One fine winter morning, I received a call from our Neuro Trauma Unit. As I entered Dr.Zirpe told me about a 29-year-old young male who was brain dead following an intracerebral bleed. We counselled the relatives and explained about brain death to the family members. They were distant relatives who told us to explain the same to the patient’s wife and brother-in-law.

After sometime we explained to the wife (22 years) and brother-in-law about organ donation and they agreed for the same. They were very positive and allowed us to take as much time as required for the entire process. But after looking at the brother-in-law my expression changed as he was a transgender. After completion of written consent of all organs, I informed Zonal Transplant Coordination Centre (ZTCC) Pune for organ allocation. Organs were allocated as per the ZTCC Norms. Lungs were allocated through NOTTO to Chennai. Tentative retrieval timing was 11.30 pm.

At 11 pm, assessment of lungs was in process by Chennai team. The brother-in-law with all his community members, about 15-20 came to me (they were all drunk), and were bargaining. They demanded cash in return for organ donation for the patient’s children or job for his wife (it was a love marriage and they were married at a very early age and had three children). I said this was against the law and it was not at all possible, so if they were not ready, they could withdraw their consent for organ donation. The brother-in-law told that they wanted to withdraw the consent. Immediately informed the same to ZTCC. I went to the NTU as I received a call from the consultant. I also made a call to our Medical Director (MD) and explained the situation.

Some of the transgenders at the same time went to the NTU where the patient was admitted and threatened the lung assessment team and NTU staff. They were continuously doing video recording. The lung surgeon saw all this, and got frightened and he left. Meantime our MD reached the hospital and asked me to bring the relatives as he wanted to speak to them. As the whole mob entered his office, all security guards also entered the office, and the relatives got violent asking why were the security called. So, without having any discussion they went off. Our MD told us to close this case for organ donation immediately; it was at 1 am at night. As I was about to leave the hospital, again the transgender community along with police caught me in the corridor. The PSI (the same PSI who had come to give NOC for another organ donation case three days back), saw me and smiled. He tried to tell the relatives that whatever this madam is doing is according to the law, you have signed the consent for organ donation which is a very valuable decision. But the relatives said that they wanted to file a complaint against me, that I have misguided them and they have the video recording of the same.

Video recording was also done of all the discussion that they had with the police and me. So, the PSI asked them to come in the morning to file a complaint and dramatically he shouted at me. I was confidently answering all the questions of the relatives and PSI, although I was a little bit scared on the inside. But I saw the MD standing behind me throughout this situation, so got relaxed. At 3.30 am I went home, after reaching home I received a message from the MD that there was a meeting in CEO’s office at 10.00 am sharp to discuss this case. Even in this tense situation, my family members supported me. My elder daughter suggested that I call Ms. Laxmi, who was the head of the transgender community. She had declared in her interview on TV the previous week that she supported organ donation. In the meeting I explained the case in detail to the CEO. But he was insisting repeatedly to get consent from the family again in front of the police.

As the relatives had filed a complaint against me, the police came for the enquiry. Immediately after that the relatives along with the brother in- law approached me in MD’s office and apologised for the night’s incident and said that they wanted to go ahead with organ donation. The relatives withdrew the complaint filed against me and in front of the police they again consented for organ donation. Meanwhile our heart recipient was medically unfit, so ZTCC offered the heart to Mumbai and lungs were not retrieved. As every case gives us a lesson, from this case as well I learnt a lot and now am able to face situations confidently while counselling the relatives from any community.

- Surekha Joshi

Transplant Coordinator

Ruby Hall Clinic

Pune, Maharashtra