Road to kidney transplant rerouted to save donor
The Atlanta Journal-Constitution
Published on: 06/11/05
Cindy Gough is a 48-year-old mother of three in Roswell, with 20 years as a flight attendant for Delta Air Lines. Her kidneys are shot and she needs a transplant.
Pat Cusack is a 54-year old divorcé in Marietta, a low-key deep thinker from New York who manages projects for IBM. He's crazy about kids but never had any of his own.
 PHIL SKINNER / AJC | |||
| PHIL SKINNER / Staff Cindy Gough needs a kidney and Pat Cusack was set to help; testing revealed a heart defect that required emergency surgery. | |||
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Pat read about Cindy's problem a few years ago in The Georgia Bulletin, the newspaper of the Catholic Archdiocese of Atlanta, and he decided to be tested as an organ donor. The tests showed he was a match for Cindy — and that all four arteries to his heart were blocked. He had emergency open-heart surgery.
So, the woman who needs help to stay alive helped save a life. And the man who tried to save a life, did so, but it was his own.
Both of them were bitterly disappointed.
Cindy's best chance for a kidney had slipped away, and Pat felt terrible about the emotional roller-coaster she'd been put on.
Pat bounced back quickly. He is fit and trim, and that helped. By the first anniversary of his heart surgery, he was back to running 15 miles a week — and Cindy was on kidney dialysis to stay alive.
Pat wrote a letter in March 2004 to Cindy's surgeon, Dr. John Whelchel, the director of organ transplant services at Piedmont Hospital. It said he wanted to try again as a donor.
Whelchel was conflicted. He wanted to help Cindy, but he didn't want to hurt Pat, whose recent heart surgery was a red flag. "Your letter presents an interesting ethical dilemma and I am not sure there is a correct answer," Whelchel wrote back. He said he wanted to bring the matter before the hospital's ethics committee.
It never got that far. Last May, just before he received Whelchel's letter, Pat was training for the Peachtree Road Race. For the first time ever, he couldn't make it up Heartbreak Hill, near Piedmont Hospital.
He went for a checkup, and three of the four new arteries attached to his heart were clogged. That meant more open-heart surgery. He made it through again, but he was finished as an organ donor.
Pat's condition is genetic. No matter how many miles he runs or how healthfully he eats, his arteries will clog. And after two surgeries, his body has run out of arteries to harvest for his heart.
So now Cindy and Pat are both in trouble. Luckily, they have each other.
"She probably looks at the kids each night and wonders if she's going to be around to see them complete high school, go to college, get married."
That's Pat explaining why he was ready to give a kidney to a stranger. He makes it sound like a simple decision, although of course it wasn't.
"He's so selfless," Cindy said. "He's like an angel."
Pat is slight and fair-skinned and he speaks in a monotone of gentleness.
The IBM guy inside him sees complex problems in simple terms: Cindy has a dedicated husband and three children who need her; he's had nobody since his divorce seven years ago. How could he not do the transplant?
"I really don't have anything else," Pat said.
At first, when Pat was set to donate his kidney, Cindy felt an overwhelming sense of appreciation. Now she's just worried about him. "He's in a dire situation, and there's nothing I can do, really. It's frustrating."
Pat is on a personal mission to help Cindy get a kidney. "I would feel totally completed," he said. Cindy, meanwhile, is keeping an eye out for the right woman for Pat. "He'd make a great husband," she said with a sly smile.
Cindy is strong — she was a tennis player before her kidneys gave out — but she's no match for the dialysis machine, which she's hooked up to three times a week.
Dialysis is a lifesaver, but it's a lifestyle killer for Cindy. It makes her nauseated and exhausted, and it gives her headaches.
She slogs through, day after day, by telling herself she's going to get a kidney and her life back.
"I feel like I'm getting closer," she said.
It won't be easy. The archdiocese article and the fliers posted at Delta have drawn a lot of potential donors — more than 100 were tested, according to Cheryl Manley, Piedmont's clinical transplant coordinator — but Cindy is a hard one to match.
She has cysts on her kidneys, like her mother had, and her mother's mother. After she had twins seven years ago, Cindy's blood pressure spiked and her kidneys deteriorated. She had a very high level of antibodies in her system, which the body produces to fight a foreign object, like a baby. Too many antibodies lowers her odds of finding a suitable donor.
"It's not impossible," Manley said, "but it's like looking for a needle in a haystack."
There have been several near misses, including one in March when she got a frantic 4 a.m. phone call about a cadaver kidney that looked good.
It was on a plane to Atlanta. She threw some things into a bag and raced to the hospital.
It wasn't a match.
One person who tested last year was a match, but backed out. That's not uncommon.
Until recently, kidney transplant surgery was a major ordeal for the donor. The incision often went from the middle of the back to the middle of the stomach. In many cases, the donor's recovery was longer and harder than the recipient's.
Today, the surgery on the donor is often done laparoscopically, which is much less invasive. The recovery takes about a week, instead of six weeks or more under the old procedure.
About 90,000 Americans are awaiting an organ transplant, and two-thirds of them need a kidney, like Cindy.
But she's got her family and Pat and several local churches and Delta in her corner, and that helps her stay positive, which is important.
"Once you have that new kidney in you, they say you feel reborn," Cindy said. "I can't wait."
Pat is on medication, trying to fight off his body's predisposition to clog his arteries.
After they became friends, Pat and Cindy found out they shared some history. Pat's been a member of St. Jude Catholic Church in Sandy Springs for 20 years, and Cindy grew up in that church. She and Jim were married there.
Their faith is important to both of them, especially now, and seems to give them strength. "I don't believe I won't get a kidney," Cindy said. "God will answer my prayers."
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