Heather Cox and Cara Connelly were friendly in high school in Berkeley Heights, N.J., but lost track of each other as careers and family took over. Three years ago, they reconnected on Facebook and became even better friends than they were before. Both 47, both are divorced and have tweens and teens. And both live in towns south of Boston, Cox Smith (her married name) in Mansfield, Connelly in Dartmouth, and they get together for coffee, dinner, or an occasional road race.
Connelly, a freelance writer and substitute teacher, was diagnosed with multiple sclerosis in 2003. She was doing well until last spring when the medication she had been on for several years caused kidney damage.
"I found myself staring down the barrel of a transplant and on dialysis," says Connelly, the mother of three. "I was in the hospital for 28 days, had two kidney biopsies, a bone marrow biopsy, 12 blood transfusions, a bleed-out that put me in emergency surgery and ICU for four days and left me with a hematoma the size of a melon."
Diagnosed with cancer, she left the hospital at the end of May and in August began chemotherapy for multiple myeloma. "Heather came to see me in ICU and when I was hooked up to dialysis, would sit with me for hours," Connelly says. "Without batting an eyelash, she offered me her kidney."
Cox Smith: "I knew we were the same blood type, and dialysis is so difficult. I can't imagine having to hook up to a machine for four hours, three times a week like Cara did."
But Connelly was no longer a candidate for a transplant. She had regained some kidney function and was undergoing chemotherapy.
And then Cox Smith read a Facebook posting about a 19-year-old graduate of a women's high school who needed a kidney. Inspired by what Connelly was going through, she raised her hand.
Because the teenager was getting her medical care at Mount Sinai Hospital in Manhattan, that's where Cox Smith went for her workup: interviews, blood draws, and tests. She took time away from two jobs and two kids.
Then the unthinkable happened: A couple of days before the transplant, the young woman and her parents turned down the amazing offer of her healthy kidney. "They said they wanted a younger donor. They said they wanted to wait until summer," Cox Smith says.
She was, understandably, shocked but not deterred. She told the transplant team to please find her someone else who needed a kidney. "We found a wonderful man," she says. "He's 51 years old, from Long Island, and had been struggling on dialysis for five months."
About 110,000 people in the United States are awaiting a kidney transplant, says Dianne LaPointe Rudow, director of the living donor program at Mount Sinai. "Heather is a special lady who did an amazing thing," she says. "I wish more people would do it. There are not a lot of family members who can donate because of medical reasons. She was able to save someone's life."
Mount Sinai officials note that New York state has the lowest percentage of registered organ donors in the country, with 24 percent of New Yorkers enrolled in the registry compared with a national average of 50 percent. Every 18 hours, someone in New York dies waiting for an organ transplant, most of them kidneys.
Studies show that a transplant from a living donor, compared with a deceased donor, works quicker and lasts longer. Last year, almost 29,000 kidney transplants were performed in this country, but only 5,800 came from living donors. Of the 5,733 living donors in 2013, only 177 were stranger donors -- or "unrelated anonymous donors" -- such as Cox Smith, according to the National Kidney Foundation. Hospitals and organ banks are seeking to change that through awareness and education, and say that donors like Cox Smith are their best ambassadors.
Her transplant took place on March 19, and she was released from the hospital on March 21, staying a week at her brother's in Manhattan to recover. She got to meet the recipient, a Korean man whose new kidney began to function immediately.
First, she met his wife and daughter. "You can tell him that he can celebrate St. Patrick's Day next year because he's got some Irish in him now," she quipped.
The wife replied: "And you can now tell people you've got Korean relatives."
Two weeks after the surgery, Cox Smith returned to her job at EDS Group, a Mansfield package design, production, and testing company. She also waitresses two nights a week at Jimmy's Pub. This week, when she is able to lift trays again, she will return to the pub.
"She is a wonderful, selfless, giving, spiritual, and kind person," says Connelly. "I am proud to call her my friend."
Cox Smith downplays the enormity of her donation to a perfect stranger, and says she isn't worried that she herself someday might need a kidney: "It's very rare that someone who donates one needs one. And God forbid if something happens, I go right to the top of the transplant list; that's part of the protocol."
Her two children, an 18-year-old son and 12-year-old daughter, were supportive, as was her fiance, Bill Foley of Quincy, who proposed on Valentine's Day. What if any of them ever needs a kidney? "The chances of people needing one are very slim," she says.
Heather Cox Smith did more than save one person in end-stage kidney failure. Her donation is triggering a three-way chain, with her recipient's wife preparing to donate a kidney to a stranger this week, and that recipient's wife in turn donating to someone else.
"I feel great about it," says Cox Smith.
Bella English lives in Milton. She can be reached at firstname.lastname@example.org.