A child's death gives life to seven others
May 24, 1999
"The Nicholas Effect" is how his parents refer to the wonderful things that people do in response to hearing Nicholas' story.
This is an edited transcript of an online chat conducted on Sunday, May 23, 1999, with Reg Green, Nicholas' father and author of "The Nicholas Effect: A Young Boy's Gift to the World."
CNN Moderator: Welcome to the chat room, Reg Green. Thank you for joining us this evening.
Reg Green: I'm glad for your interest in this little boy.
CNN Moderator: Welcome, Mr. Green. Why don't you tell us about what prompted you to write this book?
Reg Green: We were in southern Italy on a main road, like an interstate road, when highway robbers fired shots into the car, and our son Nicholas, who is 7 years old, was shot in the head. He died two days later, and we donated his organs to seven Italians. It seemed to take the whole country by storm. The prime minister and president of Italy asked to see us, and we were flown home in the president's plane. The whole world seemed to hear of this tragedy and wanted to say soothing things to us. Since then my wife Maggie and I have talked all over the world about the shortage of organ donors. We've written articles, a TV movie starring Jamie Lee Curtis was made, and we give many speeches, but I wanted to tell the story in greater depth than is possible in a newspaper article and television interview, so I wrote the book. I'm hoping one result would be to increase the donor rate so we can reduce this terrible loss of life.
Chat Participant: Didn't organ donations increase in Italy after that?
Reg Green: Yes, organ donation rates in Italy have more than doubled since the time before Nicholas died. This means literally thousands of people are alive who would have died.
Chat Participant: Mr. Green, in reading some of the reviews, I am amazed at the enthusiasm of Nicholas. Was his enthusiasm for life a factor in donating his organs?
Reg Green: Yes, I imagine it was. His teacher said he was the most giving boy she had ever met. She said she always knew he was her teacher. So it seemed quite natural in the act of dying he should help other people.
Chat Participant: It must have been a hard decision to make. What prompted you to do what you did?
Reg Green: When we looked at Nicholas, he didn't look like a sleeping child. We knew he was dead and therefore didn't need that body anymore. But he'd been in perfect health, so that body can help other people, and as it turned out it was seven very sick people.
Chat Participant: Have many others joined you in your quest to make others aware of this situation?
Reg Green: Yes, we are only one family among thousands who every year make this same decision. In the U.S. alone, 5,000 families donate the organs of a young one. Even so, 12 million people die every day in this country while on the waiting list for a liver or kidney. Many people felt like we did, still have many more to go.
Chat Participant: Had you and your wife thought about organ donations prior to this accident?
Reg Green: We were aware of organ donations just like anyone is, but we never paid any special attention to this. We can't remember ever having heard a conversation about organ donation, but when we saw Nicholas that day, it seemed perfectly obvious to us that this was the right thing to do. His future had been taken away from him. It seemed even more important than ever that that future should be given to someone else. In fact all seven of those Italian recipients are now back in the mainstream of life.
Chat Participant: What did you go through while writing this book, emotionally?
Reg Green: I wrote a lot of it through a veil of tears as I remembered Nicholas and the good times we had together but there were some very uplifting parts of this story, and that was soothing to remember how many people Nicholas had helped. Losing Nicholas was of course the worst thing by far that has ever happened to Maggie or me, but talking about it didn't really make it any worse. Our hope is by talking and writing about it other lives could be saved.
Chat Participant: Mr. Green, did they catch the highwaymen? If so, what became of them?
Reg Green: Two people were put on trial, two men in their 20s. One admitted to having killed four other people but denied Nicholas. The other man had no previous criminal record. They were acquitted in the first trial, but then the prosecution appealed, and both men were found guilty. One is now serving a lifetime sentence, and the other was convicted for 20 years.
Chat Participant: The book brings Nicholas to life for those of us who never knew him. Was writing this book a part of the healing process for you?
