Sunday, March 21, 2010

Would You by Marthe Jocelyn

You are a young teen, Natalie Johnston with your entire life before you. Life consists of boyfriends, pool parties, school, life guarding, riding your bike and shopping. You have an older sister, Claire whom you love. She's the one who goes before you, showing you the way, leading you. The two of you share a room and a life. She knows things about you that no one else knows.
And then, in a blink of a eye, life changes. In a terrible way.
Your sister is seriously injured in a pedestrian car accident. She lies in hospital, comatose. Her EEG shows no brain activity. Your parents must make the painful decision of life and death.
Marthe Jocelyn tells the Johnston story through the voice of younger sister Natalie. It is a story of pain and horror that is part of any sudden family tragedy. This short but well written book explores the issues of fear and loss, forgiveness and mortality.
Would You doesn't have chapters. Instead the book has subtitles throughout;Who Was Driving? Invasion of the Well-Meaning, and Did You Ever See Dad Cry?
I liked the short subtitles because the helped keep the story focused.
There is only one flaw with this book and that is with the science at the very end. Claire and Natalie's parents decide to donate her organs for transplantation. The description is as follows:

They said it won't take long, they said just a few minutes. As soon as the ventilator stops sending in oxygen, the rest of the system shuts down.
I keep my eyes shut and try not to listen to anything except the beating of her heart. The doctor comes in and there's some murmuring and I know they've turned off the machine because the beep stops.
There's rustling around me, and sniffling, but mostly there's just this distant drum inside Claire.
But then it's fainter and then hardly there. And then, it's not there at all. I guess I'm the first one to know, becuase I'm listening to nothing.
Another minute goes by. There's movement around me. Someone lifts Claire's hand. I'm more aware of being uncomfortable, but I don't want to get up yet. I sure don't want to open my eyes.
And then the doctor's voice. "The patient has died. Time of death is 12:16pm"

If only this were how things were done. But it is not. In organ transplantation, the donor patient is kept alive until the organs are removed. The family is certainly NOT present at this time. The heart must continue to beat because the minute death occurs, chemical processes begin directly and immediately upon death, which make vital organs unusable for transplantation.
It was for this reason that brain death criteria were developed. A way was needed to declare death without the donor patient actually biologically dying. But in fact, the donor patient is in the process of dying and is not yet dead. Therefore, doctors keep donor patients on life support, heavily sedated and paralyzed while the organs are removed.
Such a realistic portrayal in a young adult book would not bode well for either the teens reading the book nor for the organ transplantation lobby. Sad but true.
Secondly, EEG is not a reliable measure of "brain death". In fact, there is no international standard used by doctors to determine brain death.
If you don't believe me, read up on it from these links:

Vital Organ Transplantation and Brain Death

EEG Alone Cannot Diagnose Brain Death

Book Details
Would You by Marthe Jocelyn
Tundra Books 2008
165 pp

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