- 3 weeks ago
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00:00:00Transcription by CastingWords
00:00:30Transcription by CastingWords
00:01:00Transcription by CastingWords
00:01:30Transcription by CastingWords
00:01:59Transcription by CastingWords
00:02:29And so we'd like to take a moment to thank Alexander for his gift
00:02:34and for the family for consenting on his behalf
00:02:37and just take a moment of silence, please.
00:02:39Is everyone okay to go ahead?
00:02:59Yes.
00:03:01Okay, starting please.
00:03:04Can I get my headlight please?
00:03:07Do you want to do the vessel cup change?
00:03:22Yeah.
00:03:23Okay, pancreas is coming out.
00:03:26Do we have the...
00:03:30Yeah.
00:03:31Makes sense.
00:03:32So...
00:03:33Wow, those are some beautiful ones.
00:03:37I don't know, I mean you could split it and sew it together closer.
00:03:52Like you could cut some out of there.
00:03:54I don't know.
00:03:56The next time I see you, you have new lungs, you're in the ICU, okay?
00:04:00I'm gonna hold it snug so you just get oxygen and not room there.
00:04:03Big, slow, easy breaths.
00:04:04Here we go.
00:04:05Big, slow, easy breaths.
00:04:06Here we go.
00:04:10So, what we're gonna do is on the count of three, I'm gonna pull the tube out, okay?
00:04:36But you're gonna have to take in a nice deep breath for me.
00:04:38Does that make sense?
00:04:39Just a nice deep breath, honey.
00:04:42Yeah.
00:04:43Okay, so I'm gonna pull these tapes out behind your head here.
00:04:47Yeah.
00:04:48Okay, you ready?
00:04:52Remember to deep breath, honey.
00:04:55So, on the count of three here, okay?
00:04:58One, two, three.
00:05:00Nice deep breath in.
00:05:02What?
00:05:03I know.
00:05:05You better?
00:05:07Yeah?
00:05:08Okay.
00:05:09I can't do that.
00:05:10Yeah?
00:05:11Yeah?
00:05:12Okay.
00:05:13He's doing this.
00:05:15You better know what you're going to.
00:05:16I didn't leave a little bit at over.
00:05:17You're so excited about what you're going to do.
00:05:19You better know what you're going to do.
00:05:20You better know what you're going to do.
00:05:51OK, let's go to E4, print list.
00:06:02Are we going to ICU next?
00:06:06Morning, how are you?
00:06:07I'm pretty good.
00:06:08Doing all right?
00:06:09I'm Dr Shapiro. Yeah, we've met before.
00:06:11Yeah.
00:06:12So we're still planning for Friday then?
00:06:14Operation Friday?
00:06:15Yeah, yeah.
00:06:16OK.
00:06:17You might need to go back to the dialysis again a little bit after the surgery.
00:06:20It's always a possibility.
00:06:22Yeah, I am happy to see that, yeah.
00:06:24I am happy.
00:06:25You guys, when you come past, you should do this firmly.
00:06:28A quarter of our patients will die waiting for a transplant.
00:06:31And we're desperately short of organ donors.
00:06:39Some of them will wait years for a transplant in certain blood groups.
00:06:43Some of them will go straight, you know, close to the top of the list because they're so sick.
00:06:47Many people will die waiting because there's an adult that doesn't come in time.
00:06:56James Shapiro.
00:06:58The team should be there setting up.
00:07:01And waiting.
00:07:01So we won't lose any time.
00:07:03He's so scared.
00:07:19I'll always get a second chance.
00:07:21Mm-mm.
00:07:22Right?
00:07:23Mm-mm.
00:07:24This is it.
00:07:26This is your second chance.
00:07:28Mm-mm.
00:07:29This is going to go good.
00:07:33Mm-mm.
00:07:36Mm-mm.
00:07:38Okay, I think we're ready to go.
00:07:39Are you?
00:07:40Yes, we are.
00:07:42You ready?
00:07:45Here you go, Pat.
00:07:47All right.
00:07:47You want another hug?
00:07:48Kiss?
00:07:49Yeah.
00:07:49High five?
00:07:50Okay.
00:07:51I love you.
00:07:52Love you, too.
00:07:53Okay.
00:07:54It'll be good.
00:07:54Everyone will be good.
00:07:55You've got a good team here.
00:07:56Take really good care of her.
00:07:57Yeah, you've got a good team here.
00:07:59Mm-mm.
00:08:03All right.
00:08:04Take care of her.
00:08:05Yep.
00:08:07This patient is very sick.
00:08:09She has what we call a high melt score,
00:08:11which means that the liver has been very diseased,
00:08:13very scarred, a lot of pressure in the veins,
00:08:16a lot of risk of bleeding.
00:08:18I mean, this isn't unusual for us,
00:08:20but it's, yeah, as with any liver transplant
00:08:23in a sick patient, it's an extra challenge.
00:08:25And flagyl.
00:08:33Should we have a little bit of oxygen here?
00:08:35Should we have a little bit of oxygen here?
00:08:35It's a little bit of flagyl.
00:08:36Okay?
00:08:37It might smell kind of funny,
00:08:38but you're just using oxygen.
00:08:39That's right.
00:08:39Okay?
00:08:40Okay.
00:08:40Okay.
00:08:40Okay.
00:08:55So, our plan here, I guess,
00:09:07is just to rehearse things a little bit.
00:09:10Let's just put some fresh fungi there.
00:09:23Can you see how horribly diseased this liver is?
00:09:29It really is.
00:09:29It's horrible, yeah?
00:09:30The only, the end result would be,
00:09:38if she doesn't get this now,
00:09:41within three months,
00:09:42I don't think she would be here anyway.
00:09:44So, that's how critical it is.
00:09:46It was a very tight timeline for her.
00:09:49So, you can't say that it's definitive
00:09:53that she's going to be all right, right?
00:09:57There could be lots of problems.
00:09:59And the end result of some of them is death, right?
00:10:02So, it's a tough, tough decision, you know?
00:10:06But it's one of those things you have to do.
00:10:08Either you live or you die.
00:10:09And it's not fair,
00:10:12but these things happen in life,
00:10:14and that's the way it is.
00:10:27Do you need those?
00:10:30Okay.
00:10:31So, now we can blow the liver in.
00:10:35Yeah.
00:10:39So, now the liver enters the field.
00:10:52When you watch a new organ come to life like this,
00:10:55and you put new blood in it,
00:10:57seeing, you know,
00:10:58a pale brown organ come to life,
00:11:02I'm thinking,
00:11:02what an incredible thing to do.
