SYSK Selects: How Organ Donation Works

episode floats your boat. So I hope you enjoy How Organ Donation Works. Welcome to Stuff you Should Know from House Stuff Works dot com. Hey, and welcome to the podcast. I'm Josh Lark with me as always as Charles W. Chuck Bryant, who I assume has two functional kidneys. I do, but I would give one up for you, brother. Wow, would you really? Maybe? I think I think that three Chuck as a living donor maybe not? But if I died, then sure you get thanks. Man. What about your liver,

because I'm pretty certain I'm gonna need somebody's livers. I don't know that you would want mine either, to be honest. Oh yeah, that'd be like getting Mickey Mantle's liver. I need like a we need a virginal liver, don't. Yeah, so I can just start over again, wash it in vodka. So what are we talking about, Josh? We're talking about

organ donation, Chuck perfect, which I find absolutely fascinating. UM. Back in nineteen fifty four, let me take you back a little bit here, the first successful living human to human organ donation took place. It was a kidney. Yeah, it was a great story. Kidneys actually remained the most commonly donated and UM received organs. But this was actually a couple of twin brothers, one of whom was dying

of chronic nephritis. Yeah, Richard and Ronald Herrick. And Richard was the one dying, and Ronald was in good shape, right, and Ronald said, well, you know what, you're my twin brother, and I don't really want you to die young, so I'm going to give you one of my kidneys. And UM.

There have been uh some other transplants before that. They didn't work out though, well some of them did, but it wasn't live human to human UM like for example, the first I think the first organ, the first donation or transplant that ever took place was way back in sixteen sixty where they fused part of a dog's skull under human's head and that graft worked. H We have taken testicles from monkeys and successfully in playing them into humans.

A pig kidney was successfully transplanted into a human vein transplants, uh, And a lamb kidney was put into a recipient in nineteen twenty three and that person lived for nine days. But nineteen fifty four finds the first time a living person donated an oregan to another living person, and it was successful. And the reason why, they think was because they're twins, there was a very low chance of rejection, right. Yeah.

And the story is great because Richard, you know that the dying brother had a moment, a clear moment where he literally, like the day before, said don't do this. Man, get out of here right now. And the brother said, no, I'm gonna give you my kidney like it or not, chump, and he did. And it was a great story. Yeah, And they actually both lived to ripe old ages reproduced, so they fulfilled their destinies humans. And since then, Josh, there have been more than a half a million of

these organ transplants performed. Right, We've gotten a lot better at it. Um. As I was rambling off that list of stuff that took place before nineteen fifty four, we have and exponentially better. Uh. In two thousand three, we successfully transplanted a tongue. Yeah, I saw that, which I could use a tongue transplant. A slightly thinner tongue would would do me a lot better. I think you had a fat tongue. Yeah. And do you remember the um,

what do we do the face transplant? Huh um. That woman actually remember she got her face from a suicide victim. That was in two thousand five and in two thousand six, so I know it's coming. A cadaver's penis was transplanted onto a living humane and that man gave it back. Yes, and I love The reason they gave was because of uh. It caused psychological problems between the man and his wife, which I can imagine. Let your imagination running with that one. Yeah, yeah,

that's just uh. I would say the same thing would happen to my household. So thanks to m A better understanding of how the human body works of blood type, of the development of anti rejection drugs like Chuck said, we've hit about half a million transplant surgery so far. Right, So Chuck actually is hot and heavy, uh to to give out a stat and this is a very special stat because it's actually most likely going to change by the end of the podcast. Yes, these are taking away.

These are current stats. If you go to the website u n O s dot org, the United Network for organ Sharing, they actually have up to the minute statistics on who needs what and who's giving what and what operations are being performed. And I didn't realize this, but it's up to the minute because earlier in the day I checked on kidneys and the number actually dropped by three about an hour later on the waiting list, So three people got kidneys in that like half hour span.