Reg Green: I don't think it helped the healing, just as I don't think that it made it any worse. As I said before, the loss of Nicholas has been the overwhelming fact, and writing about it obviously didn't change that. I still think of Nicholas 50 times a day, and I expect the sense of loss will continue to be painful for the rest of my life. On the other hand, by writing a book, lives can be saved. It does help when I remember Nicholas, because it makes me feel his death was not in vain.
Chat Participant: Is it comforting to know that Nicholas lives on through others?
Reg Green: Maggie and I have never thought of Nicholas living on in any literal sense. Those are their organs now, we feel, not his. But it is very comforting to know that people who would certainly have died by now are leading normal lives. We met all of them, and the love of life they show and the relief in their family's faces is a wonderful reward.
Chat Participant: You mentioned that this happens all the time and that several people are in a similar situation. What about this case made people stand up and notice?
Reg Green: I'm still mystified that this small tragedy should still capture the imagination of so many people. Maggie and I have thought that our decision to donate was purely private, but Italy seemed to hear about it almost immediately, and it took the whole country by storm. The compassion that Italians of all kinds showed us helped focus the world's attention on this incident. In addition to that, we determined to speak out as clearly as possible right from the beginning; and so when the media asked questions about Nicholas and what had happened, we told them everything we could -- the stories he read, the songs he sang, what his character was like -- and I think people felt close to him. They felt they almost knew him right from the beginning. Since then we have continued to talk in every way we can think of to remind people of the good that can come out of even the most heartrending tragedy, and I think that has helped too. But let me add again that we are only one of 5,000 families who make this decision every year in the U.S. and that there are thousands and thousands of dedicated health-care professionals working day in and day out to try to increase organ donation rates.
Chat Participant:: If people want to donate their organs, what steps should they take to make sure that their wishes are honored?
Reg Green: It's very easy to find a donor card. Many organizations such as the Red Cross or The National Kidney Foundation and local groups have donor cards. In many states you can simply sign your driver's, license but that is not enough. If something happens to you, it is your family who will make the decision, and so it is vital that they know that these are your wishes. The most important thing you can do if you agree to the nature of this is to let your family know this is what you want. There is an 800 number, which is 800-335-SHARE, and on the Internet it is www.shareyourlife.org. These are the addresses of the coalition on donation, and they will send you the free brochure and the address and phone number of an organization in your own area to contact for more information. Many other groups also provide information, including the Eye Bank Association of America, who are in Washington, and National Kidney Foundation, which is 800-622-9010. Finally, there is a Web site with much information, which is www.transweb.org.
Chat Participant: Is there an age limit for people to donate organs?
Reg Green: Every year the age limit seems to go up, and people of 75 and above can now be transplanted successfully. It depends on how healthy you are. But the professionals who will decide will do all they can, and the best thing is to leave it to them to make that decision. Even old people can give corneas and other tissues that can save life and prevent other serious illnesses such as amputations and burns.
Chat Participant: Is it especially hard to find transplants for children?
Reg Green: It is very difficult to find transplants for children, because the parents of children who die are obviously very upset and often don't want to think about anything other than their loss. That of course makes it even more important that the subject should be discussed beforehand so that their mind can be prepared if a tragedy happens. If they do discuss it, they will see more clearly that they can save other families from going through the devastation they themselves are going through. Because after all, if they refuse to donate, some other children will die.
Chat Participant: I would think the loss would be so overwhelming that it would be difficult to think rationally at the time.
Reg Green: It certainly is very difficult to think beyond the loss. I remember vividly wondering how I would ever get through the rest of my life without Nicholas. But at the same time both Maggie and I could see that Nicholas's death need not be the end and that something good could come out of it.
Chat Participant: Mr. Green, you stated that Nicholas didn't look like a sleeping child, and with that statement, I was made aware that when a loved one is gone, you no longer have them, so it makes sense to me to donate organs. Thanks for saying that.
Reg Green: You have put into words exactly how we felt. We would have done anything to have kept Nicholas alive, but he was no longer in a coma. His brains had died, and that was irreversible. So in no way conceivable to us would we be hurting him by donating the organs, but we could still help others.
