Another kidney donor from the Freakonomics interview

Yesterday I got this cheerful email from Harry Huggins at Freakonomics, about another nondirected donor motivated to start a kidney exchange chain, after learning about them on Freakonomics:

"Hello Professor Roth,

I'm a producer at Freakonomics Radio. I just wanted to let you know that we've published a post on our blog about another listener inspired by your episode to donate a kidney. You can find it (the blog post, not the kidney) here: 

Another Kidney-Donation Story to Make You Smile

Hope all is well,

Harry Huggins
Managing Producer
Freakonomics Radio"

************

I now know of several donors who heard the original 2015 Freakonomics story on kidney exchane (Make Me a Match (Ep. 209)). The first was Ned Brooks (who writes about it at the link), and whose web page/organization Donor to Donor speaks about others.

And here are all my posts that mention Freakonomics, many of them (but not all) related to kidney exchange.

One kidney donor's journey

I recently heard the following story, by email from a recent kidney donor, who has given me permission to share it. It's lightly edited to preserve her privacy and mine, but I can't resist noting that her first name is Hope.

"Dear Professor Roth,

"Seven weeks ago today, I donated a kidney to a stranger in Minnesota.  Mayo Clinic sent me his email address this afternoon, just in case I want to contact him.  I'm not sure yet if I want to initiate communication but I certainly can't stop thinking about it.  It made me think about the Freakonomics episode I heard three years ago that started everything.  You know the one...

"When I heard the episode, I knew right away I wanted to become a living kidney donor.  I was 49 at the time. I never had children and my life felt incomplete.  Moreover, I lost my mother to cancer after a long battle, when I was just 14 years old.  I daydreamed about helping a child who had a sick parent so she doesn't have to go through what I went through. 

"My wife's cousin needed a kidney shortly after the episode aired.  I asked her if it was ok if I stepped up.  I played her the Freakonomics episode and she approved.  I reached out to her cousin Rick.  It turns out a few people volunteered and he got a direct match.  I felt defeated, which sounds selfish after such good news.  Then I heard a follow up episode that united a donor with his recipient.  Stephen Dubner was crying... I was crying... I called Mayo Clinic the next morning and signed up for testing.

"The rest is a long story and I know you are a busy man so I'll skip most of it.  I ended up being part of a pair, instead of an altruistic donor.  There was a man who worked with my wife that needed a kidney.  He once saved her life with the Heimlich maneuver so it was pretty poetic that I could save his.  He received his kidney from a bridge donor and I gave mine to someone on the diseased donor list.  So I got to save two lives!  I'm doing great.  I went back to work a couple of weeks ago.  I have no regrets and I hope I can inspire others to do something selfless and extraordinary in their lifetime. 

"I hope others have written to you.  I'm sure you see the statistics and know the impact of what you created with paired kidney donation.  I just wanted to make sure you hear some personal stories.  Life changing stories..."

A subsequent email exchange clarified some details:

"Hi Al!  I did all of my testing in May of 2016 to be a non-directed donor. I tested positive for Valley Fever and had to wait 90 days to be retested. The 2nd test was negative and I was approved but I was getting married in October so we put a hold on the donation. Mark came into the picture after that. He didn’t know about paired donation. We got him to switch to Mayo and we became a pair. He had lots of complications so I had to wait a long time. When he was finally approved, so much time had passed that I had to do most of the testing all over again. It took awhile to find me a match because I’m AB+. 

So a false positive Valley Fever test got Mark a kidney. 

I met Mark the day of his surgery. My wife and I were the first faces he saw. He was there the day of mine. He brought me flowers and a card from his kids. 

My team at Mayo Clinic were there for me the whole time. There was never any pressure and changing from non-directed to paired was seamless. They never discussed Mark. He had his own team. I was allowed to chicken out at any time. But I’ve never been so sure of anything in my life."
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And here are my posts linking to the Freakonomics shows that gave people so much of Hope.

Thursday, June 18, 2015

Freakonomics podcast on Who Gets What and Why

Make Me a Match: A New Freakonomics Radio Episode

Friday, February 26, 2016

A Freakonomics listener was inspired to become a non-directed kidney donor by the podcast on kidney exchange

Ask Not What Your Podcast Can Do for You

and this one (from huffingtonpost.com):

Saturday, May 6, 2017

A non-directed kidney donor speaks about his experience (which started with a Freakonomics podcast)

Ned Brooks: Donating His Kidney was Life-Changing. For Him.

Me and market design, in Forbes

Susan Adams in the August Forbes magazine (but online now) has a nice article about me and market design called (maybe for search engine reasons)" Un-Freakonomics: A Harvard professor uses economics to save lives, assign doctors and get kids into the right high school."