So I'm just gonna read a couple now and then we'll check back in for fun in twenty minutes and see if that's changed at all. Okay, I'm gonna write this down to Chuck because we'll never remember it. This is the first time we've ever used a laptop in the studio and a pen usually just us in our mouths. Uh. Total, Josh, we got one five hundred and five thousand, two people are waiting for organs, and we'll do kidney because that's

the most popular. Eight three thousand and twelve people are waiting for a kidney as of two oh three pm. All right, and we'll check that in twenty minutes and hopefully those numbers have gone down. Yeah, because that will mean that either the people on the waiting list have died or they received a transplant. I guess we could put those two, we could compare against one another, and maker we could surmise for So, Chuck, what are organs? Yeah? I had a feeling you're going to ask me that, Josh,

go ahead, No, okay. Organs are systems of cells, Josh and tissues, and they all are in our body for a very specific reason, each one. And what I like about the organs is that they are all over equipped, which is what you're looking for in an organ. You don't want like the heart to be like boy, if it beats one beat less, you're really screwed. So um our art. Actually, a twenty year old's heart beats pumps about ten times more than the amount of blood we need.

And uh, we we have this reserve capacity in all of our organs. As young lads and lasses. Right. But as Tom Chief, who you know as my bff who wrote this article, he points out that the corneas, when you talk about eye transplants, they're talking about corneal transplants. Um, they actually don't necessarily deteriorate like all the other organs. Yeah,

that's pretty cool. Um, So the corneas of seventy five year old donor are just as good, considering you know, there's not more wear and tear than say a twenty year old. Yeah, you could put a seventy year old person's cornea inside of a young person and there would be no difference. Right. But for organs, they deteriorate with age. Well that's the bad news, right, Um, so eventually you may need one, right, Well, yeah, because what happens is, let's say one organ can deteriorate while the rest of

your body remains pretty healthy. That's actually best case scenario, as weird as that sounds, because that means you can just swap that sucker out and you'll be fine again. Right. Well, that that's in a very ideal utopian world. That's exactly what happens. The problem is, there is a lot more people in need of organs than there are organs available right right, there's um a waiting list. Some aren't so bad. I think kidneys go pretty quick, as you're you're talking

about earlier. The longest wait I found, um was the old heart lung combo. That median wait time was six point seven years. It's a long time to wait for a heart and a long if you need it. Yeah, a long time because nobody goes I'm probably gonna need a heart and a long combo. Eventually, I'll just put myself on the waiting list. Now you need it, like the moment you go onto that waiting list and you have to wait six point seven years until you get it, right, Yeah,

and that's why. Um, the mortality rate while waiting for a heart, which is that's not as bad as I would I would be, like the lungs are, and um, the ever actually is the worst good Yeah, sorry, um. There's two ways you can get organs from a live person or a dead person. Yes, Traditionally we don't take organs like the heart from a live donor because they

would be a dead donor. After that, you can take things like uh, the liver pancreas uncommonly, but it can be done a portion of the intestine, um, blood, blood, stem cells, bone, marrow, bones, all and bones. Yeah, which giving up a bone that's really something like, I mean after that, you just kind of have this floppy arm, but somebody else has a bone, you know, I mean,

that's pretty nice. You Know. What I thought was interesting about the kidney deal, like why you can give up one kidney and still be okay, is that most of the times when your kidneys are affected, they are both affected at the same time, so it's one's never gonna go down and you'd be like, oh, I wish I still have my healthy kidney because they both would have been unhealthy. And uh, all right, I think we've arrived at the liver Chuck. This is fascinating to me. It

is where where should we start? Well, let's just start by saying that the liver can grow. It's like the starfish of oregans. Yeah, it can regenerate itself, which is just freaking amazing. Sure. Um, So, for instance, let's say you wanted to split your liver in half and transplant

that into two different people. You could do that. You could and actually, if you're an adult donor, they can cut off a portion, a child sized portion, UH, which is I think the same as like a child sized meal where you get like three chicken nuggets from UH and give it to a kid and chuck, this is so great. It grows along with the kid right to a full size liver once again, but in step with the kid's maturation. Right, that's just mind boggling. Let's say

