A Kidney Donor Delivers a Setback to Live Organ Donation

I am a live kidney donor. That’s a fact I don’t parade around on my sleeve except for times like these when the credibility of live organ donation is on the line. We hear lots of beautiful, affirming stories of living donors giving a kidney or part of another organ and the life-changing, life-saving effects of that gift for their recipients. But all it takes is a widely publicized story of a donation going wrong to stamp a black eye on an evolving but fragile medical procedure– fragile because there are far more needs for organ transplants than available donors.

Debbie Stevens- the donor

This week, we heard the story of a 47-year-old woman named Debbie Stevens who donated a kidney to her boss, 61-year-old Jackie Brucia. Debbie Stevens has now gone public alleging that her boss and kidney recipient, hired her, received the kidney, terribly mistreated her, and fired her. Stevens stated, “I decided to become a kidney donor to my boss, and she took my heart… I feel very betrayed. This has been a very hurtful and horrible experience for me. She just took this gift and put it on the ground and kicked it.” Now, after filing a suit against Ms. Brucia, she’s demanding her kidney to be returned.

Jackie Brucia- the recipient

There are a lot of other extenuating details we know and lot more we don’t know. I’m not going to get into the messy she said/she said soap opera. You can read the story for yourself, but from what I gather of Debbie Stevens’ own story read through my own experience as a donor, I seriously doubt the substance of many of her claims. The circumstances leading up to the actual kidney donation looked legitimate. There didn’t appear to be any kind of set-up or manipulation. I also question the validity and helpfulness of  her post-donation claims.

Now, Debbie Stevens did suffer some post-surgical complications, and that happens. (I suffered some, too that lengthened my recovery time, rendering my case “non-textbook”.) But after that, she alleges that Jackie Brucia began to harangue her for taking too much time off and vying for special treatment as Stevens coped with her post-surgical complications.

Eventually, Stevens was re-located to another office as a demotion. After she made a public stink over her treatment and filed a lawsuit, she was fired.
Stevens, a single mother of two, now claims financial ruin from all the post-surgical medical treatments and lost income. She claims psychological trauma as a result of the donation, and that her life is ruined since no insurance company will pick a kidney donor once her COBRA expires. Meanwhile, Stevens and the press have painted Jackie Brucia as a hot-tempered, manipulative, rich company executive who used and abused a gracious, poor single mother of two kids.

Oh brother… Typing out all that drama just now left me feeling like a daytime soap screenwriter!

Now, don’t get me wrong. I’m sure Jackie Brucia is no innocent saint and that there is some truth to her treatment of Stevens. And of course, we only know what Stevens has shared and how the press has told the story.
But as a donor, I felt compelled to point out some egregious red flags in Stevens’ story and allegations which people unfamiliar to the process might not see.

First, the transplant recipient’s medical insurance covers all of the donor’s medical costs related to the transplant, before and after surgery. All of my screening tests were 100% covered. The surgery and after-care has been 100% covered. When I was re-hospitalized after surgery, the hospitalization, tests, and follow-up tests and visits were all 100% covered. This usually lasts up to two years post-surgery. This is not Good Samaritan philanthropy on the part of insurance companies. As you can imagine, it’s purely about money. It costs a lot less to fully finance a transplant than years of dialysis treatments. Bottom line, unless Stevens is exaggerating her condition or not properly advocating for herself, she should not be in financial ruin from ensuing medical costs related to being a donor.

Second, insurance companies don’t typically deny coverage to organ donors. Not only that, but as established by the Affordable Care Act, a pre-existing condition is no longer a barrier to coverage. That’s one aspect of the new health care law I firmly agree with.

Third, I question the amount of recovery time and accommodations Stevens claimed she needed. Even with complications, I was back to work within three weeks. Stevens was given four. That’s plenty of time. And if she needed more recovery time or accommodations, she could have easily gotten a prescription from her surgeon. That would have cleared the air, especially with her recipient boss, for crying out loud. Chances are that through the process Brucia would have even known and  interacted with Stevens’ surgeon.

