My son died in 1994 but his heart only stopped beating this year

Article by Harry Low – BBC

May 2017

Link to the complete article: http://www.bbc.com/news/magazine-39422660 

Link to the Facebook post: https://www.facebook.com/bbcnews/posts/10154643441412217

Link to BBC Mundo – Spanish: http://www.bbc.com/mundo/noticias-39815787

Link to BBC Brazil – Portuguese: http://www.bbc.com/portuguese/geral-39818220

 

 

 

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His Heart Saved the Life of His Baseball Idol

When baseball legend Rod Carew visited Konrad Reuland’s middle school to watch a basketball game, the teenager could talk of nothing else to his family that night. Fifteen years later Konrad’s heart saved Rod’s life.

By then Konrad had become a public figure too, an NFL tight end — he had played for the New York Jets and the Baltimore Ravens — and by all accounts was in the best shape of his life. But, like so many other healthy people, he was hit without warning by an aneurysm in December when he was 29 and, despite a 17-hour operation, became brain dead. His parents donated his organs, saving the lives of some very sick people, all unknown to them.

One, it turned out, was Rod Carew, who had developed heart failure after a massive heart attack in 2015, and it was Konrad’s mother, Mary, who figured it out after friends wondered aloud if he could have been Carew’s donor.

All she knew was that the heart came from a 29-year old who lived in Southern California but it was enough for her to ask question after question until she found out what she could scarcely believe: that part of her son was keeping alive a man he had idolized. Carew, now 71, was an icon to millions: the Hall of Fame Minneapolis Twins first baseman who was a seven-time American League batting champion and who stole more bases in one season than anyone in history except Ty Cobb.

At the time of Konrad’s death, however, he was a man struggling to stay alive, the only possible cure being a donated heart. Given the severity of his condition, the need for the new heart to be compatible with his own and the chronic scarcity of families willing to donate the heart of a loved one who has just died, the chances were dauntingly small.

But there is always a trickle of families like the Reulands and Rod has recovered strongly in both body and spirits. I met him at one of the press conferences that in recent days the two families have held jointly to promote good heart health and draw attention to the power of every organ donation to transform the world for multiple people.  Asked whether having a heart that belonged to someone else gave him any physical problems he said simply, “No. I never think about it.”

At this press conference, held appropriately at the Little League stadium in Encino, California, I asked the two sides if meeting each other was beneficial. Neither hesitated. “Absolutely,” said Mary and Rhonda, Rod’s wife, added, “We feel we have known each other all our lives.” The Carews are profoundly grateful to the Reulands and the Reulands are comforted that Konrad’s decision to say ‘yes’ to organ donation, when he renewed his driver’s license a few months earlier, has saved the life of such a revered man.

More broadly, just as donating an organ gives solace to almost everyone who does it, Mary commented, “Knowing a piece of my baby is still down here on earth is a great comfort.” I had to fight back the tears. To call a 6-foot-6, 270-pound football player a baby in public takes boundless love and almost unbearable pain.

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An Open Letter to the Italian People

After taking me to dinner at the famous Cesarina restaurant in Rome the other night — once the second home of Federico Fellini and Marcello Mastroianni — my host, a renowned transplant surgeon, told the maitre d’ that I was the father of an American boy who was shot in an attempted carjacking on the Salerno-Reggio Calabria autostrada and whose organs were donated to seven Italians, four of them teenagers. “Ah, Nicholas Green,” came the reply and as we shook hands I saw tears in his eyes.

It was deeply satisfying to me for my seven-year old son to be remembered in the company of such gods of world cinema but, I have to say, not a great surprise. Twenty years ago, I wrote ‘an open letter’ to the Italian people, thanking them for their massive eruption of support for our family. In a long lifetime I still can’t recall anything else like it anywhere in the world.

Now, just back from my latest visit, I am writing another open letter to mark an equally unprecedented event: the continuation of that emotion after all these years. I have grown used to it but in many ways it is even more meaningful than the initial upsurge.

