entire body or
all my organs, none of that. Yeah. Well, if you
want to learn more about organ donation, you can read
Tom Sheave's article on how Stuff Works dot com. UH.
(33:19):
You can also check out the UM what is It?
Chuck the Organ Procurement Network UM for their side of
the story. But I think you should also check out
the Life Guardian Foundation. They have a very much opposing
view of organ donation, So such a controversial topic should
probably um get all of the facts before you make
(33:40):
the very um important decision of whether or not you're
going to be a dead donor. And if you decide
that you want to be, like Chuck said, let everybody know,
tell everybody, tell strangers on the streets. Just anytime you
meet a doctor, go I'm going to be an organ donor.
And you may want to make the decision with your
loved ones as well, even though ultimately it is it
is your right. So good luck with being a rag
(34:03):
doll in the afterlife. Which leads us, of course to listener. Now, Yes, Josh,
I am going to call this uh interesting cleptomania story
from Sarah okay um hi, Josh, Chuck and Jerry, And
she even spelled it correctly. Wow. I think that deserves
a T shirt, don't you? Oh? Actually she didn't, Sorry
(34:26):
to ours Okay close though. Uh here's a story that
I always think of when you hear anything about kleptomania.
A while ago, I was working in a large independent
bookstore that had been a city institution for years. Like
any retail establishment, they had experience about ten theft loss
a year, nothing too unusual. However, one day in the
late eighties they received a thick, densely written journal which
(34:48):
detailed to the day, our moment, weather condition, et cetera,
every single book this person ever stole from the bookstory.
But this guy turned it in. Uh. They showed it
to us in sales training. It was written in a
cramped hand and all pages front and back, which is
really creepy. When you're writing on front and back, you're
either really green or you're like a serial killer. That's
what I think. Uh. Sometimes a clipping or a picture
(35:11):
from one of the stolen books is taped to it. So,
of course the bookstore said, huh, maybe we should prosecute.
Since they confessed basically to stealing over a period of
twenty years, adding up to thousands of dollars is recognition.
They contacted the people that returned address, and it turned
out the person who wrote in was a son or
daughter the very prominent local family active in politics and
(35:31):
big charities and the like, the kind of family they
named Wings of Hospitals after food Sarah say, so, of
course they didn't want their good name, dragted the mud,
and apparently settled out of court for an undisclosed Some
money can do that. I guess that journal was something
to behold though, So, um, that's what Sarah says. That
is definitely that's awesome. Yeah. Cool, Well, if anybody's ever
(35:55):
sent you a cryptic or disturbing journal and you want
to tell us about it, or if you just want
to say hi, you can send us an email at
stuff podcast at how stuff works dot com. For more
on this and thousands of other topics, is it how
stuff works dot com. Want more how stuff works, check
(36:17):
out our blogs on the how stuff works dot com
home page. H
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Josh Clark
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