On keeping your kidneys

I want to altruistically donate my kidney. What do you think I should consider? I want to question the shit out of my motives. I’m obviously going to think further about this, let it simmer in the back of my mind for a while… I want to give this to the world, I’m scared no one will take care of me (I’ve had to take care of my parents and I don’t have many close friends). I’m worried guys won’t find me attractive with the scar. I want to do this. I don’t completely get why. I’m scared it won’t be okay.


Yeah, no. I doubt you would pass the psychological evaluation anyway, but please do not attempt to donate a kidney under your current circumstances.

I looked you up. (It wasn’t difficult with your college email address and a name as unique as yours.) You are a brilliant and accomplished young woman. Since childhood, you’ve been living under the kind of academic and socio-cultural pressures that would crush the average person. Every school you’ve attended has been among the very best in the world, and you’ve been among the highest achieving students every step along the way.

That’s all changing. You’ve finally graduated, and for the first time in your life, you aren’t tethered to any regimen or program. You’re in a phase of life now where you have to forge your own path forward rather than follow a path that has always been laid out for you, and as much as you try not to admit it, the future is absolutely terrifying. That’s why you’re entertaining fantasies about donating a kidney. It solves so many problems for you.

You’ve been taking care of everyone else all this time, and if you donate a kidney, then for once in your life, people will finally have to take care of you. (That desire doesn’t make you selfish, by the way. It makes you human.) If you donate a kidney and guys don’t find you attractive, you will always have the scar to blame, and if you donate a kidney and then never find a suitable husband, your health will always be a convenient excuse. (And we both know why I used the word suitable, don’t we? Donating your kidney is also a deliberate “fuck you” to that aspect of your culture.) Of course, the biggest problem this solves is that if you donate a kidney, you won’t have to begin your life.

Most kids fantasize about taking a year off after college to go backpacking through Europe, but that kind of shit never even crossed your mind. You’re such an amazing human being that you’d rather take a year off after college and donate a kidney instead. I respect your altruism. I really do, but the whole idea is fucking nuts. Self-sacrifice can be a noble impulse, but it can also be a pathological one. For you in this moment, it’s both.

If you need to take a little break right now, then take a little break. It’s okay to do that. Really. I’m not saying you should go backpacking through Europe or anything, but keep your fucking kidneys, kid. It will be okay.

I promise, you are going to give many gifts to the world. I also promise, you will find your place in it. You will find your way. You will build your own career. You will build your own family. You will build your own life. It all just takes time, and there are no shortcuts, especially to the kind of emotional and spiritual fulfillment you’re so desperate to find.


43 thoughts on “On keeping your kidneys

  1. Silvia says:

    Wow, this really hit home here. Not that I’m the person who wrote, but I felt kind of stucked in this situation/emotions for a while too..that feeling took for me another way to express, but yeah that’s the same. Argh, a side-thanks CQ.

  2. chicken_dinner says:

    Donating a kidney is no small thing, either. Before going into medicine, I would have given my kidney to anybody who needed it. Now, I would probably only give it to my child.

      • Brynn says:

        I may be mistaken (I’ve had a similar thing explained to me by a doctor friend years ago, so this is the worst kind of second-hand knowledge), but despite few people dying due to complications with minor surgeries, there are still a shit ton of risks. From any number of antibiotic-resistant infections to the intense strain surgery puts on all of the body’s systems, donating a kidney could end up destroying your body, shortening your life, and leaving you in substantial debt. All of that and the odds that your kidney is actually going to save that persons life, or save it for any meaningful amount of time, is way lower than we’re inclined to believe.

        I do hope they respond, though; I’m curious as well.

        • Liz says:

          Kidney donor here. There are definitely risks associated, but if you’re already healthy, they’re minor. Debt is not a concern; non-directed (altruistic) donors get a level of targeted insurance care that I’ve never seen in my life and will never see again. So risk to you: minimal.

          What did surprise me – and they made DAMN sure I knew this before I went in – was what could be expected on the other side. For a non-relative but good match (as my recipient was to me) a kidney can be expected to last 15 years. (A sibling, on the other hand, can be about 25.) My hope is that in those 15 years, advances in tech will mean (preferably!) synthetic organs, and the whole system won’t be necessary.

  3. Rainbowpony says:

    I knew a professor who used to study people exactly like you. She used to frequent forums of super altruistic people who became obsessed with doing things like donating kidneys and the prof would recruit them for research. The prof was interested because there is a ton of work on sociopaths, but almost nothing documenting people on the other side of the empathy spectrum, and yet such extreme people really do exist. (You can google it, you’ll find information.)

