SEPTEMBER 2019 | CHICAGO 83
The attending physician for both, Smith had
hoped they’d find each other. They would be
uniquely able to understand what the other was
going through and offer support. He would have
made the introductions himself had it not been
for an unwritten rule against doctors introducing
transplant patients, even those not competing for
the same organs.
Over the next weeks, a bond developed. Sarah
and Daru compared notes on the paths that had
led them here. In time, the two could be seen
walking laps together, challenging each other
on how many trips around the floor they could
make, laughing at what they must look like in
their gowns, with tubes and little machines trail-
ing behind.
“You got this” became their go-to phrase.A T 3 : 1 5 P. M. O N T U E S D A Y , D E C E M B E R 1 8 ,
the pager of Jamie Bucio, lead coordinator of
UChicago Medicine’s organ procurement team,
buzzed with an alert. A young man who was a
potential match for Daru had been declared brain-
dead. The man’s heart, liver, and kidneys were
intact and strong, and his family had agreed to
donate the organs.
Bucio is petite, voluble, and
as Italian as a bowl of rigatoni.
She’s also as efficient as a field
com m a nder, w it h a sav a nt ’s abi l-
ity to summon names, dates, and
patient histories at a moment’s
notice. She leads a five-person
team that arranges all the logis-
tics involved in securing and
transporting every one of the
180 or so organs transplanted
each year at UChicago Medicine.
On call 24 hours a day, she and her staff have one
hour to respond with a preliminary acceptance
once alerted to an available organ. Otherwise, it
goes to the next patient on the waiting list.
Every moment of that hour is crucial. Bucio
must first go online to evaluate the particu-
lars of the organ: What kind of shape is it in?
Is it a good match? Then she and her team alert
the surgeons and the attending physician, send-
ing them the particulars along with CT scans
and X-rays of the patient. If everyone approves,
then and only then is the patient notified that
a transplant is a go — and will be happening in
a matter of hours.disconnect and reattach. What’s more, she was so physically weak that
doctors weren’t sure she could even survive such a grueling surgery.
There’s a macabre math that goes into such decisions. A triple trans-
plant means using three organs that could potentially save three other
patients. Does it make sense to use them on a single long shot?
Uriel’s first glimpse of the frail young woman that day only increased
his skepticism. She was as pale as hospital sheets. She had almost no
muscle mass. Her chest seemed to have collapsed in on itself, while fluid
swelled her arms and abdomen. She could barely speak a sentence with-
out gasping for breath.
Was she nervous? Uriel asked her. If UChicago Medicine turned her
down, after all, she would be out of options.
“No,” she answered. “I’m not nervous. I’m full of hope.”
The optimism in her face moved Uriel.
What about her life posttransplant? What were her plans?
Her words spilled out in a giddy cascade. She’d travel, maybe back toEurope, where she had visited as a student ambassador in high school.
She’d restart her career as an occupational therapist; she had earned her
license but had practiced only three months before her health problems
sidelined her. Beyond that? She loved spending time with her family.
They were inseparable. Oh, and there would be Michigan State games!
How could she forget about her alma mater?
“Could you excuse me for a minute?” Uriel said.
Just outside, he spoke to two colleagues, Gabriel Sayer, a heart failurespecialist, and Catherine Murks, a nurse practitioner. “You have to meet
this young woman,” Uriel said. They did, and saw what
he saw : someone who, t houg h facing deat h, r ad iated l i fe.
Before the day was out, Sarah had gone from room
to room talking to various members of the transplant
evaluation team, telling and retelling her story to nearly
30 people. Afterward, they voted on whether to move
forward. They gave a unanimous yes.
FOR BOTH SARAH McPHARLIN AND DARU
Smith, it was now a waiting game. Waiting for organs
to become available. Waiting, to put it in blunt terms,
for the right person to die.
But there was also work to do. Work their lives
depended on. Both had seized on their doctors’ orders to improve their
strength for the surgeries — trudging quarter-mile laps around the inten-
sive care unit, hoisting light weights.
Still, as November grayed into December, Daru’s doctors worried. His
round face began to look drawn. Sullen silence replaced the jokes and
easy banter the staff had come to expect. Some days, Bryan Smith would
see his patient sweating, coughing, and lethargic, barely able to utter a
complete sentence. Daru was wasting away before his eyes. The worst
moments came when Daru would hover near death, seeing the light. To
help his failing heart circulate blood, the hospital put him on an intra-
aortic balloon pump. But it wouldn’t be enough.
Daru had never been very religious, but he began to pray: I need those
organs. If you’re up there, you need to show me something.
At his darkest point, a bright spot flickered: a friendship he’d struck
up with a young woman two doors down in the ICU.
“Sarah,” she had said, introducing herself.
“I know,” Daru answered.
He had learned about her through his sister, who had chatted withSarah’s mother in the hospital gym one day.
It is always a tense
moment when the
aortic clamp is
removed. Sometimes,
the heart won’t beat
and the surgeon has
to “tickle” it to life.