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The Heart is Beautiful - Part 4.

"He did not die so I could live. He died, and then I lived." So says Melanie of her heart donor.

CyberShrink comments on the fourth episode of the series "The Heart is Beautiful", which is screened at 19h35 on M-Net on Thursday evenings. (Read his write-up of episode 3 here.)

The series follows the real-life story of the Gird family, whose daughter needs a heart transplant. Filmed in real time, the series covers the family's wait for a heart donor for their daughter Melanie, not knowing at the beginning whether it's going to happen or not. And then their son, Trevor, gets ill as well.

More than most stories about heart transplants, this series honours the donors and their families. How admirable that some families in grief and shock, are capable of making such noble decisions.

As becomes clear through this programme, Chris Barnard was wrong when he kept insisting that the heart is just a pump. Like it or not, it is always more than that, and the extra, symbolic and emotional meanings of a heart are an inevitable part of the problems and solutions of donation, receiving transplants, and working with the entire process.

The donor's family
We meet Marguerite, seven years after her heart transplant, who, though she feels she "hasn't yet processed it in (her) mind" has decided she wants to know more about her donor, and perhaps meet the family. She refers to the earlier thoughts that "this is not my heart!", and how disquieting that was. And she makes a wise and revealing statement about the donor: "She is not part of me. But she gave me a second chance". She feels she needs to know more, "to complete the story", now she feels less need to deny the reality of the transplant. She only knows that the donor was an attractive young blonde woman.

She discusses this with Dr Thaning, and in time they share a handkerchief to dab their eyes. He says they usually do not encourage recipients to seek out donor families, unless there seems to be a strong reason for doing so - and then it's the family that must decide whether to make contact, and how they wish to do so.

Melanie and Trevor's father sees the sense of the policy of confidentiality, and the importance of giving everyone involved enough time to deal with their emotions.

Trevor back to normal
Meanwhile, 16-year-old Trevor is back to looking normal. Again he shows wisdom and calm. "A thing only stays interesting for so long," he states.

He accepted his celebrity at first, being the focus of so much attention, but is so pleased "to be treated as normal again", adding, "I don't want to be an exception". He grows tired of telling his story for the umpteenth time, yet he is not uncomfortable if he feels the person has an honest interest and needs to hear it. Melanie says she feels "almost proud" of her status due to the awesome experience she has been through. And she, too, feels a sense of duty to publicise the need for heart donations, on behalf of others who are in need of donors. She doesn't hide her scar, considering it as "a message to the world", saying to other people that they, too, could save a life.

We see Trevor plunging into a cold swimming pool, and notice that he has a remarkably tidy scar. He feels he cannot say thank you enough. But at school, he apparently operates a variety of the don't-ask /don't- tell policy and is pleased that some kids don't seem to know what happened to him.

Melanie has an excellent and succinct way of summarising her relationship to her donor: "He did not die so I could live. He died, and then I lived." But she considers his family as her heroes. For both young people, having spent so many years under the direct threat of death, they feel reprieved and enjoy the invaluable freedom to be ordinary. Trevor the father makes another wise comment: "It's so difficult - that you don't even know how to pray about it". And they all praise the bravery of the donor families.

Melanie's donor apparently had discussed the possibility with his mother, and had made it clear he wanted to donate organs in the event of his death. How great it would be if far more young people would do the same. The families seem to share the view that it was sustaining to know that despite their awful tragedy, something good could come out of it. One of them said that it had taken a lot of the pain away. One family says of the recipient that they'd like to see her, but perhaps from a distance, to see that she is well, but not wanting a direct personal relationship They see the donation as a gift they gave with love, but don't see the transplanted heart as an extension of the life of their loved one. "She'll always be in our hearts", says one, falling back to the metaphorical significance of a heart.

Overall, the donor families seem to have decided not to meet the recipients yet. Not closing the door to that possibility, but not ready for it now. But of course, everyone involved will watch this series on television, and thus will meet each other, even if indirectly. And young Trevor will become one of the few people ever to see his own, detached heart, beating in a dish.

Become an organ donor
Please remember to consider taking steps to donate your own organs and those of family members. Contact the Organ Donor Foundation, www.odf.org.za, 0800-22-66-11. They can send you an information brochure, a credit-card-size card to fill in and carry in your wallet and stickers to place on your ID book and driver's licence. And do discuss your decision with your next of kin, as it will in fact be up to them to give consent if the occasion should arise.

(Professor MA Simpson, December 2008)

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