Liver transplants for 71 year old rock stars

good god our priorities are screwed up. Here's Lou Reed's wife back in June when thing were looking rosier for the young couple, who had to travel from the third-world conditions of NYC to the midwest because :

"....the hospitals here are completely dysfunctional.Fortunately we can outsource like corporations. It's medical tourism. The Cleveland Clinic is massive. They have the best results for heart, liver and kidney transplants. Whenever I get discouraged about how stupid technology is and how greedy and stupid Americans are, I go to the Cleveland Clinic because..." assholes like me can buy an organ.

An accurate if unintentional summation of everything that's wrong with consumer med: it's the stupid technology! And greedy other people.

source of truncated quote: http://www.cleveland.com/metro/index.ssf/2013/06/cleveland_clinic_confirms_rock....

OK, so it didn't work out so well for Lou

Wealthy people (however a culture defines wealth) always get better treatment in every society. The source of that wealth may be a point of mockery, but like rank, wealth has its privileges.

You may be able to (and certainly it's a worthwhile ambition) to raise the standards of treatment available for the less-privileged, but those with power aren't going to give up their advantages.

They gave Cheney a heart. So even war criminals can get transplants if they can afford it.

Not sure I read where it says in that article that Mr. Reed jumped a line or anything of that nature. Not even sure that he was that wealthy. The Velvets never made a lot of money either from records or concerts and Reed himself never really hit superstardom. His work was influential to a lot of bands that did hit pay dirt afterwards--that's where his fame consequentially derives. Basically I see a guy looking around for options of how to stay around a bit longer--which is what a lot of people tend to do when hit with a not so hot medical prognosis.

>3 faceinbook:

Was that a replacement or an upgrade?

#4: http://www.celebritynetworth.com/richest-celebrities/singers/lou-reed-net-worth/

Was a heart transplant...new organ. Wasn't much left to upgrade. Apparently he passed his physical for VP with a statement from a doctor saying that he had normal heart function. A lie ! The first in a series of lies and false statements. Watched Dr. Gupta interview Cheney and he questioned Cheney regarding this issue as in reality, Cheney was not a healthy man. His heart problems could have had direct influence on his decision making and /or thought processes.....his answer to the lie regarding his heart "I am not responsible for what the doctor said".

I do not much go in for name calling.....not in my nature to come out with a title but in Cheney's case I give myself a personal pass......the man is a snake. In all ways I can think of.

#7

It should be said (and not contradicting most of your comments re Cheney) that he has not been convicted (nor is he likely to be tried, alas) of war crimes.

#8--apparently Cheney has a built in diminished capacities defense if he were charged.

>8 BruceCoulson:
"It should be said (and not contradicting most of your comments re Cheney) that he has not been convicted (nor is he likely to be tried, alas) of war crimes."

A technicality. The fact that he will never be tried is a crime in and of itself.

>9 lriley:
Yes he would. But, then that would be the doctor's error somehow as he could claim the doctor reported that he had a normal functioning heart.

I am surprised at you, enevada. This is private, market driven health care at work.

Or are you a fan of a single payer system? If you want the market to work, you don't get to pick and chose who in the market gets the perks.

And given that Reed never really had that major hit album, he must have done well with his investments, like any good capitalist. I am not sure where your umbrage comes from. He should be the kind of asshole you admire.

>7 faceinbook:: "Apparently he passed his physical for VP with a statement from a doctor saying that he had normal heart function. "

You don't have to "pass a physical" in order to serve in the office to which you are elected. A history of heart attacks is not a disqualifier for serving as Vice-President.

#11: There are very few assholes I admire, and those only from a great distance (usually named Vladimir, or a variation thereof). You've never been good at reading people - although I'm sure those folks you counsel get a good read on you.

Sick old folks who are wealthy enough to buy body parts to live a few weeks, days, months more aren't heroes of the free market system, and I'm no champion of markets, "free" or otherwise. A swing and a miss.

