'Thank you’ may be a beautiful expression, but there are times when it falls short of conveying all that is felt. When the darkness of death stares hard, those who step in as light to others’ lives deserve more than gratitude.
We speak here of organ donors and their families — the ones who, in the midst of grief, decide to let their loved one’s vital organs give life to those in need.
Two recent donations have turned focus back on this deeply egalitarian act, though statistics show Kerala still ranks only 11th in the country for organ donation.
Families that take this step set extraordinary examples. It is never easy. They must brace against the biting pain of loss, and still find the strength to make a decision that offers no personal benefit. Rather, they may face criticism.
Latha Sharma, wife of lawyer Neelakanda Sharma, whose heart was transplanted 10 years ago after his brain death, still recalls the harsh comments she faced from relatives at the time. Today, she is calm in the knowledge that her loved one gave another person a chance at life.
This sense of continuity — the feeling that their loved one still lives on through someone else — sustains donor families. TNIE speaks to four such families.
Nevis Sajan Mathew, 25, slipped into a coma in his sleep after a sudden drop in blood sugar went undetected until the next afternoon. His father, Sajan Mathew, a businessman from Kottayam, recalls how his eldest child — an ICAEW student who had returned from France during the pandemic — was rushed to Rajagiri Hospital in Ernakulam.
“He was in a coma for eight days. By then, we understood life would never be the same for us without Nevis. Once brain death was confirmed, we decided to donate his organs,” Sajan says.
Nevis’s organs were given to several people with end-stage liver, kidney, and heart diseases. His corneas went to Little Flower Hospital, Angamaly, and his hands to Basavana, a Karnataka native who had lost both arms in an oil mill accident.
After the donation, Sajan and his wife Sherin met Basavana at Amrita Hospital in Kochi. The sight of Nevis’s hands moved them deeply. “We asked Basavana to cut the cake on Nevis’s birthday,” Sajan recalls.
The couple stays in touch with other recipients too. “They call us papa and mama now. They speak to us every day. We are a family. Premanand, an end-stage heart patient who got Nevis’s heart, visits us with a stethoscope to let us hear our son’s heartbeat,” Sajan says, visibly moved.
The family has since set up a trust to help those struggling with transplant expenses. “If we had not done it, our family would have crumbled in grief. Now, my child has got eternity. We may pass away, but he will live on,” Sajan smiles.
Manu Manoharan, 22, had just secured a job at the airport and was returning home to Kanjiramkulam in Thiruvananthapuram when his new bike skidded on a rain-drenched road. He went into a coma.
“Manu was admitted at KIMS Hospital for four to five days. Even on the first day, we were told the chances of recovery were bleak. So, we had mentally prepared ourselves,” recalls his father, Manoharan B, who works in an oil mill.
Honouring a declaration Manu had once made at a church meet, his parents decided to donate his organs. Later, at Medical College Hospital, he was declared brain dead, and the donation was carried out.
The family, however, is not in touch with the recipients. “We did try to contact those who got his kidneys. But we were treated with indifference, as though we were seeking financial benefit. Even some relatives accused us of that. But we only honoured Manu’s wish. We do not seek any validation,” Manoharan says.
The family had buried Manu in their backyard. “Sometimes we sit around his grave, which we have covered with tin sheets. We sleep there at times. The very thought that he, in his death, granted life to so many brings us relief,” he says.
Lincy P Abraham does not know who received her husband’s organs. “What we went through, the decision we took, and how the donation happened is not known to them,” she says. “But that’s okay. We don’t need anything in return.”
Jerry Varghese, 31, a faculty member at an engineering college, was returning home to Mannanthala in Thiruvananthapuram when he met with an accident. He remained in a coma for four days.
“He was a kind man. Even on that day, he had gone to help someone in need. I wanted his memory and ideals to be honoured, so I suggested that his organs be donated,” Lincy recalls, adding that doctors were supportive.
She says the following year was tough, but she slowly rebuilt her life and now works as a guest lecturer at the College of Engineering Trivandrum. Lincy continues to live with Jerry’s memory, raising their six-year-old daughter.
“She still thinks her father is away at work. One day, I will tell her. For now, I am happy he could help so many. I sometimes think about how he still lives in this world through others. That thought comforts me and his parents,” she smiles.
For Subin Joseph’s family, contact with recipients felt more painful than healing. “A child who received his kidney once came to meet his parents. We discouraged it because they are yet to reconcile with the loss. In fact, that’s why I have been asked to speak to you on their behalf,” says Ambrose PJ Padayatti, Subin’s uncle.
Ambrose recalls the morning in April 2023 when he received the news of Subin’s accident. “He was on his way to work when a bus rammed his bike. Doctors told us chances of survival were bleak. That’s when we thought of organ donation,” he says.
A long-time member of a church team that facilitates organ donation, Ambrose also has a family history of giving. “Last year, when a 93-year-old relative passed away, we donated her eyes,” he notes.
Still, the process faced hurdles. “I contacted the Mrithasanjeevani authorities and they promised smooth coordination. But some family members accused us of seeking benefits,” he says.
“Subin’s parents and I were clear that his organs should serve others rather than decay. Many even approached me with offers of money, but we told them to go through proper channels. The only benefit we wanted was for Subin to live on by restoring life in others,” Ambrose says. “His organs were eventually donated to patients at multiple hospitals.”
The emotions that bind all donor families is a shared sense of relief. “It not only helps those in need but also gives us the feeling that somewhere our loved one is alive, granting life to someone else. The gratification it brings is beyond any material gain,” says Ambrose.
Difference between Brain death and Coma
Brian death is different from coma, says Dr Noble Gracious, state nodal officer of Mrithasanjeevani and executive director of K-SOTTO (Kerala State Organ and Tissue Transplant Organisation).
The comatose stage is like a deep sleep state. Brain stem reflexes can be intact even then. Only when brain stem reflexes are hampered, brain death sets in. A common way to check it is by checking the pupil. If the pupil is dilated and fixed when we flash light on it. Once that is rhe case, recovery is very bleak.
For declaration of brain death, comatose situation is a prerequisite but being in coma, does not mean brain death thatshows up as absence of brian-stem reflexes. Comatose patients may recover, but recovery is near-impossible for brain-dead patients.
Medical processes leading to organ donation
1. Persons having irreversible catastrophic brain injury, who are comatose, and on a ventilator are considered.
2. He/She should not be on medicines and should not be able to breathe on his/her own.
3. Apnea test is performed to confirm the brain-stem death
4. Partial pressure of CO2 is monitored for respiratory drive
5. After nuerologist spots brain-stem death, a team of four doctors constituted by the Medical Superintendent ascertains it.
6. The team will consist of treating doctor, medical admin, and two doctors empanelled by the personnel authorised by the Transplantation of Human Organs.
7. They have to confirm twice within a gap of six hours, performing a battery of prescribed tests.
8. After confirmation, the organ donation team takes over and informs the relatives for donation.
9. After consent of the relatives in front of two witnesses, organ donation team alerts possible recipients based on priority. The hospital concerned then takes over the retrieval process.
10. In between, blood cross matching is done. On ticking all these points, the probable donor thus becomes an actual donor.
How to register for organ donation in Kerala:
1. Visit K-SOTTO (Kerala State Organ and Tissue Transplant Organisation) website at ksotto.kerala.gov.in
2. Navigate to the section for pledging organs and fill out the online form.
3. Receive confirmation by getting a donor card with your unique government registration number, which is a record of your intent to donate.
4. One can also register through a similar process through the NOTTO (National Organ and Tissue Transplant Organisation) website.
5. Print your donor card after submitting your pledge.
6. Inform your family of your decision to donate.