you needed a piece of your liver. Let's say you needed liver replace and I cut half of my liver off and gave it to you. My liver would eventually grow to full size once again. Yeah, if I live that long, so mine would grow and yours would grow. And the cool thing is with the liver, you don't even have to take out the old liver. You can just put in the new one. It's like the best organ on the planet. It really is, and our favorite

organ because of the function that it serves. So Chuck, Like I said, you can neither be a dead donor or a living donor. A dead donor can donate anything, right, including your yeah, and your eyes, um, heart, lung, all that stuff that you can't really take from a living donor. Um. But there are some exceptions. If you have HIV or disease causing bacteria in your blood stream or tissue. They're

not going to be taking your organs. Um, And if you are a practitioner of the Shinto religion, there's not gonna be a lot of organ donation going on there either, right. Yeah, not only that, but if you are Amish, they might support your donation if there is a certainty relative certainty of success, but they're more reluctant if it's uh less probable of success. Right. And Tom actually mentioned why the

Gypsies don't agree with the organ donation. They believe that, um, you need your body for the first year to get around the afterlife. Apparently after that you got it down pat and you don't really need it any longer. Um. But he didn't mention Shinto, but I looked it up. Uh. They believe that the corps is impure. The body becomes impure after death. So would be like, here, take this rotting piece of flesh that will save your life, but

you're going to be impure while you live. Interesting, So, as a result in Japan, uh doing donation rates are like really really low like the USA. Yeah, and Jehovah's witnessed we should cover them because we're we always like to talk about them. Uh, they're not opposed to it, but they have one rule which I thought was interesting. You can donate your organ as long as they drain all of the blood out of the organ first before giving to someone else. So I guess we're not big

on translusions. I don't think so, that'd be my guess. Yeah, okay, Um, how do you register Chuck? Well, it's pretty easy. Actually in most states, you can do it at the d m V, which I always found interesting. Yeah, you can do it right with there when you're getting your new driver's license. And uh here in Georgia, actually we used to have the one of the highest donor rates, or I should say one of the most expansive donor registries in the country. And the reason was when you went

to go get your driver's licenses. I'm sure you remember, Um, they'd knock seven bucks off of your driver's license. I love that. So you were an idiot if you didn't sign up. The problem is that there's not supposed to be any kind of compensation whatsoever for being even though this was legal under state law. Um. The Georgia Organ

Procurement organization, which we'll talk about a minute. Um, they were very hesitant to draw from the Georgia donor list because they weren't sure if the person was just looking for the seven bucks off or else if they really wanted to be an organ donor. So actually, the contribution rates were very low in comparison of the size of the registry in Georgia until two thousand five when they stopped. They stopped it, I think to actually give you a T shirt too that says I sold my lungs for

seven dollars. That's illegal, and all I got was this lousy T shirt. Yeah. No, under UM law, you can't have any valuable compensation for organ procurement, right what we'll get to that too, the whole black market deal. Okay, So Chuck, if you're a dead donor, how do you donate? There's two ways, right? Uh? Two ways, sure, two ways of death. Brain death and cardiac death. Is that what you mean? Obviously? Cardiac death is um a little trickier because you only have a certain amount of time to

get the organs from the body. Brain deaths a lot easier in one sense, because um, there could be is you know, weeks to find a match and to prepare the organ for donation and get it carried out. But there's a wrinkle there. So there's a lot of wrinkles there. Let me let me say something about cardiac death first, right, Um this there are there are no laws really governing

organ procurement. It's not a case by case basis, And basically everybody involved in the organ procurement process does their best to walk a very cautious line while harvesting organs to try to save other lives, right, yeah, because there's families involved grieving obviously. Um. With cardiac death, there was a board I think out of Harvard in the late nineties that established a five minute wait time from the

cessation of a heartbeat. Right, so, you you take somebody off a life support, wait for the heart to stop beating. Five minutes after and while this this the heart's winding down, you're prepping the patient for surgery. Five minutes after, Uh, somebody pronounces the person dead and they cut them open and take the organs. But in five minutes the heart is useless pretty much at that point. Some of the other organs, like the liver, the kidneys, maybe the lungs