00:11:05And it never fails to, you know,
00:11:07give me some thrill to see a...
00:11:08Life comes back into an organ like this.
00:11:17Crazy high levels.
00:11:21Just, um...
00:11:22We're good.
00:11:26Good job.
00:11:28Good job.
00:11:29Emily?
00:11:33Oh, thank you.
00:11:34Oh, yeah, more than I had.
00:11:36Yeah.
00:11:37Yeah.
00:11:40Somebody has end-stage liver disease at one moment,
00:11:43you release the clamps,
00:11:44and now they suddenly have a new chance of life again.
00:11:48So, it's a wonderful privilege to be a part of that.
00:11:53Okay, good to go.
00:12:00You know I'm here, don't you?
00:12:13You're getting there, Patty.
00:12:14Yeah, you're getting there.
00:12:17It's a long haul, but you'll get there.
00:12:20Oh, yeah.
00:12:30Oh, my God.
00:12:32All right.
00:12:36Oh, my God.
00:12:38Oh, my God.
00:12:42Oh, my God.
00:13:12We love you, son.
00:13:28You are our boy, our love boy, our love child.
00:13:35Matthew, Matthew, right now is when we need you the most.
00:13:40The doctors are going to be doing some tests.
00:13:42And these results of these tests are so important, son.
00:13:46This is when we need you to shine like you've never shined before, son.
00:13:51Please, don't shine.
00:13:55Everybody join hands, please.
00:13:58Everybody join hands for our son.
00:14:02Everybody pray.
00:14:06Matthew, please, please.
00:14:09This next couple hours is so important to you.
00:14:12I'm a baptistian.
00:14:14Please, I'm a baptistian.
00:14:16Help me, Matthew.
00:14:18You can do it.
00:14:18You can do it, Jesus.
00:14:19It's so playful.
00:14:21I want the whole boy back.
00:14:24I want the whole boy back.
00:14:26You're such a good boy.
00:14:27You're such a good boy.
00:14:29You're so kind.
00:14:30He's wonderful.
00:14:31You're so kind, Matthew.
00:14:33You're so giving.
00:14:34We know how important these tests that are coming up.
00:14:47And what we're trying to do is get something in his brain working so it's worth giving a sign that we can carry on with him.
00:14:57And that's what we are.
00:14:58We're just trying to stimulate him.
00:15:01We're hoping that his brain reacts.
00:15:04And when he goes through this battery, a test is so important of what happens after.
00:15:08The doctor has explained to us that this is a very big decision-making and we're just praying and hoping that there is enough there that we do move forward with him.
00:15:21And we're terrified that if there isn't, the results aren't really what we're just scared.
00:15:31He's going to do it, Les.
00:15:33I know he is.
00:15:34He's going to do it.
00:15:35I know you're going to do it, Matt.
00:15:36He's going to do it.
00:15:37I know you are, Matthew.
00:15:38I believe.
00:15:39I believe.
00:15:40He's going to do it.
00:15:41He's going to do it.
00:15:41You're going to do it, Matt.
00:15:44We're just hoping that by reaching him, it can help him.
00:15:48And we're asking him to give his fight.
00:15:52Even though he doesn't fight, this one he has to fight.
00:15:57And I hope he beats the hell out of it.
00:16:02Matthew, I'm going to put a hat on your head, okay?
00:16:06So it's going to feel a little snug.
00:16:12How much propofol is he on?
00:16:14300.
00:16:15300?
00:16:15Okay.
00:16:16And he's having jerking?
00:16:20Yeah.
00:16:21I'm not sure if it's myoclonus or a seizure, so.
00:16:25Matthew?
00:16:27Matthew?
00:16:28Matthew?
00:16:29Matthew?
00:16:40Any response to pain at all?
00:16:42Just abnormal extension.
00:16:43Okay, but nothing?
00:16:46I know.
00:16:46Okay.
00:16:49Matthew, I'm going to just pinch your finger, love.
00:16:52Okay, right now?
00:16:55Yep.
00:16:57So we started our myoclonic jerking.
00:17:00Okay.
00:17:01Well, there we go.
00:17:02Okay there, Matthew.
00:17:03It's okay, I'm all finished.
00:17:05Matthew.
00:17:07Hang on there, Matthew.
00:17:08You okay, honey?
00:17:09Okay.
00:17:09Okay.
00:17:09Okay.
00:17:09Okay.
00:17:09Okay.
00:17:13Okay.
00:17:15Our whole world was turned upside down.
00:17:18Just in the matter of 20 minutes, my whole life changed.
00:17:23My whole life changed.
00:17:26Apparently, Matthew's getting a tattoo and the story's a little mixed up and foggy, but he
00:17:36was left and they came back and he was unconscious.
00:17:39Matthew, I'm just going to do some flashing lights.
00:17:43In one minute, we were such a content family and just felt so lucky.
00:17:50They're such a good family.
00:17:53And then, bang.
00:18:01All right, Matthew, we're all done.
00:18:08I know it has to be analyzed, and I know that is the waiting game.
00:18:20This is a very scary day for us.
00:18:23We do know we were told 72 hours.
00:18:26We do know these tests are going to show a lot, give some answers.
00:18:30I'm very afraid of what the answers could be.
00:18:35Trying to have more hope.
00:18:37But fear is there.
00:18:38Everybody's going to feel the ramifications of what's happening here.
00:18:45We've lost a lot of very young, young members in our family.
00:18:51It's horrific.
00:18:53I don't even understand how we could lose so many young, potential, amazing people.
00:19:00You need that family support.
00:19:02That is what a person needs in this scenario.
00:19:05There's no real right or wrong way to feel at this time.
00:19:08But knowing that you have the love of your family, it's very important.
00:19:14And I'm so thankful for everybody that we do have.
00:19:21And I feel very sad for people that don't have what we have as a family.
00:19:26I've been pacing up and down these hallways.
00:19:48And all of a sudden, it reminded me of when Matthew was born and the similarity of me pacing that hallway.
00:19:57And it struck me I was waiting for a birth of Matthew again.
00:20:00That's what I'm waiting for.
00:20:01That's what I'm waiting for.
00:20:03I'm waiting for a birth.
00:20:05Hello.
00:20:06Hello.
00:20:07Hi, honey.
00:20:08Hello, honey.
00:20:32So we're just going to go a little bit over the things that you've been discussing before.
00:20:36Is everything clear to you? Do you have concerns? Is something new come up?
00:20:41Do you know kind of what you have to expect?
00:20:44And you know that the perfusion of the heart with blood,
00:20:50so oxygen going to the heart itself,
00:20:52is dependent on that small chamber that is not properly formed on the right side.
