KEY POINTS:
On an autumn day in the Auckland suburb of Parnell, a 50-something Maori man meets, for the first time, a Pakeha woman in her late 30s.
She lifts her hand and rests it on his chest and, upon feeling his heart beating strongly within, she cries.
Three years earlier
For once Robbie Stewart doesn't have an early start.
Usually he'd get up well before dawn but on this particular Tuesday his job as an abseiling window cleaner isn't due to get started until around 7.30am. He leaves his wife Helen to sleep in - she's 10 weeks pregnant, though they're keeping that secret until they pass the three-month mark - and gives his 22-month-old daughter, Kathryn, her breakfast while she sits on his lap.
As the time to leave approaches, he makes a cup of tea for Helen, hoists Kathryn up and takes her to her mother. He pops Kathryn into the bed then kicks off his socks and shoes and joins his little family for a moment.
They snuggle in together and Robbie and Helen sing Kathryn "Happy Birthday". It's not technically the little girl's birthday but it's become a family tradition to celebrate every month on the 29th, the day she was born. "Oh, I've got go," says Robbie.
He picks up Kathryn. "Kiss bye bye for Dada," he says and she gives him an enthusiastic kiss and hug. Then he leans over his wife and says in his cheeky Scottish accent: "Kiss bye bye for Dada." He kisses Helen twice and gives her a wink. Before he leaves he says, "I'll be home early today; we're just working in town."
Outside, the former merchant naval-man starts up his white station wagon and heads for the depot of the company he works for. There he loads equipment into a truck and sets off for the building they're cleaning, the WEL Energy Trust building on Victoria Street in Hamilton.
It's an annual contract and last year it coincided with Waikato University's capping week parade. As the masses approached, heralded by a pipe band, the immigrant from Aberdeen had danced the highland fling on top of the building. Robbie meets several of his workmates in the carpark and together they unload ropes, ladders and waterblasting equipment. Like his boss, Graham Jefferis, Robbie is particular about workplace safety.
Graham is the kind of man who'll throw away an expensive 100m rope if it gets a drop of paint on it. Less than two weeks earlier he'd bought a new ladder because the previous one had a dent in it.
Robbie, too, leaves nothing to chance. He won't let anyone else tie his ropes for him before an abseiling job. He does everything himself, just to be sure. One of the workers in the group - a young guy - leans the new extendable ladder against the building and Robbie is the first man up.
When they met, Robbie wasn't Helen's type at all. She liked brawny men and he was trim and fit and just a little taller than she was. Her neighbour in Frankton knew Helen was looking for a flatmate and introduced them - with, Helen discovered later, an ulterior motive. Robbie was a larger-than-life Scotsman with deep olive skin, beautiful brown eyes and a wide smile.
He was bold, brave, funny, sensitive and, as Helen discovered, very easy to fall in love with. And she did. They soon began talking about having children together and by the end of the year Helen was pregnant with Kathryn.
They were married at the Hamilton lakefront a few months later, just two weeks after Robbie proposed.
They're running low on nappies. It's a beautiful day but there's a wintry nip in the air and, after the usual morning routine, Helen bundles Kathryn up to drive to a new nappy store in Nawton Mall. As the little girl pulls nappies off the shelves and Helen looks through them, Helen's mobile phone rings.
She recognises the number and answers cheerfully. "Hiya Graham, what's going on?" "How soon can you get to the hospital?" he says, flatly. "What happened?" "There's been an accident." "Did he fall?" "Yeah, can you get to the hospital now?
He's on his way, in an ambulance." "I'm on my way," Helen says, but before she hangs up she says, "Graham, how bad is it?" "It's bad." Helen gathers Kathryn up, puts her into the car seat and buckles her in.
By the time she gets to Waikato Hospital, the carseat has been twisted askew by her desperate driving. She jams the car sideways into a gap in front of the accident and emergency entrance and, with Kathryn in her arms, runs inside. Graham's there to meet her, grim-faced.
He turns to a security guard and says, "This is Rob's wife" and they rush her to a room where Robbie is being worked on. He is unconscious, with a tube in his mouth and a neck brace on.
