The Greatest Gift

The encephalopathy that often accompanies late-stage liver disease can make a patient a little loopy, prone to odd behavior and hallucinations—the belief, for instance, that you’re on a beach in Jamaica instead of fighting for your life in a hospital’s intensive-care unit. Kathy Boxmeyer assumed her husband, Don, who was sixty-three at the time, must be suffering from more of the same when he beckoned her to his bedside at The University of Minnesota Medical Center Fairview after learning that his replacement organs were en route by helicopter.

“I figured we were going to have a moment,” recalls Kathy, who met Don in “Mr. Penk’s journalism class” at St. Paul’s Monroe High School when they were teens. “I thought he’d thank me, say how much he loved me and the kids, and say goodbye—you know, just in case, because we didn’t know for sure if he’d even make it.”

“Call Effenberger to see if there were any accidents in Mankato” is what Don said instead, referring to his longtime editor, Don Effenberger, at the Pioneer Press, where he has filed more than 3,500 columns during his long career. “A fifty-something man from southern Minnesota” was the only description the transplant team had offered about the donor whose kidneys, liver, and heart would be parceled out in three separate surgeries, including Boxmeyer’s. Don wanted his newsroom friend to help fill in the rest of the details, searching databases for an obituary or, better yet, an address.

The request that seemed so out of left field a moment earlier was now a sign of how lucid Don really was—and how grateful. Even before he knew whether he would survive what would amount to thirty hours of surgery over two days, says Kathy, “he wanted to know where to send the thank-you note.”

There are, of course, channels that organ recipients can go through to make contact with their donor families. LifeSource, the nonprofit organization that manages organ and tissue donation in Minnesota, the Dakotas, and parts of western Wisconsin, generally sends a form letter to the donor family, providing the barest details of how their loved one’s donations have been used to save or improve a recipient’s life. LifeSource, which facilitates donations from an average of 174 individuals annually, resulting in more than 600 transplants, generally cautions donors and recipients who want to meet to hold off for a year or more. But Boxmeyer, a longtime fisherman and inveterate reporter (“I knew I was in the middle of a great story while it was happening,” he says), couldn’t help but coax the story along, dropping a line about his unknown donor into a column he wrote about his surgery in hopes of hooking a reader who knew more than he did. His story circulated, and days later he received an e-mail. A few months after that, he and Kathy were on their way to a hotel in Mankato.

Waiting for the Boxmeyers in the hotel’s parking lot was the family of Joe Bruender, a fifty-seven-year-old unmarried schoolteacher whose sudden death following a cerebral hemorrhage had forced them to make a decision that Bruender had not documented on his driver’s license or discussed with them. “At the time, you’re quite confused and everything is closing in around you,” says Bruender’s sister, Jan Schaible, who lives in Eagle Lake. “But we knew he was gone, and we figured, why not give someone else a chance? Joe was a good-hearted person, and it seemed right.”

A few years earlier, Jan’s brother-in-law had received a life-saving heart transplant, “so we knew what it would mean to a family,” she says of her brother’s potential donation. Even so, part of her wondered if they’d made the right choice—until that day in Mankato, when her then-eighty-nine-year-old mother, Thora, embraced Boxmeyer. “As soon as we met Don, all of that went away.”

“It was a relief for me,” Don says. “They understood right away that Joe didn’t die because of me—but I’m alive because of Joe.”

The bond between the Boxmeyers and Joe Bruender’s family is exceptional. The Boxmeyers have slipped into a familial relationship with Joe’s kin, making regular trips to visit Thora and joining the others for reunions, once at Joe’s grave. “Don’s like another son,” Jan Schaible explains. Even so, their interest in each other’s well-being suggests something of the intimate, if often anonymous, connections between transplant patients waiting for the gift of life and donor families who have the power to bestow it.

Transplant experts discuss this decision in terms of the “conversion rate”—that is, the likelihood that a family faced with the opportunity to donate the organs and tissues of a loved one who is brain dead will decide to do it. Nationwide, the conversion rate is 69 percent, but in Minnesota it’s 77 percent, one of the highest in the country. Minnesota families’ willingness to say yes may owe something to the fact that organ transplants were pioneered at the University of Minnesota more than four decades ago and we’re familiar with the often positive outcome. It may also have something to do with our sense of community spirit, our “willingness,” says Boxmeyer, “to help out the other guy.” It may even owe something to a kind of Midwestern practicality—similar to the mindset that appreciates the good sense of recycling. “That was one reason we did it,” says Schaible. “Joe didn’t need his body anymore, but maybe someone else did.”