00:20:58In her situation, I don't think there's much dispute about which is the right way to go.
00:21:03I think we all agree that transplant for sure gives the best chance
00:21:07to lead a long-term as close as possible to normal life.
00:21:14You do know, however, too, that it's not going to be a walk in the park.
00:21:18We can go in a very good condition into the surgery,
00:21:22and we know that in this condition, the babies usually do very well.
00:21:26It is exchanging a life-threatening situation, in which she is now,
00:21:32with kind of a chronic disease or chronic abnormality.
00:21:37So you know that she will lifelong depend on taking medications.
00:21:41But the reality is, with the babies, the first two years are a bit of a struggle, often.
00:21:48And in children that are immune-suppressed, that can cause a lymphoma,
00:21:52which is basically a type of leukemia.
00:21:56And that's not that uncommon.
00:21:59It's hard to even imagine how that feels, right?
00:22:01Like you go through all this, you go through a heart transplant,
00:22:03everything goes well, and then suddenly something like that strikes you.
00:22:06But I think it's, in all fairness, important for you to be aware of that as a possible option,
00:22:12but also be aware that 90% of our kids do really, really well.
00:22:18So if you have any questions, just find us any time.
00:22:21I only talk all the time now.
00:22:26Which is pretty common, actually.
00:22:36It sounds scary.
00:22:41Yeah.
00:22:43Hope for the best.
00:22:44Yeah.
00:22:44You think about going through the whole heart transplant,
00:22:47and then maybe later on dealing with cancer or something like that.
00:22:52It's terrifying.
00:22:55It's just something we've got to do.
00:22:57We love her and just want her to have the best life she can possibly have.
00:23:02So...
00:23:04I don't know if we really have many options at this point.
00:23:06No.
00:23:08Are you tired?
00:23:10No, I'm sorry.
00:23:11You're sleeping.
00:23:11Are you sleeping?
00:23:12No.
00:23:13No.
00:23:13No.
00:23:13No.
00:23:14No.
00:23:14No.
00:23:14No.
00:23:15No.
00:23:15No.
00:23:16No.
00:23:16No.
00:23:17No.
00:23:17No.
00:23:18No.
00:23:18No.
00:23:19No.
00:23:20No.
00:23:20No.
00:23:21No.
00:23:22No.
00:23:23No.
00:23:24No.
00:23:25No.
00:23:26No.
00:23:27No.
00:23:28No.
00:23:29No.
00:23:30No.
00:23:31No.
00:23:32No.
00:23:44No.
00:23:46He's got five beautiful grandchildren that he's living for.
00:23:49He's got to watch them.
00:23:50He's got to bring them upright.
00:23:52I hope so.
00:23:54I didn't make you this up last summer.
00:23:56I took my two grandsons, caught up their first fish.
00:24:02I finally talked to him out of being stupid how you doing dad
00:24:23the third I quite a bit better than I was yeah looks like he didn't stop sticking you any
00:24:31no it was close down to me pretty regularly yeah so Bruce and I go same old same old
00:24:41I can stand I just sat for a clean ride and sat on a bench and sat on a truck
00:24:49how are the kids good all of them yeah oh yes oh yes I think I think they have a big
00:25:01problem they haven't had grandpa for a while to treat them right yeah you guys
00:25:06make them follow the rules yeah I'll make up for the last time I know you will I'll go
00:25:17over here for a minute give him some time with the kids how's things going good
00:25:23you did waiting sucks mm-hmm yeah no doubt they upped me I'm a level four now that's good
00:25:34no
00:25:35oh
00:25:37yeah
00:25:38trouble is I'm too big
00:25:41I'm having trouble finding a match yeah they've been getting lots of smaller hearts but not big
00:25:53enough for me so see how it goes when did you get put on level four today they told me about it today so
00:26:06we'll go with that well that's it's good that you're next in line though yep
00:26:13you have to think positive you know that's all you do is you hang on well mama's always told us that
00:26:32you know yeah the difficult you can do now the impossible only takes longer so
00:26:39this is a little like impossible but it's just going to take longer to have it done
00:26:43he essentially needs a heart and you know he's going to need a fair bit of rehab afterwards too
00:26:51it's not going to be an easy road even after the heart transplant and I think he acknowledges that too
00:26:56so one good thing is you know the ultrasound for your heart didn't show any worsening fluid so I cut
00:27:14back here your steroids so your sugar should be better I'm hoping that you get some sleep because
00:27:21that's probably why you're not sleeping as much so you're probably the highest status person in
00:27:29Alberta right now your muscles are getting weak and your energy you're so you just got up this morning
00:27:35yeah I heard you you had a little fall like my concern is that I've seen patients like yourself who get
00:27:40weak you were once a pretty big guy and I don't mean in the stomach you keep right up to her
00:27:46well not in that group I mean like you have more muscle and when you when you're sick your body
00:27:53preferentially uses muscle for energy and if you get too weak you actually the outcome for going for
00:27:59transplant is far worse than being sick and heavy does that make sense so I want to prevent that from
00:28:05happening so I'll just give you a light I just want to see your neck here and then the other thing
00:28:11with you being weak is just kind of take it easy when you're getting up I know you're so used to doing
00:28:15everything on your own the last thing I need you to do is fall either in your chest or your head
00:28:21and then we got a whole set of other issues okay and I'll be here the whole weekend so I'll keep you
00:28:26updated every day okay anything else I can help you with fight me hard I'm on it okay talk to you later
00:28:35it would almost make sense that if somebody has viable organs when they pass that it should just
00:29:00be an automatic thing where you know you take them from them and give them to those that need it the
00:29:06most and then that lessens the strain on the medical system as much as possible
00:29:12this year I'll have completed 20 years with the Edmonton police service right now I'm on long-term
00:29:27disability so I've been off work for just about two years now
00:29:30950 150 yeah that's good enough when you have a family there's always many things on the go like
00:29:44there's you know competitions coming up she's a competitive diver so we're hoping that she qualifies
00:29:49for nationals and with that will come travel so you're trying to plan for that but like
00:29:55like can I get dialysis there can I am I going to be well enough to travel am I going to get the
00:30:02call like am I possibly missing out on getting an organ because I had to put myself on hold for a
00:30:08week to go to a competition because I could get dialysis there
00:30:19just planning Lana's birthday oh she turns 40 on the 23rd so I think she'll figure it out
00:30:25when my parents show up at the pool take Izzy home nobody says anything before then why can't
00:30:32I go to dinner dad uh because they don't let minors in there well that stinks
00:30:43and I can just press it you try and do what you can to be as healthy as possible or
