Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.
A reporter at Just the News shared our article about a man whose organs were nearly harvested while he was still alive:
Disinformed consent is standard operating procedure in the organ donation industry. And much of medicine. “The sisters said hospital staffers told them the movements were involuntary.”https://t.co/tDSp4oCNgL
— Greg Piper (@gregpiper) September 13, 2025
— Greg Piper, Washington, D.C.
Too Close a Call With Organ Donation
When I was a third-year med student doing a rotation on the trauma surgery team, we had a patient in the surgical intensive care unit who had arrived 12 hours earlier with bullet holes in his abdomen. We worked to stabilize him all night; the next day, he was still alive.
The team determined, however, that although his body was alive, he was likely brain-dead and a candidate for organ donations (“A Surgical Team Was About To Harvest This Man’s Organs — Until His Doctor Intervened,” Sept. 12).
As we prepared for him to become a donor, I noticed he had a bit of movement. Of course, I was the unknowing third-year med student, so my comments were essentially deemed a nuisance, at best, to the team. (I was, by the way, already a globally recognized researcher in a field distant from trauma surgery.)
Nevertheless, after checking on the patient, I told one of the surgeons, “I think he was trying to communicate with us.”
I was told it was just spinal reflex and I didn’t know what I was looking at.
I couldn’t shake the feeling. I was deeply concerned that I knew what I saw, and it seemed like communication. After our rounds, I went back up to the patient’s bedside, stood over him, and simply said, “Are you able to hear me?”
With a tube in his trachea, stopping any air from entering or exiting (required to make sounds with the vocal cords), he attempted to communicate something in response. The poor guy had an endotracheal tube and was on a ventilator, but because he was given a diagnosis of being brain-dead, he was not being provided with appropriate pain meds and was in and out of consciousness — as best as I could tell.
I asked him again if he could hear me, and again he tried to communicate with the tube in his throat. It was clear he was absolutely not brain-dead.
I ran and got the team. They evaluated him again — after having already spoken in front of both him and his family about harvesting his organs. This time, the surgeon made a more thorough evaluation. It turned out that he was awake and aware. As they looked him over, they realized he didn’t have bullet holes only in his abdomen; he had a bullet hole through the back of his skull, the bullet still lodged in his brain. During the exam, someone had lifted his head to discover a small, round pool of blood underneath. The bullet in his head went entirely unnoticed in the chaos of trying to stabilize his much more severe hemorrhages.
A CT scan showed the bullet clearly, lodged in the middle of his brain. The neurosurgery team did a procedure to reduce the swelling and pressure in his skull, and he sprang back to life.
The young man, surely a victim of gang violence in South Atlanta, began to interact almost normally with his family over the coming days. For his family, it was almost a rebirth of their child. He had heard the entire conversation about harvesting his organs but could do essentially nothing. It turned out his brain death was documented when he was still under anesthesia, masking his conscience and alertness that would eventually return.
Unfortunately, after an elated two or three days, the man ultimately succumbed to his brain injury.
Still, I will never, ever forget how terrible that experience must have been for him, and, honestly, I don’t know what would have happened if some “naive” third-year med student hadn’t pushed to get the considerably busier surgery team to fully recognize what was happening with their patient.
I deeply appreciate your writing, and I hope it is raising significant awareness.
And I say this as someone with an immediate family member on multiple transplant lists: While I want desperately for lists to move faster, it should never happen at the expense of providing the complete and full dignity that every life deserves.
— Michael J. Mina, Boston
A radiologist in Denver also posted his thoughts about the article on the social platform X:
This is very rare in the world of transplant surgery. But it should be “never”, rather than “rare”.https://t.co/yJ3BZkLXND
— Paul Hsieh (@PaulHsieh) September 14, 2025
— Paul Hsieh, Denver
Speaking for Kids With Disabilities
I read the article “Parents Fear Losing Disability Protections as Trump Slashes Civil Rights Office” (Sept. 15) with a renewed sense of purpose. Efforts to dismantle the U.S. Department of Education may be imprudent at best, with little or no consideration for the potential that lies within all of us. I know, because I became a recipient of its special education services after flipping over on my three-wheel motorcycle and landing on my head with the bike over me. I was barely 18 years old and not wearing a helmet. I was in a coma for a week and remained in an acute care hospital for a month. I sustained a severe traumatic brain injury — or, to be more precise, a severe cerebral contusion.
I wish the architects of this federal dismantling could know that I received rehabilitation therapy for over a year and received services through a special education program for more than six years before I graduated with a four-year bachelor’s degree from San Diego State University. I continued on to graduate school and earned two master’s degrees from the University of Southern California.
I established a 30-year career — starting as a lobbyist for the National Association of Social Workers in Washington, D.C., before returning to my home state to finish my career as a research scientist for the California Department of Public Health’s Maternal and Child Health Division. I worked there for 16 years before my retirement in 2020.
We — as children with disabilities — have much to offer to society that cannot be foreseen when we are young. I am the product of dedicated care by my therapists and teachers. This is what I believe the current president and elected officials across the country need to understand. We can be productive citizens when given the chance to thrive.
— Brason Lee, Sacramento, California
A Democratic member of Congress weighs in on X:
Disabled kids are facing great challenges in their schools, and the dismantling of the Department of Education will only worsen these struggles. It is vital we support our students of all backgrounds.https://t.co/pN1cAnRXOd
— Grace Meng (@Grace4NY) September 17, 2025
— Grace Meng, Queens borough of New York City
A Hole in ‘Big Loopholes’?