can survive that five minutes, but the heart's gone. So if you have a cardiac death, you have a useless heart, even though the heart might have been perfectly healthy. Five minutes again right, So there was this doctor in Colorado that said, you know what, there's no law whatsoever that

says I have to wait five minutes. This guy did a lot of research and found in the medical literature the longest duration between the cessation of a heartbeat and the spontaneous regeneration of a heartbeat ever recorded was sixty five seconds. So he started a sixty five second rule, got the pants suit off of them. It was an unsuccessful lawsuit, and now all of a sudden, the president has been set and now there's a sixty second rule out there that some people adhere to. That is how

organ procurement has been established in the US. Somebody pushes the envelope, they get sued. They if the cases uh isn't one by the by the plaintiff, then you have a new rule. Isn't that weird? There's like zero guidance for organ procurement except that the person has to be dead. We don't have any real definition for death. Well, that's where brain death gets really really true. Exactly. Take it, Chuck, Well, I don't. I mean, you're the you're the expert here.

I don't. I can't weigh in morally because I don't know what I think. Really Nah. I mean, I know what I might believe for myself, but I don't know about establishing guidelines for others. But we need them, though, don't we? Yeah? But I don't want to make up those rules, do you know? And apparently the federal government

doesn't either. Um. Every once in a while, I think Carter assigned a panel to create a white paper on this, and I guess George Bush did right before he left office, because there was one that came out in two thousand and eight. Either Bush did right before he left office or it was like the first thing Obama did when he came into office. But there was a very recent white paper that came out that said, Okay, here's how

we feel about brain death. Right, here's the problem. Back in the fifties, I think we came up with this thing called the ventilator. And with the ventilator, you can keep somebody who for all intents and purposes dead, you can keep their organs functioning. So you're masking death. We have no idea what would happen if that ventilator wasn't there, would the person die? And if the person does die, how long do we have to wait until we say

that that person is dead? Right? So the the ventilator made it so we could procure organs more easily in brain death because we can keep them alive. At the same time, it blurred the line between life and death. Well, now they came out with this recommendation that said brain death is disengagement of no the um end of meaningful engagement with the rest of the world, which really widened

the scope of who exactly is dead. And so when you have a brain dead patient and you procure their organs, what what you actually do is you have to run them through this battery of tests where you are um shining lights in their pupils. Uh, there's an ice water injection into the ear canal to see if you move toward or away from the stimulus um And there's this battery of tests to establish brain death. And then here's

the clincher. They do an apneus test where they take you off the ventilator for two minutes and see what happens, and see what happens. Inevitably, the um, the heartbeat is going to slow down. And then after two minutes they put the ventilator back on. But that two minutes where your brain was starved of oxygen was enough to to create real brain death if you weren't before. Wow, think about that. This is why they call you supplementary research man. Right,

that's why that's your superhero. Can you hear like people fast forwarding through to get through this, partners, It's like Josh, Josh, Josh, Josh. Okay, So we have this, we have this new definition of brain death. And when the second apnea test happens and you're declared brain dead, what they anesthetize you, they inject you with anti paralytics. Will you into that hospital room and they harvest your organs, so you actually die from a lack of organs present in your body. So that's

that it's a ghoulish matter. And this these people who are in charge of making sure that people donate and keeping the image of organ donation is a gift of life alive, have to battle with this, the fact that it's a very ghoulish process. So who's who's in charge of this stuff, by the way, for what for that whole soap op spiel anytime, buddy, Yes, Josh. That would be called an O p O, which is an organ procurement organization and they are federally designated nonprofits and they

are local all over the country. There's usually UM one in the central location of a state and then different satellite office is obviously because you need to be close by. You know, you can't be hopping all over the country to get these organs, although that happens as well. And they basically responsible for awareness, recruitment, evaluation, UM organ removal, and transportation. So they're the people that's standing there with a cooler waiting to drop your organ in there and

