You are the head of one of the branches of a hospital chain. A 42 year old patient is bought in. He was on his way to drop his wife to her workplace when his motorcycle collides with that of a Police Sub Inspector. Patient has had internal head injuries. When he is got to hospital, there is no EEG. The top part of the brain is totally gone, but the respiratory and heart related centers are working. You are to advise the family about the condition. Normally it is their call about when to pull their relative off the ventilator. Just then it strikes you that this patient can save the lives of three others, if the family agrees to organ donation.

You talk to the wife and mother. When they first hear of organ donation, they get a feeling that there is a cadaver from which the patient can get a spare brain. You spend time to explain to them that this is not the case. You end up spending the whole of your day meeting different relatives of the patient in trying to further this cause. One of the patient’s cousin, a progressive 32 year old, sees light and convinces the family members that organ donation can be a good idea. She comes to you and says that the family has agreed – but on one condition, no more medical bills for them. Given the benefit that can happen, you agree.

Being a branch hospital, you don’t have facilities for this kind of operation. Another thing is the medical protocol involved in a ventilator switch-off. After every 6 hours, the ventilator is switched off for 30 minutes and patient condition is checked. If patient is alive then the ventilator is switched off again. Patients sometimes can live for weeks before they actually die.

Head office hears your story and takes a decision that they don’t want to take this patient. There is a bed shortage – and too much of uncertainty involved. You have invested so much of emotional capital in convincing the patient that you are now in a fix. What do you do?

Post script:

Patient was transferred to another hospital which had a much bigger practice. They took care of all costs. He died after 4 days. Patient family was a bit upset. But then they later came to thank the protagonist. The families of the three people who received the kidneys and the liver had come down to meet the patient family – and they were literally worshipped. The grief of death was overcome very easily the happiness of three lives that were saved..