FDIC International 2016 Opening Keynote: Steve Pegram, Everyone Can Be A Hero

Indianapolis, IN (April 20, 2016) – Steve Pegram, in his keynote address this morning, shared with the audience how firefighters can take a step toward saving a life ‘without ever riding a fire engine again, without going on a call, and without even getting out of their seats” by becoming organ donors. He also related how ‘the simple’ 4 F’s Rule’ –Faith, Family, Friends, Fire Department—the priorities by which he strives to live his life–figured prominently in sustaining him and his family during a crisis involving the illness of Mollie, his wife, and their long, distressing wait for donor lungs that almost arrived too late.  

Pegram and Mollie, a nurse, were married for 16 years and had a son, Jackson, and a daughter, Riley when Mollie, who was 37 years old, developed a nagging cough. The cough grew progressively worse and whatever was causing it was adversely affecting Mollie’s stamina and overall health.

Following is a summary of Pegram’s account of the long ordeal the family underwent as they waited and waited for the donor lungs that would ultimately save Mollie.

One morning while I was at work, Mollie called to say she was in the emergency room (ER).  I wasn’t surprised. I knew that something was wrong. When I arrived at the hospital, Mollie was in severe respiratory distress. A scan showed she had a huge pulmonary embolism lodged between her heart and her lung. She was rushed to the intensive care unit (ICU), where she was aggressively treated to save her life. In a few days, her condition stabilized.

But, nagging questions remained: Why did she get so sick so fast? Where did the embolism come from?  After a few months and additional tests, we learned that Mollie had pulmonary fibrosis, a disease that doctors said had no cure and could kill Mollie in a few years if she did not have a double lung transplant.

Our family entered into a pattern of living fraught with repeated visits to the hospital and tests and reevaluations that revealed that Mollie’s body was in an escalating struggle for oxygen, jeopardizing her vital organs and, ultimately, her life.

Friends, Brotherhood, Hope
“Throughout my life,” Pegram interjected in his description of the medical crisis, “people have appeared at different times, at just the time for the right situation; many of them firefighters.”

As Pegram went on with his account of Mollie’s brave fight, the audience could see how accurate this statement was and also how the 4 F’s Rule figured prominently.

One example involved Chief Billy Goldfeder, a good friend and mentor of mine, who helped locate a doctor for Mollie. Goldfeder and I met while in high school in New Jersey. When he heard about Mollie, he contacted me and said when he was a volunteer firefighter on Long Island, he rode tailboard with a young boy named Johnny Ornes. Ornes now was a thoracic surgeon at Johns Hopkins University Hospital—and, his specialty was lung transplant. Here is just another example of the great network the brotherhood of the fire service is.

Dr. Ornes immediately reviewed Mollie’s case and quickly confirmed that lung transplant was the only chance for survival, and he said it should be done soon while Mollie was still strong.

We chose the Cleveland Clinic instead of Johns Hopkins because the clinic was 3.5 hours away from home instead of nine hours away as Johns Hopkins. Cleveland Clinic  is one of the top lung transplant centers in the country. At the clinic, it first had to be determined if Mollie met the criteria for a transplant. Testing results showed that she did, and she received a Lung Allocation Score (LAS) rating of 45. The LAS dictates where you are on the national waiting list. The higher the number, the sooner you will get transplanted–or at least that’s the theory. There was another challenge: Mollie’s height of five feet, two inches was considered ‘short’ for a transplant. Most donors are males in their mid-twenties who die from trauma.

Adding to our pressure was that Mollie had to be in a state of constant readiness—when we were notified that a donor had been found, Mollie had to be at the hospital within four hours; their home was 3.5 hours away. This meant having people lined up to watch the kids, feed the dog, and watch the house.

In the passing months, Mollie’s LAS score kept going up as her health continued to deteriorate. Every few weeks, Mollie returned to the clinic, underwent tests, and her LAS standing was adjusted upward. This continued throughout the summer. By fall, hope was waning. If Mollie did not get a transplant within two weeks, she would have to be admitted to the ICU and undergo a procedure that involved being connected to a machine that would take over the work of her lungs. At this time, I was commuting to the clinic three or four times a week.
 
Early fall, we were losing hope, and Mollie was getting much sicker. Her quality of life was now significantly affected. At the late-September check-up, we were told that if Mollie wasn’t transplanted within the next two weeks, she would have to be admitted to the hospital so they could better manage her health, specifically her breathing. In October, the doctors said Mollie needed to be admitted to the ICU. Mollie would need to undergo a procedure that uses a machine to take over the work of the lungs so that her body can get some rest before the donor’s lungs arrive.

