A healthcare Catch-22: Kidney transplant for a homeless man

Pedro Cendeno Lora, age 47, had come to the U.S. in 1995 from the Dominican Republic, and had lived here quite happily for most of that time.

But he knew something was wrong when he became too tired to keep going to work. In late 2006, his lethargy was attributed to kidney failure; by then, he was out of work, and struggling to hang onto his rooming house in Dorchester, Massachusetts. Doctors told him he needed a kidney transplant. But in an all-too-common American healthcare Catch-22, he couldn't work because of his health, and he couldn't qualify for a transplant while in danger of losing his home.

He was running out of time when Health Care for the Homeless and Boston Medical Center came together last year to save him, in two ways. First, they searched for a donor, and realized his younger brother could donate a kidney. Second, Health Care for the Homeless helped him catch up on his rent so he could have a home to recuperate in.

The transplant was performed at Boston Medical Center. Pedro and his brother were able to stay at Barbara McInnis House for the homeless for the week before to prepare for the surgery, and for a month afterward.

"America saved me," he says.

Advice: Work to expand the safety net so it's there if and when you're out of work.

Read another story about a brother’s kidney donation.

Thanks to Adrian Walker for the source article in the Boston Globe of Dec. 9.

I will remain forever grateful: Euthanasia and morphine

Dr. Darshak Sanghavi’s story

Afflicted with a rare, progressive scarring disease of the lungs, my father suddenly deteriorated one day and was hospitalized on a ventilator. Over weeks, my family endured repeated setbacks, as his lungs filled with fluid, his kidneys failed, and his heart weakened. His blood became acidic. Soon, fungus infected his bloodstream. His body ballooned, as if inflated with fluid. Doctors continuously infused intravenous narcotics, to deeply sedate him, and paralyzing agents to prevent any reflexive movements.

For my father, death would mean rest, or "shanti," in the Hindu-Jain tradition. For many people, death is not necessarily evil.

We met with my father’s doctors and agreed on a plan. On the day we decided to let my father die, our family filed into his room. Some prayers were said. The monitors were silenced. The doctors shut off the infusion of paralytic drugs, and injected a large dose of narcotics. The paralysis would still last for several hours. With a knowing nod to us, attending physician then left the room and my father’s nurse lingered behind.

She met my eyes and then my sister’s. Both physicians, we nodded back knowingly. Then the nurse reached over to the ventilator, and in an act of compassion for which I will remain forever grateful, she quietly turned the machine off.

Advice to families with gravely ill loved ones: Consider hospice care.

Read the source article by Dr. Darshak Sanghavi in the July 3 Boston Globe.