A Small Boy Makes Medical History

In the history of medicine how many patients, thirty years after their death, have been influencing 3 the life-and-death decisions of thousands of bereaved families around the world every year? 4Perhaps only one, my seven-year-old son, Nicholas, who was shot in a bungled robbery while we 5 were on vacation in the far south of Italy in 1994 and whose organs and corneas my wife, Maggie, 6 and I donated to seven very sick people there. 7The story is so alive for millions of Italians that a new 90-minute documentary called Effetto 8Nicholas on the results of that decision was recently shown by Italy's publicly-owned RAI 9 television channel and may soon be available in English. 10Given that the shortage of donated organs is the biggest obstacle to expanding transplantation, I 11 hope readers will find of interest some of the steps taken by a small informal group of people, 12'the Nicholas Effect' team, unpaid and without official backing of any kind that turned a sordid 13 crime in a remote place into a worldwide movement that pushed many millions of people toward 14 organ donation, saved many thousands of lives and has given hope to patients everywhere. 15Without them, all experience suggests the likely result would have been a spike of good 16 resolutions to donate organs and a fairly quick return to the norm. 17That this time could be different arose from our realization that although, like us, the mass of 18 people normally give little if any thought to organ donation, the subject is potentially of interest 19 to, literally, everyone. Anyone might need a transplant, even a world-class athlete; anyone might 20 have to decide whether or not to donate a loved one's organs; and anyone might be close to 21 someone who will die without a transplant. Surprisingly then, it is in fact one of the few subjects 22 of any kind that can command truly universal attention. 23Our first conclusion from that realization was that, if presented innovatively enough, the mass 24 media could be brought to see that their audience would find stories about transplantation 25 riveting, not repellent. The second: the only way to reach enough people to change the donation 26 rates significantly is through the mass media and, nowadays, their rapidly growing sibling, social 27 media. Third, telling the story once is not enough. Like any campaign to change public opinion it 28 has to be continuous, imaginative and adaptable. 29Why is donating organs so difficult? Many reasons, but having experienced it for myself, let's 30 fasten on a key one. Brain death is sudden death. Families arrive at hospitals to find one of their 31 members who was in perfect health a few hours earlier and to whom they said "Don't be late for 32 dinner" or "Be careful to look both ways when you cross the road" is dead or dying. Its enormity 33 wipes out all other thoughts and even families who have been strong supporters of organ 34 donation often falter. To this day, I remember one image that kept recurring when the doctors 35 told us Nicholas was brain dead: never again would I hear him say "Goodnight, Daddy." 36 So from the beginning we held nothing back, sharing our feelings with the world's biggest 37 publications and television shows --and struck a nerve. News outlets that knew virtually nothing 38 about organ donation --as their questions showed --flocked to hear more. 39We also shaped the story to interest every sliver of opinion we could think of: magazines for the 40 oldest readers (who are thrilled to know they can still do something that important when they had 41 feared they were losing their usefulness) and the youngest (whose idealism is electrified by the