There's a lot of blood and, Helen notes, it's coming out of places it shouldn't be. Holding Kathryn with one arm, Helen grabs the only part of Robbie she can get at - his feet - and squeezes them.
Helen and Graham find out later, after an Occupational Safety and Health investigation, that the ladder was faulty. As Robbie climbed, the rungs gave way and the ladder fell backwards onto the asphalt, with Robbie still clinging to it. His head took the force of the fall.
Over the next few days friends and family gather. Robbie's mother, Winnie, takes the first flight she can from Scotland. Robbie lies in a ward in Waikato Hospital, unconscious, attached to machines and with tubes everywhere.
The staff wheel in a La-Z-Boy so Helen can stay by his side. She's under no illusions. She's been told his chances of survival are negligible. On Wednesday morning she's called into a meeting with several medical staff in a bland conference room in the intensive care ward. A neurologist in a white coat explains that they strongly suspect Robbie is brain-dead.
Two specialists will conduct a series of tests, independently of each other, to confirm their suspicions. If they think there's the remotest chance of saving him they will say so. "In the event that he is brain-dead, we won't be able to keep him on life support indefinitely," the doctor begins. Helen guesses what's coming next and jumps in first, "Is organ donation an option?" "Yes," is the answer, "that was the next thing we were going to approach you about.
How do you feel about that?" Helen knew it was what Robbie would have wanted. They'd talked generally about organ donation in the past and he was the kind of guy who would help anybody at any time. She knows that he is now beyond her reach and there's not a single thing she can do to fix it.
There's nothing to be salvaged but the possibility that his death could mean life for half a dozen people. And later, she will reason with a smile, he was a Scotsman, and Scotsmen don't believe in wastage. Helen's made a lot of deals with God as she's sat in that La-Z-Boy.
Her next conversation would go a bit like this: "Okay, I realise you're going to take my man and there's not a thing I can do about it. But there's six other people on your list you're not getting. You can just bloody well wait for this lot, you sod." The tests come back confirming the doctors' suspicions and later that afternoon Helen is called back to the conference table.
The staff explain, softly and kindly, the process for organ donation and reassure Helen that Robbie will get the very best care possible whether or not she decides to donate his organs. Even once she's signed the forms, she can still change her mind. Helen has no intention of changing her mind but delays signing until Winnie arrives on Thursday morning.
Without a moment's hesitation, Winnie says, "You know that's what Rob would have wanted. Thank God you're doing this."
About 100km away in Rotorua, 20-year Navy veteran and recent tourism-management graduate Wiremu Keepa is at home alone, feeling a bit crook and weak, when the phone rings. It's been five years since he had his first blackout, five years since he was diagnosed with cardiomyopathy, five years since he was put on the heart transplant list, five years since he's been able to drive a car, five years since he's been able to work as a tour driver, and he's deteriorating rapidly.
He's been given two months to live but he's not scared of death. "If it's going to come, it's going to come," he thinks. On the line is Helen Gibbs, transplant recipient co-ordinator at Greenlane Hospital in Auckland.
Could Wiremu be up in Auckland within six hours? Gibbs doesn't give a reason and Wiremu assumes it's another check-up with his cardiologist. He's been making regular trips to the city for years and, now that he's been put on an urgent transplant list, his deterioration is being closely monitored.
He throws a change of clothes into a bag, rings his partner at work, and they hit the road. His teenage boys, Eruera and Mataia, are at school and he doesn't think there's a need to say goodbye. Still, although he's hungry, he decides not to eat on the drive north. Just in case.
After getting a call from the intensive care unit at Waikato Hospital, the donor transplant team in Auckland has been mobilised. They've ascertained Robbie's blood type, tissue type, height and weight, then they've liaised with their peers in Australia and New Zealand to match the organs with the first compatible recipients on the transplant lists.
Six have been found. Wiremu is one. Also on the way up to the hospital is another Rotorua man, who will receive a lung, a Taupo man, who will also receive a lung, a woman in her early 60s, who will receive a liver, and two men who need kidney transplants.
In these situations, at least four medical teams are mobilised. The heart and lungs are the most critical operations - they have to be reconnected to a bloody supply within about six hours. Two teams will travel to Hamilton to retrieve Robbie's organs. Two will remain in Auckland to transplant them.