Italy has turned its sorrow into the most practical benefit possible. immediately after Nicholas was killed organ donation rates soared and went on soaring for 10 years until they are now triple what they were then, a rate of increase no other country has come close to. Thousands of people are alive, who would have died, including many children. a gain of that size must have contributory causes but no one doubts that the prime reason was the story of one small boy and Italy’s generous-hearted response to it.

History is littered with good causes of white-hot intensity that cool a few months later. Every day the media is full of tragedies, sometimes involving thousands of deaths that a year or two later most readers find difficult to remember in any detail. Yet this one small death has stayed in the hearts of millions of Italians, many of them who were just children themselves when Nicholas was killed.

On this latest visit I heard again what I have heard on the forty something other times I have been in Italy to talk about organ donation: people of all types, from professors of philosophy to members of an alpine rescue team, saying just where they were when they heard we had donated his organs: “I had just come home from work,” “I heard it on the car radio when I was going to pick up my daughter from school.” “My whole family were glued to the television set waiting for more news” and tears come to their eyes. This is the kind of thing we who are old enough to remember used to say after President Kennedy was shot to describe our shocked disbelief.

On a recent trip to Sicily I talked to a class of small children, who listened wide-eyed as I told them how a little boy not much older than them had saved the lives of five people and restored the sight of two others. “You and your wife spoke in this school in the year after Nicholas was killed,” the principal reminded me. It was only then that i realized I was talking to the children of the children who had also gazed at me in wonder that day in 1995.

In the hallway of another school there are two clocks, one like those in every other Italian school, the other marked ‘bodega bay time,’ a daily reminder of the little village in California where Nicholas lived and a continuing stimulus to the idealism of the students.

Traveling on a road in southern Italy last year, we suddenly came to a road block manned by strikers from a local factory. The line of traffic was long and growing. Burly men were on hand to silence anyone pleading to get through. My driver drove on slowly but undaunted. “Get back over there,” the strike leader ordered us. “I’m with the father of the American boy who was shot,” the driver replied. “He’s going to give a speech about organ donation.” A suspicious face peered inside the car, then broke into a smile. “Let this one through,” he told his fellows and off we went.

Nicholas at the age of 7, on the Alps, a few days before he was killed

Every segment of the population continues to show its sympathy: young, old, rich, poor, every shade of political opinion, every religion or none, some of the world’s most prominent men — Maggie and I have met two Italian prime ministers and a president, all of whom have treated us like old family friends, not as leaders of their country — and some of the most beautiful women. At a dinner at the White House for a visiting prime minister, some years ago, where i was a guest, I spoke to Sophia Loren, another guest, who told me, “We Italians feel very close to you.” (Wow!). One night in Rome, when blonde bombshell Alessia Marcuzzi was sitting at a nearby table in a restaurant, I introduced myself as Nicholas’ father. That night she wrote a short piece on her Facebook page. Normally she receives a thousand ‘likes’ for these posts. For this one, it was 39,000 including thousands of passionate comments in favor of organ donation.

The Catholic Church has been heartfelt in its support at every level. Pope John Paul II authorized the making of a magnificent bell with Nicholas’ name and those of his recipients on it for a bell tower commemorating children who have died that we built in Bodega Bay. On the tower are 140 other bells, most of them sent by Italian families. I think of it as a little piece of Italy’s soul on the Pacific Ocean. At the grassroots level, an order of young nuns, The Apostles of the Interior Life, who combine four hours of prayer a day with the most tender compassion for humanity, were eager to help extract the greatest possible good out of Nicholas’ death, when I visited them in Rome recently.

I also met for the first time Valentina Lijou, a cousin of Andrea Mongiardo, the boy who at age 15 received Nicholas’ heart and who died a few weeks ago. Two years older than her, he had been the driving force in their childhood games. “He was always making us laugh,” she said. By the time of the transplant, however, he was receiving transfusions of blood products twice a week, a gaunt, frail little figure who could barely shuffle to the door of his apartment.  All that changed with the transplant: “I’ve now got a Ferrari for a heart,” he used to say. Like most transplants, this one didn’t prolong a sickly life: it transformed it and, until last June, he was living a more or less normal life in good spirits and with a job. Once, when I met him, I remember putting my hand on his heart and feeling it beating strongly and regularly. “Good boy, Nicholas,” I said to myself. To the very end that heart did its work perfectly and Andrea’s death was due not to its weakening but to respiratory failure.