We continued to wait for the donor lungs. I spent a few days at work, then a few days in Cleveland each week, sometimes making the trip three or four times a week.

During this time, we were also dealing with financial matters. Transplants and the associated costs are very expensive, and Mollie would have to stay in Cleveland for months post-transplant. Insurance did not cover any of this expense. In addition, the anti-rejection medications Mollie would need post-transplant could cost thousands of dollars a month, after insurance.

The support of Family, Friends, and Firefighters buoyed our family, and the Cleveland Clinic staff helped set up a non-profit Web site to raise money for the medical expenses. We were amazed at people’s outpouring of support and generosity: Our firefighter-neighbor and his wife coordinated the Web site and non-profit paperwork; firefighters, township trustees, and friends coordinated a fundraiser; dozens of firefighters who once worked with me contributed; FDIC 2014 students and instructors and other fire service members made donations and offered support; church members would put checks in my pocket; and random donations appeared in our mailbox.

On November 10, 2014, as Mollie was being prepared for the bypass procedure, it was the first time I feared the end was near and was imaging life without Mollie and wondering how I could manage without all the things she did every day. As the thoracic surgeon was explaining the procedure and the consent forms to Mollie, her cell phone rang. She handed me the phone to screen the call. A female voice said, ‘Tell Mollie, we have her new lungs’ I couldn’t believe what I was hearing. The voice then advised that Mollie would be going to pre-op and be prepared for the transplant. For a second, ‘I was exploding with every emotion I had ever felt in my life: joy, fear, pain, happiness, love, disappointment.’   


So now I ask all of you, wouldn’t you like to save a life?
We have all taken an oath to save a life, even if it means
losing our own. If you were to lose your life today, wouldn’t
 you want to continue to honor that oath? Register to be an
organ donor.


When I learned of the availability of the donor, I sent out requests for prayer to family and friends. “I felt this was an imminent emergency.  Mollie was in severe distress by the time she was taken into surgery.’

My pastor, Mollie’s parents, and two of my longtime firefighter buddies sat in the waiting room waiting for the lungs to arrive. It was 1 a.m., November 11, 2014, Veterans Day. Surgery was expected to take about 10 hours. We were sitting there quietly for just a few minutes when Mollie’s mom yelled, “Can we please pray?” I thought ‘how random this outburst seemed, yet it seemed appropriate to pray for Mollie, the doctors, and the donor and his loved ones. We joined hands and prayed together out loud.’

After eight hours, we received an update that the surgery was progressing well and should be done soon. Around 10 a.m., the surgeon came out; he looked very tired.

He told us that Mollie’s new lungs look perfect, and the surgery went very well. Then he said there was one complication early on: Mollie had stopped breathing as she was wheeled into the operating room, minutes before the transplant. The entire surgical team assembled for transplant had rushed to resuscitate her, but they could not get her heart started. She was under cardiopulmonary resuscitation for almost 11 minutes. The surgeon chose to go ahead with the surgery and see what happens instead of declaring Mollie dead on arrival and discarding the donor lungs.

‘As the doctor was telling us about the first few minutes of surgery, I realized this was the same time when Mollie’s mom yelled out, asking us to pray. I don’t know whether she sensed the danger or felt it, but I do know it is much more than a coincidence.’

Complying with Mollie’s request that I talk to her post-surgery because during her 10-plus years as a surgical recovery nurse, she noticed that patients reacted to the touch and sound of family members, I went to her bedside, leaned over, and told her the surgery went well and that she looked good. Mollie, who was on a vent and had multiple chest tubes and IVs, suddenly had tears running out of the corner of both eyes. I later asked Mollie about this time in the ICU, she said she did not recall it, but I think she heard me. Pegram then challenged the audience:

Mollie was saved because someone somewhere unknown to us made a
decision to be an organ donor. Without the transplant that day, there is
no doubt in anyone’s mind that Mollie would have died. The donor and
his family are our heroes. At the horrible moment of their loved one’s
death, they made the decision to save a life through organ donation.
Mollie’s life was saved by this selfless act, and we are forever grateful.
So now I ask all of you, wouldn’t you like to save a life? We have all
taken an oath to save a life, even if it means losing our own. If you
were to lose your life today, wouldn’t you want to continue to honor
that oath? Register to be an organ donor. Register right now at
www.donatelife.net.