    Im not saying you have a personality disorder, but I think this is more than wanting to take a break. I think you should consider talking to a therapist.

  4. OP says:

    Thanks for responding! Most of what you said is spot on. You’re amazing, Coquette <3 <3

    Oh, and I gave you my name and college email because I wanted you to have them. I respect you (and your anonymity) tremendously, but that you looked me up makes me very happy!

    • Tissue Donor says:

      Consider signing up to be a marrow donor! Or, if you’re in the Indianapolis area, you can also donate healthy breast tissue to a biobank for research purposes. It’s a relatively novel form of donation and only available in Indy at this point, but I’ve done it and it’s incredibly rewarding and minimally invasive. Info here:

    • Nerdlinger says:

      If you want to do the most good, considering looking into effective altruism, especially because it also has a ton of people who have self-sacrificing scrupulosity issues and have learned how to process and deal with those. Seriously, donating a kidney is nice, but it isn’t cost-effective for a person with your talents (not that you’re obligated to use them to give back to society or that only people with little prospect should donate kidneys).

    • I r says:

      Why not volunteer and give back? There is a humanitarian crisis going on in parts of europe. Thousands of refugees stuck between borders in flooded camps, and winter is coming in.

  5. Good luck says:

    It must be terrible to have been raised under such academic pressure. Retrospectively, I’m glad I was raised not in the best, but in the good enough structures. It makes fending for myself intellectually challenging, it makes the uncertainty familiar.
    Don’t fucking donate a kidney. I think CQ is wrong, you probably know that live kidney donors are healthier than the rest of the population. The boys and care preoccupation is just your survival instinct shouting at your altruistic self not to go under and lose a kidney for no particular reason. And it’s right don’t fucking give a kidney when you are college aged.
    Register for bone marrow donation if you can. It’s there we need the widest library of living donors (donors might need to be solicited repeatedly). The actual donation procedure varies in invasiveness, from a couple injections and blood donation to actual surgery depending on the needs of the recipient. It’s kind of unlikely anyone will ever need your specific HLA typing, but if they do, you become indispensable.
    I’m actually putting this out there for anyone with an altruistic bone in there body: register for bone marrow donation if you can! A lot of people’s lives depend on doctors finding them the right match. We now have international registers for this kind of thing, which obviously work better the more people register.

    • Yeah says:

      Re: bone marrow donation

      Everyone should sign up to be a donor, but especially if you belong to a racial/ethnic minority (in the U.S., anyway.) It is much more difficult for patients of color to find a donor match because of a lack of diversity in the registry of donors.

      Signing up is easy, and as Good Luck mentioned, there’s a low probability of actually matching with someone who needs a donation. If a match doesn’t come up, you won’t ever need to go through any medical procedures. However, if you are a match for someone, you could be one of the only people able to help them.

  6. BlinkingLights says:

    My Dad would’ve died when I was three if he hadn’t received a kidney transplant. Instead I had him til I was twenty-three. I can’t imagine how I would’ve turned out without those bonus years.

    I realize you’re talking about this specific case, Coquette, which is why I agree entirely. As other people have commented, she should perhaps pursue other less permanent options. For others though it may not be so crazy.

    Really though, if more people would just register to donate upon death it would make a huge difference. It’s important to inform your family of your wishes now because they have the right to block donation when the time comes. Also, you can choose what you’re willing to donate. I was squeamish about my eyes so opted out of donating them specifically but after a few years I realised it’s all the same anyways and added them to the list.

  7. Nat says:

    This advice really fills a void on this website.

    I’m not in the same situation as far as being mega-accomplished, but the number of insane plans I cooked up when I was finishing undergrad are frightening to think about. This next time around, I think I’m a bit more steady and a bit less obsessed with external validation. I’ll only really know if that’s true that in 6 months time.

    Almost goes without saying, but I agree that thinking about donating a kidney (in this situation – I am registered as an organ donor/bone marrow donor) is not thinking straight.

  8. Damien Otis says:

    if she did donate that kidney, it would most likely to go someone whose lifestyle brought them to that place in the first place. there are better ways to be altruistic.

    • JC says:

      Many people have kidney disease for reasons that are not their own fault. Apparently, your lifestyle leaves you in need of a heart transplant.

    • Liz says:

      Incorrect. Recipients with lifestyle concerns – smoking, drug use, etc., which I assume is what you’re talking about – are only eligible for the cadaver donor list, and rarely get even that. Do some research before you make flippant, judgemental assumptions, eh?