00:30:50at least as alert and have as much energy as possible um but going from you know having a parent that
00:30:59goes to work is like every other parent in the world and then hangs out on the weekends and
00:31:05you know you go do stuff to planning your life around this machine um she came up and up one night
00:31:14and you know she saw the the tubes in the arm and something she had to leave
00:31:18she couldn't it just wasn't you know tolerable for her to see see after
00:31:26no come here be love you have a good sleep i'll see you in the morning
00:31:36bye daddy love you
00:31:38well it just it cleans out the blood i don't know it's uh i don't feel any different really i feel
00:31:54kind of wiped the next day
00:32:12i'm pretty used to it by now so it's just kind of that's that's my routine three times a week i'm
00:32:20here late if i was at home i'd be in bed already
00:32:33so
00:32:55thank you
00:33:03what i'll need is um a four by four and uh the flashlight if you have sure yep i do
00:33:33uh you maintain turn on the light now so
00:33:53you're able to you can come in if you wish i'm just repeating what we did this morning okay
00:33:57you can hold his hand if you wish my son my beautiful boy you're so blessed matthew you're
00:34:06so blessed yeah he will be moving we just stopped the drug for the exam and then
00:34:11i'm just going to put this in his mouth to check his gag reflex
00:34:27okay would you like to stay here i'm just going out to the family conference room to meet with your
00:34:34family would you like to stay here or join me i want to join okay we'll come back yeah you have an
00:34:39opportunity to come back so yeah we'll just go out there now okay so girls please stay with them okay
00:34:45okay i'll be back
00:34:55i love you matt i'll be right back to see you i love you i love you i love you i love you
00:35:13i'm so scared
00:35:40there's no need to be
00:35:47do we have everyone here that uh that you would wish here yes i'm dr kutsianos i'm
00:35:53the attending intensive care unit physician this week here i've been caring for matt uh since monday
00:36:00as you're aware he had an episode where his heart stopped for uh for a long period of time it was at
00:36:05least 20 minutes before uh he recovered his blood pressure um when we look at everything from start
00:36:13to finish um uh he's been ill in the icu he's been comatose in the icu he's had
00:36:20uh many irregular movements that we do see sometimes in these circumstances so um i i examined matt this
00:36:29morning and this afternoon and um what we look for is different basic reflexes in the brain that
00:36:36um are often preserved even though we're not conscious the upper part of our if our upper part
00:36:43of our brain doesn't work by that i mean we can't communicate we can't understand uh
00:36:50uh often the lower part of our brain which is very primitive still works so we're in a scenario
00:36:56um where just by examining him and uh i had mentioned to most of you yesterday that it didn't
00:37:05appear that he would recover his brain function although we can't uh tell that just by examining
00:37:11him early on we have to wait till approximately the third day for more um solid proof that he won't
00:37:20recover his brain function i had organized another special test yesterday to be done today uh so both
00:37:27examining him and based on the test i i can tell you with a great degree of certainty that he he will not
00:37:35recover brain function so so we're left at this circumstance where i don't think any family would
00:37:44want um an individual to be left on life support in this circumstance in the long run
00:37:53i'll stop here to ask for any questions currently
00:37:56i'll stop here to ask for any questions
00:38:08Oh, my God, they killed my baby.
00:38:20Oh, my God, they killed my baby.
00:38:27Oh, my God, they can't be saved.
00:38:29This is a nightmare.
00:38:31Oh, my God, this is a nightmare.
00:38:33Oh, my God.
00:38:34Are there any people that were maybe missing here
00:38:35that may want to see him or he would want to visit?
00:38:38His mother's showing up.
00:38:39Tonight, why is that?
00:38:40Why, why, why, why is that?
00:38:42Well, I think at this stage,
00:38:45I'd recommend that he, in the long term,
00:38:50by that I mean days not stay on life support
00:38:52because we're really prolonging the dying process.
00:39:01So what you're also saying, there is no miracle?
00:39:05I'm saying that I can tell you what it is.
00:39:07It's done, yeah.
00:39:08Yeah, pretty good.
00:39:09We don't want to make an error in this situation
00:39:11because you can understand it's someone's life.
00:39:13Yes, I understand what you've...
00:39:15There's very few things that we can say in medicine
00:39:33that are fairly solid in this, I think,
00:39:37from our experience worldwide is...
00:39:40Yeah.
00:39:40I can give you a good degree of certainty.
00:39:45Yes, I think it'll be best.
00:39:47Luz, what do you think?
00:39:49Yeah, I just want to be by Matthew's side.
00:39:51Now I know I'm saying goodbye.
00:39:56He's such a special boy.
00:39:58I personally would like it the sooner the better
00:40:01because I don't want him to be in this state, this comatose.
00:40:04I also find this very hard on all the family and friends.
00:40:07Like, the hurt is just...
00:40:09You're not alone.
00:40:10We see this not infrequently and it's a common...
00:40:13Yeah, I just see everybody's gut-wrenching feelings
00:40:17and all I want to do is hold my boy
00:40:20for the last couple of days or hours that I have.
00:40:24Just let us know how many chairs you want in there
00:40:26and that we can organize that.
00:40:27We can let his arm rest down.
00:40:28I think that's...
00:40:29Oh, boy.
00:40:33We'll be okay.
00:40:34I've got to go be with Matthew.
00:40:35Now, when I walk out, the boys are all going to look at me
00:40:38and I'm going to go like this
00:40:39and then I'm walking straight to see Matthew.
00:40:42So good luck with the guys.
00:40:44I have one more thing that I want to discuss.
00:40:48It's an obligation on my part.
00:40:50I know what you're going to talk about.
00:40:52By law, I have to discuss this.
00:40:54And now that after we've discussed the issue of...
00:40:57Oh, please, please.
00:40:58...taking him off life support at some point in time
00:41:02in the next few hours or days.
00:41:04And that is the issue of organ and tissue donation.
00:41:06So I think I just plan to open the discussion.
00:41:11I don't think it sounds like the intention is
00:41:13that you would want to take him off life support tonight
00:41:16because he's got other family coming.
00:41:18But it's an introduction to that to think about, to discuss.
00:41:22And we can have another discussion tomorrow regarding that.
00:42:02No?
00:42:04There's no chance.
00:42:07There's no chance.
00:42:09Ma de will leave us.
00:42:12There's no chance.
00:42:14There's no chance.
00:42:16There's no chance.
00:42:18There's no chance.
00:42:19My voice, there's no chance. My voice, there's no chance.
00:42:24It's fine.
00:42:29What's happening?
00:42:31So I've been caring for this young man, Matt, a physician.
