“Do you have any questions?” the surgeon asked. After a year of learning all I could about kidney donation, I did not. Following a quick debate over who would shave my abdomen – the surgical team, eager to start, waved off a nurse – it was finally happening.
On October 30th my left kidney was removed via laparoscopic surgery, flown to California, and transplanted into a complete stranger. This kicked off a chain of paired transplants: in exchange for that person receiving my kidney, their loved one put their spare kidney up for grabs to another stranger with a loved one willing to donate, and so on. Last I heard, seven transplant surgeries were scheduled as a part of my chain.
Those recipients will live longer lives. And richer ones: free from dialysis, they can play, work, and travel. This came at little cost to me. I spent a night in the hospital followed by several weeks of recovery at home, mostly spent reading and taking walks. During the screening process, a surgeon categorized me as a “chronic do-gooder” type – guilty as charged – and as such I will confidently say there is no better deal out there when it comes to doing good.
Here are my collected notes from throughout the process. Along the way, I read, listened, and watched much of what’s out there about non-directed (aka “anonymous,” “altruistic,” or “good Samaritan”) kidney donation and have woven in a reading list of sorts. Those writings were above all what convinced me to donate.
The Journey
Making the decision: October 2023-January 2024
“Have we talked about organ donation?” My brother texted me last October, when Tim Faust’s kidney donation article appeared in Defector.

I’d read Dylan Matthew’s donation story a few years ago and generally agreed with his argument, but it hadn’t gone farther than that (Vox also made a short video version that I rewatched as my own donation neared). This time the idea stuck in my head.
A week later, Scott Alexander (AstralCodexTen) blogged about his non-directed donor experience. Scott’s post went deep into the (minimal) risks to the donor, which I appreciated. The post got 500+ comments and he turned those into a follow-up post where he curated the themes and highlights.
Matthews and Alexander are both close to the Effective Altruist (EA) community, while Faust comes from a different political angle (I attended a talk he gave years ago advocating for Medicare For All). More on that later.
I bounced the idea – it had now blossomed into a tentative intention – off my loved ones. During screening, the transplant team asks, “what will your friends and family think when they hear you want to do this?” I replied that this was in character for me. Indeed, my wife wasn’t too surprised, and once caught up on everything it entailed she was solidly supportive throughout the process. She said later that even if she had objected, it would have been a matter of respecting my bodily autonomy.
My mom, a retired doctor, took her best shot at dissuading me. This was a good stress test of my decision, since she made the case as effectively as possible. I was not swayed. She eventually accepted my point of view and came to help out during my first week of recovery, though she remained concerned about my well-being the whole time.
My biggest potential hangup came from having three kids. The absence of children in the “I donated a kidney to a stranger” stories I read was conspicuous. Did my donation conflict with my obligations to my kids – or to my wife, who even in the best-case scenario would shoulder increased domestic work while I recovered?
It raised ethical questions about the value of my own children’s experiences vs. that of my kidney’s recipient, who is someone’s child and may have their own kids. In the end, two things put me at ease.
First, my donation was itself an act of parenting. I demonstrated my values and the importance of walking the walk.
Second, on the self-interest level: I learned that if one of my family members needs a kidney while I’m still alive, they go to the top of the list. From the Alliance for Paired Kidney Donation (APKD)’s KidneyPledge:
Non-directed donors will receive the assurance of knowing that should a family member need a kidney transplant in the future, they will be given priority placement and a guaranteed kidney from the APKD.
This is arguably even better than if I held on to my spare kidney, as I might not be a compatible donor for my family members. Covered “family members” include any potential spouse, children, and grandchildren the donor doesn’t yet have.
There are a few neat protections such as this that remove barriers for non-directed kidney donors. Another is compensation for lost wages, travel, and childcare expenses. I took four weeks off work to recover and two charities (APKD and the NLDAC) made me whole. APKD even covered the cost of boarding my dog while I was in the hospital.
I officially decided on January 27th. I was on vacation, cooking with a friend. I had just finished the 2004 New Yorker article on Zell Kravinsky, an extreme altruist who after giving away his tens of millions of dollars gave away his kidney, too. I found the article challenging, in a good way.
