Mariel Christian Overcomes Fear to Give a Gift of Life

LIS manager’s bone marrow donation exemplifies RTI staff members who give of themselves to improve human condition The call came out of the blue: “You are a match. Are you still willing?” That was the essence of the message Mariel Christian, RTI’s manager of Library and Information Services (LIS), received one day back in May. It had been so long since she signed up to be a bone marrow donor that she had forgotten all about it. More calls followed, plus a physical exam and consultations with medical specialists. Finally, on a recent October morning, Christian found herself walking through the doors of the Adult Bone Marrow Transplant Clinic at the Duke University Medical Center. In a clinic surgical room, a doctor inserted a special hollow needle into her pelvic bone, six times, until the desired quantity of liquid marrow had been extracted. The precious substance was then packed in a climate-controlled container, rushed by courier to the airport and flown--possibly hundreds of miles--to be injected into a waiting recipient that same day. Waking up in the recovery room, Christian reflected that she might have just saved a life. Donations of healthy bone marrow, especially from African Americans, are needed by people afflicted with a variety of serious illnesses. Leukemia is the one that comes most readily to mind, but there are others, including hereditary and acquired diseases that prevent a person’s own marrow from producing normal blood cells. Christian’s decision to be a potential bone marrow donor was made long ago, but not without trepidation. Mainly, she had to overcome a persistent fear of needles. “I had never even donated blood, because my veins are small and tend to roll away from the needle. It usually takes several jabs and lots of hunting around before someone can get blood from me,” she said, laughing. “My family was amazed that I would do this.” Prospective marrow donors must give a blood sample, from a pin prick, during the initial screening, for the purpose of tissue typing and matching. Needles come into play if and when an actual donation is made. The story of how Christian became a donor goes back a decade to the time when she was working at Duke University’s Fuqua School of Business. “Duke held these health awareness clinics, and one time they were giving out information on the need for bone marrow donors. I was really impressed with the huge need that exists, so I agreed to sign up.”

She was screened and entered into the National Bone Marrow Registry. Then she waited. And waited. Eventually she forgot about it. When that May call came, she remembered. She also remembered what she had learned about the need for bone marrow, including the fact that many people, even some infants, die for lack of a matching donor. Between the call and the donation procedure itself, scheduled for a date in October, she was given several opportunities to back out. “They wanted to make sure I was absolutely committed to doing it.” Finally, about a week before the procedure, the stakes became incomparably higher. “There’s a point where they tell you, ‘If you back out now, chances are that the person who needs your marrow will die.’” That’s because the recipient must be prepared to receive the new bone marrow by having his or her own diseased marrow destroyed through chemotherapy and/or radiation treatments. The healthy donor’s cells are given directly into the recipient’s bloodstream. If the transplant is successful, the cells travel to the marrow, where they begin to function and multiply. Christian had no intention of backing out. Knowing something about the intended recipient of her donation only strengthened her resolve. “The Registry tells you a good bit about the patient, including the age, sex and the health problem. They don’t tell you the name or where the potential recipient lives, though,” she said. “I could only imagine what it must have felt like for that family to have to depend on the donation of a stranger as the best, and possibly, the only hope for their loved one.” (The National Bone Marrow Registry tightly guards the privacy of both donors and recipients. Although Christian can speak about her own experiences, she has been asked not to share even anonymous demographic information about the recipient in a story such as this one.) Early on the day of the procedure, Christian’s husband, Kevin, drove her to the transplant clinic. By 8:45 she was under the knife—or the needle, in this case. Around 11:15, she was awake, though groggily so, and ready to be driven home. “Everything went exactly as they had told me it would,” she said. “Including being very sore afterward for several days.” Would she do it again? She might be asked to. When a hundred days have passed from the day of the procedure, Christian will get an update on the condition of the person who received her bone marrow. If the initial donation “took,” she will not be called back. But if the news is not so good, and the

person needs more of her marrow to continue to have a chance to live, she may have to consider heading to Duke one more time to face the needle. Although donating bone marrow involved some nervousness, physical discomfort, the usual risks that go with surgery and a chunk of time taken from her daily routine, “It was a deeply rewarding experience,” Christian said. “I believe that we all have the power to change someone’s life. Each of us may go about it in a different way. “I still laugh at what the nurse said to me in the recovery room. She said, ‘That is really an amazing gift that you gave someone. It’s way better than a sweater.’” Information about the National Bone Marrow Program is available on the Web here [link: www.marrow.org]. By Steve Smith