Every time the telephone rings, it could be you. Waiting for a transplant is long and difficult. With renal dialysis you are hopefully quite stable, but with other conditions it may be a race against time. Every phone call could be your lifeline so the telephone becomes the focus of your day. Silence weighs heavily. Quietly checking that the phone is working, looking for the signal on your mobile, you cannot bear to see someone on the home telephone for too long- they could be blocking that call. When the phone rings at an odd time, the heart skips a beat. That’s when you resent having Australian friends who phone at all hours. With mobile phones you can now, at least, leave the house. But, how far can you go? Should you go fishing, sailing, a walk in the country- will there be a mobile phone signal and could you make it back in time?

And, when will an organ become available? Listening to the local radio news is not about politics, current affairs or local interest- you are waiting for the road traffic accidents. Someone else’s tragedy could be your life changing opportunity. And the greater the tragedy- the younger, the fitter, and the more sudden and unexpected  the better it could be. Hearing that someone is ‘critical in hospital’ raises hopes, as it is usually someone on life support with a serious/brain stem injury who provides organs.

Going for regular dialysis, you watch as others who started after you, appear to jump the queue. It seems unfair. Glad for them, but disappointed, even angry. And, still you wait. And, you wonder how close you have been to getting the call, did your name ever come towards the top of the list. Before you go to bed you listen to the last radio news of the day- hoping for the worst. No bad news. No phone call

These thoughts are borrowed from the reflections of patient’s- quiet admissions in the intimacy of the consultation. Within the transplant community they can admit these uneasy sentiments. But, the general population might not understand. They dare not speak the truth; that death means life. I checked with a friend who inspired this piece before I posted it – “Seems a bit callous looking at it in print but that’s the way it is.”

Domhnall MacAuley is primary care editor, BMJ