G265

From behind her desk with its piled-high candy dish, Laura Montoya beams whenever her friend arrives for work. Mary Kirby, a customer service representative, breezes into the cheery office decorated with dangling wind chimes and framed movie posters. The two spend a few minutes chatting, enough time to remind Montoya that she did the right thing.

Just a few years ago, Kirby was in dialysis. Anti-rejection medication for an earlier liver transplant had left her with failing kidneys. So Montoya, a co-worker, came to her with a simple offer: Take one of mine.

The surgery June 25, 1998, left Montoya with a 12-inch scar, eight weeks of recovery and incredulous questions from others. What was it like? Why would you do such a thing? Would I?

A small number of colleagues are quietly donating kidneys to co- workers -- gestures that cross generational, racial and hierarchical lines. An employee gave to her boss. A white employee to her African- American colleague. A 46-year-old mother to a co-worker young enough to be her son.

These living gifts are kindling ethical debates, turning everyday employees into office heroes and showing the extraordinary lengths that co-workers will go to in the name of friendships forged on the job.

"It's like having a baby. You remember the pain, but it's worth it," says Montoya, 39, who handles human resources training and development at Albuquerque-based Comcast Cable. "Co-workers say, 'I wouldn't do it; you're braver than I.' It's hard for me. I don't see myself that way, as a hero. I just know that I get to see my friend every day."

"It was amazing," says Kirby, 35. "My friend is doing this so I don't have to be on a machine, so I can travel, so I can wear a sexy tank top without all these tubes hanging out."

More living donors

Statistics aren't kept on how many transplants are provided by co- workers, but the number of kidney donations from living persons soared 118%, from 1,903 transplants in 1989 to 4,156 in 1998. The U.S. Health Resources and Services Administration reports that the number of living kidney donations from those who aren't related to recipients is climbing as the list of people awaiting transplants grows and medical advances make the procedure easier on donors.

"The big increase has been in unrelated transplants, people who hear about a colleague or a neighbor or someone in their church," says Jon Nelson, director at the administration's office of special programs.

Co-workers who have donated kidneys have answered all sorts of questions from curious friends and outsiders. They know all the myths and misperceptions. No, a donor doesn't have to be related. Anyone can provide a kidney if he is a good match.

No, not everyone who wants to donate a kidney can do so. The donor must have the right blood type, be free of diseases such as hepatitis, pass medical tests ensuring that he is healthy enough to withstand the procedure, and undergo other screenings such as psychological counseling.

And no, there aren't long-term health problems for donors. They can function with one kidney, which takes over the function of blood purification that once was handled by two.

But there are other questions that are tougher to answer: What if an employee donates to a co-worker who later becomes the boss? How comfortable can an employee feel working with someone whom he or she may have saved? Should a subordinate provide a kidney to a supervisor?

"When you donate to someone, the relationship can become complicated afterward. The person may feel indebted for the gift," says Arthur Caplan, a bioethicist at the University of Pennsylvania. "The person may say, 'You owe me something.' These things happen. I've seen them. . . . And what if it doesn't work? People feel guilty, flawed; they blame themselves."

Difficult questions

Nancy Nearing grappled with questions tougher than most: She donated a kidney to her boss. It was 1998 when Art Helms, a project manager at Rockville, Md.-based Applied Management Systems, assembled staffers and told them that he had polycystic kidney disease, which is genetic. He had scheduled surgery to remove both kidneys.

Later, sitting out on the deck with her husband and a cold beer, Nearing realized the implications of Helms' surgery: He needed a kidney. She talked it over with her husband and left a message on her boss's answering machine telling him they'd like to get evaluated to see whether either of them could be donors.

"I realized that if I had any intention of living, I had to take it seriously," says Helms, 51. "It was humbling. I thought I was macho enough to handle it. I was really on death's door when Nancy came in and said she was OK for a transplant."

Nearing, 43, had talked with counselors and decided that if she ever felt favoritism on the job was an issue, she could always leave. What mattered more, she decided, was helping now. The surgery took place on Sept. 10, 1998. His insurance covered the procedure, and her company offered to pay for the time she missed work. Nearing was out for about 10 days.

Looking back, neither regrets the decision.