rush it to the recipient. They're also the people that talk to the family generally. Well. Sure, so anytime somebody dies, you the hospital is legally obligated to notify the organ procurement organization, right and you know this this is a good point to bring this up. If you want to be an organ downer or if you are, you really need to tell your family the stuff, and you should have it all in your living will because things can get a little ugly. UM for instance, let's say you

are from a very strict religious background. Maybe your family doesn't want you cut up. They think that would be a bad thing, but you want it. You gotta have that, you know, in paper on paper, in writing, right, you need and if you have a documented um in a lot of cases, even if you if your family is like, no, we don't want to donate the organs, the organ per human organization will say, you know what, ts sorry, he want he or she wanted to be an organ owner.

And the last thing you want after you die is for your spouse, let's say, to have to mountain this campaign against your family like a tug of war like that. You gotta have it all spelled out nice. Um. So where are we? The United Network of organ Sharing that's another group. This is where that's where you got the

kidney statistics. We're gonna go back on and look at right. Yeah, they're in Richmond, Virginia, and they are responsible for placing donated organs um and maintaining the waiting list like you just said. And they never close No. Seven three sixty five, which is how it should be. Obviously, we should calling them right now to see if they're open now. Let's

not do that. I'm sure they're open. And then Chuck, there's the Scientific Registry of Transplant Recipients, right, Yes, the s R t R. And they basically maintain like every amount of data you could possibly want on transplants, right for like policy makers and doctors and drug makers and

that kind of stuff. Yes, And there was one more called the ORGANS sorry, the Organ Procurement and Transplantation Network, and they're they're just another network that matches people with recipients and has waiting list that kind of thing, right, So this is actually a pretty um lean, mean streamlined machine. Yeah, the Procurement and Donation Network. It has to be right, So, Chuck, you were saying like they can't be hopping all over

the country, but they have to sometimes. So what happens with like, let's say somebody dies in Sacramento and they have the perfect heart that somebody in Tampa needs. What happens while they will put it into a cooler and fly to uh what was the destination? Tampa? Tampa? They

fly to Tampa. Apparently like the hospital in Tampa. Those people will go fly to Sacramento, take possession of it, and then fly it back unless there's somebody in the like, like, let's say somebody in Sacramento needed it and somebody at the Sacramento General Hospital died. That's when that cooler comes in. Which have you seen the one that's at the office. We have an organ transplant cooler. Yeah, it's pretty cool,

roxane keeper tab in its. Uh. You know what I thought was really cool is if you were on the organ donation list as a living donor, you are actually given consideration if you need an organ transplant yourself. And they said that they won't like bump you to the top of the list, but they will give that a little bit of extra weight, which I think is that's

only right. Did you also see that? Um, if you are a living donor and you usually your insurance company won't raise your rates after that, but move to another insurer change like plans, they'll hit you with a pre existing condition. That's how evil. Seriously you sign up for listening, I will give someone my kidney as a living human and the insurance companies are like, oh, well, you might

have to charge a little extra for that. Don't you think we should start publicly executing CEOs of insurance companies? It should be part of the healthcare reform package. Right, of course we don't mean that, right, Thanks for the Ceoh so chuck. When when you're talking about people running around with coolers and all that, it kind of creates this harried pace right in your mind. Um, and that's very much true. You have a very short amount of

time for an organ to survive. Remember I said, like even five minutes can kill a heart once it's deprived of oxygen, which it stops beating, right. Um. What happens when you die too, The body undergoes all these huge changes. Um. That happened almost immediately, Like, um, there's this uh, parasympathetic flow of chemicals right um, which is like kind of fight or flight on steroids. So I guess it's a sympathetic flood. Like dopamine levels increase eight hundred percent, epinephrin

levels increase, nor EEF levels increase. So all these chemicals that are meant to like either speed you up or slow you down or just flooding fro the body. That's why you have to take the drugs right most times, Well, no, this is when you die. So when they're trying to harvest these organs, they're like trying to get them out of the body before this flood just damages these things

