Kidney donations from 'Perfect Strangers'

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Kidney donations from 'Perfect Strangers'

by Salil Dudani on Thursday, March 27, 2014 - 9:13am

Perfect Strangers film posterMost people who donate a kidney transplant it to a family member or friend in need, but from the outset Ellie was determined to give her “spare” kidney to a stranger. In a community college class, she met someone with kidney disease who was in need of a transplant. Her curiosity piqued, Ellie wrote a research paper on the topic. She was struck by how much a donation improves the recipient’s life, and by how safe the procedure is for the donor. She began reading through online profiles of individuals requesting donation from strangers, typically because their loved ones’ kidneys are not a medical match.

Art and Art History Professor Jan Krawitz’s film, Perfect Strangers, follows kidney donor Ellie and kidney recipient Kathy over the course of four years as they navigate the complex ethical and emotional terrain of organ donation. The film was screened in Annenberg Auditorium recently, followed by a discussion on the film and on kidney donation in general between Krawitz, Professor Debra Satz, Stanford alumnus Alexander Berger, and Ellie herself, who drove 200 miles to attend the event and share her perspective on this intimate episode of her life.

The profile of a woman named Kathy stood out in particular to Ellie. Kathy had been on dialysis for several years, but like many others on the donation waiting list, had no luck with finding a donor so far. The two women lived 500 miles apart, but Ellie knew this was the individual to whom she wanted to give her kidney. Ellie met with Kathy and her husband, and the visit confirmed her gut feeling that Kathy was the recipient she wanted to donate to. Both women had the blood type B+, and initially the donation seemed possible – but unfortunately, medical tests later showed that they were not a match.

Jan Krawitz, Ellie

For both Ellie and the audience attending the film, this news was hard to bear, especially after seeing Kathy’s dialysis firsthand. Her dialysis consumed several hours every day, and it was a painful process throughout which she was required to stay stationary. Ellie described witnessing Kathy’s dialysis as being privy to an intimate process that deepened her love for Kathy and her desire to donate, and Krawitz’s shots of the medical procedure and its oppressive effect on the lives of Kathy and her husband conveyed the same feeling to the audience. Now Kathy was back to square one, and Ellie had to decide how to proceed.

On one level, donating to Kathy would have been a donation to a stranger. On another, however, it was not: while she did not know Kathy outside the context of donation, she had grown attached both to Kathy and to the idea of giving Kathy her kidney. It was thus a “directed” donation, not an “undirected” donation with an anonymous recipient that Ellie knew nothing about (akin to blood donations). Last year, there were about 5,000 kidney donations in the United States, and only 161 were undirected donations to strangers.

Ultimately, Ellie decided to give to a stranger in a truly undirected donation. The recipient was a man on the East Coast named Mike, but Ellie was barred from knowing his identity before the donation. After her surgery, it was up to Mike to reveal what he wanted. Mike and Ellie spoke once, when Ellie was on a radio show discussing the donation and Mike called in to introduce himself. And, after waiting for eight years, Kathy was finally given a kidney from someone else.

Though Ellie stressed throughout the film that donating a kidney is relatively cost-free and does not involve any heroic sacrifice, the audience seemed to feel differently. When introducing the film, Dean of Continuing Studies Charles Junkerman said that the title Perfect Strangers has a double meaning. And when Ellie walked on the stage for the post-film discussion, she received a standing ovation.

Because of how easy it is for the donor, and how meaningful it is for the recipient, Berger likened it to giving $100 knowing that the recipient would get $100,000. 

Debra Satz, professor of philosophy and director of the McCoy Family Center for Ethics in Society, remarked that while directed donation to a loved one is viewed as a duty, undirected donation to a stranger is seen as heroic but a little crazy. This was certainly borne out in the film, in which Kathy, Mike, and their respective spouses all said they did not understand how Ellie could be motivated toward such altruism. Mike said that giving a kidney is not a normal favor: it’s not like giving someone a couple bucks. He can see why someone would altruistically donate a little money – but a kidney?

Alumnus Alexander Berger, who donated a kidney to a stranger while at Stanford, suggested that donating a kidney does not really require so different a motivation than giving a little money. Because of how easy it is for the donor, and how meaningful it is for the recipient, Berger likened it to giving $100 knowing that the recipient would get $100,000. In the discussion, one could very clearly see two of Ellie and Berger’s motivations to donate: the intensity of need for the recipient, and the thought of how small a sacrifice it would be for them. Berger likened the surgery to having one’s appendix removed, and Ellie said the most difficult part of the recovery was that laughing hurt for a little while. She said that on average, 17 to 18 people die every day as they wait for a kidney; Berger followed this up with statistics on the mortality risk associated with donating a kidney, which he said is a mere one in 3,000.

An audience member asked Ellie if she knows of anyone who has donated because of her story. Ellie replied, “No, but I hope this film does that.”

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More Gender News: "Looking in the mirror: In films, Jan Krawitz reflects on female body concepts, sexual assault"

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This article originally appeared in The Buzz, which is the McCoy Family Center for Ethics in Society's student-driven news portal. In addition to the Center for Ethics in Society, the event was co-sponsored by the Department of Art & Art History, Stanford Continuing Studies, The Center for Compassion and Altruism Research and Education, and Stanford Arts Institute.

J Krawitz
Jan Krawitz
Filmmaker; Professor of Art and Art History

Jan Krawitz has been independently producing documentary films for thirty years. Her work has been exhibited and awarded at film festivals in the United States and abroad, among them Sundance, Nyon, Edinburgh, Margaret Mead, London, Sydney, Full Frame, South by Southwest (SXSW), Ann Arbor, and the New York Film Festival. Her latest film is Perfect Strangers.

Salil Dudani

Salil Dudani is an undergraduate student at Stanford who writes for the Center for Ethics in Society's student writing team.