I realized that while I could keep “considering” indefinitely, I couldn’t imagine learning any new fact that would change my mind. The decision was effectively made. I ducked out from preparing a pasta bar and completed Michigan Medicine’s Living Donor Form (“what organ are you interested in donating?”) on my phone.
Around then I read the other big New Yorker piece on non-directed kidney donors, “The Kindest Cut” (2009). The main theme is “what’s wrong with these weird altruistic donors?” which felt off to me. I later learned from a Dylan Matthews podcast interview, nominally about the push to compensate non-directed kidney donors, that he too had found the donors in that article inspiring, not creepy, and that it had motivated him to give.
It seemed like a straightforward decision. On a calculating level – I am a data analyst by trade – it was a slam dunk. People on the internet have analyzed this excessively, e.g., in this EA forum post. In short, I was giving up a couple of weeks of expected life to add five hundred weeks to my immediate recipient’s life. And as a typical non-directed donation starts a chain leading to say, three kidney transplants, I would be trading two weeks to save an expected fifteen hundred weeks of other people’s lives. I’m living a good and meaningful life, but it’s sure not 750x more valuable than the average person’s.
And it checked out on an emotional level. I didn’t know anyone suffering from kidney disease, but the internet gave me a sense of what it was like. I saw social media posts from a dad looking for a kidney for his 2-year-old, and from an open-source enthusiast in his 30s on dialysis, wrestling with the fact that he was slowly dying from kidney disease. Imagining myself in the shoes of someone needing a kidney – maybe a dad like me, desperate to watch his kids grow up and hoping for a miracle – flushed away lingering doubts.
(I was grateful that an algorithm designated who would get my kidney. The idea of trying to decide myself who was most worthy, as on the Matching Donors site described in The Kindest Cut, horrified me. While my recipient may choose to contact me someday through our respective transplant centers, I went in with the expectation that they won’t, and I remain at peace with not knowing their identity).
I had investigated and decided. Now began screening.
Screening & waiting: February-August 2024
I was subjected to a rigorous workup – the “million-dollar physical” – to confirm I was healthy enough to donate. (There is no charge to the prospective donor. It’s refreshing to visit the hospital and not be asked about insurance!) Walking in the first morning for an hours-long testing regimen felt alien, but I became familiar with the people and place soon enough. The transplant team at Michigan Medicine took good care of me from initial outreach through post-donation followups.
It was extensive. At one point I sat down with a phlebotomist to have 23 vials of blood drawn. I asked if I was setting a record; she said no, transplant recipients have me beat.
There were scans. I was told before getting the contrast dye injected for my CT, “people often say it feels like they’re peeing in their pants.” And indeed, lying there in a noisy machine as part of my quest to give away an organ, that’s precisely how I felt. It was briefly all too much and I broke into laughter.
Most interesting was the nuclear medicine testing. Kidney function is quantified in glomerular filtration rate (GFR). That can be estimated (eGFR) or measured (mGFR). I spent a morning getting my GFR measured. I was injected with radioactive iodine-125, then drank water and had my urine collected at precise intervals over several hours. Lastly I was put in a scanner and injected with technetium-99m, which emits gamma rays as it decays. The machine detected the radiation and traced my blood vessels on the screen as the chemical pumped through me, revealing physical characteristics of my kidneys.
(Donors at other centers have written about their GFR being measured via 24-hour urine collection. I believe that method is more common.)
These acts of modern medicine felt magical. As does the fundamental fact of the enterprise: they can cut a kidney out of one person and put it into another. It’s a marvel, from the carefully-considered little steps to the big picture. (I heard fascinating stories during this process, like a prospective donor who was found to have a kidney stone during imaging. The kidney was removed, the stone was flushed out, and the kidney transplanted into her father).
In the end I was found to be a good candidate. The game of life had dealt me a lucky hand in relevant dimensions:
- Physical health: I had high kidney function, low blood pressure, and good overall health. My right kidney was slightly smaller than my left. They prefer to leave donors with the bigger one, but my right kidney had complex vasculature, with multiple veins and an artery that branched very close to the organ. My left kidney had simple plumbing, so they took that one.