00:42:35He's 28.
00:42:37Came in Saturday evening after cardiac arrest.
00:42:40He's lost some but not all of his brainstem reflexes.
00:42:43And I had organized for a somatosensory potentials today, which were done, and they showed no conduction on either side of his brain.
00:42:54So I finished meeting with his family.
00:42:57It's some mother, father, a brother that just arrived, and a sister, and some cousins, and his girlfriend of 10 years.
00:43:07And I talked to them about, you know, withdrawing life support, because that was really the only option in this circumstance.
00:43:15And I approached them about the possibility for organ donation, and they will be deliberating on it.
00:43:22You know, if they're interested, it wouldn't be until tomorrow, because I think they wanted to have more time with her.
00:43:30And have more time with her.
00:43:32And have more time with her.
00:44:02And have more time with her.
00:44:32It's hard to see a human being in the situation that Pat's in, but, you know, we've seen it enough times that we know that we can pull people through.
00:44:48And, you know, yes, I can see there's a lot of resources gone into Patricia.
00:44:53You know, she's been on a ventilator, then she's trached, and then she's plugged.
00:44:57She's receiving antibiotics.
00:44:58She's sitting in the, you know, in the intensive care unit.
00:45:01And that's expensive if you put a dollar figure to it, but it's a temporary situation, and she can pull through.
00:45:09Now, this isn't a, you know, her liver's working really well now.
00:45:12So if we can do one simple maneuver, we're, yes, all right, it's a surgery.
00:45:16It's not complicated for me.
00:45:18You know, incision, drain the fluid, close.
00:45:20So if that, to me, is a no-brainer.
00:45:25You know, it's a big collection.
00:45:27So, you know, the thinking is, take her to the UR and drain the collection, wash it out, send some cultures off.
00:45:35Then we can tailor any body towards that if she needs ongoing therapy.
00:45:38You know, from surgery-wise, it's a pretty straightforward surgery to do.
00:45:43I don't think it's going to set her back too much, but, you know, she's got that trach in place.
00:45:47She's going to, she probably is going to spend some more time on the vent.
00:45:50So, Scott, go ahead.
00:45:52We'll do the dual physician consent form.
00:45:56We'll book her as an E6, and we'll get it done.
00:46:00Okay, thanks for good.
00:46:01Yeah, thanks, Wendy.
00:46:39Surgery is an absolute detail-orientated profession.
00:46:44You know, everything, every detail matters.
00:46:46People have to be thinking, you know, where does the decision go?
00:46:49Where does the retractor go?
00:46:50So it's all about the surgeon and the assistant.
00:46:54Very important dynamic.
00:46:57Now, what would you do, Scott?
00:46:59You're into this, and you get a big pool of vial.
00:47:04You get a bunch of vial?
00:47:05And leave drains.
00:47:07Don't bother putting the thumbs up.
00:47:09Let's have five sponges per side, and four towel clips, please.
00:47:13There's a person like Scott, who I've worked with a lot.
00:47:17You know, I know he's done a full surgical residency.
00:47:20He's done two very intense years now as a multi-organ transplant fellow.
00:47:24I know that I can trust him.
00:47:26I know that if he's helping me with something difficult, I can trust that he'll be putting
00:47:30his hands in the right place and exposing things in a way that I need to see.
00:47:36Scott himself had a liver transplant when I first arrived in Edmonton in 1993.
00:47:41And it's incredible.
00:47:43Here he was, you know, a 14-year-old boy.
00:47:46And I spent hours and hours, not only in his surgery, but by his bedside while he recovered
00:47:52and got to know him and his family very well.
00:47:54And now it's incredible that he is here training exactly the shoes that I was in at his stage.
00:48:04And he's going to be a brilliant liver transplant surgeon.
00:48:06Yeah, I learned all about liver transplant from looking after him.
00:48:13It's four more Paxels and maybe two more FFP.
00:48:17When you're set on a journey with transplant, you take in an organ that can save somebody's
00:48:24life, and it does save people's lives.
00:48:26So you have a responsibility once you've set off on that journey.
00:48:29I mean, probably the most important thing is making the right decision at the beginning.
00:48:32And once you've made that commitment, you've got to make sure that you do everything possible
00:48:36to get a successful outcome.
00:48:45I knew it was going to be hard.
00:48:47I knew it was going to be hard.
00:48:49For one thing, she was so ill when she came in.
00:48:51Then she was in the hospital for five, six weeks before the operations.
00:48:56She was sick.
00:48:58You know, she didn't have much time left.
00:48:59You know, months probably.
00:49:02Probably by now, she probably wouldn't be here.
00:49:04So this is a life-saving situation for her.
00:49:07Now we've got to get her through the rest of it.
00:49:11Because I know that Dr. Shapiro has done a good job.
00:49:14He's quite happy with things.
00:49:16Delivers functioning properly.
00:49:18All her vital signs are good.
00:49:20In Pat's case, very complicated.
00:49:23So I kind of knew it was going to be.
00:49:26Oh, you're not well enough to go home, sweetie.
00:49:33You're going to be a while yet.
00:49:35But you're on the right path.
00:49:37It won't be long now.
00:49:40They got that infection.
00:49:43Everything under control now.
00:49:44Now you can really start to heal.
00:49:47Your new liver is doing very well.
00:49:51Okay.
00:49:52Okay.
00:49:52There's lots of pressures.
00:49:54People will, you know, intensive care unit docs, others will approach you and say,
00:49:59this is hopeless.
00:50:01We've been here for three months now.
00:50:03We're on dialysis.
00:50:04We're on this, that and the other.
00:50:06You know, we're making no headway.
00:50:07We should just pull the plug and let the person die.
00:50:10And I can also see the till tallying up, you know, every day how much money's gone into it.
00:50:17But, you know, we've got to think more than how much is a person's life worth and how much to give, how much not to give.
00:50:24You ought to think about the value of the organ.
00:50:26You have a huge responsibility to the organ donor family and to the organ to do what it's meant to do, which is to save a life.
00:50:33I think probably the list, more so than the dialysis, the list itself becomes the overriding factor on absolutely everything.
00:50:59Because you kind of, you get to that point on the list where you're, okay, a year and a half, two years on, you're like, I should be getting close.
00:51:09So you're always just kind of waiting.
00:51:11You always have your phone with you.
00:51:12You don't turn it off in movies.
00:51:13You leave it on at nighttime beside your bed.
00:51:18You're in that perpetual state of waiting.
00:51:23That's a weird thing to go through.
00:51:29Watch out for the dog.
00:51:38I know.
00:51:40Ideally, it'd be nice to, you know, you get the kidney.
