Big Al's Used Organ Lot

Mar 20, 2012 | Shilo Zylbergold | Best Medicine
Big Al's Used Organ Lot

image by: Alan Turkus

Most philanthropists would still rather donate to elite schools, concert halls or religious groups than help the poor or sick - Noreena Hertz

The year was 1970 and I was bumming and thumbing my way across Europe and Asia. While overnighting in a youth hostel in Thessaloniki in northern Greece, I overheard a couple of Californian bikers discussing their intentions to sell their blood at a nearby clinic the next day. Being a little short on drachmas myself, I decided to tag along with them.

We arrived at the clinic, which was not much more than a ground floor apartment in a non-descript three story concrete building. The lab techie ushered us into one of the small rooms where we had our fingers pricked and our blood types determined. We then joined about a dozen others lined up according to our blood types against the wall in a larger room. Almost all of us were western European, Aussie, or North American transients who were passing through Greece on our way to the beaches in the south.

One by one the local clients came into the room and chose which one of us they wanted to buy blood from. The more "presentable" ones in the room were picked first but, eventually, even the scruffier specimens like me were selected. Although there was a suggested price, most of the buyers haggled a bit. Using hand signals, the buyer and I finally agreed on a number and I was led back into another room where I lay down and had my blood drawn. I still remember the old Greek putting the plastic sack of my blood in a paper bag, opening the door, and walking out into the 110 degree noonday sun on his way to the nearby hospital.             

The buying and selling of blood is still around, but it has been pushed into the background by the phenomenal emergence of organ transplants and the demand for living human organs. Even though the sale or profiting from the purchase of human organs has been outlawed in every country in the world (except Iran), a planet-wide black market has arisen as a consequence.

If you think about it, just the idea of a black market in human organs sounds seamy enough. You can just picture someone wearing a fake beard and false moustache, dressed in a long trench coat, and lurking in the shadows of a downtown back alley. "Pssss, hey buddy, can I interest you in an organ? Top quality, high grade and fresh off the operating table. I'm talking prime cut." He pulls open his coat surreptitiously and offers you a glimpse of several still-pulsing organs poking out from secret pockets sewn into its lining.

The organ black market may not be quite that "Hollywood", but its repercussions are much more ominous and dangerous. There are reports of donors having been recruited from the Brazilian slums and flown to South Africa where their kidneys were surgically removed. They were paid six to ten thousand dollars and flown back home with one remaining kidney. The South African middlemen were then able to flog the "donated" organ for about one hundred thousand. Not too shabby a margin of profit.

Some organ donors may not even be that lucky. There are documented cases of wealthy Americans on dialysis who "short-cut" the wait by travelling to China to receive the kidneys of executed prisoners. There are even stories of women in India who are forced by their husbands to sell their organs to western buyers in order to provide dowries for their daughters. 

As the shortage of transplants continues and the demand increases, it can only get worse. Is there a way out of this conundrum? There is talk now of legalizing the trade in human organs in order to choke out the booming black market. If this somehow happens, one can only imagine what the future will look like.

Picture a large downtown lot with shiny colourful banners waving in the wind. Welcome to Big Al's Used Organ Lot. You've been tantalized by the ads on TV in which Big Al implores you to "come on down and trade up", and now you find yourself in organ shopping mode.

As soon as you step on the lot, you are quickly approached by a gum-chewing salesman wearing an unbelievably loud checked blazer. After a little small-talk, he asks you what kind of organ you are interested in. When you inform him that your kidneys can no longer get you to and from work he shakes his head sympathetically but then tries to talk you into going for a half-liver that just arrived on the lot.

"This baby has got all the bells and whistles," he whispers looking around suspiciously, "and it's your good luck you got here when you did 'cause
you're the first one to get a look at her. As you can see, she's in real good shape --- only one owner --- and low, low mileage. She was basically just used to get from the La-Z-boy recliner to the fridge and back again."

When you tell him that you're not really interested in a liver because yours is working perfectly well, he informs you that he can give you a great deal on a "beater" lung that has been sitting on the lot for ages. "We're practically giving this baby away. Used to belong to a real athlete, a marathon runner in fact, who wandered out into traffic and was popped by a John Deere street sweeper. We managed to save it from the scrap heap but we'd like to get it out of here to make room for some of the newer models. Why don't you let me do a quick little procedure on you and then you can take her out for a test spin?"

Again you insist that you don't need a liver or a lung and he comes back at you with a pitch for a used heart. "This here beauty can go from zero to 120/70 in a heartbeat. I'm talking four chambers with compression to spare!"

Okay, maybe this is no laughing matter. The demand for viable organ transplants, however, is not going away any time soon. We are either going to have to find an ethical and honourable way of solving this enormous problem or the day of "Big Al's Used Organ Lot" may not be so far away.


Shilo Zylbergold lives on a small island somewhere in the southwest corner of British Columbia, Canada. He grows vegetables, teaches math, and is a columnist for a local paper. Send complaints to [email protected]

Shilo Zylbergold

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