I thought you meant as a recipient that would happen. No, that'd be pretty awesome though, to have your dopamine levels raised eight percent, right, But it's not as easy as just throwing the new heart in there either and sewing you up and say good luck with your life. No, no, it's not you. And uh, there's also some expectation that you lead a very healthy life after that. You're not supposed to be drinking or smoking or swearing, and um, you have to stay away from call girls and things

like that. Yeah, you shouldn't get a new liver and then like dive into the vodka bottle. You're you're pretty much signing a contract to become ned Flanders after you get your organ donation. Yeah. Actually, just over Christmas heard of a friend of a friend of a family member that was a candidate for I think a liver transplant and they would not do it because he wouldn't enter um rehab. Really yeah, wow, so that's hardcore. Yeah, that

guy's dedicated to the booze, isn't it. Yeah, pretty much. Um, And also you're if you are a recipient, there's some expectation that you pay, like for the lodging and travel

expenses of the person who donated. Yeah, it's kind of an unwritten rule from what I understand well and have to be real, you know, it's kind of against the law really well, but it makes sense though, because if you're let's say, you want to donate a kidney to someone that lives across the country and you're spending money off from work and flying out there and putting yourself all right, it's gonna cost you some dough and a kidney. Yes, you'd have to be a really nice person to be

an an anonymous Yeah, that'd be cool. All right. So, Chuck, you want to talk about the black market? Yes, the black market does exist. Isn't that crazy? Um? Yeah, but not surprising. No, but it's pretty interesting. Um. It obviously exists, Um, typically outside of the United States, although there have been some cases inside the United States. Usually it's like, and this is what's so said. Usually it's impoverished nations, And what happened is that will be a couple of countries involved.

You'll take someone out of a really poor country offered them like five thousand dollars for their kidney, and then the middleman will get, you know, a hundred thousand dollars for that kidney. And you know, it's not like these are done in professional surgical rooms. It's a lot of time. It's it's the back room, if you know what I mean. And that's actually exactly what happened in two thousand three in South Africa. Yeah, they were importing people from uh I,

guess the City of God in Brazil. Yeah, slums of Brazil. Yeah, and um giving them five grand for their kidney and then turn around selling it for a hundred k yep. That's nuts, yep. And uh where else did it happen? Villagers in India so that they were getting they weren't getting nearly. They were getting about eight hundred dollars for their organs, which is just unbelievable. And at one time the Israeli organ brokers were obtaining these from Soviet Bloc

nations and doing the operations in Turkey. And this one guy made a middleman, made about four million dollars before he was caught, which is not bad harvesting organs, although I imagine being an illegal organ broker is a fairly stressful job. Yeah, and it happens in the US too, although customarily it's um an organ broker and a nefarious funeral director who harvest organs before cremation. Did you know this happened? No? I didn't either, and I saw all

the six ft under of course you did. Uh. Did you see the movie Thererista's No, that wasn't very good. That was the the deal there though kids are like captured in the jungle. No, but it was like an Eli Roth movie. It was like hostile, except they were harvesting organs basically instead of just blind torture. Uh. And speaking of that Thereristas. That actually does happen in the world. It's not just old wives tales. Poor Mohammed legend kidney

theft does happened. It really does, Mohammed. What do you say? His name was Selim Khan. Yes, he lived in Delhi, India, and he was looking for a day's work and agreed to go to a house under the premise that he would get about four dollars a day for performing uh work. Their construction work. All is on the up and up so far then, he has held at gunpoint for several days along with two other day labors. They were taken to an operating room drugged and they awoke with a

horrific pain in their side and minus one kidney. And when they took him to the hospital. When he went to the hospital, he checked him out and he had indeed been down one kidney. Not an urban legend. That really happens, although it makes me wonder if the urban legend gave rise to the actual practice. Oh yeah, you know, maybe so. And Josh, the one US case that was in here was really interesting too. Yes, Michael Master Master Marino.

