The Goralski family

Mark Goralski headed out the door almost every Thursday evening to go to prison. He spent years as a volunteer at the Warrenville Youth Corrections Center in the suburbs of Chicago, befriending and mentoring young people who had been swept into the juvenile justice system. The stories of incarcerated youth became part of the fabric of his family’s life. “It was important to him that we came to the prison,” reflects his son, Josh. Alongside his two sisters, Hannah and Bethany, and Peggy, their mother, the whole family would attend theater productions put on by inmates, showcasing the possibilities of a better world—one where mutual support and compassion can heal great pain.

It was just one small example of the symbiotic relationship between their father’s undue burden and the ideals that guided him. “His volunteerism was spurred by some of his health issues,” says Josh. “Suffering resets your priorities in life.” Mark passed away in 2018 at 57 years old from kidney failure, in need of a second transplant, after a health battle that lasted the majority of his life. Diagnosed with Crohn’s disease in his late teens, he ended up having part of his colon surgically removed. Starting in his 40s, this led to numerous complications with calcification in his kidneys, including kidney stones and IgA nephropathy, an autoimmune condition that severely hampered his kidney function. Josh donated a kidney to his father in 2011, temporarily restoring some health, however, even this could not stop the forthcoming decline.

But Mark’s death is not remembered tragically by his loved ones. Instead, his health challenges inspired a selfless altruism that has permeated to his children—all three of whom became living organ donors. Less than a year after their father’s passing, Bethany and Hannah donated their kidneys, one day apart, to total strangers. Their actions helped start a donor chain which sparked subsequent donations and raised awareness about the shortage of available organs for those in need. Mark’s legacy lives on as inspiration that arose from a mire of difficult circumstances.

Bethany, Josh, and Hannah gathered outside the building where much of Mark’s journey unfolded: Northwestern Memorial Hospital in downtown Chicago on a late-summer day. The building holds a mix of memories, and they reminisce freely about their father’s life, and their own progress in the world. Bethany in particular, now 27, really bonded with her father over his sickness. “I would tell him that being sick was both the worst and the best thing that ever happened to me. I became a nurse because of the experiences that he was going through.” She now works in the same hospital in the MICU as an RN, and was privy to many of her father’s challenges toward the end of his life, alongside her colleagues and medical professionals.

The milieu of the hospital was familiar to the siblings growing up, as were the realities of surgeries, complications, and convalescence. “I remember my mom picking me up from elementary school and going straight to the hospital to see him,” reflects Bethany. “It was all very normal to us as young kids.” Spirits remained high throughout Mark’s journey, in large part due to his own optimism. “He always asked, ‘how are you?’ He never complained. He never wanted anybody to feel his suffering. He always had a positive attitude about it.”

For Mark, having his wife and kids with him through the journey, helped bolster his spirits. Peggy remained a solid pillar of support, bouncing between work, home, the kids, and the hospital while reaching out to others when she needed help. “She really sacrificed a lot during his hospital stays,” says Josh. She regularly found friends and extended family to take care of the kids while she stayed with Mark overnight countless times. “She gave everything to him and supported us too,” adds Josh.

However, by 2010, in the siblings’ teenage years, it was clear that Mark’s kidneys were damaged beyond repair. That Christmas he told the family that he would need a transplant to survive. Josh, 18 at the time, felt compelled to act. His instincts took hold, and he scoured the internet for more information about kidney donation. He learned that a living organ donation would likely yield the best outcome. “There was no other response… I told him, ‘I’ll do this Dad,’” Josh recalls. Mark was reticent at first to accept his son’s offer, but warmed up to the idea in the months to come. That autumn, Josh began attending university, but his mind stayed focused on the possibility of helping his dad in this unique way.

Josh’s kidney was a strong match and Mark’s physician scheduled a transplant for the following winter. The whole family rejoiced. However, at their final antibody check, they were found not to be a compatible match and the operation was postponed. “That was the worst Christmas ever,” remembers Josh. “But my dad took it in stride. I took it harder than he did.” Through a process called plasmapheresis, physicians were able to remove Mark’s incompatible antibodies, to make Josh’s kidney a good match.

To everyone’s relief, the transplant was scheduled during Josh’s upcoming spring break. In March 2011, father and son entered the transplant ward at Northwestern University Hospital. After surgery, Mark awoke with a new, healthy kidney and was cleared to return home in only 48 hours. As much as the procedure changed Mark physically, it transformed his family in many ways. “I felt like I was giving life back to the person that gave me life,” Josh reflects. “The bond between my dad and I—we were already close—but this strengthened it so much.” He recovered quickly and returned to school in ten days. With renewed optimism, Mark also recovered well at home.

