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Melissa Carter Headshot

Conversation With a Dying Man

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Neil Millman wanted to give me some pointers about what was ahead of me. As I walked into his hospice room, I knew it could just as easily have been my room.

The cancer that is attacking his body may, in part, be the result of taking drugs for years that kept his transplanted kidney alive. He is, for all intents and purposes, dying young in exchange for not having died much, much younger.

After receiving his cancer diagnosis, Neil reached out to me to discuss donating to my transplant fund at Piedmont Hospital here in Atlanta. But that conversation soon turned into a compilation of war stories as two veterans of the same war reflected on all we have seen. Neil received his transplanted kidney 20 years ago. I have had mine for just under a decade. He wanted to use his experience as a guide for me and other transplant patients on what we and the medical community should pay attention to in the future.

An Illinois native, Neil was living in the Chicago area when his kidneys began to fail during his late 20s. He was healthy enough to avoid dialysis while waiting for a kidney. His savior was a 12-year-old boy named Brian who died tragically. Two years after the transplant Neil became a runner, ultimately completing the Kiawah Island Marathon near Charleston and the Country Music Marathon in Nashville.

Last year, Neil noticed a nagging back pain that lingered. He blamed the pain on a pulled muscle from his training. But after seeing his doctor, he was told it was not a normal sprain and he needed to go to the hospital immediately.

After several MRIs and CTs, Neil learned he had numerous malignant tumors up and down his spine and lytic lesions across his ribcage. It started out as basal cell carcinoma, or skin cancer. More than likely, his transplant medicines contributed to the spread of the cancer, since immunosuppressants make it difficult to fight infection.

A transplanted organ is foreign to the new body it belongs to, and without immunosuppressants that new body would trigger a fever and infection and reject what it sees as a dangerous foreign object. But those same drugs that tell the body a new organ belongs there is also open to other foreign things as well, like cancer. Despite the risk, transplant recipients like Neil and I have no choice. Either we take the risk as prescribed or we die.

Neil knows these medications are new and experimental. It wasn't until 1951 that immunosuppressive drugs were even used to help transplant patients. But he questions whether enough research has been done into these medications. How long with they stay in your body? What other effects do they have on your body? Neil wants to make sure there is an evolution to transplant treatment so others won't have to face his current struggle.

He has only months to live, but Neil's ultimate goal was met.

"I got this gift of 20 years that I wasn't suppose to get," said Neil. "That was never promised to me. I had one goal, and that was to keep the kidney healthy. And I've done the one thing I had to do."

People want to know their purpose, but some believe the true answers to life lie in death. It's not until you face your own mortality that you can fully have the perspective to see life as a gift with an expiration date. My life should have been over in my 20s, but thanks to modern medicine I am now enjoying my 40s. When my time comes, I hope to face my final days with dignity like Neil, who hasn't lost sight of the blessings his kidney, and kidney medications, have afforded him despite the shortcomings they had in the end.

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