Helen and Winnie Stewart are told they can take as long as they like to say goodbye to Robbie but they resolve they will leave his room at 3pm. Shortly before that, Helen brings Kathryn in and puts her on Robbie's chest. "Say 'bye bye, Dada'," says Helen.
Kathryn looks around the room and says, "No Dada." It's as if he's invisible. Helen wonders if it's because the little girl knows Robbie has already gone. Helen feels that way herself.
At home that evening, Helen sees the Westpac Rescue Helicopter fly overhead, in the direction of the hospital. "That's for Rob," she says. Later she hears it leave.
At Greenlane Hospital, Wiremu is surprised to be asked to shower, and asked if he needs help to shave his chest. It's a bit odd, he thinks, for just a consulation with his specialist.
Things become clear when a nurse attaches a drip to his arm. He's sedated and wheeled into a pre-op room. There's already another man in there, also Maori. They exchange mihi and wish each other well. "See you after the op when you wake up," says Wiremu. "Cher, cher."
It's a strict rule of Organ Donation New Zealand (ODNZ) that the donor's family is not put in touch with the recipients of their loved one's organs. The family is told the age and gender of the recipients and can get updates through the organisation on how the recipients are getting on but they are given no extra details.
However, since New Zealand's rate of organ donation is low by international standards, it wasn't hard for Helen Stewart to figure out her connection with two men in Rotorua and a man in Taupo who'd received heart and lung transplants at Greenlane Hospital on May 1, 2003 when she read a story about them in the New Zealand Herald.
The blood brothers, they were called. Every year in April or May, ODNZ hosts a thanksgiving service for the families of organ donors and transplant recipients at Trinity Cathedral in Parnell. The first service Helen attended happened to also be the first anniversary of Robbie's death. She drove up from Hamilton with Kathryn, by then a boisterous two-year-old, and her new five-month-old daughter, Callan.
Like Kathryn, Callan had inherited Robbie's brown eyes and wide smile and Helen's blonde hair. It was the Rotorua lung transplant recipient Helen recognised first, from the photo in the paper. She walked up boldly and said, "Hi." For a moment they just stared at each other. "Um," she said, "you might be the one who received my husband's lung." He nodded. "We saw you on TV.
[Helen had featured in a television news story about the OSH investigation.] Don't move," he said, and disappeared. He came back with a few people, including Wiremu and the widow of the recipient of Robbie's other lung, who had died suddenly from a complication 10 days after the surgery. He was the man to whom Wiremu had spoken in the pre-op room.
Helen told the woman she was sorry it hadn't worked out. "Don't feel like that," Helen recalls the woman saying. "He'd been on oxygen for five years. He had been bedridden for the last four years. He was dying right before my eyes.
We couldn't even have a conversation because he'd be gasping for breath. Those 10 days were the best 10 days of our lives. He had 10 days of hope. "He went into surgery a dead man and he came out alive. "On the second day after the surgery, he stood up unaided beside his bed and he was laughing because he hadn't been able to stand on his own two feet without collapsing for years.
He got back his dignity and his self-esteem and he was so full of hope because he felt so strong and so well."
Wiremu remembers that Helen kept looking at him, too. She raised her hand to touch his face "to feel her husband through me". Helen says she put her hand to his chest to feel Robbie's heartbeat again.
In Helen's words, Wiremu "hasn't wasted a heartbeat" since his operation. He's done a graduate diploma in business and then a master's degree in business administration. He's learning te reo Maori, he's exercising regularly, he's a fan of the Canterbury Crusaders, to the chagrin of his Chiefs-supporting friends and he's working "as a deck-hand", as he calls it, for Mana Tours on Rotorua's lakefront, renting out boats and kayaks and organising guided trips.
He still has to take nine pills every day, he tells Canvas, after seeing off a boatload of young English tourists on a self-drive trip one fine autumn morning, and he will be on medication for the rest of his life.
He speaks regularly about organ donation and most of his four brothers and five sisters have decided to become organ donors. "It's so difficult for Maori," he says, because of the strong cultural belief that the body should be buried whole.
