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May 13, 1998

The Positive Aspect of Tragedy: A Matter of Perspective—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(18):1441. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-18-jac80006

In Reply.—Dr Friedman raises an extremely important point. Surely, we each have a desire to see some good come from the tragedy we experience—life from death. As a transplantation specialist, Friedman has insight into this case that adds a new dimension. I honestly do not recall whether the patient's organs were donated or not. Her death occurred more than 5 years ago and perhaps because of my own paradigm, transplantation was not my take-home message.

In retrospect, this patient with basilar artery thrombosis deteriorated over a 24-hour period to a locked-in state, except for 1 part of her body—her hand. Her husband was flying in from another state to be with her before she died. When he arrived, although the patient could not speak, they communicated by sign language. She died only hours later.