Here's the sentence I liked best:
"Leaning over a cup of Turkish coffee at a cafe across the Charles River from his messy journal-strewn corner office, he bends over backward to give credit to his younger protégés, students and coauthors. "Market design is a team sport," he insists."

If you want to see me bend over backwards while leaning over a cup of coffee, we'll have to have a cup of coffee:) But seriously, Ms. Adams got that part very right--lots of people have to do lots of things before a new marketplace is designed, adopted, and implemented. I'm very lucky in my colleagues.

The article title might suggest I have some sort of quarrel with Freakonomics, but that's not the case, although my work is very different. I recall reading Freakonomics and being full of admiration for the way it brought Steve Levitt's work to a general audience. I wouldn't mind doing that someday with market design, and maybe Ms. Adam's generous article will be a step towards making market design known to a wider public.

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Freakonomics MD on deceased donor organs for transplants

 Freakonomics MD has a podcast focusing on the scarcity of deceased donor kidneys for transplant, and why recovered organs are sometimes discarded. They interview (separately) Dr. Sumit Mohan at Columbia, and me. (I was in fact interviewed by Jessica Wapner, not by the narrator, Dr. Bapu Jena, using a fancy microphone which they FedExed to me beforehand and I FedExed back to them afterwards...so my snippets probably sound like me...)

You can listen to it right below, or at the link...

x  x

Why Do So Many Donated Kidneys End Up in the Trash? (Freakonomics, M.D. Ep. 11)

November 11, 2021 @ 11:00pm

by Dr. Bapu Jena
Produced by Jessica Wapner

  

LISTEN NOW:

Every year, thousands of people in the U.S. die while they’re waiting for a new kidney, yet thousands of available organs get thrown away. Bapu talks to a kidney doctor and an economics Nobel laureate about why this happens and how the system could improve.

Follow Freakonomics, M.D. on Apple Podcasts, Spotify, Stitcher, or wherever you get your podcasts.

Freakonomics podcast on Who Gets What and Why

Stephen Dubner came to visit me in Palo Alto to talk about my new book. He also interviewed some other people, including Ruthann Leishman who now manages one of the active kidney exchanges, at UNOS, but who I met when she helped launch the New England Program for Kidney Exchange. You'll also hear from an incompatible patient-donor pair who quickly found a match, and the nondirected donor who started the chain that worked for them..  We end the conversation over dinner...

(I haven't figured out how to embed the podcast itself, but you can listen to it if you click on the title below which will take you to the Freakonomics page for this show.)

Make Me a Match: A New Freakonomics Radio Episode

STEPHEN J. DUBNER
06/17/2015 | 11:00 pmPRODUCED BY: GREG ROSALSKY

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(Photo, cropped: Newtown Grafitti)

Our latest Freakonomics Radio episode is called “Make Me a Match.” (You can subscribe to the podcast at iTunes or elsewhere, get the RSS feed, or listen via the media player above. You can also read the transcript, which includes credits for the music you’ll hear in the episode.)

The gist of the episode: Sure, markets generally work well. But for some transactions — like school admissions and organ transplants — money alone can’t solve the problem. That’s when you need a market-design wizard like Al Roth.

Al Roth, an engineer by training, is a professor of economics at Stanford and won a Nobel in economics in 2012. (Roth shared the prize with Lloyd Shapley, whose research influenced Roth). What kind of work did Roth do to land the Nobel? It’s not the kind of thing that typically wins a Nobel. Roth has helped people who need a kidney transplant find a donor. He’s helped new doctors find their first jobs. He’s helped high-school students in New York City find the right high school – even though Roth himself, who grew up in New York City, dropped out of high school.

ROTH: I was, you know, a poor ungrateful student who didn’t appreciate what my teachers were trying to do for me. You should tell all your listeners they should complete high school.

Roth has also just published a very fine new book that is a great survey of his work — and his worldview, which is just as impressive. It’s called Who Gets What—and Why: The New Economics of Matchmaking and Market Design In the podcast, I visit Stanford to speak with Roth about market design, what’s it’s like to get that middle-of-the-night Nobel phone call, and why the world needs an economist-engineer like him in the first place:

ROTH: Matching markets are markets where money, prices don’t do all the work. And some of the markets I’ve studied, we don’t let prices do any of the work. And I like to think of matching markets as markets where you can’t just choose what you want even if you can afford it — you also have to be chosen. So job markets are like that; getting into college is like that. Those things cost money, but money doesn’t decide who gets into Stanford. Stanford doesn’t raise the tuition until supply equals demand and just enough freshmen want to come to fill the seats. Stanford is expensive but it’s cheap enough that a lot of people would like to come to Stanford, and so Stanford has this whole other set of market institutions. Applications and admissions and you can’t just come to Stanford, you have to be admitted.