There's an oral surgeon in New York and he opened a company called Biomedical Tissue Services with an embalmer, which should have been a real red flag that he partners up with an embalmer. And this is in the year two thousand, not even that long ago. Actually it was ten years ago. I'm old. Uh. For many years though, they harvested human tissue provided by funeral homes and sold

it to research facilities. And one of those bodies belonged to who Alistair Cook Alistair Cook, famous host of Masterpiece Theater. So he was chopped up and given to unwitting well, I don't know about recipients. They did harvest some of his tissue. Yeah, yeah, how about that? It's pretty awesome. So where are we now? We are I think we're at the point where we check those stats. I have them written down here as of two oh three pm. What time is it now? Chuck's got to get out

of his h Okay to thirty one. I gotta telling any disappointed if this number hasn't gone down, I think all of our listeners will be too. So we started out Chuck with a total of one five thousand two on the waiting list. What are we at one oh five? Okay, nothing has changed in twenty minutes with the kidney. We are at three thousand twelve. Well, it would be the same because that was the master stat. So the kidney didn't change either. Let's just hope Jerry didn't put a

drum roll in anywhere, right. But I will say, though, don't be disappointed, because, like I said earlier this morning, um three people received kidneys that were in searches. Yeah, let's let's like to think the other scenario hand out. Are you a donor? I don't remember I was. At one point in time I was seven bucks off, But um,

I think I'm going to go ahead and do it. Yeah, this article inspired me because I'm of the belief that the human body after you die is like worm dirt, So I have no problem with donating my entire body or all my organs, none of that. Yeah. Well, if you want to learn more about oregan donation, you can read Tom Sheeve's article on how stuff Works dot com. UH. You can also check out the UM what is It Chuck the Organ Procurement Network UM for their side of

the story. But I think you should also check out the Life Guardian Foundation. They have a very much opposing view of organ donation. So such a controversial topic should probably um get all of the facts before you make the very um important decision of whether or not you're going to be a dead donor. And if you decide that you want to be, like Chuck said, let everybody know, tell everybody, tell strangers on the streets. Just anytime you meet a doctor, go I'm going to be an organ door.

And you may want to make the decision with your loved ones as well, sure, even though ultimately it is it is your call. So good luck with being a rag doll in the afterlife, which leads us, of course to listener mill. Yes, Josh, I am going to call this U interesting cleptomania story from Sarah Okay um Hi, Josh, Chuck and Jerry. And she even spelled it correctly. Wow. I think that deserves a T shirt, don't you. Oh?

Actually she didn't. Sorry to ours Okay close though. Uh. Here's a story that I always think of when you hear anything about kleptomania. A while ago, I was working in a large independent bookstore that had been a city institution for years. Like any retail establishment, they had experience

about ten theft loss a year, nothing too unusual. However, one day in the late eighties, they received a thick, densely written journal which detailed to the day, our moment, weather condition, et cetera, every single book this person ever stole from the bookstory but this guy turned it in. Uh. They showed it to us in sales training. It was written in a cramped hand, all pages front and back,

which is really creepy. When you're writing on the front and back, you're either really green or you're like a serial killer. That's what I think. Uh. Sometimes a clipping or a picture from one of the stolen books is taped to it. So of course the bookstore said, huh, maybe we should prosecute since they confessed basically to stealing over a period of twenty years, adding up to thousands

of dollars. Whose recognis They contacted the people that returned address, and it turned out the person who wrote in was a son or daughter the very prominent local family, active in politics and big charities and the like, the kind of family they named Wings of Hospitals after hot sarahs So of course they didn't want their good name drafted the mud and apparently settled out of court for an

undisclosed Some money can do that. I guess that journal was something to behold though, So um, that's what Sarah says. That is definitely a c. That's awesome. Yeah. Cool. Well, if anybody's ever sent you a cryptic or disturbing journal and you want to tell us about it, or if you just want to say hi, you can send us an email at stuff Podcast at how stuff works dot com. For more on this and thousands of other topics at

how stuff works dot com. Want more how stuff works, check out our blogs on the how stuff works dot com home page. H