"It changes your whole perspective. I'm here doing this funny job, and I'm not exactly sure how I got into it. I keep thinking I'm going to get back to real life," Helms says. "But one of the things that happened after the transplant is that I saw I'm wrong. I'm right where I'm supposed to be."

Despite promising outcomes, the procedure can leave friends, family and co-workers shocked, even unsupportive. Some discourage a healthy person from undergoing an invasive operation, especially for someone who is not kin.

When Sandy Heiler offered last year to donate a kidney to Jane Baier, her lunchtime bridge partner and colleague at GTE Laboratories in Waltham, Mass., some took the news hard; her mother was appalled, and her sister and children said she wasn't thinking straight.

And the procedure was tough. After the 5 1/2-hour surgery in July 1999 to remove Heiler's kidney, doctors gave the 60-year-old researcher large amounts of fluid to jumpstart her remaining organ. Swelling was so severe that Heiler couldn't close her eyes. Small, broken capillaries ran across her skin and gave her an odd purplish hue, like a pale bruise, alarming her family.

The swelling subsided by the next day, and Heiler still remembers watching Baier -- with her new kidney already functioning -- walk into her hospital room. The 54-year-old technical writer, who for months had been losing her energy to polycystic kidney disease, appeared healthy again. Her skin, once yellow, looked pink. Even Heiler's mother, once opposed to the transplant, told her daughter that she was proud.

"It's above and beyond what the average workplace friendship involves," says Baier, who still meets her friend for lunchtime bridge games. "It made everybody think about, 'Would I do that? Could I?' Sometimes you spend more time with your work friends than family. It's a natural extension."

Becoming heroes

In the aftermath of the transplants, donors and their recipients often become workplace folk heroes. Coworkers point them out to new hires, and colleagues they've never met send effusive e-mail and cards. In some cases, company CEOs have written gushing letters of praise to the donors and honored them in front of their peers with awards and ceremonies. Some employees find themselves before news cameras or on national talk shows -- experiences that can be both heady and overwhelming.

Rhonda DeLaremore, who suffered from kidney scarring caused by a recurring infection, received a new organ in 1993 from her sister. But that kidney also developed scar tissue. So her co-worker Margie Goralski Stickles, a nurse and procurement coordinator at Baltimore- based Transplant Resource Center of Maryland, gave her one of hers.

DeLaremore is black; Goralski Stickles is white. Their story garnered a flurry of media attention. The two went on the Queen Latifah Show. The Discovery Channel filmed the surgery Dec. 16, 1998, for national television.

"The media attention was wonderful. I wanted people to know that even though Margie and I were different races, we're all a lot more alike underneath than people realize," says DeLaremore, 43. "This person has chosen to give me a part of her body, and she didn't have to. How do you thank someone for that?"

Her co-worker was up and moving around two weeks after the surgery and now is 21 weeks pregnant.

"I am so healthy I can give life yet again, which is cool," says Goralski Stickles, 36, already a mother of two. "This was truly the right thing."

But for donors, the surgery itself can be intense. Doctors may remove part or all of a rib to get to the kidney, although new lapropscopic procedures minimize the trauma. And though the cost of the procedure in many cases is picked up by the recipients' insurance, there are unexpected expenses: in some cases, weeks off for recovery; the cost of buying new, looser-fitting clothes; and finding someone to care for the children during recovery.

None of this fazed Cindy Scimemi, who donated a kidney to a coworker, Steven Schibetta, 30. He ran the company showroom at a branch of Kelly's Pipe & Supply but had become so sick with kidney disease that he needed dialysis to clean his blood. Scimemi, a saleswoman at the wholesale plumbing supplies provider in Las Vegas, came to the showroom and told Schibetta she would like to look into offering him a kidney.

"He was just like a little kid," she recalls. "His eyes got really big and he said, 'Oh wow.' "

Since the surgery in September 1999, the employees have shared an indescribable bond.

"Yesterday, he sent me an e-mail and said how well he's doing. I'm very proud of him," the 46-year-old mother of two grown children says. "I have a son that's really close to Steve's age, and I would hope if he needed it that someone would help him out. I didn't save his life. God did that. I just provided a tool for someone else to make his life better. If you know you can do that and don't, that's a shame."