Reed's earlier work is certain enough to send some people into shock, and shows the immaturity of that age and of his age. From Street Hassle on he exhibits a much mature style, and while the work was still only sporadically top notch, he hit the mark enough to be considered a better than decent journeyman musician. Forget the one hit wonder, or the deco boy who hung around with Warhol and move onto Magic and Loss, The Bells, or New York, and you encounter a musician for whom the word asshole would be totally inappropriate.

I doubt Lou Reed would much give a fuck whether you thought him an asshole.

Reed's work with the Velvets is actually outstanding. He was a close friend of the poet Delmore Schwartz (a professor at Syracuse U. at the time) and he had in mind to weave ideas from literature into his music and lyrics. Sister Ray for instance was a tribute to Hubert Selby Jr. There was very often a wistful sense of loss in his lyrics from that period. Probably the closest comparable for his time was Jim Morrison. The Velvets always had a gritty New York City vibe (something that no doubt turns people with conventional tastes in music off) and were a precursor to the entire punk and post punk oeuvre. Much of their music was very dark thematically in contrast to the Flower Power happy music of the mid to late 1960's. The Velvets also got a lot of musical inspiration from avant garde musicians with classical roots such as John Cage and Lamont Young. His sidekick John Cale was a classically trained musician of some note with a really intense and creative and wild edge.

#15--Reed the teenager was put in the hands of psychiatrists by his parents--they didn't like his musical tastes. He had homosexual inclinations.They didn't like that. Late 1950's--he was getting electric shock treatments to cure him. The basis of his later song 'Kill your sons'. He would grow some hard bark and did not suffer critics or hecklers--he'd lash out at them. He could indeed be an asshole. There was a lot of anger to burn off though. The bit about him being uncompromising is pretty true.

Among those who gave tribute to his passing--the Vatican Office of Cultural Affairs.

Yeah, I wondered about this. If organs were given out on merit, I'd have given it to him. But I don't think that's how it works.

#15: well, sure, indifference is a big part of the punk brand. But a couple of questions remain: what motivates a 71-year old - any 71 year old - to go shopping for a new liver? And what kind of medical huckster sells him one?

(The average life expectancy for males in the US is 76, I imagine among the subset of elderly rock stars it is significantly lower. Reed had already beaten the actuarial tables.)

I guess I don't know much about liver transplant protocol. These days it seems to me that when your doctor tells you your liver is shot--there are two options 1. get a transplant 2. don't get a transplant and die. I had the idea in any case that there were waiting lists for liver transplants---like for heart transplants---and that there might be other criteria such as likelihood that this or that organ might work with some people and not with others--so that lists might be somewhat flexible to accommodate organ transfers that might actually have a good chance of success. If the argument that somehow Reed got his transplant jumped ahead way out of turn then I can understand the reason for this thread--I haven't seen any proof of that.

It's strange with some people as well. They don't have a strong fatalistic streak. My dad went through 3 angioplasty's--one triple heart bypass surgery--two cancer wins--prostate and a kidney before cancer in the region of his spine finally did him in at 89. He'd also had both knees replaced and his eyes fixed. No transplants but he always faced each obstacle (at least til the last one) with the determination that he was going to live. Not sure that I'd have that same determination--some people just don't want to find out what's on the other side of life. Sometimes people with these problems have other interests like loved ones tugging at them to do whatever they can to stick around. What are you going to do about that?

>12 nathanielcampbell:
"You don't have to "pass a physical" in order to serve in the office to which you are elected. A history of heart attacks is not a disqualifier for serving as Vice-President."

No but it certainly would have been a point of interest if his examining physician had stated publically that his condition could impair his thinking.

>18 timspalding: If organs were given out on merit, I'd have given it to him. But I don't think that's how it works.

I know people who've spend $30K on their pet dog. And $50K to redecorate their house. I can't fault someone spending their money on a new liver, as long as it wasn't black market or something.

Full disclosure: I love Lou Reed's music as much as I disliked Andy Warhol's art....which is to say, quite a lot.