Recipients, on the other hand, do often require more recovery time than donors. That is especially the case today with minimally invasive surgical techniques to remove the donor’s kidney. Surgeons have even perfected a single-incision procedure through the donor’s naval! Amazing stuff… So Stevens’ implication that she was forced back to work while her still recovering, pampered boss reamed her out from the comforts of her home looks to be little more than an emotional ploy.

Lastly, something obviously went wrong while preparing and evaluating these two women for the relational after-affects of the donation.
Back to my story… I’m a pastor, and I donated a kidney to one of my parishioners. Live organ donation is emotional enough, but in a potentially awkward situation like this one, it could have been even more so.

Part of the evaluation process was weighing the effects of being a donor on my parishioner recipient, on our unique relationship, how this might affect the church, and how this would affect our families, especially within the church. As a part of my evaluation to be a donor, a social worker from our kidney donation program asked me some very pointed questions, “What are your motives? Do you expect to gain anything from being a donor? How would you react if there was a falling out between you and your recipient? How would you react if the surgery is not successful?” These were tough questions to wrestle through, and if my answers were any less than genuine, my donor application would have been flatly denied. I also had to work very carefully with our church’s leadership and my denominational supervisor to get their support, to discern the best way to share what was happening with the rest of our church, and to work up a recovery plan.

It’s clear from the Debbie Stevens and Jackie Brucia story that something went wrong with this evaluation and preparation process. Perhaps everyone involved was not as thorough or truthful as they needed to be. Maybe the donation program they worked through fell down on the job.

In any case, donation does significantly change the relationship between donor and recipient. It certainly brought my recipient and me and our families much closer. But we also had to figure out healthy, meaningful ways for us to express “thank you” and “you’re welcome” for an unusual, life-altering gift. That creates some discomfort and stress, and I think that stress contributed to the messiness between Stevens and Brucia. I can imagine Stevens feeling that she was owed gratitude and respect from her boss and Brucia struggling over how to be both a thankful recipient and an unbiased supervisor. No doubt those uneasy dynamics came to play.

Yet no matter the extenuating facts, Debbie Stevens’ public behavior since losing her job has cast live organ donation in a dark shadow. She may very well have a case, but why go so public with it, crying out things that are clearly out of line and false? The public sees this story and could very well walk away thinking, If that’s what can happen after donating a kidney, no thank you! Meanwhile, the list of people waiting on the kidney transplant list still grows.

Being a kidney donor is a huge decision, granted, but it is a truly viable, inexpressibly rewarding thing that any healthy person can do. How often are we given an opportunity to give something of ourselves that saves another person’s life? Yes, I live with one kidney now, but I’m just as healthy now as ever. Actually, the process forced me to lose weight and take better care of myself, so I’m healthier now before. My life expectancy has not diminished. I live everyday unaware that anything is different with my body. Aside from avoiding certain medications and avoiding high impact activities, my lifestyle is no different. My kidney donation took place January of last year. That November I ran a 5K race and beat all my previous times.

My body lives just fine with one kidney. And my recipient’s quality of life and life-expectancy has dramatically improved. Her transformation has been a humbling, stunning thing to see.

I really do pray and hope that everything works out as it should for both Stevens and Brucia. Something went terribly wrong that needs to be corrected. But in no way does a tragedy like this paint an accurate or fair portrait of live organ donation.

From one donor to another, Debbie Stevens owes it to everyone on a transplant list and to all potential donors to publicly uphold the worthiness and viability of live organ donation.


Filed under Bodily Health

7 Responses to A Kidney Donor Delivers a Setback to Live Organ Donation

  1. I don’t think she’s doing any damage to live organ donation. In fact, I would hope this would nudge potential donors and recipients to examine their motives more closely in order to avoid this sort of debacle. If that helps screen the wrong kind of people, all the better. I also suspect Stevens’ very human reaction of anger, irrational as it seems, may be fueled by bad or predatory legal advice.

  2. Ed, excellent critique as always and an angle on this story which I hadn’t even considered. I think you’re right that donor programs will study this case carefully to prevent something of this magnitude to happen again. Something obviously went very wrong, and with better prevention and intervention, it could have been avoided.
    I was more concerned about the blatant misinformation and distortions that Ms. Stevens has been spouting, albeit perhaps goaded on by her attorneys. I’m always amazed at how little people know about the donation process and that they’re basing what they do know on older practices long since surpassed. A lot of that discourages people from considering it. Then comes along a Debbie Stevens to make it look a lot worse than it really is! As a fellow donor, I’m in a unique position to know and to say something while admitting that I don’t know all the facts of her case. But I can evaluate the merits of some of her claims to know that a good part of it is a bogus emotional ploy.

