Gail’s eyes were red and they spoke volumes. I knew before she said anything that the decision had been made and it had to happen today, perhaps was already happening even as I stood there and watched tears flowing silently down her cheeks.

“Two o’clock,” she said, in response to my unasked question. “They’re getting the recipients to pre-op now.”

“Here?” I asked, incredulous. It made sense for clinical reasons, but emotionally it felt all wrong.

“It was what her husband said she would have wanted. Here. With her friends.”

Susie had been a nurse in the DMH Cardiothoracic ICU for more years than she cared to admit – twentysomething, she’d say with a smile when anyone asked. When she received the Excellence in Professional Nursing award just four weeks ago – a prestigious honor for lifetime achievement – the emcee lauded her “twentysomething” years of service to DMH, to the ICU, and to her patients. Who was really counting, anyway? We all are now – because it was exactly four weeks ago that we gathered to honor her, and today we have gathered to mourn.

She wasn’t even old. Her youngest is only seventeen, an awkward boy whose spindly height doesn’t quite distract from the fact that he hasn’t grown into his feet yet. She was strong and creative, a brilliant mentor to everyone she worked with, a thoughtful and compassionate nurse with clinical skills beyond compare… and yet she fell. After a friend’s barbecue in her neighborhood, she left to walk home. They found her hours later, crumpled up on the ground, unresponsive and completely brain-dead but alive.

It wasn’t assault, which was everyone’s first assumption. I’ve found myself thinking that if she HAD been assaulted, she could have kicked the dude’s tail and she could have lived. She was that tough. Susie lived and breathed for the daily battering she got in the CTICU. The sickest patients, the neediest families, the craziest doctors – she handled it, all of it, anything you could throw at her from the outside. But it was an inside job, an aneurysm, that quickly and quietly brought her down.

It’s two o’clock now. Despite the fact that every bed is full and monitors are beeping in every direction, the CTICU seems deathly quiet today save for the sound of tissues being pulled from cardboard boxes and nurses trying desperately to disguise sniffles as coughs and frequent throat-clearings. The atmosphere is one of disbelief – not just because their best and brightest has been taken from them, but because at this very moment, we know that her organs are being harvested and prepared for transplant into patients that Susie’s own friends will have to care for. One of the patients who comes in here tonight will have Susie’s lungs. One will have her heart.

Susie lived out of town, and after she was found, EMS took her to the closest hospital. They knew right away that there was no chance, no hope of recovery. That other hospital was where they made the brain-death diagnosis and her family made the decision to pull the plug after three days of goodbyes. But her organs are coming here to DMH for the transplants – here, to her own division where her heart beat and her lungs breathed every day for twentysomething years. It makes some sense, as I said, because we’ve got some of the best transplant teams in the country… but how can we bear to let her come back to us in pieces? How can her friends check breath sounds and respiratory rate on Susie’s lungs in someone else’s body? How can they monitor her heart rate when it’s not her heart anymore?

The anonymity of the donor system wasn’t even considered today – we all know who’s getting Susie’s organs. Her life-support removal was scheduled so that her harvesting could be scheduled and the transplants could be scheduled (as transplants rarely are), so everyone knows. The clinical director made the decision to tell the recipients’ families as well. I think this move was partially to explain why all the nurses will be crying when they care for these patients, but more than that I believe that it shows the families that their loved ones will be receiving the best possible care because Susie, the nurse who taught everyone in that unit everything they know, will be guiding them one more time. That’s why her husband wanted BGH doctors to do the transplants and Susie’s friends to care for the patients – so we would have one more chance to make Susie proud. It was so we would have the chance that we were denied on Saturday night – the chance to save her, the chance to help her live and continue giving hope to us and to others.

“Here with her friends,” Gail repeats quietly. “It’s what she would have wanted.”

Fighting back tears, I am inclined to agree.

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Today I Feel: a little lost
Now Playing: “Heaven is a Place on Earth”
Belinda Carlisle
(I really was listening to that.)