Chat Participant: What are some of the common misconceptions about organ donation?
Reg Green: Many people ask, 'Will I have to pay for the medical expenses?" The answer is no, the donor family pays nothing. Another fear is that if you have signed a donor card, the medical team will not take as good care of you because they want to have the organs. I have found not the slightest evidence in the world to support that idea. The surgeons who try to save you have their reputation to defend, and their whole interest is trying to keep you alive. The organ donation medical team is a completely separate one, and they are not brought into it until brain death could be rigorously determined. There are some other misconceptions, however, which are even deeper. I remember a nurse telling me that when her mother died she asked her father, "Shouldn't we donate the organs?" and her father replied, "Hasn't your mother suffered enough?"
Chat Participant: How many organs in the human body can be donated?
Reg Green: I can't tell you the exact answer to that question, but the normal organs include the heart, two kidneys, the pancreas, the liver. There are also the corneas and tissues such as skin, bone and cartilage. So one person can help a large number of others. The average number of organs taken is three or four, but with tissues, the recipients can be very many more.
Chat Participant: What primary message would you like readers to come away from the book with?
Reg Green: To me the Nicholas story will always have two levels. One is the practical one that all over the world, donor rates are too low. People are dying, many of them young, some of them just babies, because of the failure of just one organ. It's like throwing the car away because the battery is dead. But there is another level, and that is the sense of unity of mankind. When organs are donated, you do not know who will receive them. White men are walking around with black women's hearts in them. Anglos are breathing with Mexican lungs. American children are being saved by the organs of Italians and vice versa in all of those cases. The differences between us as human beings are trifling compared to what we have in common. There is one more thing that has struck me about this story. It seemed to remind people all over the world how fragile young life is, therefore how precious. I said at the time I imagined parents giving their children an extra hug before they went off to school in the morning or reading an extra chapter to them at bedtime. I thought if that happened, Nicholas would say that this is the very best thing that could have came out of that story.
Chat Participant: Can't skin be used for burn patients?
Reg Green: Yes, I didn't give a whole encyclopedia of things that can be donated, but skin is one that both relieve the pain of severe burns but can also prevent death. Bone donations can avoid amputations, heart valves can save lives, so yes, there are many possibilities, and ones that can save many other people.
Chat Participant: Mr. Green, I really appreciate the time you took to be with us. It is a very moving story, and the story of Nicholas will long be remembered. Thanks.
Reg Green: Thank you very much.
Chat Participant: How are the recipients of the donations faring, and do you hear from them often?
Reg Green: All of them are living normal lives. One woman had never seen her baby's face clearly but now has regained her sight. The two children who had spent hours a day, three days a week, hooked up to dialysis machines are now perfectly normal youngsters. The boy who got Nicholas's heart had previously had six operations on his own heart and all had failed. Now he's like any normal boy. The woman who got Nicholas's pancreas cells was a diabetic and had been repeatedly in comas. She was completely dependent on others. The last time I saw her, she was living alone for the first time. And then there was the 19-year-old girl who received Nicholas's liver, and she was going to die, and the family had gathered to say goodbye. But with the new liver, she came back to good health, was married, and last year had a baby. It was a boy, and they have called him Nicholas. Yes, we hear from them quite often -- a postcard perhaps when they go on vacation or when one of the children passes an examination. When we go to Italy, we try to visit. I spoke to a reporter who had seen them recently, and she said that they speak of Nicholas in what I could only call reverence and you can see they are grateful to him, and that of course is very comforting to us. CNN Moderator: Do you have any final thoughts for us this evening?
Reg Green: I'm grateful to everyone for being interested in this story, and I hope that the book will carry this story forward so that organ donation doesn't seem unusual or weird or disrespectful but quite simply the natural thing to do. Thank you.
CNN Moderator: Thank you for joining us and sharing your story, Mr. Green. I think once one reads about Nicholas, it should not be a hard decision of any of us.
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