Much more than a sum of parts

The desire to make an impact, extraordinary surgical expertise and some coincidental DMU connections came together in the past year to save one life and change others.

David Drake, D.O.'83, and Johan Aerts, D.O.'03, crossed paths again in Drake's kidney transplantation surgery.
DMU alumni Johan Aerts, left, and David Drake first met when Aerts was an osteopathic medical student; the two interacted in a much different way during 2014.

THE DECISION – Early last summer, David Drake, D.O.’83, wrote a letter to family and friends remarkably off the how’s-the-weather-what’s-new-with-you path.

“I just learned the surgery is a go…This is a pretty different surgery. I’m not sick and have no significant health issues,” penned Drake, a Des Moines family psychiatrist and clinical professor of psychiatry at DMU. “So what is it? I’m going to serve as a humanitarian kidney donor — giving my left kidney to someone I’ve never met.”

Not surprisingly, that decision met with a crowd of questions and concerns from loved ones. “Aren’t there other ways you can make contributions in your life?” asked one. “What if the person [receiving the kidney] is a scuzzball?” challenged another.

The process of donating an organ also is arduous enough to shake the intentions of even the most determined prospective donor. Rightfully, it’s an operation not entered into lightly, involving months of medical, social and psychological screenings and tests. Drake and his wife of 28 years, Claire Cumbie-Drake, had meetings with the transplant coordinator, surgeon, kidney specialist, transplant social worker, counselor and patient advocate connected to Des Moines’ Mercy Transplant Center. Because his father had suffered a severe stroke at age 76, Drake also underwent an extensive heart evaluation, including a treadmill stress test, an electrocardiogram test, a cardiologist consultation and a heart echocardiogram.

“You have doubts at many points all along the way,” Drake says now. “You learn of the many dangers of donating. But I did it first and foremost for myself. It added meaning to my life. I’d just turned 62 and was thinking about the kinds of contributions I’d made.”

The desire to make this significant contribution sealed the deal. On July 8, 2014, Drake willingly went under the knife — a knife wielded by one of his former students and fellow DMU alumni, Johan Aerts.

THE ORGAN – The pair of fist-sized kidneys that come standard in the human body filter the blood via their nephrons, removing wastes, controlling the body’s fluid balance and regulating levels of electrolytes. According to the National Kidney Foundation, these organs can lose function due to diseases such as diabetes and high blood pressure; inherited or congenital conditions; and ingested drugs, toxins and germs.

Many kidney diseases can be successfully treated, but when kidneys fail, the patient has three options: hemodialysis, in which the patient’s blood is pumped out of the body into a machine that cleans it; peritoneal dialysis, in which wastes are removed from the blood by a sterile cleansing fluid inserted via a catheter; or the transplant of a healthy kidney from a suitable donor. The latter is generally far more desirable yet elusive. According to the Organ Procurement and Transplantation Network of the U.S. Department of Health and Human Services, more than 100,000 people are on the nation’s waiting list for kidneys, far more than on the lists for livers, pancreases, hearts, lungs or intestines.

The good news is that success rates for kidney transplantation — while varying based on living versus deceased donor, age of recipient and other factors — are relatively high, ranging from 80 to 95 percent.

“Kidney transplant is considered life-saving. It’s about giving people hope and getting them off the dialysis machine, which is a brutal way of living,” says transplant surgeon Johan Aerts, D.O.’03, FACOS. “It gives people opportunities to return to full-time employment, travel and better quality of life with their families.”

Making such a huge impact on someone’s life was powerfully motivating to David Drake. Two events fueled his goal – a New Year’s Eve party in late December 2011, where Drake’s and Aerts’ paths crossed for the first time since Aerts’ days as a DMU student, and an extraordinary kidney transplant “chain” that occurred about one year later.

THE PARTYJacqueline Stoken, D.O.’90, a West Des Moines physician, throws an annual New Year’s Eve party with a special tradition: Celebrants toast the new year on Dec. 31 at 5 p.m., which is midnight Central European Time. In the final hours of 2011, her guests included Claire Cumbie-Drake and David Drake.

“From a distance in her large home, I heard, ‘Dr. Drake!’” he recalls. The shout-out came from Johan Aerts, one of Stoken’s neighbors who had been a student of Drake’s at DMU.

“We got reacquainted,” Aerts says. “He seemed very genuinely interested and fascinated by my journey.”

His journey includes a childhood in Belgium, participation in a high school foreign student exchange program that landed him in Algona, IA, and his becoming an organ transplant surgeon at Des Moines’ Mercy Transplant Center. It’s a place he’s proud to be. In October 2012, Mercy received Iowa’s only Medal of Honor Award at the Gold Medal level for transplantation from the U.S. Department of Health and Human Services. Even more remarkably, in January 2013, Aerts, his fellow transplant surgeon, Cass Franklin, M.D., FACS, and their colleagues performed 10 donation and transplant surgical procedures involving five living donors and five recipients. It remains Iowa’s largest-ever kidney paired donation chain.

“We did those 10 surgeries in three days. All that happened at a community hospital in Des Moines, Iowa,” Aerts says. “We’re providing cutting-edge services in transplant, including for people who have been turned down elsewhere.”

That set of successful surgeries and a three-kidney chain performed at Mercy in December 2013 received extensive media coverage, catching Drake’s attention.

“I began to realize that with good luck, good genes and taking care of myself, at best a third of my life remained,” he says. “I took this to heart and began to wonder what kind of contribution I wanted to make in my remaining years. Somehow the idea of becoming a live humanitarian kidney donor began to strike my interest. I called Dr. Aerts and let him know of my initial curiosity.”

While the number-one priority of Aerts and his colleagues was to ensure Drake — like all the living donors they accept — was “squeaky clean” health-wise, his ability to perform the surgery was particularly meaningful.

“He was someone who’d taught me medicine. To have a professor trust a former student — it was very rewarding to share that experience with Dr. Drake,” Aerts says. That was on top of the reward he reaps daily in his practice.

“Transplantation is very hard work, but it’s always about the patient and giving the patient hope,” he notes. “To cut a person open, remove an organ and put it into another person is quite a concept.”

Read part two in the Winter 2015 issue of DMU Magazine: Learn more about the Belgium-born surgeon and how his mother’s tragic death influenced his career; the supportive spouse behind David Drake’s decision to donate his left kidney to a stranger; and the main event — Drake’s surgery and its aftermath.

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