Late one evening this past autumn, two cars with a shared purpose were en route to the University of Tennessee Medical Center in Knoxville, Tennessee.
Arriving separately, accompanied by their spouses, Jason Gattis and Randy Martin checked in to the hospital, were shepherded to their rooms, poked with IVs, cleansed with a special soap, briefed by physicians and then wheeled into the pre-op room full of other patients awaiting surgery, where they greeted one another from their respective beds.
Martin said a prayer. Gattis said a prayer. A hospital staffer said a prayer. Then Gattis, the senior pastor at Chattanooga’s First-Centenary United Methodist Church, was whisked to another room. Doctors removed one of his kidneys and then put it inside the body of his friend.
The kidney is not all that links the Chattanooga area pastors, whose lives have been bound by rituals of love, faith and tragedy. Martin officiated Gattis’ wedding nearly three decades ago. Their friendship deepened when they worked alongside one another as district superintendents in the Holston Conference of the United Methodist Church.
Credit: Olivia Ross/Chattanooga Times Free Press
Credit: Olivia Ross/Chattanooga Times Free Press
Both, too, are grieving fathers. The very notion of donating a kidney came to Gattis following the 2017 death of his eldest son. He planned to give the kidney anonymously, thus letting one more person off the long waitlist. But then he learned his friend was in need of one.
Kidneys maintain equilibrium, said Wala Abusalah, a nephrologist at the University of Tennessee Medical Center. When kidneys fail, toxins build up in the body, less urine is produced, appetites diminish and fatigue sets in. The resulting potassium build-up, she said, could cause a heart to stop.
Martin, mindful of an adverse predisposition after his father spent much of the final years of his life on dialysis, has been seeing a nephrologist for well more than a decade. Around 2019, he said, his own chronic kidney disease worsened as his kidney function dropped from 40% to 10%, a threshold at which dialysis or a transplant is necessary.
Transplants have better results, and someone with less than 20% kidney capacity is technically eligible for one, Abusulah said. But the waiting list can take years. Tens of thousands of people in the U.S. seek kidneys, and the limited number available are distributed on the basis of knotty — and as of late, much scrutinized — bioethical debates and administrative processes.
Federal data shows most donated kidneys come from people who have died, but some, and generally better quality ones, come from living donors who volunteer to donate one. Incentivizing this practice is the general policy that someone who needs a kidney can generally get one straight away if they have a willing direct donor.
“I always tell the donors that ‘God gave us two so that we help each other,’” Abusalah said in a phone interview. “But you only need one.”
Grief stricken after his son’s death in a car crash, Gattis wondered what he could do that might save someone from the pain he felt.
He was moved by a TV news segment touting the need for living kidney donations and decided to make an anonymous donation, without a specific recipient in mind. Piedmont Atlanta Hospital summoned him for testing — of blood type and other aspects of his and his kidney’s health that help determine its suitability, both in general and for a given recipient.
Then he heard Martin needed a kidney and decided to donate directly to his friend.
Martin said he thought Gattis was too young, but according to Gattis, the 40s are a great period of life in which to donate — young enough that the kidney is still in good shape, old enough that any issues that would make a donation inadvisable, like, say, drinking problem, would have already been perceived.
Gattis’ test results were paired with Martin’s, and they learned they were indeed a good match. The pastors prepared for surgery in Chattanooga. Then, on account of COVID-19, all nonessential procedures were canceled until further notice.
‘Faith or fear’
So began an extended journey for Martin, whose doctor recommended he go on dialysis — in which an external machine periodically does the work of a kidney — since it remained unclear how long the surgery would be postponed.
No one educated him much about dialysis or its effect, he said, and early on, feeling fine, he drove home from a clinic down Highway 58 near his home and pulled into his garage.
He doesn’t remember what happened next. But what he’s reconstructed is that his blood pressure dropped as he got out of the car, and in the ensuing fall he fractured his right hip and hurt his head.
A new medical ordeal commenced, but because of the pandemic, his family couldn’t see him at the hospital. And even when kidney transplants were again offered, doctors, wary of his new injuries, consistently delayed the procedure pending further testing.