You’ll hear how Roth and others have revolutionized the organ-donor market, and we hear the amazing story of how one particularly selfless woman kicked off a donor chain that gave life to many others. And you’ll also hear Ruthanne Leishman, from the United Network For Organ Sharing, talk about  the organ-donor algorithm developed by Roth and his colleagues:

LEISHMAN: It’s saving a lot of lives. We have about 600 kidney-paired donation transplants a year right now in the United States. In 2000, we had 2. … We would have stayed doing 2 or 4 or 6 a year without the algorithm.  

The next time you hear someone say that economists are a bunch of selfish good-for-nothings, feel free to counter by telling them about the fine work of Al Roth.

NPR's Marketplace: Ryssdal interviews Dubner about his newest Freakonomics podcast--the four minute version

An algorithm that matches kidney patients and donors

The link above will take you to the four-minute version of the fifty minute Freakonomics podcast in which Dubner interviews me about my new book.

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Doctors from Johns Hopkins Hospital in Baltimore, Maryland, transplant a kidney. 

Interview by Kai Ryssdal, Interview with Stephen Dubner

Wednesday, June 17, 2015 - 14:49

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Matching markets are markets where money isn’t allowed to do what it usually does. For example, school admissions — colleges don’t just raise the tuition price until demand meets supply. Or how new M.D.’s get assigned to their residencies — they can’t just buy their way into the hospital they want. In each case, you have to find a way to match a candidate with an available slot.

You also can't buy a kidney, or pay for somebody's college education to get a kidney, or purchase a car for them in exchange of a kidney.

So how can you make a market for something that is indivisible and can’t put a price on? Al Roth, a professor of economics at Stanford, realized that this model could be adapted to help kidney patients find a potential donor.

"Let’s pretend you and I, Kai, we both need a kidney transplant. And that both of us have a relative who’s willing to donate one, but your relative is not a biological match for you and mine isn’t for me," says Stephen Dubner, author of "Freakonomics." "Wouldn’t it be awesome if you could enter all your data and all of the donor's data into some algorithm that could magically sort these data from all the transplant centers in the country and match up donors and patients?"

Roth’s algorithm has helped save a lot of lives. Ruthanne Leishman from the United Network for Organ Sharing says the United States has about 600 kidney paired donation transplants per year right now. In 2000, the U.S only had two.

Featured in: Marketplace for Wednesday, June 17, 2015

About the author

Kai Ryssdal is the host and senior editor of Marketplace, the most widely heard program on business and the economy in the country.

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Incentives and mis-incentives in science (Freakonomics part II)

 Freakonomics has a second post on fraud in science, and you can listen or read the transcript here:

Can Academic Fraud Be Stopped?

Two quotes stood out for me:

1. VAZIRE: Oh, I don’t mind being wrong. I think journals should publish things that turn out to be wrong. It would be a bad thing to approach journal editing by saying we’re only going to publish true things or things that we’re 100 percent sure are true. The important thing is that the things that are more likely to be wrong are presented in a more uncertain way. And sometimes we’ll make mistakes even there. Sometimes we’ll present things with certainty that we shouldn’t have. What I would like to be involved in and what I plan to do is to encourage more post-publication critique and correction, reward the whistleblowers who identify errors that are valid and that need to be acted upon, and create more incentives for people to do that, and do that well.

...

2. BAZERMAN: Undoubtedly, I was naive. You know, not only did I trust my colleagues on the signing-first paper, but I think I’ve trusted my colleagues for decades, and hopefully with a good basis for trusting them. I do want to highlight that there are so many benefits of trust. So, the world has done a lot better because we trust science. And the fact that there’s an occasional scientist who we shouldn’t trust should not keep us from gaining the benefit that science creates. And so one of the harms created by the fraudsters is that they give credibility to the science-deniers who are so often keeping us from making progress in society.

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Earlier:

Sunday, January 14, 2024

"Why Is There So Much Fraud in Academia?" Freakonomics interviews Max Bazerman and others

Freakonomics replay and update on kidney exchange and organ donation

 Freakonomics Radio yesterday revisited some of their old podcasts about kidney exchange. In one, they interview me, and in another, they interview Ned Brooks, who listened to that interview and went on to become a non-directed kidney donor and to found an organization to support other kidney donors, the NKDO, National Kidney Donation Organization.  You can listen and/or read the transcript at this link:

EPISODE 209

Make Me a Match (Update)

"Sure, markets work well in general. But for some transactions — like school admissions and organ transplants — money alone can’t solve the problem. That’s when you need a market-design wizard like Al Roth. Plus: We hear from a listener who, inspired by this episode, made a remarkable decision.