- Mental health: I was asked many times “why do you want to do this?” and my answers were evidently acceptable.
- Support network: my partner was supportive and I had plans in place to take care of my dependents during surgery & recovery.
- Job/finances: my employer was understanding and made accommodations.
- Age: donors can be accepted across a large age range. At 40, I was old enough that many potential health conditions would have emerged, yet nice and young in terms of ability to recover and donating a kidney with lots of life left in it.
- Lifestyle & diet: I’m vegan, which is ideal for living kidney donors as plant protein is easier on kidneys. I drink lots of water. I exercise regularly and don’t have hobbies such as motorcycle riding or boxing that would put me at risk of injuring my remaining kidney.
- Location: I live two miles from my transplant center, which made the logistics easy.
Kidney donors must avoid NSAID painkillers like ibuprofen since they cause wear and tear on kidneys. No problem, I would switch to acetaminophen.
In late March I got the call: I was cleared to donate. When did I want to do it? They would work around my schedule. I picked late October, so I could enjoy outdoor activities in summer and coach the fall soccer season. November in Michigan seemed like a good time to sit around the house.
That meant a seven-month period of limbo. For most of that stretch I told only a handful of people outside of my family. I worried that it was premature, that I would be seeking attention for something I hadn’t done.
When I told a good friend, a writer, she asked if I was familiar with the “Bad Art Friend.” I was not. Learning about it years after it occurred, it seems like too much ink spilled over a petty personal drama. I feel obligated to mention it on my kidney donation reading list but am not including a link as I find the whole saga disheartening.
As summer ended, the transplant coordinator started assembling a chain. We pinned down a week for surgery, then a specific date. They took another dozen vials of blood to check if anything had changed. The situation suddenly flipped: I needed to tell people before it would be weird that I hadn’t. I felt awkward bringing it up in conversation, but telling people went surprisingly well. Their encouragement helped motivate me and many offered post-surgery support that added up to a huge help.
I listened to Christine Gentry tell the story of her non-directed kidney donation (start at 26:40) and cried in my kitchen. I was ready. (I heard her tell the story two different ways but now I can only find the one! In the other version she focuses on meeting her recipient, a corrections officer in Ohio. That version was also great – if anyone finds it please leave a link in the comments).
Surgery & recovery: October-November 2024
It all went down as smoothly as the apple juice I was instructed to drink 2.5 hours before surgery (i.e., at 3:30am). I was ready to get knocked out while my poor wife had to pace in the waiting area for a few hours.

The anesthesiologist started the IV of what he called his “Patron special” (midazolam) and I was instantly tipsy. Everything after that is foggy. I have a hazy, possibly-dreamed-up last memory of lying in the operating room, briefly delayed while a final piece of paperwork was completed out of my sight. I chatted with someone about the breathing mask they were putting on me; they said it would saturate me so that I would be full of oxygen before they put me on a breathing tube.
My first post-operative memory was making a joke: I was being wheeled through the hospital to my room and wanted to dangle my hand off the side to fist-bump everyone I passed, like a hockey player celebrating with his bench after a goal. I’m told my doped-up delivery rendered the attempt at humor incomprehensible.
Recovery went better than I expected. My pain never got above a 5 or 6 and I didn’t need opioids beyond the first night. The prior summer I had endured a thrombosed hemorrhoid and the kidney removal was definitely less painful.
Lying in my hospital bed that evening, I was told my kidney had completed its journey and was functioning well in my recipient. This soothed my discomfort and gave me great peace-of-mind.
A pleasant surprise at the hospital: the food was good. They had many vegan options, featuring the Amy’s line of products. I eat a lot of fiber on a normal day but as I’d been warned of the risks of constipation following abdominal surgery, I dialed it up even further.
I was put in a shared recovery room at the hospital. I felt bad for my roommate as he had some sensitive conversations and invasive procedures performed that anyone would be mortified to have a stranger overhear. A nurse gave me earplugs and that helped to get through the night.