Three times a week for four-hour sessions, over what became a period of years, dialysis became a central rhythm of Martin’s life.
“You sit there four hours, then you get up and feel like crap till the next time you go,” Martin said, adding, “By the time you recover, it’s time to go back.”
TVs were on in the background, and he wore his Kindle out reading John Grisham-style thrillers. He said he tried to get to know the other patients, and he tried not to complain because the staff was doing great. And he knew the treatment was saving his life.
It didn’t hurt, but it was exhausting. After a session, Martin’s wife — “She took that ‘In sickness and in health’ thing to heart,” he said — would pick him up and they’d combine lunch and dinner with “linner.” Then he’d collapse into sleep in a chair at home.
His son died in late 2022, a new shadow to face as he wondered what he might have done to save him.
“The only thing I felt like I was living for was getting ready for the next dialysis treatment,” he said. “And hoping I don’t fall today.”
In 50 years of ministry, Martin said he often advised that, in difficult situations, exists the choice of faith or fear. It was a refrain his wife often reminded him of during this period, he said, when he was letting fear predominate.
But he said he doesn’t know what he was scared of. He said he’s not afraid of dying.
The issue seemed to be: Who had Randy Martin become? He’d faced mandatory retirement as a pastor when he turned 72 and went to work part time at Ooltewah United Methodist Church, where he’d previously served. But eventually he had to give that up, too. In the interview, Martin looked at his arms. No one, he suggested, would know he used to be a 60-foot shot putter.
‘Stood by me’
Eventually Martin got the University of Tennessee Medical Center to approve the transplant.
“Jason stood by me the whole way, was available the whole time, and said, ‘We’ll go where we need to go,’” Martin recalled. “And so that’s what we did.”
One day, Gattis said, he was contacted by the hospital and the date just a couple weeks out was scheduled. With the Nov. 10 surgery, he thought, he might just be recovered by Christmas.
The night prior to the procedure, Gattis and Martin both set out with their spouses to Knoxville. They checked in separately, went to their respective rooms. Gattis thought he might sleep but instead he went through hours of preparation. His body was marked, he recalled, so there could be no mistake as to which kidney was going to be removed.
Then, for a period early that morning, Gattis and Martin were unexpectedly placed adjacent in the pre-op room. The prayer session — the “pre-op revival,” Martin now calls it — ensued, before Gattis, who said he never had surgery before, was wheeled into the operating room and looked up at the lights.
Credit: Handout
Credit: Handout
When he awoke, he had one kidney and an aching abdomen. Hospital staffers warned the post surgery period could be emotional, too.
He recalled that he began to weep, and that, thinking of his deceased son, he turned to his wife and said, “I wish I could have done this for Brad.”
Not far from Gattis and his wife, Martin’s abdomen had been opened and the new kidney put inside and connected to the rest of his body. Almost immediately, he recalled, it began to work.
As in the case of many donors, Gattis’ surgery was laparoscopic, less invasive than a traditional procedure. He went home Sunday, and Martin followed him out the next day.
In a show of optimism that his body would accept the kidney, hospital staff took out his port that would be used if he needed dialysis again. And several months after the transplant, Gattis’ kidney seems, miraculously, to be working well in Martin’s body.
“There’s a 49-year-old kidney in a 76-year-old body,” Martin said in the interview at First-Centenary United Methodist Church, though Gattis corrected him that in fact the kidney is now 50.
They never themselves got to see the organ. And although Martin said he feels the responsibility to care for it and they make dad jokes about how Martin now has some Alabama Crimson in him, Gattis said they’re the same friends as they were before.
Martin said he is still trying to figure out what to do with the extra time the transplant likely bought him. In the meantime, though, he’s been reveling in the unheralded delights of a functioning kidney.
“Getting up in the middle of the night to go urinate,” he said. “I never thought I’d be thanking the Lord for that.”
Credit: Chattanooga Times Free Press
Credit: Chattanooga Times Free Press
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