Louise Jacobbi's Donation to Life

              17-E
Sunday, April 18, 1982
Louise Jacobbi's donation to life
Times photos/AAIKE SILVA
Miss Jacobbi works in lab
by MARGARET MARTIN
The Times For Louise Jacobbi, the Golden
Rule means signing on the
dotted line.
That's writing your name down on
a donor transplant card. When you
die, it is left behind, so that others
may begin a meaningful life.
For her, life begins with death.
The death: of a human whose brain
waves have stopped functioning.
The life: a patient sick with disease
which only another kidney can cure.
Transplantation. Sometimes it just"
means buying a little time — the next
medical development might be just
around the corner.
Miss Jacobbi, 39, transplant coordi-nator
with the LSU Medical Center's
Louisiana Organ Sharing Program,
explained it simply: "I deal with
death."
But the subject is not so simple. She
talked at length about trans-plantation,
tissue rejection and organ
preservation.
She talked coldly, concisely and
clinically, yes. But she continued. The
feelings became religious. The job is a
mix — coldly clinical. Personally
religious.
Her job is several fold: procuring
organs for a transplant candidate.
Fighting — always fighting — tissue
rejection. Searching for a better
method of organ preservation.
"We are investigating and studying,
but there is still tissue rejection. The
work isn't the best. It's just the tip of
the iceberg. There's a lot we need to
learn," she said.
She uses the editorial "we" to dis-cuss
a nationwide phenomenon.
Transplantation in this country is
25 years old.
And Miss Jacobbi is a pioneer in the
field.
RfeeycleVburseHL
BE AN ORGAN DONOR
Louise Jacobbi (at left) discusses her work. The bump-ersticker
above is a reminder of the need for donors
When she stepped into it 20 years
ago, transplantation was a baby born.
Three hundred transplants had been
performed in the United States, she
said.
Today there are about 3,000 per-formed
in a year. That includes 130
kidneys and one pancreas trans-planted
here.
"What I do is not written in any
book. You can't learn it in any
school," she said of the transplant
coordinator's job (a job made legal by
an act of Congress).
And she participated in a World
Health Organization Committee
which characterized or named the
specific antigens used in tissue typ-ing.
In 1963, Miss Jacobbi held an as-sociate
degree from a physician assis-tant's
program in Buffalo, N.Y.
Dr. John C. McDonald, now head of
surgery at LSU and internationally
known in the transplantation field,
came to Buffalo as a surgery resident
with a fellowship in immunology, and
he hired her.
She's been working with him ever
since — from Buffalo to Tulane Medi-cal
to Shreveport.
Organ procurement. Cold clinical
terms.
The best donors are young — be-tween
2 and 50 — and in good health
when they are involved in an accident
one day. That accident usually in-volves
cerebral or head injuries.
Up until several years ago — and
especially in the beginning — Miss
Jacobbi raced to the hospital, met the
family of the accident victim, talked
to them and encouraged them to
donate their organs to the patient-recipient.
Today, in Louisiana, she said, physi-cians
do that.
"The neurosurgeons are very tuned
in to doing our work for us. They have
taken it and felt that it is part of their
practice — to give the family an
opportunity to make a 'meaningful
death' out of this death," she said.
How does she deal with this job of
death?
"I deal with it strictly clinically. I
can't get personally involved in the
job. All are tragic stories," she an-swered.
But she admits that she has to deal
with the tragedies in her own way.
"I think about it later. I discuss it
later. But when I deal with the donors
at the time, it is strictly a clinical
observation," she said.
"I function as a person when I get
home — the tragedy, the children left
behind, the wives," she said, but
added "I feel that the donation of an
organ is, on the personal level, the
thing to do.
"It is morally wrong, unethical,
irresponsible as human beings NOT to
do it."
But as strongly as she feels about
that, it was not until 1967 that she
herself signed a donor card. "No one
wants to admit their own mortality,"
she said.
And though organ procurement,is
her job, she never urges anyone to
sign, until they are willing.
"We inform you. You make the
decision," she said.
"I think organ donation is an ex-tension
of the Golden Rule."
"It is the only Christian thing to do.
We talk about do unto others. It is the
only true, altruistic thing one can do
— donate your organs to someone.
There is no reward and you can only
give. The only thing that is required of
you is the donation of an organ.
"If you die from an accidental
death, it is a waste of several lives if
the organs remain unused. They are
of no benefit to you."
When dealing with possible donors,
Miss Jacobbi, a warm, kind and giv-ing
person, has been called cold and
indifferent. She's been told she's infr-inging
on the privacy of the victim's
relatives. She agrees: "We are, because the
grieving process is a part of
death. I must be able to remain calm
and grieve with them — that is impor-tant.
I can't be cold and indifferent."
And she's been told "Go to hell" and
"Get out of this room." ("I have left at
that point, but I have also gone
back.")
What assurance does a donor have
that he won't be pronounced dead
prematurely?
"You've been reading Coma," she
answered with a smile. "Probably 20
years ago that might have been pos-sible
— today NO. The criteria are
strict. All donors have to die in a
hospital."
But she explained that there is a
procedure the officials follow —
checking for response to pain, fixed
pupils, and, of course, the EEG. This
procedure is repeated — some doc-tors
require 24 hours between EEG
readings — before death is pro-nounced.
And if you want to be an organ
donor? Miss Jacobbi is glad to answer
how: 1. Sign a donor card. 2. Indicate
on the back of your driver's license,
when you renew. 3. Let your next of
kin know and ask them to allow you to
be a donor at the time of your death.
You can sign up to donate any
organ which is transplantable or one
specific organ. Organs which can be
used for transplantation are the inner
ear, the cornea, liver, bone, bone
marrow, skin, pancreas, heart-lungs
and kidneys. (The Louisana Organ
Sharing Program will have a booth at
the Health Fair '82's Thursday site —
the Convention Center. You can sign
up or just ask questions.)
Miss Jacobbi also deals with those
who would get the organs — there are
100 kidney patients on the list in
Louisiana.
She interviews every potential
transplant recipient.
She explains that the transplant is.
not a cure, just a treatment. She tells
them that they'll only trade one kind
of medication for another kind, and
one set of problems for another.
Only a third of the patients on
dialysis are even offered the trans-plant
choice. And some patients say
"no" themselves.
She laughed when asked what she
does to relax, to get away from it all.
To get away from the death, the
tragedies, the blood, the clinic, the
personal feelings.
"This job has interfered with my
social life — I'm on call 24 hours a
day," she answered. "I used to be a
skiier, but no longer."
And she said that through family
tradition that she is a good cook.
When she lived in New York she-helped
her dad, who owned a restau-rant.
"I do a very good cassada," she
said, describing it as "a cake, orange
with Grand Marnier and filled with
ricotta cheese."
Although she likes to entertain, it
always has to be with very under-standing
friends who come to her
South Shreveport townhouse — "all of j
them have to be understanding. I may
be having dinner with them and I will
have to up and leave."
But she does like to sail, and "lately
I'm back in my reading phase —
that's a compelling reason to read
every best seller. I can do that and my
job will not interfere."
And home is decorated with an
Oriental flair.
She purchased it new, she said,
knowing that her job would be deman-ding
and she didn't have time to fix
up, redecorate or mow the lawn.
Louise Jacobbi — the pioneer who
is helping write the books on trans-plantation.
She deals with death, but
she is full oHife.
Through her work, others live.
She helps buy time for them.