The morning after surgery I was walking the halls and ready to go. They discharged me around noon, with a kidney-shaped pillow as a souvenir. It cushioned my incision from the pressure of the seat belt on the drive home.

Ahead of surgery I had raced to finish tasks and finalize plans. Recovery was simple: just let my body heal. The day after surgery I walked up the flight of stairs to my bedroom. Every day after that was a milestone. I showered without help the next day, stopped taking one medication, stopped taking another; shaved. I walked to the corner, around the block, a half-mile, a mile. The pain was gradual, not bad, and steadily fading.
There were some oddities. My abdomen had been inflated with CO2 during surgery. For two weeks, a gas bubble would periodically bubble up from somewhere inside me and present as mild pain above my right pectoral. The skin over my quads felt a little crispy when I kneaded it, also from the gas. And my recovery walks ended in non-stop bouts of yawning, not something I’d ever experienced while exercising.
Sleeping was hard for a while. On the third night I rolled from one side onto my stomach – a mistake – and then onto the other side. I swear I felt my innards slosh into an empty space. I might have heard it. It was the middle of the night and, half-awake, I imagined all of the plumbing in there getting tangled up, the veins and arteries and the remaining kidney’s ureter. I rolled back the other way, thinking that might undo it, and didn’t roll onto my stomach again for another couple of weeks.
I snapped a picture of my surgery scars 18 days out:

I had assumed the big scar, where they reached in and removed the kidney, would be horizontal. Waking up to vertical was a pleasant surprise. They closed me up with superglue on the outside and dissolving sutures inside. In the picture above, the scabs on the two laparoscopy port holes are still intact and covered with glue.
Sneezing was the final pain to depart. Apparently you don’t rip apart from a sneeze after abdominal surgery, it only feels like it. I tried my best to suppress the sneeze instinct and sometimes succeeded. It was three weeks until I could sneeze comfortably.
Before I knew it I was six weeks recovered, working at full output and once more hauling two kids on the back of my giant bike. Easy peasy.
Things I wish I’d known before I started
National Kidney Registry centers aren’t the only option. In articles and on Reddit, everyone linked to the NKR and its Donor Shield program. Which looked amazing: guaranteed priority for me and family members if we needed a kidney someday, plus lost wage reimbursement, paperwork help, etc.
I looked at the map of participating centers and balked. I live in Ann Arbor, home to one of the world’s top hospitals, and the closest NKR center is in … Grand Rapids?
I contacted Michigan Medicine. They explained they belong to a different network, the Alliance for Paired Kidney Donation (APKD). And APKD has its own Donor Protection Program with benefits for non-directed donors just like the ones offered by NKR. Whew! I could do the surgery close to home and return to this hospital for post-surgical follow-ups.
I now see Michigan Medicine lists itself as a participant in the AKPD, but didn’t notice this initially. Maybe that’s an artifact of most prospective donor materials being written for directed donors, who make up the vast majority of living donors.
If you are considering making a non-directed kidney donation and there’s a hospital you like that isn’t an NKR center, contact them and see if they participate in a paired-exchange program that offers similar benefits to non-directed donors.
More about what it’s like to need a kidney. I don’t personally know anyone on dialysis or waiting for a kidney, but it was motivating to read about what that’s like. Especially when I would get nervous leading up to the surgery, it helped to think about the recipient – sometimes I imagined a particular someone – getting their kidney and what it would mean for them.
After donating I heard moving stories from friends and family about their loved ones who had been affected by kidney disease and transplant. And Reddit communities where recipients (r/transplant, r/kidneydisease) and donors (r/kidneydonors) share their experiences and questions offer a sampling of stories.
The details of taking unpaid leave from work. I had been fortunate to never interact with FMLA. I was aware of a legal ruling that organ donation is covered by FMLA and incorrectly assumed that meant anyone was entitled to unpaid time off (which I needed to take advantage of the lost wages reimbursement from NLDAC/APKD). It turned out to be more complicated than that.
It all worked out in the end, though I would have saved a lot of stress if I’d gotten the paperwork sorted out in the months before donating. Some states have laws related to donor time off work, mostly for state or public employees; for instance, people employed by Washington D.C. and New York state get paid days off for organ donation. Michigan enacted a law in 2023 giving state employees this PTO. I’d love to see more employers offer paid leave for organ donation.
