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Outside the cadaver preparation and storage area at Oregon Health & Science University in Portland, Bill Cameron explains that OHSU has so far been able to enroll enough donors to meet the educational needs of the students it serves. To help ensure that continues, Cameron, the director of the university’s Body Donation Program, says it’s important to educate the public about what body, organ and tissue donation is all about so more and more people can consider that as an option. (Mark Ylen/Democrat-Herald)

Mark Ylen

At 48, I realize I’m a bit beyond college age, but I still aspire to follow in my big brother Duane’s footsteps and get into medical school — in a manner of speaking, anyway.

Duane, a longtime Portland otolaryngologist — ear, nose and throat doctor — took the conventional route: He enrolled in premed courses at Oregon State, earned excellent grades, and applied and got accepted to what was then known as the University of Oregon Medical School.

As for me, well, I didn’t do those things. I did attend OSU, and even graduated, but with an eye toward a sportswriter’s notebook rather than a prescription pad.

Now, however, all these years later, I’m dying to qualify for med school.

And dying is, quite literally, what it’s going to take to get me there.

Because I’m volunteering to be a cadaver after the great editor in the sky highlights my name and hits the delete key.

Why? And what all does making such an offer entail, besides no longer breathing?

Well, for the benefit of those of you who might also like to donate your body or organs or tissue, it goes like this ...

That D on your license

OK, I’m far from perfect and certainly not bucking for sainthood, as the trail of empty beer bottles and echoes of swear words would attest. I do, though, like to help people when the opportunity presents itself.

That’s why, for example, every 56 days or so I walk down to the regularly held blood drive at Albany’s Sybaris restaurant. I figure donating blood is a really, really easy way to do something worthwhile.

Along those same lines, I ultimately decided I wanted to be an anatomical donor. I mean, why not? My eyes, kidneys, etc. were going to be of no further value to me after I was dead, so if someone else could put them to use, it only seemed reasonable that they should get that chance.

So the next time I got my driver’s license renewed, I opted for the donor designation, D; 71 percent of Oregon drivers have the D on their license, incidentally, about 2.2 million people.

Somewhat curiously, the D shows up under the heading of restrictions along with the B that says I need corrective lenses.

Does that mean I’m supposed to drive under certain limitations because I am a donor, like maybe not going very fast so as to not mangle my organs in a high-impact crash? I’m still unclear on that.

Then one day about 15 years ago — Nov. 6, 1997, to be exact — I came into possession (can’t remember how) of a card from the Oregon Donor Program, filled it out, and had my wife and father-in-law sign it as witnesses.

The card reads in part: “In the hope that I may help others, I hereby make this anatomical gift, if medically acceptable, for the purposes of transplantation or medical research, to take effect on my death. The word and marks below indicate my desires.”

I checked box A, signifying I was willing to give “any needed organ or parts,” and box C, which noted I was also game to donate “my entire body for study, if needed (additional forms needed for whole body donation).”

Alas, there was no explanation as to what those additional forms were or where to get them, and in 1997 the Internet wasn’t what it is today; thus, finding out was going to take a bit of effort.

So, being something of a bluff-caller as well as a procrastinator, I just tucked the card into my wallet and hoped it would be enough to one day earn me a ticket to Oregon Health & Science University, as my brother’s alma mater is now called.

Giants need not apply

Good thing I’m still alive, because as it turns out it’s not enough. Bill Cameron, director of the OHSU Body Donation Program, says you really do need that extra paperwork if you want to do more than avail yourself as an organ or tissue donor.

Sure, your next of kin could always make that whole-body decision for you, but if you’re certain of your own wishes, why leave your fate in someone else’s hands?

So what you want to do is go to the university’s website, ohsu.edu, and work your way to the body donation section. There you’ll find a one-page information sheet and two-page enrollment form that you can print, complete and mail to the med school.

At that point, you’ve basically done all you can do as a living, breathing person to punch your ticket for the anatomy lab, save for:

• Doing your best not to acquire MRSA, HIV/AIDS,  hepatitis or tuberculosis; those infectious diseases are automatic disqualifiers, as are any recent surgeries that haven’t healed, or diabetes or circulation problems.

• Not growing to a height of beyond 6-foot-5 or becoming obese; the examination tables in the lab aren’t long enough for the super tall, and because students need to turn cadavers over from back to stomach while studying them, an out-of-proportion subject would pose a problem for all but the strongest students.

However, even a totally healthy, normal-size Oregonian who has filled out the body donation paperwork faces long odds for reaching OHSU  (the new osteopathic college in Lebanon currently gets its cadavers from California, home state of its parent organization).

Among other reasons, that’s because society’s greatest need in terms of anatomical donation is not cadavers for medical students but organs and tissue for transplant. And yes, organs are composed of tissue too; the differentiation is just for transplant terminology purposes.

A numbers game

In the United States, an average of 18 people die every day while waiting for an organ transplant. The goal of people like Mike Seely, the director of the Pacific Northwest Transplant Bank, is to reduce that number; getting it to zero is out of the question.

That’s because to be a candidate for organ donation, a person has to end up — and there’s really no delicate way to put this — brain dead. He or she has to be alive and with just enough neurological function to keep organs working until a harvest team removes them.

Once out of the donor, the organs have to be transplanted in a matter of hours — up to 48 for a kidney, for example, but a maximum of six for a heart.

“Fifteen hundred miles is about as far as we can go with a heart,” said Seely, whose organization is one of 58 agencies in the U.S. designated to provide organ recovery services to hospitals.  “Alaska is pushing it for us.”

In the U.S., any given person has less than a one in 100 likelihood of ending up brain dead — meaning that upwards of 99 percent of even those willing to give organs can’t.