00:51:43The surgery goes well.
00:51:45Recovery goes well.
00:51:46So in about six months or so, you're healed up and life's pretty much back to normal.
00:51:53You want everything to go as fast and as smooth as possible so that there's no disruption on her life.
00:52:05I want to be done with this part.
00:52:07I want to move on and, you know, get to be able to go on holidays and go to work and live a normal life.
00:52:14You're running out of options here, aren't you, Doc?
00:52:34You're scaring me.
00:52:35A lot of us were fearful and we thought we might have to pull the plug and say, no, we can't list them like this.
00:52:42And so that's why, I mean, it came to a head and both the surgical team, the medical team, the ICU team all came together and said, we got to do something or do nothing.
00:52:50So we actually went ahead and implanted a secondary mechanical device, which is a temporary device.
00:52:58It's not a permanent one compared to what he had before.
00:53:02So we've almost essentially bypassed the whole heart.
00:53:08I want a chance at this.
00:53:10I mean, I've already invested how much time and energy into recovering?
00:53:16What am I going to do, quit now?
00:53:18Well, I've worked too hard at this.
00:53:23So I have grandchildren.
00:53:27Yeah.
00:53:30That's what it really means to me.
00:53:37It's unbelievable.
00:53:41I want to get out and do things with them.
00:53:44I'm a little fight for that.
00:53:51If it was just for me, I'd have probably gave up.
00:53:57But I want to be there for my grandkids.
00:54:04Oh my God.
00:54:19Oh my God.
00:54:22Oh my God.
00:54:23Oh my God.
00:54:28Oh my God.
00:54:29That's all.
00:54:30Charlie, I'm good to the light.
00:54:42Christy speaking.
00:54:43Hi, Christy.
00:54:44It's Karen Paul.
00:54:45Hi, Karen.
00:54:46Hi.
00:54:47How are you doing?
00:54:48Good, thanks.
00:54:49And you?
00:54:50So I'm actually calling you with a heart offer.
00:54:54You have a couple high status receipts.
00:54:58Right.
00:54:59Do you want me to email you the chart?
00:55:03Oh, sure.
00:55:04That'd be great.
00:55:05Okay.
00:55:06Do you want me to give you the CTR numbers, too?
00:55:07Oh, sure.
00:55:08That would be great.
00:55:10I know that.
00:55:12I guess you can kind of guess what's going on if we're coming with the big team and not
00:55:18stay at the bedside.
00:55:19So we actually do have an organ for her, which is a pretty good organ.
00:55:26A little bit smaller child than her.
00:55:29And it's going to come from a little bit further away, so we still have a little bit of time
00:55:35today.
00:55:36From what we guess now, it's going to be sometime tonight, probably around somewhere between
00:55:458 and 10 that she goes to the operation room, and then coming out sometime tomorrow morning.
00:55:52So I just wanted to give you a heads up.
00:55:57We're pretty happy about it, too.
00:55:58I think it's actually the perfect time.
00:56:00And it is a very good organ.
00:56:03It's going to be, everything should be pretty straightforward.
00:56:07Okay.
00:56:08No, it's the car and the van are for the same purpose.
00:56:18People and equipment.
00:56:21So we are now en route.
00:56:35Okay, great.
00:56:36Thanks, Paul.
00:56:37Okay.
00:56:38Bye.
00:56:39What questions do you have?
00:56:43I'm just excited.
00:56:46Yeah.
00:56:47So it's going to be a couple of tough days, of course.
00:56:49It's a surgery.
00:56:50It's a long surgery, and don't be worried if it takes long.
00:56:54So the way it's timed is that we will try to have the heart removed at the time that
00:57:01the other heart comes in the door, pretty much.
00:57:03So she will go into the operation room before, maybe around the time that we obtain the heart
00:57:11from the other place, and only if everything is fine, they will go ahead and open the chest.
00:57:24We're doing a pediatric heart recovery to transplant into a little babe in Edmonton.
00:57:31So time is of the essence, and what we call the time from, the time from the heart is stopped
00:57:40to the time that it's beating again in the recipient, there's a very finite time, which
00:57:46is, like for adults, about four hours where that time is, and then for peds, they may be
00:57:52upwards of six or seven.
00:57:54They don't like that, but sometimes you have no choice.
00:57:57Just let it begin.
00:58:05Hi!
00:58:06Hi, buddy!
00:58:07Guess what?
00:58:08Harlow, you want to give me a hug?
00:58:10Guess what, Tato?
00:58:11Harlow's going to give me a new heart.
00:58:14Wow!
00:58:15Yeah!
00:58:16Say yay!
00:58:17Harlow's getting a new heart today.
00:58:21Good night!
00:58:23okay so I'm just thinking here out loud so 10 o'clock we're done 11 12
00:58:5212 so it looks maybe more like 3 o'clock would be our ETA so right now the baby's completely
00:59:01asleep so we're gonna breath and then we open the sternum put the retractor and do all dissections
00:59:11well when we open the precardium we need to see visualize the heart be sure the heart is good
00:59:19there is no any congenital malformation or and the heart contract it is fine there is no tumor
00:59:26there is no any any pathology or any any problem with the heart
00:59:30UTA 9 30 10 30 12 31 32 30
00:59:40hi Jenny Karen hi so the heart looks good and our ETA looks closer to three
00:59:53make your head nice and greasy for surgery crying with something
01:00:07I know
01:00:07I know
01:00:16I don't know.
01:00:46Hello, hello.
01:01:16Single cannula and SVC, what's the ICT?
01:01:29Okay, go on bypass, please.
01:01:31Cool down to 34.
01:01:3434 degrees.
01:01:37Mm-hmm.
01:01:39Was Venus in too far?
01:01:41Yeah, I was in about 8 centimeters too far.
01:01:44That's right, yeah.
01:01:47Okay, mixture.
01:01:50You can cut across there.
01:01:56Uh-huh.
01:02:03Yep.
01:02:05Okay, four 5-O-C-1s.
01:02:09Hold it here.
01:02:14That's good.
01:02:15Tag, please.
01:02:16That's good.
01:02:17Tag, please.
01:02:18Another stitch.
01:02:20Okay, that's good.
01:02:24Okay, let's have a look.
01:02:27Hold off the RPA there.
01:02:30Let's see the new heart.
01:02:33Mmm.
01:02:34They said no.
01:02:35Okay, that's okay.
01:02:36Good side.
01:02:37Okay, um, problems, please.
01:02:39Uh-huh.
01:02:40Uh-huh.
01:02:41We can go through the transverse sinus.
01:02:42Okay.
