Brad Francis sat down at his computer in Vallejo and began to write a letter that would save his life.
It was tougher than he thought it would be. He wasn't sure how to even begin. How do you go about asking someone to put their life on the line in order to save yours?
Asking friends and family was difficult enough, but now, he was preparing to ask complete strangers.
"My heartfelt appeal is for someone to step forward to donate a kidney," Francis wrote in a letter that would find its way into church bulletins and hopscotch around the world e-mail by e-mail.
"All that is required is that you be healthy and have type O blood, which is the same as mine. You don't have to be related to me.
"I know that is asking a lot," Francis typed. "If my life didn't depend on this request, I would never ask for such a sacrifice."
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Some 30 miles away in Rossmoor, Kathy Dorsey was busily going about her life. Dorsey, a native Canadian who fell in love, married and moved to the Bay Area 10 years ago, hadn't slowed down a bit in retirement.
In her professional life, she had been senior vice president of a $5 billion insurance company and she still is considered an expert in the area of pensions and benefits. Now, when asked, Dorsey calls herself a "domestic goddess." Her days are spent volunteering and working with the Soroptimists.
Dorsey's plans for her future were like most people's, full of hope for good health, long life, much love. Specifics were to be filled in later. Donating an organ was not even a vague notion.
But one evening as Dorsey, 52, sat at her computer, wading through the mass of discount medication offers and sure-fire weight loss plans that clogged her e-mail inbox, a familiar e-mail address caught her eye. It was from a friend who works at a Catholic school in Vallejo.
She double-clicked and began to read. It was a story about a 56-year-old vice principal, a good man who was in trouble. He had been born with polycystic kidney disease, and when he was in his early 30s, his kidneys had failed.
He had a transplant in 1979, receiving what is called a cadaver kidney. The transplant worked well for 23 years, but now it was failing and he needed a new one. His best chance was to receive a kidney from a living donor.
Friends and family had been tested, but, for one reason or another, no one was a match. Now he was turning to strangers. Time was not on his side. Before long, his kidney would fail and he'd have to endure hours of dialysis three times a week. And he would grow steadily weaker.
Dorsey read the letter several times. She could do it, she thought. She could sign up to be tested. She could be a donor.
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Brad Francis is that rare person: a native Californian. He was born in Castro Valley and had pretty much a run-of-the-mill childhood. Then, when he was almost 10, his father died of kidney disease -- a disease that Francis later would learn ran in his family. Eventually, his mother remarried and the family moved to Pittsburg.
Francis was attending Pittsburg High when he was diagnosed with the same disease that killed his father and several relatives. By the time Francis was in his early 20s, he was showing signs that his kidneys were in trouble. At 32, he was in crisis.
"My kidneys began to fail, I was bleeding internally," Francis says. "I was put on the transplant list."
His kidneys not only were failing, they also were turning against him. Doctors were forced to remove them and Francis began the dialysis nightmare, spending hours each week having his blood cleansed by a machine.
Not long before Christmas 1979, he got the call he was waiting for. A kidney was available for him.
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Harvested organs begin to die the moment they are removed from the body. Measures are taken to preserve them as best as possible, but the clock begins ticking the instant the blood supply is cut off. By the time Francis received his new kidney, almost 30 hours had elapsed and although the kidney functioned, it was not perfect.
But it worked and Francis was thrilled. He spent his birthday and Christmas in the hospital, recovering. Like most transplant patients, he rode a roller coaster of emotion, happy to be given a second chance, worried that his body would ultimately reject the precious gift.
Eventually, Francis settled back into his life, returning to his teaching career, falling in love, getting married. He didn't know he was living on borrowed time.
Three years ago, the symptoms returned. The kidney had grown progressively weaker as Francis' body worked against it. It wasn't too bad at first, Francis says, but with his renal system losing ground, overwhelming fatigue set in. It was a struggle to make it through the day.
Last year, when his kidney's function fell to just 20 percent, doctors put him on the transplant list. They warned him that should the kidney worsen, he would have to go on dialysis again.