The article “Big Loopholes in Hospital Charity Care Programs Mean Patients Still Get Stuck With the Tab” (Sept. 25) by Michelle Andrews had one glaring omission: The hospitals are supported by government funding for charity care, but private practice providers — such as the specialists in emergency medicine, anesthesiology, and radiology who were mentioned — are not. Do you expect those providers to work for free? I think, to be fair to doctors, there should have been a mention of that in the article.
— Roger Broome, Galena, Ohio
A science writer in New York shared her thoughts on X about our coverage of Trump administration policies:
These clinics were already stretched thin before the new guidance. That seems unlikely to change given the major staffing cuts at HRSA, which directs funding to community clinics and other HHS programs. H/t @sjtribble and @HMLLarweh at @KFFHealthNews https://t.co/ngit8sP9X8
— lauren schneider (@laur_insider) August 8, 2025
— Lauren Schneider, New York City
When HRSA Hurts, Nursing Suffers
The Health Resources and Services Administration, or HRSA, is vitally important to building and maintaining the strength of the pipeline of new nurses and other clinicians entering our health care workforce. With a growing health care shortage across the country, it’s incredibly important that HRSA be maintained and strengthened to meet the growing and more complicated health care challenges of tomorrow (“Deep Staff Cuts at a Little-Known Federal Agency Pose Trouble for Droves of Local Health Programs,” Aug. 1).
One of HRSA’s most important responsibilities is managing Nursing Workforce Development Programs under Title VIII of the Public Health Service Act. These grants help fund everything from education to practice, recruitment, and retention, particularly in rural and underserved communities. As both a nurse and nurse educator myself, I’ve seen how, for decades, Title VIII programs have strengthened the pipeline by covering scholarships and education to support registered nurses, advanced practice nurses, and nurse educators.
As the U.S. population rapidly ages and develops increasingly complex health care needs, we must ensure we have a robust workforce equipped to provide high-quality care in every community. Unfortunately, the Bureau of Labor Statistics projects an average shortfall of roughly 190,000 registered nurses each year from 2024 to 2034. Complicating this issue, faculty shortages, limited clinical sites, and capacity constraints forced nursing schools to turn away over 80,000 qualified applications last year alone.
Our country must do more to graduate enough students to close these gaps. Maintaining funding and staffing for HRSA is essential to sustain a robust health care workforce and ensure patients’ access to care nationwide.
Policymakers must protect and fully appropriate HRSA in the 2026 budget and beyond. There are countless passionate, smart, and dedicated learners out there ready to step into the roles of nurse and nurse educator. We must protect HRSA to open pathways for them to get there.
— Patty Knecht, chief nursing officer of Ascend Learning/ATI Nursing Education, Downingtown, Pennsylvania
A health economist and health policy expert at the Altarum Institute expresses his opinion succinctly on social media:
Make America Ill Againhttps://t.co/DPFJtfB0fl
— Paul Hughes-Cromwick (Pooge) (@cromwick) August 1, 2025
— Paul Hughes-Cromwick, Ann Arbor, Michigan
Keeping PACE With Vulnerable Seniors
Elder homelessness is one of the clearest symptoms of our broken senior care system, as highlighted in the recent article “Health Care Groups Aim To Counter Growing ‘National Scandal’ of Elder Homelessness” (Aug. 18). Today, too many seniors are walking a tightrope, threatened to be tipped off balance when financial or medical issues arise.
This risk of homelessness is especially prevalent in rural communities, where older adults often have lower incomes, higher poverty rates, and greater prevalence of chronic illness. And while homelessness nationwide rose by less than 1% from 2020 to 2022, rural areas saw nearly a 6% increase — clear evidence that rural community members are being left behind by our current system.
Thankfully, the Program of All-Inclusive Care for the Elderly, or PACE, is uniquely equipped to address these challenges. Often, rural PACE programs like ours encounter participants struggling to get through the winter without heat, living in homes with leaky roofs, or lacking safe wheelchair access. In these scenarios, we can authorize heating installation, arrange urgent repairs, or build ramps that make it possible for our participants to remain safely at home.
These are just a few of the many examples that demonstrate how far PACE providers can, and do, go to ensure our participants can stay in their homes. And, by addressing these issues early, the program is saving Medicaid dollars.
To reduce housing instability among older adults, policymakers at both the state and federal levels should expand eligibility and ensure that PACE providers have the flexibility to act quickly when warning signs appear. By investing in PACE, we can reduce homelessness and build a stronger model for community-based care in America.
— Craig Worland, interim CEO and COO of One Senior Care, Erie, Pennsylvania
Saw mention of an idea on Facebook a couple of days ago and then read your PACE article about senior housing and felt compelled to share. Please pass along to your PACE colleagues and anyone else who can help make this possible. The idea was/is to convert the many closed malls, shopping centers, and big-box stores across the U.S. into affordable housing. Rather than leave them as empty eyesores, decaying and becoming havens for vermin and worse, rather than trying to find and fund land purchases and building from scratch, just think how many thousands of people could be housed! Some spaces could be reserved for essential services — groceries, drugstores, coffee shops, restaurants, salon/barber shops, laundry/dry cleaners, etc. Recreate nature with a walking path complete with live trees and plants, and paint the ceiling like the Wienermobile, where “the sky is always blue!” The possibilities are endless. Go for it! Thanks for the opportunity to share. I’ll be out here advocating and watching for this to blossom!
— Brenda Peters, Charlotte, North Carolina
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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