I think everyone who has heard about Nicholas knows he loved Italy: Maggie, who studied architecture, gave him his fascination with its art and monuments and I, through my love of history, helped add color. But it was his own personality that brought all this together into an appreciation for Italy far beyond his years. He thrilled to the idea of the ancient roads radiating out from the center of Rome to the ends of the known world, he was astonished by the mosaics at Ravenna and when I read to him the story of the blinded Polyphemus running his hands over the giant rams where Ulysses’ men were clinging I thought he would burst with excitement.

Having lost all this, we are asked at almost every stop, “Don’t you hate Italy?”  I hope the answer is clear. Maggie and I have never thought that Italy pulled the trigged. Two criminals killed Nicholas: it could have happened anywhere. But what couldn’t have happened anywhere was the response. I don’t think any other country in the world would have shown involvement of this order. It was that flood of human warmth that helped turn a reckless act of brutality into a universal lesson in which life has triumphed over death and hope over despair.

What else is there to say, except “Thank you, Italy”.

Reg Green

Link to the Italian version: https://nicholaseffect.org/2017/03/28/una-lettera-aperta-agli-italiani/

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Una Lettera Aperta Agli Italiani

Dopo avermi portato a cena nel famoso ristorante Cesarina a Roma qualche sera fa – una volta seconda casa di Federico Fellini e Marcello Mastroianni – il mio anfitrione, un rinomato chirurgo dei trapianti, ha raccontato al maître che io ero il padre del bambino Americano che era stato ucciso sull’Autostrada Salerno-Reggio Calabria e i cui organi erano stati donati a sette Italiani, quattro dei quali adolescenti. “Ah, Nicholas Green”, ha risposto lui, e mentre ci stringevamo la mano, ho visto delle lacrime nei suoi occhi.

E’ stato profondamente appagante per me che il mio bambino di sette anni fosse ricordato in compagnia di tali Dèi del cinema mondiale ma, devo dirlo, non è stata una grande sorpresa. Più di vent’anni fa, scrissi una ‘lettera aperta’ agli Italiani, ringraziandoli per la loro imponente esplosione di supporto verso la nostra famiglia. Nella mia lunga vita, ancora oggi non riesco a ricordare nulla di vagamente simile, in nessuna altra parte del mondo.

Adesso, tornato da poco dalla mia più recente visita in Italia, scrivo un’altra lettera all’Italia per registrare un evento ugualmente senza precedenti: la prosecuzione di quell’emozione dopo tutti questi anni. Dovrei ormai essermi abituato a questa cosa, ma in molti modi, ciò è ancor più sorprendente dell’iniziale impennata.

L’Italia ha trasformato il suo dolore nel beneficio più pratico possibile. Immediatamente dopo l’uccisione di Nicholas, i tassi della donazione degli organi sono schizzati verso l’alto e sono cresciuti costantemente per 10 anni, fino a che oggi sono il triplo di quanto non fossero inizialmente, un tasso di crescita a cui nessun’altra nazione è andato vicino. Centinaia di persone, inclusi molti bambini, che sarebbero morte, sono invece vive. Un incremento di tale portata deve avere delle cause che hanno contribuito, ma nessuno dubita che la ragione primaria sia stata la storia di un bambino e la reazione generosa dell’Italia ad essa.

La Storia è disseminata di buone cause che hanno un’intensità incandescente e si raffreddano pochi mesi dopo. Ogni giorno i media sono pieni di tragedie che a volte coinvolgono migliaia di persone, e che uno o due anni dopo i lettori fanno fatica a ricordare nei dettagli. Eppure questa piccola morte è rimasta nei cuori di milioni di Italiani, molti dei quali erano loro stessi bambini quando Nicholas venne ucciso.