The future laid out before him was not the one he had chosen for himself. Francis has devoted his life to teaching. He has been a teacher and administrator for 32 years and currently is a vice principal and teacher at St. Patrick-St. Vincent High School.
"I knew I'd have to go on disability and that it could take five or six years to get a cadaver kidney," Francis says. "And by that time, I'd be retirement age and I could say goodbye to my career."
Francis had been given a great gift 23 years earlier. Now, he would need another.
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Dorsey is a woman who, when she makes up her mind, is instantly ready to move ahead with the plan. Time was not meant for wasting.
She has always lived her life with a strong sense of purpose. She was a powerful woman in a business setting that is not always accepting of powerful women. Before her marriage, she had been chosen as the first female president of the Board of Trade in Brampton, Ontario.
"Her father had been slated for the same honor some 30 years earlier," says Julie Black, one of Dorsey's closest friends, "but he died suddenly. Although she certainly earned the position on her own merit, for many who knew her father, Roy, Kathy was completing the circle."
Black was concerned when Dorsey first told of her decision to donate a kidney. Worried, but not surprised, Black says.
Dorsey's husband, Terry, also was worried. Kathy had already made up her mind and no amount of caution from friends and family was going to change that. But her decision, while sparked by her desire to help, was not made blindly. She researched the surgery, weighed the odds and became assured that she had little to fear. And in doing so, she assuaged the fears of those around her.
She would not have done it if her husband had not supported her, Dorsey says. She is determined, but not foolhardy.
The doctors, Dorsey says, asked her if she understood the risks.
"I said at the worst, we could both die," Dorsey says. "But at the best, we both go on to live long lives."
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The hardest part was not the surgery, Dorsey says. It was the long wait between her decision to donate her kidney and the surgery. Determining the physical compatibility is relatively simple, but the transplant team at UC San Francisco Medical Center, which has pioneered the living donor transplant program, wants to make sure the donor is emotionally prepared for the sacrifice.
Dorsey underwent psychological testing and counseling, and had to attend lectures that explained the risks. The doctors also insisted that she get to know Francis, something Dorsey had not wanted to do.
She was willing to take the chance and give her kidney. If it worked, great. If it didn't, at least she had stepped to the plate, Dorsey says. There was a limit to the emotional toll she was willing to invest.
"I wasn't going to get to know him at all," Dorsey says. "It was a defense mechanism."
But the doctors pushed them together, and Dorsey and Francis quickly got past the awkwardness. Their families supported each other during the operations in August, and they remain friends.
Dorsey is resolutely nonchalant about the surgery and her gift.
"I don't feel altruistic," Dorsey says. "I figured if it was something I could do, I'd do it. I have no sensation of having the surgery. I don't feel any different than I did before. I feel better, actually."
Almost four months after the transplant, Francis is feeling much better, too. He suffered a bacterial infection indirectly related to the transplant -- the anti-rejection drugs he takes make him more susceptible to such infections -- but he's back at work, his energy level has returned and he says he feels better than he has in years.
Barring complications, doctors believe the kidney will last the remainder of a long life. Francis believes Dorsey is too modest. She has given him a second chance at life.
"It's a humbling experience," says Francis, who celebrated his 57th birthday on Dec. 20. "I would encourage people in need of a transplant to think outside the box. Don't be afraid to go out there in the community. It's worth the risk."
Joan Morris is a lifestyle reporter for the Times. Reach her at 925-977-8479 or [email protected].
ORGAN DONATION
Every day, 2,000 names are added to the national transplant waiting list that includes more than 80,000 people. And although hundreds of transplants occur each day, about 7,000 people die each year awaiting the operation that will save them.
The living donor program allows healthy people, age 18 to 55, to donate a kidney, bone marrow or parts of the lung, liver and pancreas to help family members or complete strangers. For more information, contact the National Kidney Foundation, www.kidney.org, 800-622-9010, or talk with your health care professional.
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