Showing posts with label organ donation. Show all posts
Showing posts with label organ donation. Show all posts

Monday, December 27, 2010

Boxing Day

I'm not doing well on the "taking a blogging break" thing, but I keep finding things I want to announce to the world. A month ago today an Internet friend of mine got "the call." There are a lot of situations in which there is a "the call." This friend was not a Canadian pilot, so it wasn't a place in a groundschool at Air Canada. It was even better than that. Those of you who read the tags before the post already know how much better. "The call" came in as he was hooked up to a dialysis machine, telling him that a matching donor kidney was available.

He received the transplant, and although they say that the donor organ has not entirely woken up yet, he is feeling better than he has in a long time. I've never met him in person. He lives on a continent where I've never been. But the person who decided to sign that donor card and the family that okayed it make me so happy that I'd better stop typing this post or I'm going to cry and wreck my make-up, and I'm just going out to a party.

So to everyone who ever took the trouble to indicate according to their local regulations that they were willing to donate organs after death, you not only do it for the recipient and to ease the minds of your family who might otherwise be asked to donate the organs not knowing your wishes, but you also do it for everyone who knows that recipient, even a little bit.

Thanks.

Oh, I called this post Boxing Day, not just because it will still be December 26th in Canada when this posts, but also because in my family the origin of the term "Boxing Day" was said to be the tradition of boxing up the things you no longer need, and giving them away to someone who can use them, just what happens to donor organs.

Friday, October 30, 2009

Dead: Two in the Cockpit, Four in the Cabin and One Far Away

This accident investigation tells a sad tale. It's not just the story of an airplane that had some kind of problem after takeoff. The crew consisted of a results- (as opposed to safety-) oriented maverick chief pilot and what the NTSB terms an "ill-prepared" first officer. They explain that term only in stating that the company gave inadequate checkrides, but one can imagine he or she was new, got less actual training than the company records stated, hadn't been required to demonstrate an ability to fly the airplane unassisted, and did not operate in an environment where he was given the opportunity to absorb an understanding of two crew teamwork.

They take off, and something happens that makes control of the airplane difficult. It might be runaway trim, the autopilot misbehaving: the investigators don't know. As soon as this happens, the pilot who notices, probably the flying pilot needs to articulate the problem to the other pilot, even if they aren't quite sure what is wrong. "I can't hold the nose up!" "The trim is freaking out!" "I'm holding full left rudder to keep it straight." The flying pilot needs to continue flying the airplane, concentrating on keeping the airplane right side up, clear of obstacles and with an appropriate heading and airspeed. If it's an emergency for which there is an aircraft checklist, there will be a call for that, e.g "runaway elevator trim emergency checklist," and the correct aircraft configuration, procedures (and exactly what the pilots say to one another) may be specified right in the checklist with the first few steps committed to memory. If it's something outside the checklist, well that's why pilots learn how their airplanes work, so they can make reasonable decisions.

Usually any relevant checklists are followed exactly, but if there are extenuating circumstances and where the crew hasn't yet determined what is going on, the captain makes the final decisions. But the division of labour is fixed: one crew member flies the plane, and the other one does other stuff. For this reason the captain often gives control to the FO in an emergency, because anyone can fly a plane, I mean really, you could. I tell you "you have control. maintain 140 knots, three thousand feet, on this heading, and you're going to have to exert about 10 kilograms of back pressure to keep the nose up." If the FO has toothpick arms, then the captain may make a different decision, but someone has to be flying the airplane. They shouldn't both be trying to find a circuit breaker any more than they should both be working on their laptops.

There are many events like the one the NTSB describes that led to this fatal accident that are non-events, because a crew manages the situation professionally and returns to the airport to get it fixed. The "we don't know what happened, but they should have handled it better" vibe is a little harsh here. After all, if they don't know what happened who says that the crew didn't manage it in a flawless textbook manner, but it was more than human beings could handle? The dead, ex-drug runner captain has already shown a disregard for the law and others' safety, so he's an easy mark on whom to pin the blame.

Also do you see what they are doing regretting the absence of cockpit video monitoring? Every time they say "too bad there was no video recording," they are angling for video monitoring of our workplace. YouTube of the future will be a more grizzly place.

And finally, the fact that their cargo includes a human transplant organ, introduced extra pathos for me. Had there been five in the cabin instaed of four it would have made no difference to me, but I imagine someone's cellphone ringing that afternoon, with the joyous news that a matching donor organ had been found. That person grabbed an overnight bag and went straight to the hospital, or perhaps they were already in hospital, knowing a transplant was their last chance at life. They were prepped for the operation, and then received the news that the organ wasn't going to arrive after all. And the loved ones of the donor were hoping to hear news that their deceased family member's organ had helped someone else to live. Instead they learn that six people died transporting it, and the organ became fish food.

The NTSB investigation report from which I have inferred all this melodramatic speculation is here.


Yesterday Cirrocumulus pointed out that the aviation industry "needs objective research into effective ways of keeping boredom at bay and humans alert while they're just monitoring safety-critical machinery. At present the humans are between the rock of forbidden pastimes and the whirlpool of stupefaction." I liked this by itself, and then Aluwings took up the standard to outline some of the strategies employed. I laughed at his post because I have done and seen similar ones. Never met the UFO guy, though.

Tuesday, December 09, 2008

Google Brain Transplants

My news aggregator caught this story because it features an airline, and while it isn't really airline news, I want to blog about it.

The synopsis is that a surgical team managed to grow a new windpipe for a patient who was dying of tuberculosis, using a donor windpipe from a deceased person, and stem cells from the patient's own bone marrow. They chemically stripped the cells from the donor windpipe, then convinced the stem cells to become cartilage and regrow a new windpipe using the template provided by what was left of the old one. (Biology-type people, please tell me what is left when you remove cells from a biological part. Dirt? I was under the impression that a human being was entirely composed of cells).

Stem cell research mainly makes it into the news when it's involved in the ethical question of using foetal tissue for research. It's bandied around by politicians as a theoretical, so I'm embarrassed by how taken by surprise I am by the present practical application of this research. The smiling 30-year-old woman in the linked article is breathing today because someone grew her a body part in a laboratory. Why has this not been on the front page of my newspaper? This is huge. I'm sure I have doctors and biologists among my readers. Is this not a medical advance as great as any in the history of medicine?

Airplanes come into this because the windpipe was grown in Bristol, England while the patient was in Barcelona, Spain and the whole thing could only survive for a few hours outside of the laboratory or patient. The airline refused permission to take the human tissue onto the airplane. (More than 100 mL of fluid, I presume). There must be a policy for transport of donor organs that could be tapped, and I have to fault the medical staff for not prearranging transport before taking the windpipe out of the laboratory, but they did solve the problem.

Someone knew someone who had a PPL and they managed to scare up a private airplane and pilot and get everything to the right place in time to do the surgery.

Oh and speaking of advances in medicine, I saw the most recent X-Files movie and damn, that was painful watching Scully the brain surgeon do her medical research by typing "stem cell therapy" into Google the day before the operation.