We live in a capitalist consumer-based society, sure. Shopping, for body parts or matching furniture, defines us as Americans. Wealth wins – in that it scores an organ, but not that it actually eludes death. There are ethical considerations within the transplant industry – and also political considerations (Congressional oversight simply reflects the influence, and funding power, of industry lobbyists . See: liver, Steve Jobs, for more info: http://www.cnn.com/2009/HEALTH/06/24/liver.transplant.priority.lists/ )

Sounds like Cleveland Clinic follows uniform protocol for choosing liver transplants? http://my.clevelandclinic.org/transplant-center/transplant-programs/liver-transp...

Someone with money or good insurance might present themselves. I heard elsewhere that one must have been sober for a period of time (six months?) to be considered. I think liver can be donated by live volunteer, because only a piece is needed?

It will be a great day when everyone in need of a transplant can apply for one. Up to the rest of us to make sure supply is there!

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#24: Not according to this NYT article, which notes that the Cleveland Clinic’s no-age limit on heart and lung transplants is contrary to international guidelines that discourage transplants on anyone over the age of 65:

http://newoldage.blogs.nytimes.com/2013/01/08/who-should-receive-organ-transplan...

Evidence-based guidelines are great, but some discretion is needed. Check out https://watsi.org/ for a taste of how difficult it can be to decide distribution of limited health dollars.

I agree that when all is equal, younger person should get the organ, but bet it's rarely the case and I wouldn't hold back organ if geezer is only match.

I'm on the bone marrow donor registry and it's always seemed arbitrary to me that my marrow will no longer be considered for transplant once I'm 60--no matter how healthy I am or how desperate the wouldbe recipient. Surely my marrow will be as good the day after my 60th birthday as it was the day before??

On the other hand, I don't want bits of my corpse sold for frivolous, commercial cosmetic uses...

#26: thanks for the link, I appreciate it.

Like with most organs I'd assume that the demand is higher among older people for liver transplants than younger. With age things break down. Reed's own lifestyle as a younger man may have led to this malfunction but in that case we might want to think about banning alcohol just for one thing if we want to seriously curtail liver problems. The likeliness of that happening is 0 and the historical record in the United States with prohibition argues that would be a big loser--would only create a huge black market industry.

As far as setting age standards--that could be argued as age discrimination. How about wealth discrimination--say we limit anyone's net worth to $10 million dollars? It's not really like making rich people into poor people and we might just see a more even distribution of wealth.

>28 lriley:: It should be pointed out that Prohibition did, actually, have a positive effect in that one particular area: rates of cirhosis of the liver (sp?) dropped significantly in the first few years of prohibition, and then levelled off into the 1930's.

enevada at #19:

(The average life expectancy for males in the US is 76, I imagine among the subset of elderly rock stars it is significantly lower. Reed had already beaten the actuarial tables.)

A minor correction - the statistic you need here is NOT the average life expectancy - - it works the other way: the ones who make it to retirement age are tougher than average and (by definition) have not died in infancy, in childhood, in young adulthood, in middle age - - so the appropriate stat is "E", "expectation of life at the age at the beginning of the age interval".

A white male in NYC who has achieved the age of 71 can (statistically...) expect to live another FIFTEEN years. (And a white male who then survives to age 86 can then expect to live another six years: it's nearly paradoxical.)

(And by-the-by, David Crosby had a friend buy him a liver when he was in his 50s, and he's gone twenty years or so on the new one.)

Was it the age that was unsettling, or the fact he was a rock star?

I have to say, the BBC Version of Perfect Day is simply fantastic.

http://www.youtube.com/watch?v=WJpQJWpVJds

From story on Steve Jobs' liver transplant:

"...Some people can avoid the transplant waiting list entirely by receiving a transplant from a live donor, usually a friend or relative who volunteers to give up part of a liver. But Dr. Teperman said he would not recommend that kind of surgery for people with extensive liver tumors, because they might also need a vein that could not be removed from a live donor. They are better off waiting for a liver from a cadaver, he said."

"The nation’s organ donor system is managed by the United Network for Organ Sharing, or UNOS, a nonprofit group in Richmond, Va., that operates under contract with the federal government."