Durante questa recente visita, ho ascoltato ancora quello che ho sentito nelle circa quaranta volte e più che sono venuto in Italia per parlare di donazione degli organi: persone di ogni genere, dai professori di filosofia ai membri del soccorso alpino che raccontano dove erano quando hanno saputo che avevamo donato gli organi di Nicholas: “Ero appena tornato a casa dal lavoro”, “L’ho sentito alla radio della macchina mentre andavo a prendere mia figlia a scuola”. “La mia famiglia era incollata al televisore in attesa di ulteriori notizie”, e mi vengono le lacrime agli occhi. Questo è il tipo di cose che noi che siamo grandi abbastanza da ricordarlo dicevamo quando fu ucciso il Presidente Kennedy, per descrivere la nostra sbigottita incredulità.

Durante un recente viaggio in Sicilia, ho parlato ad una classe di bambini piccoli, che ascoltavano ad occhi spalancati mentre raccontavo come un bambino non molto più grande di loro avesse salvato la vita di cinque persone e restituito la vista ad altre due. “Lei e sua moglie avete parlato in questa scuola un anno dopo la morte di Nicholas”, mi ha ricordato il preside. E’ stato solo allora che mi sono reso conto che stavo parlando ai figli dei bambini che mi avevano fissato anche loro con espressione meravigliata quel giorno del 1995.

Nell’atrio di un’altra scuola, ci sono due orologi, uno come quelli di ogni altra scuola italiana, l’altro con su scritto ‘Ora di Bodega Bay’, un promemoria quotidiano del piccolo villaggio della California dove viveva Nicholas, ed un continuo stimolo all’idealismo degli studenti.

Viaggiando in una strada dell’Italia del Sud l’anno scorso, incontrammo improvvisamente un blocco stradale creato da scioperanti di una fabbrica locale. La fila del traffico era lunga e aumentava. Uomini robusti erano a portata di mano per chetare chiunque implorasse di farlo passare. Il mio autista continuò a guidare lentamente ma imperterrito. “Tornate indietro”, ci ordinò il capo della protesta. “Accompagno il padre del bambino Americano che fu ucciso”, replicò l’autista. “Sta andando a tenere un discorso sulla donazione degli organi”. Una faccia sospettosa fece capolino nella macchina e poi eruppe in un sorriso. “Facciamoli passare”, disse ai suoi compagni, e così riprendemmo la nostra marcia.

Nicholas at the age of 7, on the Alps, a few days before he was killed

Ogni segmento della popolazione continua a mostrarci la sua compassione: giovani, anziani, ricchi, poveri, ogni categoria politica diversa, persone di ogni religione o non credenti, alcuni degli uomini più in vista – Maggie ed io abbiamo incontrato due Presidenti del Consiglio ed un Presidente della Repubblica Italiana, e tutti ci hanno trattato come vecchi amici di famiglia e non leader di una nazione – e alcune delle donne più belle. Ad una cena alla Casa Bianca per un Presidente del Consiglio in visita, alcuni anni fa, dove ero stato invitato come ospite, parlai con Sophia Loren, anche lei ospite, che mi disse “Noi Italiani ci sentiamo molto vicini alla vostra famiglia”. (Wow!). Una sera a Roma, quando Alessia Marcuzzi era seduta ad un tavolo vicino, mi presentai come il padre di Nicholas Green. Quella stessa sera, scrisse un breve messaggio sulla sua pagina Facebook. Normalmente riceve un migliaio di ‘mi piace’ per i suoi post. Per quello lì furono 39000, inclusi migliaia di appassionati commenti a favore della donazione degli organi.

La Chiesa Cattolica è stata accorata nel suo sostegno ad ogni livello. Papa Giovanni Paolo II autorizzò la realizzazione di una magnifica campana con il nome di Nicholas e dei suoi riceventi incisi sopra, per una torre campanaria che commemora i bambini che sono morti e che abbiamo costruito a Bodega Bay. Sulla scultura ci sono altre 140 campane, la maggior parte provenienti da famiglie italiane. Penso a questo monumento come ad un piccolo pezzo dell’anima dell’Italia lungo l’Oceano Pacifico. A livello di base, un ordine di giovani suore, Le Apostole della Vita Interiore, che combinano quattro ore di preghiera al giorno con la più tenera compassione per l’umanità, si sono dimostrate desiderose di aiutare ad estrarre quanto più bene possibile dalla morte di Nicholas, quando ho fatto loro visita a Roma recentemente.