Other Thoughts
On the nature of charity
My wife’s grandmother had posted on her refrigerator the eight levels of tzedakah (charitable giving) defined by Maimonides. The way I’d remembered it, the highest form of charity is when neither the donor nor recipient know the other’s identity. That’s a nice fit for anonymous kidney donation, eh? Russ Roberts shared this same observation on an EconTalk episode where he interviewed Penny Lane, non-directed donor and director/subject of the documentary Confessions of a Good Samaritan.
I looked it up and Russ and I were wrong. We were remembering the second highest form. Maimonides’ highest level of charity is to set up people to sustain themselves, making “it unnecessary for them to become dependent on others.” This is the perfect fit for kidney donation. The recipient can filter their own blood, no longer depending on dialysis!
I’d brought along The Bone Clocks to read during my night in the hospital. That was overambitious. That evening I was capable only of watching a little TV. I browsed documentaries on Netflix and serendipitously found the just-released Confessions of a Good Samaritan. I recommend it along with as the follow-up podcast interview with Penny Lane linked above.
The film emphasizes her loneliness and mental health struggles. I found it questionable to have this surgery requiring follow-up care from others while at a place in your life where you are writing down a fake emergency contact on forms. But in the interview, she makes it clear that some of this was a filmmaking decision to shape the narrative a certain way.
Doing this without support from a village must have been difficult. Calling on my community for help made my donation possible. My kids stayed with friends, got driven to school and taken out trick-or-treating. People brought me meals and schlepped my hockey-playing kid to and from practice. When I told people what I was planning to do, they asked how they could help. I nodded my head at the role of community support in this donor story.
Lane wrestles with the self-promotional nature of her film, though she makes it clear she decided to donate a kidney well before the idea for a documentary came to her. I was similarly wary about the self-congratulatory nature of the act in general and this post in particular. It goes back in part to the “donors should remain anonymous” principle. During the screening process, I talked with the psychologist and social worker about if/how to tell people about the act.
But the cringey self-acclamation of writing about my donation is outweighed by the potential impact of convincing other people to join me. For I would not have decided to donate without personal testimonials from Dylan Matthews, Scott Alexander, Wency Leung, Tim Faust, and others (I linked to Leung’s short video; I’d also been moved by an article she wrote that is now behind a paywall but is available on this Internet Archive version). This act is rare enough that social license + normalization comes almost exclusively from the internet.
If this blog post leads to one more person donating, it will have been worth writing. In person, I’m largely succeeding at bringing up my donation in conversation only when appropriate. And I try to stay grounded by remembering that I don’t believe in having a self or in free will. That’s too long to get into here; if you’re curious, I liked the books Why Buddhism Is True (here’s an interview with the author) as an intro and Losing Ourselves for a deeper dive. In short, acts good and bad transpire due to circumstance, and we thus shouldn’t give people so much credit or blame.
Would I have donated if my brother hadn’t texted me? What if he hadn’t seen Tim Faust’s Defector article? Would he have read it if he hadn’t known Tim? He wouldn’t have known Tim if they hadn’t once worked together… and so on.
You can see the articles bumping each other along this way, too: MacFarquhar influenced Matthews, Matthews influenced Alexander, Alexander influenced me. As with any act, it rests on a pile of contingencies. My decision was shaped by everyone I’ve interacted with along the way.
How It Feels
I second the commenters from the AstralTenCodex post: the act was self-affirming. I was able to demonstrate to myself that I’m the person I consider myself to be. In the course of donating I considered famous cases where people have risked themselves to improve the lots of strangers:
- Helping enslaved people escape on the Underground Railroad, like Harriet Tubman
- Hiding fugitive Jews during the Holocaust
- Enlisting in the International Brigade and traveling to Spain to fight fascism in the Spanish Civil War
- Paddling a kayak into the path of an oil rig, like the “kayak-tivists” who blocked Shell’s Artic drilling expedition in 2015
- Medical workers who have traveled to Gaza
Those deeds dwarf kidney donation! They require vastly more personal risk and time investment. But they feel morally relevant.
