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Kevin Sack and the amazing kidney chain

Featured April 26, 2012
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Imagine this as a narrative:

A man’s child needs a kidney transplant. Despite successfully enlisting an organ donor, the man finds the U.S. transplant network frustrating and ineffective. To spare other families needless anxiety, he sets up an independent kidney registry (the only kind of registry in this country, since there’s no centralized database) and uses his background in quantitative mathematics and data management to build specialized software that matches “Good Samaritan” donors to potential transplant recipients.

One chain of transplants grows, person to person, across the country, to an unprecedented length. And yet if just one individual changes his mind along the way, the chain breaks and someone could die. So, buried in the man’s algorithms are the fates of potentially hundreds, even thousands, of people, given the country’s escalating diabetes rate and demand for kidneys.

That single-protagonist scenario of the man and his chain has built-in narrative potential. Does the man succeed? Does he ultimately fail? Where does the story crest? How is it resolved? Whose lives are affected? Oh, and it doesn’t hurt that the man is an ex-Marine − an ex-reconnaissance ranger − with a Wharton MBA, and that he’s “Disney-hero handsome.”

Kevin Sack might’ve taken that predictable storytelling approach with “60 Lives, 30 Kidneys, All Linked,” a New York Times story that we’ve been eager to name a Notable Narrative since it ran in mid-February. But Sack, a two-time Pulitzer winner who covers health care for the Times, decided on a more surprising protagonist: the transplant chain itself. Between the first and last surgeries we meet women and men who literally gave pieces of themselves to others, a transfer of life that started, improbably, with a confessed curmudgeon who one day simply decided he wanted to give a stranger a kidney:

What made the domino chain of 60 operations possible was the willingness of a Good Samaritan, Mr. Ruzzamenti, to give the initial kidney, expecting nothing in return. Its momentum was then fueled by a mix of selflessness and self-interest among donors who gave a kidney to a stranger after learning they could not donate to a loved one because of incompatible blood types or antibodies. Their loved ones, in turn, were offered compatible kidneys as part of the exchange.

The narrative engine in this piece is both procedural (what function or dysfunction of the country’s kidney-transplant situation contributed to this chain’s success) and personal (desperate people, literally dying for a break).

Policy narratives, like investigative narratives, often focus on paper trails and bureaucratic breakdown at the expense of human emotion. Yes, you have to document the dysfunction; yes, go ahead and FOIA your little heart out. But the narrative journalist’s other job – the equal, and equally difficult, job – is connecting that reporting to the human experience. It’s not enough to simply find a family or an anecdote that represents the subject matter and then book-end the investigation with a couple of poignant scenes. The human factor demands equal consideration and reporting time if the overall piece is to reach its greatest potential. Some explanatory-narrative writers may consider the human reporting the lesser work journalistically and therefore spend less energy on it, but as Sack’s piece shows, the human reporting is entirely the point.

Coming tomorrow: Kevin Sack talks with Storyboard about how he and his multimedia team pulled this story off.


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