Monday morning. 6:40am. Shawn, his wife Melissa and I walk from the hospital hotel where we stayed the night to the hospital around the corner where Shawn is about to donate his stem cells. He’s a donor through Be The Match, a national bone marrow registry, that matches donors to people in need. 

In 2012, a friend in Shawn and Melissa’s town found out she had Non-Hodgkins lymphoma and needed a marrow donation. A benefit was held in her honor to help raise money for her family, knowing she and her husband would need some time off work. Representatives from Be The Match also attended the benefit so that guests could become part of the registry to donate life-saving bone marrow. Shawn, and a majority of the guests that night, joined the registry hoping to help. Although he was not a match for this friend, Shawn found out in 2014 that he was a match for someone else. In March of 2014 Shawn donated stem cells to his match.

After his donation, Shawn continued to be a part of the Be The Match registry of donors. In 2018, Shawn found out he was a match for another individual. He later received a letter saying that the donation was cancelled. In April 2019, Shawn received a call informing him that the donation request had been reinstated and asking if he would be willing to donate again. He was.

In May 2019, Shawn headed to Boston to get checked up. In this process he saw a doctor who asked lots of questions regarding the current state of his health. Do you have any physical pain? How are you sleeping? Are you allergic to anything? Shawn’s blood was drawn for testing and his veins were checked for the arduous process of donating cells. 

After this appointment a donation date was set for mid-June.

 In-between these dates, Shawn had a visiting nurse stop by his home to give him injections once a day for the four days leading up to the stem cell donation. These filgrastim injections increased the number of blood-forming cells (blood stem cells) in his bloodstream.

 In mid-June, Shawn and Melissa arrived to Boston late on a Sunday evening. They live less than two hours west of Boston and they had an appointment at 7am so it made sense to stay overnight. Quickly falling asleep after arriving, they slept until 5:45am. We arrived at the donation center just before 7am. Upon arrival, Shawn was taken to the donation room where he received an intake line and IV. Here, Shawn’s blood circulates out through an incredibly impressive machine called a Spectra Optia apheresis system. This machine pumps the blood out and separates the stem cells. Then, through a direct line, the blood is put back into Shawn.

 In this section of the hospital there are seven bays where people donate cells for matches or to themselves. Each space is about the size of a small bedroom, with a divider wall, computer monitor that can swivel from the wall and windows that we can see out of, but no one can see in. Since we were on street level it’s quite a fishbowl to gaze out of all day. There are three to four other people donating this day, and each have a bay or two in between them so it feels like we are here by ourselves.

 The process of watching the donation is fascinating. There are a series of knobs that spin counterclockwise on the apheresis machine processing Shawn’s blood. The top knob is the largest but spins at a moderate speed. Two smaller knobs at the bottom spin faster and then two on either side spin slower than the rest.  We watch the deep red blood enter the clear plastic plate on top of the machine. The blood processes through various shaped boxes and lines and it becomes a lighter color as it moves and the stem cells are separated from the blood. The machine shakes vigorously as it processes Shawn’s blood.

 The nurse gets an alert on her phone hourly. When she hears it, she rolls her chair over to the machine and photographs the screen. She then rolls back to her computer and types in the stats for that hour. She tracks the process for the entire visit, which so far had been about three hours.

 There are a lot of questions every few hours from the nurse; Do your hands tingle? How about your face? Does anything hurt? Shawn’s answer is always no.

 While Shawn sits for hours we can all see an empty bag attached to the top of the machine fill with stem cells and red blood cells.

 As I look down into the machine where a strobe light and 4 cameras track the plasma pump speed to make sure the process is continuing as it should. It’s a small hole about the size of a half dollar with plastic covering the top. It looks like a lightning storm.

 It’s 12:58pm and Shawn is just starting to fall asleep. He twitches every so often. Enough that his wife grabs his foot and places it in a better position on the chair so his leg doesn’t hit the floor. 

Shawn’s been hooked up to the machine since about 8:55am but really didn’t get going until about 9:30. There was a struggle to get connected to his veins. At one point three nurses walked in the room to verify he had his veins checked on his last trip to the hospital. They try a few times before they safely access the vein in his right arm. In his left arm, just above the top of his wrist is his intake line. As the blood is drawn, it heads to the Spectra Optia apheresis system. Once the red blood cells and stem cells are moved to the bag they’ll be transported in, the blood is then sent through a plastic tube. This tube is wrapped 11 times around a circular device about 3x5 inches. It’s a heater. His blood is then heated up and the intake line brings the warm blood back into his body.

It’s now 3:52PM 

Shawn and Melissa are both lightly napping. Shawn has one headphone in, listening to a book. When I ask which one he says “a silly one. I can’t remember.” He closes his eyes and moves his feet to either side of the lounging chair. Melissa opens her eyes and re-adjusts herself in the chair. “I wish I had a pillow,” she says. At this point they have been awake for 10 hours.

30 minutes to go.

“Two minutes to go and then we collect your plasma” says the nurse. Collecting the plasma extends the life of the product she says. The product here being Shawn’s stem cells.

 And now, we are finished. Shawn has both lines disconnected from his arms. He is smiling from the freedom as he stretches and gets out of the chair he’s lived in for nine hours.

 Waiting outside the room is the volunteer courier who works with Be The Match. She is waiting for the nurse to finish taking notes and checking that all the paperwork is in order for the stem cells to be transported. She checks her phone every couple of minutes to make sure she can still make the flight that’s been booked for a few hours from now. Shawn’s stem cells will be in another human’s body in less than a day.

I later ask Melissa “what do you find the most interesting about this process?” She says “What I don’t know I find most interesting. What’s going on and the whole process we won’t see.  I’m grateful for that. How the patient feels, what their families going through. It’s intriguing.”

I ask Shawn the same, and he tells me “I guess the matching process is the most interesting to me. How they find people to match via DNA. How rare it is to be a match. All of that.”

I contacted Be The Match while working on this project to ask how common it was to be selected twice and donate to two different people. They informed me that only 4% of individuals donate twice and only 2% of donors will give to two different patients. Shawn is in a pretty special group of humans.

Melissa was with Shawn the first time he donated stem cells five years ago. A nurse at the time informed her that once the recipient received Shawn’s stem cells they would be Shawn’s blood type, not the blood type they were born with. The recipient will also have two sets of DNA.

 Be The Match conducted its first transplant in 1987. To-date they have facilitated 92,000 blood stem cell transplants. If you are interested in supporting this organization or saving a life by donating your bone marrow, you can learn more at their website: Be The Match Registry