If had lived in Virginia in the 1850s, would I have aided fugitives freeing enslavement, hiding them in my cellar? I would like to think so, but there’s no way to know. Giving a kidney was a small but visceral way to put my body on the line for righteousness.
I also mention these historical feats of altruistic courage to put the act of kidney donation in perspective: it’s ultimately not that big a deal for the donor. Scott Alexander notes the asymmetry between the huge accolades that people bestow for this act (“you’re so brave!”) vs. his sense that a couple of months out, it feels like a pretty minor thing to have done.
Past, present, future
When Joyce Roush became the first person to donate a kidney to a stranger in 1999, most people thought she was crazy. (There’s a nice recap of the history of non-directed donation in Confessions of a Good Samaritan). You can see that attitude change through the New Yorker articles I linked above, moving in tandem with the increasing frequency of anonymous donations. Unlike the early donors, and even Penny Lane, virtually no one told me I was crazy or tried to stop me.
Currently a few hundred people a year make a non-directed kidney donation in the US. That’s still not much, not enough to make a dent in the ever-growing waitlist (17 people waiting for a transplant will die today).
I haven’t seen the non-directed kidney donation counts for recent years (there are official statistics) but it seems like it’s getting more attention online. Maybe it’s the sort of thing that could achieve critical mass and blow up, with hundreds of annual donations quickly turning into thousands.
On that note, I support the effort to increase the number of non-directed donations in the US by paying donors $50,000 spread over 5 years (the campaign to “Modify NOTA“). Dylan Matthews makes a good case for modifying NOTA in his interview with The Atlantic; in particular, that in maintaining the current system because we have qualms about compensating donors, we are choosing thousands of preventable deaths each year.
Fun kidney donation facts I learned along the way
For starters, I found the financials of kidney transplants fascinating. Dialysis is really expensive and all patients on dialysis are eligible to have it covered by Medicare. At $100k+ per patient annually, dialysis costs make up 6% of Medicare’s budget and almost one percent of the entire federal budget. This means that a transplant operation, expensive as it is, can actually save the federal government money in avoided dialysis costs.
Here’s an academic paper analyzing the financial costs and benefits kidney transplant; it finds that taxpayers save $146,000 per transplant, as the savings from avoiding future dialysis outweigh the costs of the surgery and post-surgical healthcare (the libertarian Cato Institute estimates $517k in savings per transplant, though I think the academic paper has more robust methods). You can’t put an exact price tag on the longer and higher-quality life for the recipient, but the paper tries: it estimates that benefit at $937,000.
Another paper I stumbled across was a study of the phenomenon of kidney paired donors backing out or “reneging.” Turns out it hardly ever happens and when it does, the reasons are usually out of the donor’s control. I’d originally read that paired kidney donations had to happen simultaneously to avoid reneging; turns out that’s obsolete and now paired donations take place over weeks, making longer chains logistically possible.
How one’s worldview motivates donors
Read some of the articles I’ve linked and you’ll see references to Abigail Marsh’s research on the brains and traits of non-directed kidney donors. She finds some physical differences in the brains of these donors vs. the general population. I didn’t find that so interesting (though maybe it bolsters my case against free will). In observing donors, what jumped out at me was that a disproportionate number of people who donate a kidney to a stranger seem to hold a particular political or religious worldview outside of the mainstream.
Most notable are the Effective Altruists. Dylan Matthews and Scott Alexander are both aligned with the EA movement. Non-directed kidney donation is widely discussed on EA forums and websites. It makes sense for EAs to “share their spare” given that they habitually make unconventional, high-leverage choices.
I find compelling the core of the EA movement, that we should consider how we can most effectively do good, and I’ve donated through GiveWell. Many EAs are vegan and take animal suffering seriously. And the EA case for kidney donation is above all what convinced me.
Other aspects of EA rub me the wrong way, above all the toxic worldview of longtermism. So I’m not fully on board. But I appreciate the EA concept and it’s gotten me to change my thinking, for example on directly compensating organ donors.
