OTE Reflection - Brett Simchowitz, c/o 2013
I found the longitudinal organ transplant experience to be a highly valuable opportunity for a number of reasons. It gave me insight, from a patient's perspective, on the way in which healthcare is delivered over time and across specialties; it presented a highly successful effort by traditionally discrete branches of the delivery system to integrate care; and it offered a rare glimpse into the pool of emotions and motivations that underlie the intensely altruistic act of living organ donation. Organ donation, perhaps more so than many medical specialties, requires close collaboration between the surgical and medical teams, for the sake of both the recipient as well as the healthy donor. Transplant services at UCSF and elsewhere have made significant efforts throughout the process to integrate care, from the multi-disciplinary transplant boards where cases are discussed around a conference table to the coordination of medical and surgical appointments at the same visit. The donor pair I followed, a young woman and her diabetic stepfather, clearly benefited from streamlined communication and from the guidance of a dedicated nurse practitioner who synthesized information and provided regular follow-up by phone and in-person. A social worker was available to the pair to think through the financial and psychological implications of undergoing the operation and to assist the pair with numerous logistical hurdles leading up to the transplant. And while both patients recuperated on the wards in the days after the surgery, a transplant-focused pharmacist helped manage their complicated medical regimens.
All that hard work seems to have paid off. From what the two shared with me during my time with them, both before and after the surgery, the experience was far more difficult than they anticipated but also far more rewarding.