Ho anche incontrato per la prima volta Valentina Lijou, una cugina di Andrea Mongiardo, il ragazzo che a 15 anni ricevette il cuore di Nicholas e che è morto poche settimane fa. Due anni più grande di lei, Andrea era stato la forza motrice dei loro giochi d’infanzia. “Ci faceva sempre ridere”, mi ha detto. All’epoca del trapianto, comunque, Andrea riceveva trasfusioni di prodotti ematici due volte a settimana – una magra fragile figurina che riusciva a malapena a trascinarsi fino alla porta del suo appartamento. Tutto questo cambiò con il trapianto: “Adesso ho una Ferrari per cuore”, era solito dire. Come molti trapianti, questo non prolungò semplicemente un’esistenza malaticcia: la trasformò e, fino a Giugno scorso, Andrea ha vissuto una vita più o meno normale, di buon umore e con un lavoro. Ricordo che una volta che lo incontrai misi la mia mano sul suo cuore e lo sentii battere forte e regolare. “Bravo, Nicholas”, dissi a me stesso. Fino alla fine, quel cuore ha fatto perfettamente il suo lavoro, e la dipartita di Andrea non è stata dovuta al suo indebolimento ma a dei problemi respiratori.

Penso che chiunque abbia sentito parlare di Nicholas sappia che lui amava l’Italia: Maggie, che ha studiato architettura, gli infondeva il fascino della sua arte e dei suoi monumenti, ed io, attraverso il mio amore per la storia, lo aiutavo ad aggiungerci colore. Ma fu la sua propria personalità che mise tutto questo insieme, in un gradimento per l’Italia che era molto oltre i suoi anni. Si entusiasmava all’idea delle vecchie strade che si irradiavano dal centro di Roma fino alla fine del mondo conosciuto. Si stupiva di fronte ai mosaici di Ravenna e quando gli lessi la storia di Polifemo che accecato tasta le pecore dove gli uomini di Ulisse si erano aggrappati, pensai che stesse per esplodere dall’eccitazione.

Avendo perso tutto ciò, a quasi ogni tappa ci viene chiesto, “Non odiate l’Italia?”. Spero che la risposta sia chiara. Maggie ed io non abbiamo mai pensato che l’Italia avesse premuto il grilletto. Furono due criminali ad uccidere Nicholas: sarebbe potuto succedere ovunque. Ma quello che invece non sarebbe potuto accadere ovunque fu la reazione. Credo che nessun’altra nazione al mondo avrebbe mostrato un coinvolgimento di tale grado. Fu quella inondazione di calore umano che ci aiutò a trasformare uno sconsiderato atto di brutalità in una lezione universale in cui la vita trionfa sulla morte, e la speranza sulla disperazione.

Cos’altro c’è da dire, se non “Grazie, Italia”.

Reg Green.

Link alla versione in Inglese: https://nicholaseffect.org/2017/03/28/an-open-letter-to-the-italian-people/

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“How ‘The Nicholas Effect’ changed (in better) the history of transplants”

Article published on “Il Corriere della Sera” (Italy)

corriere-della-sera-9-2-2017

To read the complete article, go to:

http://www.corriere.it/salute/17_febbraio_09/cosi-l-effetto-nicholas-ha-cambiato-in-meglio-storia-trapianti-5cbd3fe6-eeb6-11e6-b691-ec49635e90c8.shtml

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The final beat of Nicholas Green’s heart of gold

The boy who received my son’s heart died Tuesday, although he wasn’t really a boy any longer. He was 37 years old. But when my 7-year old son, Nicholas, was shot in an attempted carjacking on a family vacation in Italy, Andrea Mongiardo was just 15.

