Gift of Life: What's a Kidney Among Friends?
Happiness, "Peanuts" creator Charles Schulz declared, is a warm puppy.
For Jay St. John, happiness -- euphoria, actually -- is a new kidney from an unlikely source.
"I feel great, just great," St. John says as he gestures with open arms, as though welcoming his restored life.
After years of illness and six months of dialysis, St. John, the 60-year-old headmaster at Episcopal Day School in Southern Pines, received a gift of immeasurable value medically, emotionally and spiritually.
The kidney transplanted on May 5 at the UNC Kidney Center in Chapel Hill was volunteered by 27-year-old artist, musician, teacher and cabinetmaker Jonathan Brower, who is neither relative nor old friend -- but a good match. Success was immediate.
"(The kidney) started peeing while I was still on the operating table," St. John admits with a chuckle.
This match was definitely made in heaven -- or at least in church. Brower's wife, Meaghan Kelly, serves as associate rector at Emmanuel Episcopal Church in Southern Pines, where recipient and donor met -- not "in a dark alley" as Brower, a master of wit, first answers.
"Right away, I thought Jay was a great guy -- he had a smile I could see from 10 yards away," Brower says.
Later, he learned that St. John is the type of educator who stations himself outside to welcome students by name as they arrive at school each morning. Brower, a Rhode Island native and former instructor at Syracuse University, is a man of similar leanings.
"Jonathan has been on mission trips to New Orleans," St. John says. "He built a fence and playground equipment at a church in Durham. The things he does helps people in need at our church -- and in his life."
To which a modest Brower replies: "You see somebody in the rain, you help them get out."
Their banter camouflages a powerful connection; the two routinely greet each other with bear hugs. They cry together. They joke that St. John has absorbed Brower's drumming skills through the donated organ. Their eye contact is electric.
'You're Going to Do What?'
The big question, however, remains: Why? Why did a healthy, successful young husband elect to endure a painful surgery and extended recovery for an acquaintance?
"Why not?" Brower bounces back. "I found out in November that Jay was ill and had just started dialysis. Meaghan told me he needed a kidney. I said, 'He can have my kidney -- or whatever.'"
Brower "put his hat in the ring" along with two other volunteers, former students and associates of St. John's. Tests revealed Brower's blood type was a match.
"I'm in good shape, I take care of myself, I have a great job," he says. "So I asked my boss if I could take four to eight weeks off."
His parents, Phyllis and David Brower of Tiverton, R.I., were shocked in some ways -- others, not.
"You going to do what?" Phyllis Brower responded when her son conveyed his decision.
"We'd heard of other people who (donate kidneys)," she says, "but it's a surprise when it's one of your own. It was hard."
But the Browers knew their son as a person who loved people and life and poured his heart into everything he did.
"He's always been on the front end of things, a motivator," David Brower says.
They did not try to dissuade him.
'Sure I Was Worried'
This saga began in Vietnam-era 1970 -- years before Brower was born -- when St. John flunked an army physical. He developed Type 2 diabetes. But symptoms of kidney disease did not emerge until 1994, when a biopsy revealed 50 percent kidney function. The diagnosis: IgA neuropathy, a disease occurring when protein settles in the kidneys, causing them to leak blood and protein into the urine. St. John was told there was no treatment.
By 1999, he was feeling unwell and began medication. In 2007, his kidney function had fallen to 20 percent.
"Sure I was worried," he says. "My doctor said I needed to think about getting on a transplant list somewhere."
His options included Johns Hopkins Hospital in Maryland, the Mayo Clinic in Florida, Duke Medical Center and UNC Hospitals. He chose the last, where the waiting list is about five years.
He decided he wanted a living donor after learning that the success rate was 95 percent, as opposed to 90 percent from a cadaver. Only half of the 10,500 kidneys transplanted annually in the U.S. come from living donors. About 76,000 people are wait-listed for kidneys. St. John concedes that many of his dialysis companions may never find a match.
'The Power of Spirituality'
Once arduous tests were complete and Brower's kidney had been deemed acceptable, each man was assigned a transplant team consisting of a surgeon, nephrologist, nurse-coordinator, financial coordinator, social worker/psychologist, pharmacist and dietician.
Brower's motives were examined, as was the possibility of a "change of heart." He was assured he could live a normal life with one healthy kidney. St. John's private insurance and, by law, Medicare, covered all costs for both participants.
Because death is listed as a possible complication, St.John prepared an obituary and planned a funeral complete with music that, besides liturgical, included "A Whiter Shade of Pale" and Bruce Springsteen's "Racing in the Street."
"Meaghan and I have also made our promises about what should happen (if I die)," Brower adds.
He and Meaghan went to Chapel Hill the night before. Jay, his wife Beth and teenage daughter Kate left home at 4:30 a.m. on surgery day.
"We felt we needed to stay in our own house, our environment until the last minute," Beth says.
'The Power of Spirituality'
While a vigil continued at Emmanuel Episcopal Church, Rector John Tampa prayed at the bedsides of donor and recipient. Brower entered one operating room at 7:30 a.m., St. John another at 9 a.m.
"I really wasn't afraid," Beth St. John says. "The power of spirituality, Meaghan being there, all of us together reassured me." Beth brought a 1,000-piece jigsaw puzzle, which the three women nearly completed during the wait. Brower's surgery took about three hours; St. John's lasted seven.
Beth St. John recalls one tense moment when she got a message that Dr. Kozlowski, the transplant surgeon, wanted to speak to her.
"He looked disheveled," she recalls. "He said, 'Jay is fine, but the surgery was not uneventful.'"
The day after the surgery, Brower had a visitor.
"I was shocked," he recalls. "Jay walked into my room on a body tether, singing."
The patients remained in hospital for four days. Brower had been warned that, while the recipient's quality of life would improve immediately, his would decrease during the first phase of recovery.
'Nobody Walks This Alone'
Five weeks post-op, Brower has returned to work with some restrictions. He looks and feels fine but admits to lowered stamina.
Smiling impishly, he lifts his shirt to reveal a 6-inch vertical scar that he says will always remind him that although he can't help everyone around the world, he was able to help someone here.
St. John positively glows over the improvement.
"I didn't know how badly I felt until now that I don't," he says.
Transplanted kidneys have 20- to 30-year viability. Former N.C. Gov. James Holshouser, who practices law in Pinehurst, received a kidney transplant in 1986. St. John, like all transplant recipients, must take anti-rejection medication for the rest of his life.
Good begets better. Brower and St. John are stunned by the outpouring from their church and secular communities. Students at Episcopal Day School created banners and cards.
One says, simply, "You Rock." Flowers, food, letters, e-mails still arrive. People stop St. John on the street for tearful embraces.
After the surgery, Brower's parents sent St. John a card that read "Now you're part Brower." When Tampa learned that Brower had furloughed without pay, he approached the congregation.
"I invited them to join in this sacrifice," he says. "Although Jonathan has no official position here, he gives of himself every Sunday evening, helping Meaghan with youth groups. This was an opportunity to give back."
The congregation responded. A few days before surgery, Brower and his wife were presented a check exceeding $20,000.
"Nobody walks this journey alone," St. John discovered.
Happiness, like beauty, is in the eye of the beholder. In Jay St. John's eyes, happiness looks like a youthful, functioning kidney.
For Jonathan Brower, happiness presents as a selfless act of humanity -- or, as the tall, handsome young man might say with a shrug, " whatever."
Contact Deborah Salomon at firstname.lastname@example.org.
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