"Last month, the federal government announced plans to modernize the U.S. organ-donation system. They want to speed up the process by which organ-transplant patients are matched with donated organs, and they also want to reduce racial inequities in the system. When we saw this news, we decided to go into our archive and put together the episode you’re about to hear. It’s a mashup of a 2015 episode, No. 209, called “Make Me a Match,” and a portion of a 2016 episode, No. 237, which includes a personal story from a listener who was inspired by that earlier episode to make a remarkable decision. All the relevant facts and figures have been updated. As always, thanks for listening."

***********

Here are my previous posts on Freakonomics episodes.

A non-directed kidney donor speaks about his experience (which started with a Freakonomics podcast)

Here's more on Ned Brooks, the non-directed donor who heard about kidney exchange chains on a Freakonomics podcast:

Ned Brooks: Donating His Kidney was Life-Changing. For Him

“The concept of leverage was absolutely the driver for me, “ recalls Ned. “The idea that my one wholly redundant kidney could impact multiple lives, not just the patients themselves but their children, their parents, was huge.”

And the idea of starting a kidney donation chain touched his competitive side: “How many lives could my kidney donation impact?”
***************

See my earlier post

Friday, February 26, 2016

A Freakonomics listener was inspired to become a non-directed kidney donor by the podcast on kidney exchange

"Why Is There So Much Fraud in Academia?" Freakonomics interviews Max Bazerman and others

Below is the latest Freakonomics podcast (and transcript), on fraud in academia.  Those most in the headlines weren't available to be interviewed, but their coauthor (and my longtime HBS colleague) Max Bazerman gives his perspective.

Also interviewed are the Data Colada authors/data sleuths Leif Nelson,  Uri Simonsohn, and Joe Simmons (with some clues about the name of their blog), and Brian Nosek, who founded the prizewinning Center for Open Science (https://www.cos.io/ 

Here it is:

Why Is There So Much Fraud in Academia?  Some of the biggest names in behavioral science stand accused of faking their results. Freakonomics EPISODE 572.

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And here are two paragraphs from Max's HBS web page (linked above), suggesting more to come:

"I have been connected to one of the most salient episodes of data fabrication in the history of social science – involving the signing first effect alluded to above. I am working on understanding all known social science frauds in this millennium. Social science also struggles with a broader problem, namely the fact that many studies fail to replicate due to faulty research practices that have become common in social science. Most replication failures can be traced back to the original researchers twisting their data to conform to their predictions, rather than from outright fraud. Trying to produce “significant” results, they may run a study multiple times, in a variety of ways, then selectively report the tests that worked and fail to report those that didn’t. The result is the publication of conclusions that do not hold up as accurate. Both problems – outright data fabrication and this reporting bias that shapes results – need to be tackled, so all of us in academia can publish results that are replicable and can help create value in society.

         "The last dozen years have witnessed multiple efforts to reform social science research to make it more credible, reproducible, and trusted. I am writing a book on reforming social science, which will provide an account of recent data fabrications, and highlight strategies to move forward to create more credible and impactful scientific research."

Followup on the latest Freakonomics kidney exchange chain

Earlier this month I blogged about a kidney exchange chain at Virginia Mason Hospital, in Seattle, initiated by a non-directed donor who had heard an interview about kidney exchange on Freakonomics.  Subsequently, my colleague Elena Cryst, whose dad is a transplant nephrologist at that hospital, sent her the email below about a short talk he'd prepared, which they have given me permission to reproduce with minor edits. (They also note that "the participants OK’d sharing this so no HIPA violations.")

Dr. Cryst writes:

"I’m a transplant nephrologist, and  I’m  sharing this story on the insistence of these four patients who want to get their story out and encourage others to participate in organ donation and increase the options for kidney transplants in our country”

This is a photo of 4 people – I hope you can see them as you read this.

Three out of four of these folks in the picture just so happened to have appointments in my Monday AM clinic.  I’ve been taking care of kidney transplant patients for thirty years, but by the end of clinic, I was astounded by seeing how much this meant for each one of them and the different reasons why.  As this morning went on I heard this story from three of the four points of view.  It very much took me by surprise how much had changed for all four.…  It was just another day in the office, but this story is striking and they all wanted to share it with everyone in hopes more people can receive transplants.