  9. ThankDog says:

    I totes agree with the marrow donor / organ donor after death suggestions, and a year or two of service, in Peace Corps or Americorps, might be a different way to help.

    But mostly, take some time to figure out what *you* want. That is the hardest thing for a lot of people. I knew some pieces (a kid, a partner) but not others (career) when I got out of a similar academic stew. I took a few years working at some places that only needed 9-5 attention, and played the rest of the time. I had a lot of parental support, so this may be harder for you, but it does actually help. Eventually I went back for another degree and found a career I really like, and I’ve got at least one more career before I retire.

    On the kid and partner front, I spent about 10 years poking around with various people. Now we’ve been together for about 15 years, the kid is 8, and that part is great.

    I put it down to taking the time to figure out what I wanted, and being patient with myself during that time.

  10. Susan devore says:

    Wow I think it’s weird that you actually found out a whole lot of information about this letter writer, so that you were really tailoring your advice to stuff we couldn’t see. It sounds like you are basically telling her–no,because you work so hard and have been through so much and are SO ACCOMPLISHED, you mustn’t make this sacrifice. What does that say about the rest of us homies? Do I sound jealous?

    • Jessica Sen says:

      It’s all of us. She’s talkin’ to all of us. We would donate our spare kidney for a stranger. Jealousy’s for tinkle fairies. Save it.

  11. Soooooooooooooooo says:

    I like this one! It’s…weird. Excuse my limited vocabulary.

    I think you should do it. Just do it. Then write back in a year and tell us what you feel.

    • Jessica Sen says:

      Second this question. Please be specific and list programmes and schools which embody this ideal you are talking about, Coquette.

      PROmpts: Catholic independents, International Baccalaureate, Wikipedia.

      • I was schooled on the streets as an orphan and donated my kidney to my neighbor (two alleys down). It was the best altruistic thing I ever did and I’m so glad I did it. Anyway, in the hospital, they taught me to read. I was illiterate before. They had all sorts of magazines and a beautiful case of books. This old man who was living there permanently – he damaged his head carrying heavy steel bars – kept vandalizing the books so they had to put the books in a special room where they keep sterilized infants. It was a pretty crazy place.

        The procedure was massively easy – they just anesthetized me and cut me open, basically.

        It was like having easy childbirth – and I didn’t even have a scar.

        But later my birth mother tracked me through the blood samples and scolded me for doing it. She said I should have just donated blood, marrow, or my time volunteering or some shit.

        What the FUCK kind of mother is that? You tell me. She didn’t even bring me flowers – just some canned soup. Fucking hobo.

    • Galah says:

      Coquette never answers anymore unless you really wind her up. She’s a really bad teacher. My desk is marked with her fucking carbon footprint.

  12. Liz says:

    I did a non-directed (altruistic) donation last year. It was one of the most meaningful events of my life, and I don’t regret it for a second. I would love to get every healthy person in the US to sign up for the registry, and get kidneys to the 80K people on the list.

    With that said, if Coquette’s description of you is true, you’re not a good candidate right now. There is some possibility – and this is covered in the multiple psych evals you have to do to qualify – that the transplant will fail. The organ may die in transport, the recipient’s body may reject, etc. In order to do this, you have to be able to let go of your responsibility/your investment at the moment you get on the operating table. It sounds to me like if you were in that hospital room the night of surgery, and the team came in and told you that it had failed, you might feel you’d done it for nothing – and I can imagine that being devastating.

    Wait five years. Consider again. We need you, but not for these reasons.


    What the fuck???? It’s a legitimate question. You are just being passive aggressive by not answering it. I sincerely wanted to know and you just shoved me in the face like a fucking can of beer. And shut the door in my face. Well, thanks a lot. You spoiled the whole day with your hairy reply. I’m just gonna fucking kill myself now, thanks a lot. I’m actually standing on the edge of the Trump tower with my heel on the ledger. FUCK OFFFFFFFFFFF

    • . says:

      Traction creates content which creates more content, the volume will make more people react in their Gaussian distributive way, while our working memory acts constantly surprised, which means ppl’s weird reactions become more apparent. Don’t act fucking surprised.
      And this isn’t YouTube, there is no algorithmic incentive to write controversial comments to get to the top of the list. Stuff here is organised by good old chronological order.

      • Melissa Low says:

        I’m so sick of all you people being all TALK and no ACTION. I asked a month ago if you wanted me to set up a platform for constructive discussion – now look what this place has turned into. There’s no Patreon either, nor is there a Google Drive to share resources. You guys are the worst and I am done with this bullshit. Really. Fuck me.

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