At the hospital in Sicily, my wife, Maggie, and I decided to donate Nicholas’ organs and corneas for transplant. They went to seven very sick Italians, four of them teenagers.

Perhaps the most agonizing feature of being on a transplant waiting list is that patients can do nothing at all to influence if and when a new organ becomes available. Their future depends entirely on whether a family they have never met is willing to put its own mourning aside to help total strangers.

When Maggie and I were told that Nicholas had no brain activity, it was she who said, in her usual thoughtful way, “Shouldn’t we donate his organs?” We had no sense of what the outcome would be, who could be saved, what they would be like. But we realized we could squeeze some good from what was otherwise just a meaningless act of violence.

What we couldn’t have guessed was how much good: News of our decision spread like wildfire and so galvanized Italy that in the next 10 years organ donation rates there tripled, an increase no other country came close to. As a result, thousands of people are alive who would have died.

Some of Nicholas’ recipients were very close to death. One was a diabetic who was almost blind, couldn’t walk without help and was dependent on others. After receiving Nicholas’ pancreas cells, she moved into an apartment of her own for the first time in her life.

A 19-year-old got Nicholas’ liver. The day he died, she was in a coma. She bounced back to health, married her childhood sweetheart a year later, and a year after that they had a baby boy, whom they named Nicholas. He is now a tall, handsome young man with no trace of the liver weakness that has dogged his family.

Andrea took longer to heal. He had been sick for so long that his strength was undermined and, whereas the other six were soon back in circulation, he only slowly came back to full health. But when he did, it was for real. He got a job, played soccer, lived more normally than he had ever been able to growing up.

And that is how things stood until we got an email on Tuesday. “His heart was still functioning,” Andrea’s longtime doctor told us, “but the lungs were fibrotic because of drug toxicity related to chemotherapy treatment received three years ago after diagnosis of lymphoma. The final cause of death was respiratory failure.”

It was deflating, like the loss of a young nephew you never dreamed would go before you did. But we don’t feel as if Nicholas died all over again, as some doctors fear will happen to donor families. And, of course, we still have no regrets about the decision we took in 1994.

When the Italian media first asked Maggie how she felt about our son’s heart being transplanted into another boy’s chest, she said: “I always hoped Nicholas would have a long life. Now I hope his heart has a long life.”

Sadly, Nicholas’ heart didn’t reach old age. It did, however, perform nobly for three decades. I’m not surprised: I always knew it was pure gold.

What we couldn’t have guessed was how much good: News of our decision spread like wildfire and so galvanized Italy that in the next 10 years organ donation rates there tripled, an increase no other country came close to. As a result, thousands of people are alive who would have died.

Some of Nicholas’ recipients were very close to death. One was a diabetic who was almost blind, couldn’t walk without help and was dependent on others. After receiving Nicholas’ pancreas cells, she moved into an apartment of her own for the first time in her life.

A 19-year-old got Nicholas’ liver. The day he died, she was in a coma. She bounced back to health, married her childhood sweetheart a year later, and a year after that they had a baby boy, whom they named Nicholas. He is now a tall, handsome young man with no trace of the liver weakness that has dogged his family.

Andrea took longer to heal. He had been sick for so long that his strength was undermined and, whereas the other six were soon back in circulation, he only slowly came back to full health. But when he did, it was for real. He got a job, played soccer, lived more normally than he had ever been able to growing up.

And that is how things stood until we got an email on Tuesday. “His heart was still functioning,” Andrea’s longtime doctor told us, “but the lungs were fibrotic because of drug toxicity related to chemotherapy treatment received three years ago after diagnosis of lymphoma. The final cause of death was respiratory failure.”

It was deflating, like the loss of a young nephew you never dreamed would go before you did. But we don’t feel as if Nicholas died all over again, as some doctors fear will happen to donor families. And, of course, we still have no regrets about the decision we took in 1994.

When the Italian media first asked Maggie how she felt about our son’s heart being transplanted into another boy’s chest, she said: “I always hoped Nicholas would have a long life. Now I hope his heart has a long life.”