THE PHOTO: 

THE STORIES:  First with hat on backwards is DC my patient.  A naturally shy and private person.   Happiest I’ve seen him in three years but has had many disappointments.   It has been an emotional roller coaster, as three years ago he thought he was passing a kidney stone- only to learn he had an advanced kidney disorder and soon would either need to get a transplant  or start on dialysis.  There had been lots of struggles to get to the point of transplant…. one by one, donors came forward but were disqualified due to minor health issues.  Finally one did  get through testing and qualify to donate, only to find out she was not a match.  He was devastated again.  After working with our program, we were poised for a paired donor exchange but with time running out…we needed a non-directed donor to step forward.  If someone could donate for DC, his donor would give a kidney for the next person on our waiting list and he would not have to start the process of dialysis. 

Next to DC’s left is Steve, healthy tugboat pilot who commutes to his home inland and on the way listens to lots of podcasts.  Freakonomics Radio had one about Al Roth, a Nobel prize winning economist at Stanford who researches how to create markets for things that don’t have a price.  He was the economist who worked to redesign the resident matching program to accommodate couples in the 1990’s and was fascinated by the challenge of how to allocate kidneys from live donors.  This is another problem of how to make a market for something that could not be exchanged for cash.  He and colleagues designed the system and did the math.  And won the Nobel prize!  Steve caught on to a few facts in the story – like the huge number of potential living donors in this country, and the benefit that could be afforded to those waiting for a kidney from a deceased donor.  The fact that the number of such paired donor exchange transplants has grown from only 2  in 2000 to 1000 in 2018, and said sign me up.  His generosity and courage started this chain of events.  Al Roth’s work is changing the way we are doing kidney transplants at my hospital and bringing in more and more living donors together with recipients they don’t know. The process was hugely important to Steve and it was icing on the cake that he was able to meet DC after it was done.  They all mutually agreed to make the process open rather than confidential which was their personal choice.

Next is Debbie from Ukqiagvik Alaska (formally Barrow)  – the literal ‘end of the earth’ the northern most point in the USA above the arctic circle in Alaska.   Debbie is an Alaska native who toughed it out with barely enough renal function for many  years but time was running out for her as well.  She was at the very top of the waiting list and she was waiting for a deceased donor kidney at our far away transplant center. The logistics of urgent travel to a faraway city fast enough to get a kidney transplant from a deceased donor -- while the clock was ticking -- made it much more better for her to have a living donor transplant that could be scheduled.  As you can tell Debbie has been delighted with her new kidney.  She is a long way from home for a few months, but enjoying the challenges of being in the city, even trying foods not part of her diet - like cucumbers (“not my favorite” she says) - not often available above the arctic circle!  She is here with family for a few months recovering and adapting to having normal kidney function again.

Next is Wendy – Journalist, community organizer and friend of DC.  She did gently insist that he let her get tested to donate.  He was apprehensive and certainly did not want to ask her.  But, as usual, Wendy prevailed.   In exchange her kidney went to Debbie who now feels better than she has in years.  Wendy is being ‘adopted’ by the women in Ukqiagvik and in clinic that morning, she was wearing the traditional hoodie blouse with big pockets that Debbie’s sisters back home had specially made for Wendy.  She is thinking about how to make the trip up north to see her new family of friends.  It was Wendy who also gently admonished me for not doing a better job of telling our story to others.  She strongly felt that we need to point out that her life and Steve’s are forever changed for the better - -  as well as the obvious benefit for DC and Debby. 

Although this is the kind of work we do every day, we would like to do many more living donor transplants for people and take more people off the waiting lists and out of the dialysis units.  There are a lot of moving parts and a lot of people who contribute, but we can scale it up.  The more scheduled procedures we do, opposed to deceased donor surgeries which are by necessity emergency surgeries, the greater our impact  can be. Each living kidney transplant also frees the deceased donor kidney to go to someone else - in effect doubling the benefit.  Thanks to Al Roth, there is now a new market for getting our willing donors together with recipients they do not know.  We always respect privacy and our default is to keep this process of ‘entering the market’ safe and anonymous.  But, as in this case, the participants can decide to share their experience, meet each other and . . . as Wendy said, “get the word out.”   In fact this photo captured the moment after surgery where this group organized a first meeting on their own and went off for lunch.  As a kidney transplant physician, I know we have the systems in place to grow this work.  Facilitating living kidney donation benefits not only more recipients, but it positively  changes lives of these donors.  It really positively affects lives of everyone involved. . .even the doctors like me…and I bet even the economists! 

Cyrus Cryst MD FASN