"When an organ like a liver becomes available, the UNOS database is searched for patients who need it most and have registered at the transplant center where the organ is available, said Anne Paschke, a spokeswoman for the group."

"To qualify for an organ, a patient must have first been examined and approved for a transplant by a doctor at that center. Patients often register with a transplant center close to where they live or are directed to register with a specific center by their insurance company, Ms. Paschke said."

"But there is nothing, apart from cost, to prevent a patient from registering with multiple centers throughout the country, Ms. Paschke said. A person with generous insurance coverage, or who themselves can afford to pay for the medical work-ups and the transplant, would have an advantage..."

http://www.nytimes.com/2009/06/23/business/23liver.html?pagewanted=2&ref=tec...

Less opportunity under single payer system for rich folks to game the system unless they go elsewhere for treatment, I assume. In Ontario, which likewise assigns organs in local area, if at all possible, people with especially rare genotypes who live in Greater Toronto Area are said to have much shorter wait times than those in less populated areas. Advantage of local assignments is that organs are "fresher" and transplants thus more successful?

#33: On keeping organs fresh, and bodies alive for optimal delivery: one of our library book groups is discussing Dick Teresi’s The Undead: Organ harvesting, the ice-water test, beating-heart cadavers – how medicine is blurring the lines between life and death today, on Halloween. Downright ghoulish!

(But first the parade of children in sweet and adorable costumes).

#31: I’m not really outraged* at Lou Reed’s liver failure and his inglorious quest for a new one. The quote from Anderson appealed to my morbid personality. Proust himself couldn’t invent better dialogue, and the idea of Anderson as a modern Mme. Verdurin , who can afford to shop for only the best body parts from the best team of docteurs Cottards seemed worth a poke or two.

*Outrage seems to be the default setting for Pro and Con, I’m not sure how to re-set it.

Empathy and ethical considerations of organ transplantation are the utmost logical thinking the doctors have to assess.

Put in this scenario:
Who will the doctors save and prolong his/her life ?

1) A new-born baby

2) A retired 70 years' man

"Hospital Tourism" have made "the rich" to have organ transplants overseas. Money talks.No need any ethical considerations to be made.

The decision must be based on ethical considerations,should you let a low-income young man who could not afford to pay the medical bills or a rich billionaire,80 years man to die without a transplant?

You decide. This young man have a good future ahead, an intelligent undergraduate. A rich billionaire with a string of medical problems.

#36

Although it's nice to think that doctors (and hospitals) make their decisions on empathic and ethical grounds, it's not how things get decided.

That rich guy may not have much life ahead of him; but not only can he pay the bills, he could make a hefty donation to the hospital, allowing them to offer treatment to a lot of people.

As opposed to a new-born from a poor family, who not only will require a lot of resources to save (resources that COULD save many other lives), but is unlikely to ever be in a position to repay those resources.

Save one person now, knowing that the time and resources expended will be lost and unavailable to save lives later; or save another, with knowledge that your resources will be replenished, and possibly increased, to the benefit of future patients?

Kill all rock stars.

Decisions are tough. As potential donor, I hope my bits would go to best, youngest match, but I would spend the money to get my kid--and maybe me--a needed organ. At watsi.org, I identify with similar people (gender, age), but also suffering from health problems that I and my family have experienced--even though I can see that my donation might relieve more misery per dollar on others. Spock, I am not!

Why kill rock stars? They make many people happy with their music. Without them, our world will be a very dull place. Only kill the unrated and unpopular ones.Prolong the good ones . Let " Rolling Stones" gather more moss or "Eagles" keep them flying. The songs ,"Satisfaction" and "Hotel California" are "legendary" LOL.

Message 37: True. Well said. You have to weigh carefully the decision to prolong the life of a patient in question.

Even when there is no written consent from the deceased to donate the vital organs after natural death/brain-death, is it a right thing to do by seeking permission from his next-of-kin to remove the organs. Do you agree ?

