In the early hours of the morning, the busy operating room falls silent as a tribute to the man undergoing surgery.

This is not a typical surgical procedure. Detrick Witherspoon passed away before being brought in, and now two inexperienced medical students are about to learn about organ donation firsthand.

This is a new program aimed at increasing the number of Black and other minority medical students who are interested in the field of transplant medicine. The goal is to build trust among patients of color.

Dr. James Hildreth, the president of Meharry Medical College, expressed that there are not many transplant surgeons who share his appearance. He mentioned that Tennessee Donor Services collaborated with their college for a project aimed at addressing transplant disparities, joining other historically Black colleges and universities in this effort.

After completing their first year at Meharry, six students spent the summer observing the donor agency to understand the intricate process of conducting transplants. This involved identifying suitable donors, discussing donation with bereaved families, retrieving organs, and matching them with potential recipients who may be located far away.

In the surgical theatre, Teresa Belledent, a student, was concerned about becoming emotional upon seeing the face of the donor, particularly because he was a 44-year-old Black father of six who reminded her of her own father. However, as the organ agency’s surgeon, Dr. Marty Sellers, began removing the kidneys and liver and instructing Belledent and her classmate Emmanuel Kotey, a sense of tranquility overcame her.

“I can simultaneously experience sadness and pay tribute to this individual… while remaining able to concentrate on the act of aiding others,” shared Belledent as the exhausted group embarked on the two-hour journey back to Nashville from the hospital in Jackson, Tennessee.

The difficult lesson of the evening: After several hours of surgery, the room becomes silent once more. Sadly, the donor passed away from a brain hemorrhage, but during the procedure, it was discovered that they had undiagnosed cancer in their lungs. The kidneys and liver, which had been carefully preserved on ice, could not be used. However, the corneas were able to be donated, providing a valuable learning experience for the two students involved in the surgery.

Belledent expressed, “I had the opportunity to witness and experience a lot – and attempting is preferable to not trying.”

Suspicion and the Disparity in Transplants

While there has been an increase in the number of transplants performed in recent years, a significant amount of people still die while waiting for donated organs due to a shortage. This issue is particularly prevalent among Black Americans, who are more than three times as likely as white individuals to suffer from kidney failure. Unfortunately, they often face delays in being placed on the transplant list and have a lower chance of receiving an organ from a living donor, which is considered the most effective type of transplant.

In general, 28% of individuals waiting for organ transplants are Black, but they only make up about 16% of deceased donors. Diversifying the pool of donors can increase the chances of finding a suitable match.

“What steps can we take to bridge this divide?” asked Jill Grandas, the executive director of Tennessee Donor Services, as she approached Hildreth.

Meharry students are aware that there is a lack of trust towards the medical system, which stems from past mistreatment such as the well-known Tuskegee experiment where Black men were denied treatment for syphilis. This lack of trust serves as a hindrance to both organ donation and seeking unfamiliar procedures like transplants.

Austin Brown, a resident of Memphis, stated that his grandfather had a strong aversion towards medicine. Sadly, he passed away from a heart attack when he declined to have a stent placed in his artery to clear it.

Belledent, a resident of Miami, remembered her mother advising her not to select the organ donor option on her driver’s license. This was due to a commonly believed myth that doctors are less likely to put in effort to save the life of a registered donor.

“After witnessing the process, it’s hard to fathom,” expressed Belledent. “In the ICU, nobody is searching for your license or specifically looking for the heart symbol indicating an organ donor.”

Stacey Scotton, a resident of Cleveland, Tennessee, shared that a chef at Meharry’s cafeteria had expressed concerns about being an organ donor. After hearing these concerns, Scotton was able to offer comfort and correct any misconceptions.

AWE IN THE OPERATING ROOM

Kotey and Belledent are receiving a unique anatomy lesson at the hospital in Jackson, Tennessee, which differs greatly from the introductory cadaver lab typically experienced by medical students.

Machines keep oxygen and blood flowing to Witherspoon’s organs — and Kotey lets out a quiet “wow” upon touching a pulsating artery while assisting Sellers, the surgeon.

He later expressed that it was his first time attempting something of that nature and he didn’t want to make any mistakes.

The seller provides clear guidance: Position your right hand in this location, pinch this area, and clamp that one. The students are taught how to remove fat from a kidney, stitch a biopsy incision, and locate a lung nodule that was proven to be cancerous – experiences that they would typically not have until much later in their training.

Hildreth believes that students cannot become truly enthusiastic about something unless they have been exposed to it. He suggests that introducing students to experiences like this at an early age could increase diversity in the field of transplantation.

Less than 7% of kidney specialists and only 5.5% of transplant surgeons are of Black ethnicity.

The students at Meharry were surprised to discover the scarcity of donation opportunities. It is estimated that only 1% of deaths meet the necessary criteria for consideration, and hospitals must promptly notify agencies such as Grandas in order to assess potential candidates and approach families.

Sam Ademisoye from Lawrenceville, Georgia explained that becoming a donor does not happen automatically after passing away at the hospital. There are various factors and processes involved.

MATCHING ORGANS TO RECIPIENTS

In a hospital intensive care unit in Nashville, Brown is being trained in providing care for a donor who has passed away – specifically, an 18-year-old who was killed in a motorcycle accident. They are also learning how to match the donated organs with individuals on the national waiting list.

The heart is quickly taken, but there is a problem with the lungs: Hospitals have rejected 16 patients due to a scan from a week ago in the donor’s medical records that showed signs of bruising.

Brown is aware that organs from young donors are typically highly sought-after, and that these particular lungs are functioning effectively.

“The refusal is astonishing,” he stated, assisting nurses in the daring task of relocating the body for another CT scan to validate the proper functioning of the lungs.

The risk pays off and the next available transplant center accepts them.

According to student Mikhail Thanawalla from Scottsbluff, Nebraska, the numerous steps involved in a successful donation are comparable to gears in a machine. If one gear malfunctions, the entire machine fails. This is the most important lesson he learned.

What sets families apart?

The students may have most vividly recalled the grieving families who shared their experience with making donations.

Daphne Myers, who was experiencing difficulty coping with the loss of her 26-year-old son, was initially prepared to decline.

Myers recalled saying, “I do not wish to discuss that.” She explained, “I was not knowledgeable about it. My generation was not taught to be organ donors.”

The person representing the donor did not ask for that, but instead inquired about Myers’ son. They discussed how Haston Stafford Myers Jr. was always willing to assist others and had a passion for singing. It was during this conversation that Myers discovered her son was a registered organ donor, and she then understood and approved of his decision.

Myers remembered that she was compassionate. This altered my perspective and thoughts. The influence you all can have on families, the compassion that goes hand in hand with performing your duties, it makes a significant difference.

It is currently too early to determine if the program has guided students towards new career opportunities. However, next year, Grandas intends to extend invitations to students from a traditionally Black nursing school.

Kotey plans on becoming a general practitioner and promises that all of his patients, regardless of age, will be informed about organ donation.

Belledent’s desire to become a surgeon has been long-standing. Growing up in Haiti, she witnessed friends and family suffering from kidney disease without access to transplants. She dreams of specializing in transplant surgery in order to give others a second chance at life.

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The Howard Hughes Medical Institute’s Science and Educational Media Group provides support to the Associated Press Health and Science Department. The AP is fully responsible for all of its content.