I initially saw the act of kidney donation through the EA lens. It was a math equation, one with a staggeringly good risk-to-reward ratio. But I came to be at least as compelled by the qualitative, storytelling perspective. Penny Lane, a former EA who has drifted away, points out in her EconTalk interview the significance of the story of a kidney donation. For instance, getting a kidney might mean someone can watch their kids grow up.
The other group that seems vastly over-represented in the pool of non-directed kidney donors is Orthodox Jews in the NYC area who have donated through Renewal (here’s a Forward article about Renewal). From the article:
Ultra-Orthodox Jews account for just 0.2% of America’s population. Yet last year, by the Forward’s estimates, they accounted for up to 17% of the people who donated a kidney to strangers.
That 17% number needs a caveat because Renewal donors have some say in choosing a recipient. They might see an ad in a community paper saying “I’m a 60-year-old man, a grandfather, a scholar, and I’m dying from kidney failure” and choose to donate to that recipient without knowing anything else. For the purposes of official national statistics, these get counted as donations to a non-relative, as they’re not truly non-directed.
I think it’s great that the mitzvah of kidney donation has taken off in that community. Reading this everywoman story about an Orthodox woman in Teaneck, NJ who donated her kidney through Renewal makes it seem like the act has been somewhat normalized; it mentions that the the woman’s rabbi had donated a kidney and then part of his liver.
(The liver is the other organ that a living person can give without long-term consequences to their health. They remove part of the liver and the remainder grows back in the months after surgery. But that surgery is more invasive and has a harder recovery, so most non-directed donors choose to start with a kidney. Donating bone marrow would complete the donor trifecta, but all you can do there is get swabbed for the registry and hope to eventually be matched to someone in need).
If there’s an ideology that pushed me to give a kidney to a stranger, it’s my politically-left worldview, motivated by a care for and solidarity with other beings. Tim Faust, whose Defector article about his donation experience got me moving, is a professional Medicare For All advocate. His worldview shines through his article’s conclusion:
What more durable pleasure is there than aiding someone in need? Our lives are woven together by unbreakable thread; we cannot be happy unless the people around us are happy as well. Donation is as beneficial to me as it is altruistic.
Amen. Seeing non-directed kidney donation as an act of mutual aid, reinforcing the tapestry of humanity, makes it a logical act for a leftist. As Bernie memorably asked in 2019: are you willing to fight for someone you don’t know?
Or, Marx, simply: “From each according to his ability, to each according to his needs.” That’s pretty much what it came down to: I had the ability to give a kidney to someone who needed one.
Religious people, libertarian EAs, the left: it’s nice to see everyone aligned on something. For now, non-directed donors may be more likely to come from outlier worldviews. But if I’m right that these donations are poised to snowball in popularity, it’ll eventually become a more mainstream act. Either because of the word spreading – this post is my little nudge, though movies like Confessions of a Good Samaritan on Netflix and the upcoming Abundant will do far more than my blog – or because America decides to compensate non-directed donors.
The end
It’s past time to wrap this up. At least I didn’t give a TED Talk, which is the least enjoyable format I have encountered for kidney donor stories. I’ll echo what I’ve heard so many other donors say: if I had another kidney to spare I’d do it again in an instant.
And now that this blog post is in the bag, here’s to shorter and more frequent posts in 2025!
4 replies on “Notes on a Non-Directed Kidney Donation”
Sam, I love your spirit and you. My favorite part was when you were drugged up after donating your kidney you were celebrating with strangers in the hospital with fist bumps. Glad you are okay and helped save multiple lives.
Everything about these reflections and the decision to donate is very thoughtful and very you! Also definitely better than a Ted Talk. 💛
no matter the path the donor has chosen to come into this decision and inspiration behind it or any other reasons etc. thank you to all who took the courage, to try and to go through to donate in making a difference and helping recipients out there.
A remarkable and beautiful story. As someone who knows your mom(and is a mom herself), I understand her apprehension. However, she and your dad have planted the seeds of tsedakah and gimilut chasadim in you-so really this is their fault! 🙂
What an amazing act of kindness you have done. Kol Hakavod.