Soon Bethany went off to college, leaving Hannah, the youngest, at home with her parents. “I felt really lucky to get to hang out with my dad during some of his good days,” she says. The next three years marked a relatively stable time for Mark. The kidney took well, he gained back energy, and was able to work again.

In 2014, Mark’s recovery was dealt a serious blow when his transplanted kidney got a kidney stone. Things were further complicated in 2016, when Mark started running a fever that would not break. It turned out to be pneumonia which raged on for six weeks. Then, that October, he got a brain abscess, an infection likely caused by anti-rejection medications. All the while his kidney functioning was declining. His creatinine levels began to soar, and his doctors found his kidneys were functioning at 50% capacity. “He still had Crohn’s through all this,” says Bethany. “His kidney and his colon weren’t working. He started losing a lot of weight. At one point, he was 95 pounds.”

In 2015, The day before Bethany started her first day as a nurse at Northwestern Memorial Hospital, Mark was admitted there, suffering from an opportunistic infection. “His room was only two floors away from where I worked,” she recalls. “So I could visit him easily.” The infections and illnesses became more and more frequent over the next two years. Mark started undergoing dialysis regularly in 2017, as his kidney function dwindled. “We knew that he needed another transplant; that would solve a lot of his issues,” says Bethany. It was painful knowing that she was in fact a good donor match, but Mark simply never got healthy enough to undergo another transplant. “For every two steps forward, it felt like he took three steps back,” adds Josh.

The situation was changing as a more permanent malaise set in. Mark was admitted to the hospital eight times in his last nine months of life. “His final admission was at the ICU in which I worked,” recalls Bethany. Mark’s blood pressure had dropped dangerously low. He was on dialysis and suffering from malnutrition. Questions swirled: Would he be intubated, put on a respirator, what lengths would he go to continue on? “I really trusted the people in the ICU,” says Bethany. They were her colleagues who she had now worked with for over three years. “They told me that he wasn’t leaving the hospital, unless he was on hospice.” After decades of living in and out of the hospital wards, Mark was coming home one last time.

“It was a very special time,” reflects Hannah. She called out of work, and along with extended family, camped out at the family’s home in Naperville, IL. “We had all the right people there at the end,” says Bethany. Friends and neighbors dropped by to say goodbye to a man that touched many lives, and made a difference in his community. “For years, we had given him the strength to hold on,” says Josh. “We finally told him, ‘we are ready to let go.’” Less than five days after coming home, Mark passed away on September 23th, 2018.

“I wanted to take the worst thing that ever happened to me and make it into something beautiful,” says Bethany. As grief rippled through her family, she hatched a plan—to again transform her pain into something positive. “I always told myself I was going to be a donor in my 40s, after I have kids,” says Hannah. “But I knew people were dying. I knew there weren’t enough donors. I knew that I could help someone who needed life now and I hope that by the time I am 40, there will be new options so that organ shortage won’t still be a problem.” So rather than waiting, she signed up, along with Bethany, to do the same—in honor of their father. “Hannah and I have always been best friends. It just made sense to donate our kidneys together.” In that moment, a new and deeply enduring bond was formed between them.

That March, the sisters donated their kidneys in successive surgeries. It was an intentional act in hopes of inspiring new donors, and the press took notice. Their story made its way through social media and into the headlines. They were featured on the website for Good Morning America, to take their message to a national audience. That June, Northwestern shared their story and allowed them to meet their donor chains.

Promoting organ donation seems natural to Josh, Bethany, and Hannah. It is something they talk about with modesty and sincerity, knowing that through sharing their story, they can convince other young adults to donate as well. “Being in the medical field, you would think people would be inspired to donate,” says Bethany. “But it’s only the people that have seen their loved one receive an organ transplant—who have a personal connection—that realize how important a living donation is. You see someone waiting for a miracle, and then it happens. It changes them.”

“We’re involved in transplant groups, but I don’t hear much about artificial organs,” says Hannah. While she and her siblings advocate for more donations, they also share hope in technological advancements such as xenotransplantation to help solve the organ shortage crisis. “That would just solve so many problems and be a game changer. People are dying. If there is a way to save them, we should figure it out.” “I think more people need to hear about it,” says Bethany. “And people need to keep sharing their stories.”

The Goralskis are a family forever changed by their experiences of loss. The vitality that Mark instilled in his children lives on through his family’s continued advocacy for more donation and innovation in the transplant field. It is a small contribution when compared to the organ donation shortage felt around the world, but no less valuable. To the Goralskis, each donor has the ability to save a life, to renew hope, and to stoke more acts of kindness. “I have watched a lot of people die while waiting for an organ transplant,” says Bethany, reiterating her maxim. “I tell people to donate. I would do it again if it wouldn’t kill me.”