There are some religions that forbid this practice of organ removal after death.
I may be wrong or out-dated on this belief.

There is actually an indie label--kill rock stars.

>39 margd: As potential donor, I hope my bits would go to best, youngest match

I understand the desire to give organs (a scarce resource) to recipients who would use them the longest (youngest donors) but I'm not sure I really agree with it. At least on a theoretical level. After compatibility, first-come-first-serve seems like the only way to make such a determination without being forced to render a judgement on the worth of a person's life.

We are talking about the waiting list for USA's hospitals only.

"first-COME-first- SERVE" is being practised. You are right,

Look at the statistics:

http://www.unos.org/

What about on the global situation?

very interesting abstracts:

http://jme.bmj.com

search : Human organs

Some nations have make the removal of vital human organs after the dead of a person mandatory unless you have signed a declaration to disallow such an act of "organ harvesting' for human organ transplants.

Really? Which ones?

>37 BruceCoulson:: To the benefit of future rich patients. It seems a self-perpetuating system to me.

The East Hampton Star October 31, 2013 - 2:15pm:

For Lou Reed

To our neighbors:

What a beautiful fall! Everything shimmering and golden and all that incredible soft light. Water surrounding us.

Lou and I have spent a lot of time here in the past few years, and even though we’re city people this is our spiritual home.

Last week I promised Lou to get him out of the hospital and come home to Springs. And we made it!

Lou was a tai chi master and spent his last days here being happy and dazzled by the beauty and power and softness of nature. He died on Sunday morning looking at the trees and doing the famous 21 form of tai chi with just his musician hands moving through the air.

Lou was a prince and a fighter and I know his songs of the pain and beauty in the world will fill many people with the incredible joy he felt for life. Long live the beauty that comes down and through and onto all of us.

— Laurie Anderson
his loving wife and eternal friend

"Singers , Music Composers & Musicians fade away, but their good music lived , loved, and

forever remembered"

44 > Austria springs to mind.

Spain, too, apparently. Wikipedia on organ donation and opt-in v. opt-out:

"There are two main methods for determining voluntary consent: "opt in" (only those who have given explicit consent are donors) and "opt out" (anyone who has not refused is a donor). Opt-out legislative systems dramatically increase effective rates of consent for donation.1 For example, Germany, which uses an opt-in system, has an organ donation consent rate of 12% among its population, while Austria, a country with a very similar culture and economic development, but which uses an opt-out system, has a consent rate of 99.98%.12"

"However, because of public policies, cultural, infrastructural and other factors, this does not always translate directly into increased effective rates of donation. In terms of effective organ donations, in some systems like Australia (14.9 donors per million, 337 donors in 2011), family members are required to give consent or refusal, or may veto a potential recovery even if the donor has consented.3 Some countries with an opt-out system like Spain (34 effective donors per million inhabitants) or Austria (21 donors/million) have high donor rates and some countries with opt-in systems like Germany (16 donors/million) or Greece (6 donors/million) have effective donation lower rates.citation needed The president of the Spanish National Transplant Organisation has acknowledged Spain's legislative approach is likely not the primary reason for the country's success in increasing the donor rates, starting in the 1990s.4"

I thoroughly approve of opt out for organ donation. We're not quite there yet in Colorado, but it is really easy to sign up - you do it as part of getting your driver's license and you can opt out again at any time by signing the back of your license. I figure if someone doesn't care enough to find a pen and sign their license, then they really won't mind donating their organs. I hope we move to the point where you don't have to even sign up when you get your license and it's a pure opt out system.

For those of you with HBO, there's a documentary at 9 pm on Monday, Nov 4, 2013: The Organ Trade. Looks at ethics and choices of paid donor and desperate patients. Apparently there are villages in the Philippines in which virtually every man is scarred from kidney donation?

Weird territory! 24 hours before execution, a death row inmate offers organs before and after death to his mother, sister, and others. Ohio Governor orders stay of execution to determinne if and how organs could be harvested--legally and medically: http://www.usatoday.com/videos/news/nation/2013/11/14/3525291/