01:02:43Uh-huh.
01:02:44We can go through the transverse sinus.
01:02:46Okay.
01:02:47Okay.
01:02:48Okay.
01:02:49Okay.
01:02:50You can tie that knot there.
01:02:51This one?
01:02:52Okay.
01:02:53Okay.
01:02:54Um, problems, please.
01:02:55Uh-huh.
01:02:56We can go through the transverse sinus.
01:02:59Okay.
01:03:00Okay.
01:03:01You can tie that knot there.
01:03:03This one?
01:03:04Okay.
01:03:05Okay, you can tie that knot there.
01:03:09This one?
01:03:10Yep.
01:03:11Okay.
01:03:12Okay.
01:03:13This is wound around here.
01:03:14So just take that driver off.
01:03:16The tag off.
01:03:17That's nice.
01:03:18Okay.
01:03:19Perfect.
01:03:20And I'm gonna take this one.
01:03:21Okay.
01:03:22Okay.
01:03:23Okay.
01:03:24We can tie it back there.
01:03:25Okay.
01:03:26This one?
01:03:27Yup.
01:03:28Okay.
01:03:29This is wound around here.
01:03:30So just take that driver off.
01:03:31Take the tag off.
01:03:32That's nice.
01:03:33Okay, perfect.
01:03:34Okay.
01:03:35Perfect.
01:03:36And I'm gonna take this one.
01:03:37You gotta take that one.
01:03:38And I'm going to take this clamp off the PA for the moment.
01:03:43Pull this over here.
01:03:45And the heart's starting to beat already.
01:03:48That's cool.
01:03:50Okay, we need another angled clamp.
01:03:53I'll grab one of the other two.
01:03:55The size difference is not huge.
01:03:57We can go, like, two or three times body size in a baby.
01:04:03We've got to be careful it's not too small,
01:04:06because if it's too small it won't have enough pumping capacity.
01:04:11So it's a good heart.
01:04:12It just came from a long ways away.
01:04:15So it was in the bucket there for, like, five and a half hours, huh?
01:04:33Okay.
01:04:35Hi.
01:04:36Mr. Burgundy of Men, I'm Dr. Rebecca.
01:04:39How are you?
01:04:40Good.
01:04:41So we're all done.
01:04:42Everything went very, very well.
01:04:44It, um, the heart started up right away.
01:04:48And getting it in wasn't any major issue.
01:04:52So, um, heart's working on its own now.
01:04:55And, uh, we're just going to wait for the bleeding to settle down just a little bit before we close up.
01:05:01And then the baby will go back to the ICU.
01:05:04Uh, first 24 hours is sort of the important time.
01:05:07Heart's got to recover from the operation and all the bleeding's got to settle down.
01:05:11So it's a bit early to relax completely.
01:05:14But, um, things look pretty good.
01:05:16So I think we're in good shape.
01:05:18Okay?
01:05:20Okay.
01:05:22We don't shake anymore because we're too many germs, huh?
01:05:25Sure enough.
01:05:26Okay.
01:05:28I'll talk later, folks.
01:05:29Thanks.
01:06:00This has been a great big blackout to me.
01:06:11Yep, big blackout.
01:06:15And when I found out I almost died, that was something else.
01:06:22I even saw...
01:06:24i even saw you know how they say that you see a figure before you croak i saw a little virgin mary
01:06:37oh is this dr shapiro it is oh hello how are you good very nice to see you again
01:06:48yeah nice congratulations congratulations to you thank you it's been a long haul hasn't it
01:06:54too long yeah yeah it was um difficult transplant yeah you were very very very sick before it that's
01:07:03what i heard yeah anyway times are gonna get a lot brighter for you yeah you've got a new chance
01:07:10yep it's very lovely to see you pat yeah it's nice to have met you yeah my lifesaver well likewise
01:07:17it's been a pleasure to look after you we'll see you in the clinic okay okay keep your spirits up
01:07:23yep i will okay all right love to see you pat okay bye
01:07:40sometimes i wish i wouldn't have gone through all this
01:07:47kind of hard all my wasted days it would have been better just i think anyway but i thank the person
01:08:07that's all i can do
01:08:14that's all i can do
01:08:18he gave his life to save mine
01:08:23which was nice
01:08:27sorry for the tears you have every right you have every right
01:08:32yep you're welcome
01:08:51okay now say the back look it's full you take a picture yeah okay
01:09:02i don't think anyone would call my life balanced but i i certainly have more control over it now
01:09:11than i've ever had before and i and i know what the priorities are it's take me a while to learn that
01:09:18when you when you're young and fresh and trying to prove yourself
01:09:21it's not quite the same you know you feel you have to every invitation you have to take every
01:09:30grant you have to apply for every paper you have to write now it's different for me
01:09:36well i had an event two years ago when i was um thought fairly healthy running could you know run
01:09:51down a quarter every every day
01:09:55and one night in the middle of the night i got out of bed and i fainted on the floor and i went to
01:10:02emergency and i had a temporary pacemaker put in and then a permanent pacemaker and a bunch
01:10:08of tests and i was found that i had a condition called cardiomyopathy and i had no idea
01:10:17it's not bedtime yet it's too early it's too early for bedtime so i had this pacemaker put in
01:10:24happened during a vacation i don't think i lost a day of work because of it
01:10:29and i haven't turned back since i've been able to you know do do everything that i've done before
01:10:35so are we reading this one yeah i don't know what this is about is this about
01:10:44what i've learned is
01:10:47life is precious and time is precious and you know i want to look after my patients i want to have fun
01:10:52doing surgery have fun doing research and i want to come home early i want to have it all and i've
01:10:58learned that actually by letting go of a lot of things i can do that
01:11:06and i feel very lucky
01:11:07and i feel very lucky
01:11:13what are they for songs
01:11:17that's what
01:11:18what
01:11:20what
01:11:22what
01:11:26what
01:11:28what
01:11:30what
01:11:32what
01:11:34what
01:11:42matthew was born here and it's kind of sad that he started his life and finished his life in this
01:11:49hospital we were so proud that he was uh born here so um we have all agreed that we will uh matthew's
01:11:56organs are to our it will be donated that is listed as you think you said yeah i can go through
01:12:03all that specifically when it comes to the tissue um we did not realize
01:12:12part of the skin part was to the degree and we did not realize the need for it at the same time
01:12:19the eyes
01:12:20uh
01:12:23uh
01:12:25not so it's i don't know how much matthew has to give matthew's already given his life and um
01:12:33um we don't have to yeah we we don't have to do it all you know we we're already you know he's already
01:12:41given um and but i don't think we have to do it all i dain he's your brother what i've said my piece
01:12:51about it i say do the organs the essential organs and leave the tissue i just i don't feel comfortable
01:13:01about the tissue on my own donor card i am not i don't donate my if that's the case just my organs
01:13:10and i just don't and then leslie just said it everybody's done enough yeah and matthew has
01:13:19contributed more than all of us so so basically what will happen is that if for organ only there