Sadly, Nicholas’ heart didn’t reach old age. It did, however, perform nobly for three decades. I’m not surprised: I always knew it was pure gold.

Published on The Los Angeles Times.  
February 13, 2017

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Twenty-two years after he was shot, Italians still keep a little American boy in their hearts.

A few weeks ago an emotional email arrived from southern Italy from people we had never met. They are the Santangelo family, who — after our seven-year old son Nicholas was shot in an attempted carjacking in southern Italy and his organs and corneas donated to seven Italians — had opened a coffee bar named for him.

Now they were telling us they had three bars, all of them named Nicholas, and were inviting us to visit them. They seemed to think of him as part of their family. One of the young men in the family has the word Nicholas tattooed on his arm. Their business cards have his face on them.

As it happened, I was giving a talk to the Italian Transplantation Society soon after and my friend and tireless worker for the cause of organ donation, Andrea Scarabelli, who lives in Rome, offered to drive me to Naples.

        On the way down, we called ahead. When we arrived at the first location the whole family was waiting on the sidewalk, the men looking serious, some of the women in tears, the children fidgeting with excitement. Immediately we walked into the group, we were engulfed in hugs and smiles and more tears, some of them mine.

They proudly showed us the huge picture of Nicholas outside the café and I caught my breath, standing next to that beloved face with the honest open look I knew so well and the gentle whimsical smile. I remembered the time I gave a reporter a list of his organs that were transplanted and adding “I wish they could have used his freckles too.”

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Inside we were given steaming cups of coffee, so concentrated in the Italian style that they barely covered the bottom of the tiny cups. I asked for a Café Americano, much bigger, though still only a juvenile version of the mug I use at home. I felt like a sissy, as if I’d asked for Miller Lite in an Irish pub.

With the exquisite tact that Italians of all walks of life show to strangers, they did not press me with questions about Nicholas but nevertheless, seeing that they seemed likely to burst with curiosity, I told them stories about him, and that Eleanor, his sister, the four-year old who was sleeping next to him on the back seat of the car when he was shot, is now a 26-year old teacher; that Maggie, my wife, is the costumer for an opera company; that our twins, born two years after the shooting, are at college; and that the drought in California has shriveled up our lawn. In short, it was like visiting friends I’d known for years.

The mayor of the little town, a suburb of Naples, came too and Dr. Giusy de Rosa, whom I met when she was a teacher at the Nicholas Green Primary School in a nearby town. A renowned nephrologist was also there, Professor Emeritus Natale de Santo of the Second University of Naples, who has done everything he can to help make transplantation an essential part of medical study. This was an opportunity, they all felt, to draw attention to the urgent need for organ donation in an unusually persuasive setting.

None of the three locations is grand, just the traditional meeting places of locals where, along with the weather and the upcoming soccer match, the story of a small American boy whose donation changed the thinking of a nation would be told over and over.

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 “Why did you call it Nicholas?” young people often ask, one of the family told me. “When I tell them the story, they look him up on the Internet,” he added “and, when they come back the next time, they know more about him than I do.” Including, no doubt, that in the 10 years after he was killed organ donation rates in Italy, until then the lowest among comparable European countries, tripled (!) so that thousands of people are alive who would have died.

There are many ways to spread the message of organ donation. To me this kind of spontaneous grassroots growth is the most satisfying of all.

(Written on November 2016)

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Emotional Upsurge for Italian Earthquake Victims has one Precedent: Death of a Small American Boy

The recent devastating earthquake in Italy caused an enormous increase in blood donations. Searching for a parallel, the highly-respected health writer, Margherita De Bac, could only find one: an organ donation story. Here is an excerpt from her article in Italy’s largest newspaper, Corriere della Sera.

Earthquake, the Amatrice Effect, thousands of blood donors.