He's not a Christian, he says, but he now goes to St Faith's Church on Rotorua's lakefront to thank Robbie, Helen and all the medical staff - "and the fulla up there" - for what he calls his second life. He keeps in touch with Helen and sees her every year at the Parnell service. After they first met, he got a copy of his chest x-ray and ECGs and sent them to her so she could see her husband's heart.
Helen and her daughters now live in Papamoa and when Canvas visits there's again a Scottish accent in the house. A friend of Robbie's, fresh from Scotland, with an impenetrable accent, is staying with the family while he looks for work. The girls adore having him around and Helen is reminded of the enormous gulf in their lives.
She's planning to set up a support group in Tauranga for widows because she's found it helpful to share her story with women in the same situation. She also continues to draw comfort from Robbie's gift of life to Wiremu and the other recipients.
She thinks of them as her "team" and was stoked to find out a little while ago that one of the kidney recipients had had a child. "That's another person in the world who wouldn't be here," she says. "How do you describe meeting face-to-face the person that you know is alive because you chose to sign that piece of paper?" She raps on the kitchen table, as if the consent form is again under her hand.
"Rob would have been angry with me, absolutely, he would have been fuming wild with me had I cremated him with all of those parts intact. He would have haunted me for the rest of my days if I'd said no, because it's what he wanted and it's the person he was. "How could I not steal something back from death?
I couldn't just let him be dead for no good reason at all. I had to salvage something. It wasn't a noble gesture, it wasn't generosity, it was the need to get something back out of this. This is my payback, being able to see these people doing alive and well.
I couldn't let him just go. "It's a gift of life for me and the girls as much as it is for the recipients. I'm not condemning all those people who choose not to do it. It is a very personal choice.
However, I think if people reading this article are aware of how much we have benefited from it, and how very, very quiet and very, very dignified it is, they might not be so horrified if it happens to them and they might be able to say, 'This could be a good thing.' "I'd like people to see there is life after death."
The reluctant donors
Helen Stewart is an exceptional woman. Literally. She's the exception to the rule that New Zealanders don't donate their loved one's organs.
New Zealand's organ donation rates are among the lowest in the western world. In the last international comparison, in 2006, Spain had 33.8 donors per million people. The United States had 26.9 donors.
Britain had 10.5, Australia 9.8. And New Zealand had just six donors per million people. That was a particularly quiet year for Organ Donation New Zealand, with just 25 people donating their organs. Last year the number rose to 38 people, which still leaves New Zealand near the bottom of the international statistics and doesn't give a lot of hope to the 580-odd people languishing on transplant waiting lists. Most - about 530 - were waiting for a kidney, which can come from a live donor.
It's sobering that last year just 68 single kidneys were donated. Even those at the top of each list can't rely on getting the first organ that becomes available - organs have to compatible with their blood and tissue types and, in some cases, their height and weight.
Little research has been done on the reasons for our low rates and ODNZ doesn't have data on how many potential donors we have in New Zealand each year, though it has just started a project - the first of its kind in the world - that will collect such information from intensive care units.
Some of those reasons are good things - ODNZ team leader Janice Langlands says we've become far less likely to die in road crashes, our treatment of brain injuries has improved and our hospitals take a gentle approach with grieving families.
Some other countries take a far more persistent approach, asking families several times even if they've already said no. "We wouldn't want that to happen in New Zealand," she says. But it's probably fair to say that when it comes to the subject of sudden death and organ donation, we are a reticent and squeamish lot.
Just under half of New Zealanders with driver's licenses have the word "donor" printed on them - but that's not an official consent, it's just an indication of their wishes.
The decision still rests wholly with the next of kin. Helen Stewart thinks everyone should discuss the possibility of organ donation with their families and says there's no ghoulishness about it.
"People close to me who were involved in the whole process with Rob, people who had been staunchly, 'Oooh, no, you're not cutting me up when I die,' have changed their minds. "It's an awful time.
You've just been told the person you love is going to die and there's nothing you can do about it. For some people I expect being asked for the organs at that time must feel intrusive. It must be something that people have a lot of trouble dealing with. In reality, the process is very, very dignified."
* Organ Donation New Zealand stresses that the organ donation process is anonymous and recipients are not put directly in touch with donor's families, though the families are kept informed about how the recipients are getting on and the recipients can them write letters of thanks.