  3. Susie

    I am also a living kidney donor (6/2009) and while this case is seemingly negative I do feel that it provides a counter balance to the very rosy picture that is painted about living donation.
    There is no across the board standard for transplant programs, except in very broad terms. Yes, they must do a psychological assessment of every living donor, but that doesn’t mean that people who may be unstable get ruled out. I personally know of a jobless man with no medical insurance who was deemed a suitable donor. He’s now homeless and living in his car. He was an altruistic, or non-directed donor and I think that he, like Ms. Stevens was most likely not mentally stable prior to donation.
    It took me 13 weeks to return to work and six months to feel normal again. I ended up with moderate to severe depression, something I’d never really experienced before. The transplant center where my surgery was performed followed me for 7 days and after that I was on my own.
    I think it’s awesome that you received after care for 2 years, but I believe that’s an exception, not the rule. I wish that all living donors received medical care for the rest of our lives.
    As to the insurance question I did a lot of research on that prior to donation and what I learned is that if I were to lose group coverage I would have to be medically underwritten for an individual policy. The fact that I’d had nephrectomy would be considered in that process and my insurance premium would be $300 – $400 higher due to the fact that an insurance company could not exclude nephrectomy and any conditions arising from that in the future. For that reason I purchased an individual policy prior to donating so that I would be covered. When I lost my job and no longer had group insurance I was very happy that I’d made that decision.
    I monitor my health with a thorough check up every year that costs me about $600 out of pocket and I don’t put any medication or supplement in my body without checking it out with my doctor. I wear a med-alert bracelet so that if anything were to happen to me an emergency room would know that I’ve had nephrectomy so they don’t do contrast dye CT which could damage my remaining kidney.
    There are a lot of things that I do differently now and most of them I figured out on my own
    I agree with the first commenter – if this case helps people take a closer look at their motives when choosing to donate that can only be a good thing. If it gets the transplant community to be more vigilant when assessing potential donors that would also be a good thing.
    We are at a point in time where our I believe our technological abilities need to be balanced with ethical questions and tempered by spiritual guidance.
    Just because we can doesn’t mean we always should.
    My concern is that the message seems to be “you can donate a kidney and it will have no impact on your life,” and that’s just not true. There is no good long term research or follow up done on the living donor population and the urological research that’s been done on people who’ve lost a kidney to injury or illness shows that population to have an increased risk of CKD and cardiac issues as they age.

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  5. allan

    If you will donate something, do not expect any kind of special treatment or to be special after that, it will really break your heart. You’ve have done a good thing, that’s it. It’s already somehow a plus point in St. peter’s book once you’re are being evaluated in heaven on where you are supposed to go.

  6. Julie Robertson

    You are a pastor, NOT a doctor. Good for you that you were a donor for someone in need, but don’t put yourself on a pedestal because everything went great for that which you were involved, and then bash a woman that did the same out of selflessness for another!!
    Judge not and be not juged!!

  7. Ruby

    Jackie Brucia did damage live organ donation. And Jackie Brucia’s company, Atlantic Automotive Group, was found culpable and had to settle with Debbie Stevens. Atlantic Auto Group doesn’t just treat their employees badly–they rip off customers. More info at the link below.
    There is a myth perpetuated in the media that average Americans file many unnecessary lawsuits. As a medical doctor, I know that that is untrue. In medical malpractice, 90% of patients who suffered from their doctor’s malpractice never sue.
    Employers have many more rights and control than in the US than in any other first world nation. The upshot is that America has the highest poverty rate in the developed world and higher than most poor countries. That’s what happens when one lives in an oligarchy. We never really had a democracy. The architect of our constitution, James Madison, said that the purpose of government was to protect the opulent minority from the majority. So he designed a system that nominally appears democratic, but is in actuality tilted heavily to the wealthy.

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