“The emotion after the earthquake brought a huge number of volunteers to the blood transfusion centers. Now the people in charge of such donations hope that the solidarity does not end. It has been called ‘The Amatrice Effect’. Thousands of blood units were donated by citizens to help the victims of the shock that crumbled towns between Lazio, Abruzzo, Umbria and Marche regions. There has never been such an immediate and spontaneous response [from blood donors.] The same thing happened in 1994, when the death of Nicholas Green, the American child killed along the Salerno-Reggio Calabria highway when he was traveling with his parents, moved the consciences of the Italian people about the problem of transplants…….. Sometimes emotion is worth one thousand campaigns of awareness.”

[After Nicholas’ organs were donated, donations in Italy increased every year for the next 10 years, until they were three times as high as before he was killed.]

Link to the article: http://www.corriere.it/salute/16_agosto_29/terremoto-effetto-amatrice-d5eae0fc-6e06-11e6-8bf4-ee6b05dcd2d0.shtml

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When the Lights Are Turned Off

      In “The Gift that Heals” (www.authorhouse.com) Mindy Zoll, then a transplant coordinator with TransLife, the organ procurement organization in central Florida, described the operating room — at one time crowded and noisy with perhaps 15 or 20 people in it — as the removal of a donor’s organs comes to an end. “The first surgeon will take the heart and he’s gone, already on the roof and into the helicopter or in an ambulance, with the lights and sirens going, while the others are still working. One by one each team leaves and, in the end, it’s just two or three people cleaning up, and everything is quiet again,” she said.

“I generally help put the patient in a shroud before they are taken to the morgue and I always thank them for what they gave. I think of their family at home, in a house that suddenly seems empty, and I want them to feel that I cared for their loved one, just like I would my own.”  

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Fifteen-Year Old, Weighing 60 lb., Now Has My Son’s Heart

A few months ago I received a letter from a transplant surgeon who helped put my dead son’s heart into the body of a boy who would have died without it . He is Dr. Stefano Marianeschi, now Director of the Pediatric Surgery Unit at Niguarda Ca’ Granda hospital in Milan, one of Italy’s foremost transplant hospitals. “We have never met in person but our lives crossed in 1994,” he wrote.

At the time, Dr. Marianeschi was a young cardiac surgery assistant at Rome’s famous children’s hospital, the Bambino Gesu (Baby Jesus) where one of his patients was “a bright boy” named Andrea, 15 years old, who suffered from a complex congenital disease of the heart for which he had already had three major operations, none of which had cured him. This time the diagnosis was terminal complications from the third operation, namely protein-losing enteropathy.

“When I met him he was struggling to survive, he was grossly undernourished, weighing only 27 kilos (60 lb.)and twice a week he had to be admitted to our hospital for albumin and calcium infusions. The only hope for him to get back to a normal life was a heart transplant.”

In those days organ donations in Italy were just about the lowest in Western Europe. “People were resistant to the idea of consenting to donate the organs of their loved ones. So every heart transplant brought challenges and great emotions at the same time,” Dr. Marianeschi wrote.

“I clearly remember the night of October 2. Andrea was in our ward and suddenly we were called because there was finally a heart for him. Dr Antonio Amodeo flew to Sicily to harvest the heart. I went to the hospital and gathered with all the surgeons assisting Professor Carlo Marcelletti to perform the transplant.

 “Initially I did not know who the donor was. I was just happy for my patient to receive the transplant. But as I realized that it was Nicholas’ tragic loss that was the light at the end of a very dark tunnel it was with mixed emotions that we proceeded, trying to make the best of a bad situation. The operation went well and Andrea gradually recovered. Now he is 35 and we meet sometimes on the social media on the Internet. He is still bright like when  he was a child.”

Just another medical miracle.

I remember that night too and the numbness that came with having made a decision that meant we had given up any last hope of holding on to Nicholas. But it never entered my mind, nor Maggie’s either, that this was anything other than the overwhelmingly right thing to do. And that is as true now as it was then.

P.S. I should add that the letter was mailed from Cambodia, where Dr. Marianeschi and other doctors from Niguarda hospital work several weeks of the year to make a dent in the huge backlog of medical problems in a country where a whole generation of physicians was blighted by civil war and repressive regimes and where even now medical resources are woefully inadequate.

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