First responders arrived at the home initially, followed soon thereafter by paramedics. We picked up the dispatch over the radio scanner and prepared our minds and equipment in trauma room one. This one was a long time coming which surprised us all since the scene was within five minutes of the ER by car. 45 minutes passed before the call came telling us they were inbound.

The ambulance pulled up to the doors and he was brought in on a stretcher. He was SOA- smurfed on arrival, or perhaps I should say cyanotic for the sake of the purists, which really means that his skin was a most unappealing shade of blue. No IV line had been started, and the rescue team were bagging as they hurried him into the ER. 45 minutes on scene, four paramedics accompanying him - the focus of the time on scene had been concentrated on CPR alternating with unsuccessful attempts to intubate.

My heart leapt into my throat as the stretcher was rolled into place beside where I stood waiting, under the saucer shaped overhead exam light, with IV catheter in hand & fluid hung ready to get a line started. With his face partially obscured by venti-mask this bare-chested man lying on the stretcher was the spitting image of a man I deeply cared for- was it... ? No time to pause to know that instant- other things took priority and the IV was started, the ER doc tried to intubate, the parameds kept up CPR and the theater became a whirlwind of fast working professionals, some drawing blood for lab, taking x-rays, connecting the lines for cardiac monitoring etc...

Very quickly I became busy pushing medicines through the IV line, atropine, bicarb, epi, we drained the crash cart in short order and had the house supervisor dashing for more. As I paused between each administration I was able to see the man more distinctly and know he was not the person I thought him to be at first glance, although he could surely have been the man's brother.

All efforts to intubate were unsuccessful as were the medicines we were giving and the jolts from the defibrillator The patient's wife had arrived and we learned that he was on the waiting list for a new heart. With sadness, and after an hour of all out effort in the ER we knew his name would be off that list this night.

The doctor called the code. The patient was pronounced. We removed the signs of our interventions and made him presentable. His wife grieved. The ER physician returned to his call room and the nursing staff began the mountain of tasks and paperwork that follow an unsuccessful code.

My partner had recently been certified for organ harvest and she noted on his driver's license that he had agreed to be a donor and so after providing his wife a bit of time to cry, we

"K" and I studied the manual closely, assembled all the necessary items and got started. We worked together and by carefully retracting, snipping and cutting delicately, removing first one eye, and then the other, being sure to get as much optic nerve as possible, pin it, cage the specimens and pack them properly. It's a highly emotional feeling, the first time you actually perform a harvest, and as nurses a scientifically interesting change of routine as well. "K" and I remained high on our experience the remainder of our tour of duty.

That was the first time I participated in a harvest. There have been others since that night, but no matter how many chance and circumstances will bring me to participate in or perform over the course of my nursing career I will never forget Mr. "S" or his brave wife. I am left filled with awe every time I think about the contribution Mr. "S" made.

If I were to write a blockbuster movie or a best-selling novel I would never come close to leaving a more meaningful contribution than that of Mr. "S" and all those who like him donate their organs. My mother had cataracts from an early age and her quality of life was greatly improved by being able to have lens implants. My father, still flying his private plane at age 82, recently had a lens implant done and passed his FAA flight physical. I hope it comforts Mrs. "S", as it should, to know that her husband gave of himself so that others would be enabled to lead better lives. What finer contribution can any of us hope to make? I remember Mr. "S" with great respect and reverence and every once in a while speak quietly and smile while telling him ... Mr. "S", you're a hell of a man. Somehow I think he looks down and smiles back...

I hope that the next time you renew your driver's license, or otherwise come across the question of whether or not you would like to become a designated organ donor you will remember Mr. "S" too and all of the fine people like him and consider checking the box that says yes.

Written as I smile, remembering Mr. "S"

Sara Ellis, RN has an extensive career in nursing at all levels with over 20 years experience in NICU, ICU, and ER (both civilian and military). She currently runs Medi-Smart.com (http://medi-smart.com), a site that offers career advancement resources and extensive skill development features for nurses.

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