Hence the need for Donate Life Northwest, formerly known as the Oregon Donor Program, to sign up as many potential donors as possible. It’s very much a numbers game.

Both the PNW Transplant Bank and the OHSU Body Donation Program operate under the Donate Life Northwest umbrella, which also covers the Lions Eye Bank of Oregon, American Red Cross Oregon Trail Chapter and Community Tissue Services.

Donate Life Northwest is in turn part of Donate Life America and another nationwide entity, the United Network for Organ Sharing. The goal is to make sure organ harvesting and transplanting are done as efficiently, effectively and ethically as possible.

In case you were wondering, people like Mickey Mantle and David Crosby didn’t get new livers because they were famous; they received transplants because at the time those donated livers became available, the rocker and the ballplayer topped the list of potential recipients.

That list is ordered based on two simple questions: How bad is the patient’s need, and what is the likelihood the transplant will work?

“The key is stewardship,” Seely said. “How can we do the best that we can with this precious gift?”

Donor generosity, and the outcomes it can effect, continue to amaze Seely after 27 years in the organ transplant field.

“Forty to 50 percent of our organ donors in the last year were on registry — they had made their wishes known, they had consented. The magnanimous nature of the public’s generosity is what keeps me every five years from wanting to do something else. I’ve seen a lung transplant recipient play the bagpipes — never in my wildest dreams did I think I would see something like that. Do you know how hard it is to play the bagpipes?

“It’s just so incredible,” Seely said, “that people will look beyond themselves and consider donation, that families have a willingness to look beyond themselves, beyond the tragedy, and give the gift of life.”

Private-sector options

In addition to OHSU, there are a pair of private companies in this state to which a person or his next of kin could donate his body for science.

Based in Portland, they are MedCure and Biogift, and they work like this:

They will take your body and harvest parts to be sent to research labs and other insititutions around the country; those parts aren’t returned but are disposed of by the insitutions that use them when they are done with them.

What’s left is cremated and returned to the family in a matter of weeks or, in the case of MedCure, scattered at sea if that’s what the family wants.

The cremated remains of OHSU’s cadavers are returned to the families also, but possibly not until a couple of years from the time of death. A cadaver is used for an entire academic year, and it may have been stored at OHSU for a year or more before that.

OHSU needs about 50 cadavers per year and stores about twice again that many.

The university is a publicly funded entity, whereas MedCure and Biogift operate on what’s described as a cost-recovery basis; it’s illegal to sell human body parts, but not to charge recipients for the expense of harvesting organs, bones, tissue, joints, etc. or transporting them.

The companies accept nearly everyone who wishes to donate. Disqualifying factors would be infectious diseases like AIDS/HIV, obesity, or a history of incarceration or drug use.

Cadavers in the OHSU Body Donation Program have been initially taken care of by a funeral home paid by the donor’s family or in advance by the donor himself; the total cost is typically $500 to $1,000.

MedCure and Biogift, however, contract with funeral homes and cover those expenses, meaning there is no cost to the donor or his family.

OHSU is a public corporation with a board of directors appointed by the governor, while the private companies operate with minimal state supervision; they are neither licensed nor inspected by either the Oregon Health Authority, which oversees health care, or the Oregon Mortuary and Cemetery Board, which governs the funeral home industry.

The only regulation specific to their work that they must follow is the federal Uniform Anatomical Gift Act, the law that prohibits the selling of human remains.

If you have your heart set on having your body used for science and don’t like either the OHSU or private company options, you could always make provisions to end up at one of the five “body farms” in the U.S.

The farms are research facilities that study human  decomposition for forensic anthropology and crime investigation purposes.

The original body farm is the one at the University of Tennessee, which has been in existence since 1981.

The largest is Texas State’s seven-acre operation.

At the finish

When photographer Mark Ylen and I visited OHSU in January to gather information for this story, one thing we learned is that a decent percentage of organ donors are people who’ve suffered catastrophic head injuries — brain death — in motorcycle accidents.

Being an avid motorcyclist myself, that sort of caught my attention; it was then clarified, though, that riding helmetless — which by law you can’t do in Oregon, and by choice I wouldn’t do anyway — is what put most of those riders in a position to have their organs go to other people.

Of course, someone could perish in a motorcycle crash with or without headgear. But I like to think that with 53,000 accident-free miles on my resume, that won’t happen to me.

Still, what exactly will happen when I, with the D on my license that lets people know I am on the rolls of Donate Life Northwest, reach the end?

Again, on the very off chance I end up brain dead before being actually deceased, my organs will be harvested by a team from the PNW Transplant Bank, which works with about 80 hospitals in Oregon, southwest Washington and western Idaho.

If I progress right to the officially dead part of the show, my organs are then no longer usable, but my tissue, including my eyes and bones, still are, so they will be taken if there’s someone who needs them; the Lions Eye Bank handles cornea harvesting, and Community Tissue Services takes care of skin, bones, etc.

Only if organs and tissue are not harvested, and if I haven’t picked up one of those infectious diseases we talked about earlier, and if I haven’t become really overweight, would I follow my big brother to OHSU and become a cadaver in the anatomy lab.

So basically my odds of getting into med school via the body donation route are only slightly better than they would have been had I tried to follow the path my sibling took.

Oh, I suppose I could stipulate in my will, “Use me at OHSU or forget the whole thing,” but that seems both selfish and presumptive.

Who am I, after all, to decide the most valuable use of my body after I’m done with it?

I get to make those kinds of decisions now, while I’m still alive. When I’m not, I’ll leave it up to the Donate Life people to know what’s best.

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