01:13:26would be a cut probably from around an adam's apple for um a male um down to the pubic area
01:13:34and then usually just across from the abdomen tab
01:13:40and so other than that there should be no visible scarring or anything if
01:13:45if we go just for organ donation now leslie let's uh do the organs
01:13:51part of the the process as well requires us to uh take part of the spleen so pardon me the spleen
01:14:02so the spleen basically is attached to the pancreas and we use that tissue to determine
01:14:12his tissue typing matching to the the recipient
01:14:16so yeah i like basically the spleen is just um they take a piece of it just to
01:14:26check his his genetic typing versus the recipients because what they want to do is match
01:14:33the donor organs to the recipients as closely as possible so that there's less chance of rejection or
01:14:40having the the organs fail but it's not really a an organ that we're taking or anything like that it's
01:14:46just a basically a tissue sample that we're using to make sure that the the matches is the best match
01:14:55possible leslie it's all right matthew would be okay with it he honestly would be okay can i okay let's sign
01:15:03i i have to leave i want to sign this i feel nauseous can we just let's move forward okay we're moving too
01:15:10slowly for me i need let's let's let's let's move forward you know let's we're being all this
01:15:14delicate and i need to get to my son let's move forward with the giving person that we know matthew was
01:15:23we would know that this is what he would have wanted he would have done it without hesitation
01:15:40so getting me speaking hi could you tell me who's on call for lung transplant
01:15:58hi karen speaking hi i'm ali i have a lung to offer you okay i do not have hla or serology at this
01:16:13point in time okay but we're trying to rush this as quickly as possible and we need to go to or today
01:16:21before midnight okay oh matthew oh matthew you should be filling out that form for me
01:16:36why did i have to fill that out for you
01:16:39so these lungs sound promising they have multiple um recipients and liver i still have to get a hold
01:16:56of that liver recipient kidneys um that sounded promising i think okay
01:17:02i think we'll talk to the lab just to see that serology will be done and yeah it will be done and then
01:17:14give a couple hours flex and really confirm that or our time okay so that everyone can tee up their
01:17:19recipients they're going to fix me up they're going to give me a new heart they've got a uh according
01:17:37to dr sharma and from what i've heard since i got here they've got an excellent heart lined up for me
01:17:42the best yeah perfect we have found you a very good heart uh that's what they tell me yeah it's
01:17:52a very good quality heart so i'm very confident you're going to do well so of course there's
01:17:56a bonus lots of complications that can occur along the way yeah well hey there's nothing got you nothing
01:18:02gained right yeah that's right but things like infection or having trouble with your lung function
01:18:08or kidney function or things like that and any one of those things can contribute to not actually
01:18:12making it through this whole experience which that risk is probably in the 10 to 15 percent mark
01:18:16i would think yeah so quite a bit higher than usual but but uh i think that's another game i
01:18:22think given the fact that we've got this heart for you uh we should go ahead that's why we've
01:18:26gone to all the trouble of getting this organized it's gonna do good absolutely power of positive
01:18:32thinking exactly right good all right bet i got a chance to chat with you yeah see you soon see you
01:18:38soon okay i'm a little nervous i'm ready to start the final leg of this journey it's unbelievable how good that feels
01:19:06oh
01:19:11oh my god this is so unfair
01:19:15relax because the best thing you do is
01:19:17this is so bad
01:19:23you are you are has delayed i would like to delay for one hour okay i wonder can i call you at a different phone darren
01:19:35i can't lose it i just i just don't want to lose it
01:19:45this is not abnormal this is pretty routine but in this case it's much more sensitive and the delay is much
01:19:58more you know um much um maybe not received in the same you know as uh it's more difficult for for the family
01:20:11it may be in this situation to have a delay
01:20:20but it's not quite yeah pretty soon we're just gonna have a minute of um silence this has been an
01:20:43incredibly stressful time for everyone because it's been so busy but this family has really really
01:20:48hung in there and this is this is a loss of their son and it's been really really hard on them and as
01:20:56always it's so totally unexpected so they have graciously agreed to consent for transplantation
01:21:01so if we can have like five seconds of silence to just remember the gift that this family
01:21:08is willing to give through their son
01:21:18so they're gonna withdraw life support like any minute now okay what i will need from you and in
01:21:23in sequence is the scalpel followed by the sternal saw and i'm gonna put the debakeys and the meth in
01:21:33there so i have that up already
01:21:53so
01:22:03sounds like they're coming thank you
01:22:15i will see you again matthew i'll call you when we're done okay i'll see you again matthew
01:22:39i love you matthew i love you
01:22:48okay so we're going to go into the right
01:23:08here they come i know feet first
01:23:24feet first yeah
01:23:28that's okay great teresa um who's checking the id
01:23:34okay
01:23:49okay suction's up to dr white give me the skin knife please good night
01:23:53second place
01:23:56nice moving the liver and not the liver
01:23:59the pancreas can
01:24:02perfusion cannula karen we need our pulmonal pleads please
01:24:08right away please
01:24:11the uh protractor
01:24:15yeah we should be able to take the whole thing out
01:24:22where's the pulmonal pleads yeah wonderful thank you chris
01:24:26yes
01:24:35yes
01:24:37yes
01:24:39yes
01:24:45yes
01:24:47yes
01:24:49yes
01:24:51yes
01:24:53I'd like to thank you all for joining us here tonight as we pay tribute to and remember
01:25:09Matthew.
01:25:12He lived his life how he wanted to, and he lived his life to the fullest, with no regrets.
01:25:19I love you.
01:25:20I miss you.
01:25:21You're my friend, you're my best friend, you're my brother, and I'll see you again.
01:25:27So, the other thing was Matt was really, really generous.
01:25:31He was really giving.
01:25:33That's what made him such a joy, even for Leslie and I.
01:25:36He's probably put less than I on more adventures than we could shake a stick at just by spontaneous
01:25:42taking us out there and have us live life full.
01:25:45We want you to know that Matthew was an organ donor.
01:25:55We knew that he would want to give this gift of life to someone who needed it.
01:26:06Our load was shared by so many, and our son was so loved by so many.
01:26:12We want you to know how grateful we are.
01:26:18We are so glad you all were.
01:27:08That one's right up there! Right up there!
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