It was the end of my first week at the Naval Legal Service Office in Naples, Italy, when Information Systems Technician 1st Class Christopher Cookson walked in my door. The day prior, Cookson learned that his father, U.S. Air Force retired Master Sgt. Culinary Specialist Ronald Alden “Cookie” Cookson, had been diagnosed with liver cancer and had only two weeks to live if he did not receive a liver transplant. Without any hesitation, Cookson decided to donate part of his liver in hope of saving his father’s life. However, he was unsure how this decision would affect his career. So, he came to us.
The first thing Cookson said to me was, “My father is concerned for my career, but of course he gets my liver. He is my dad.” I understood his position, but it was my job to ensure he followed all of the Navy’s rules and regulations in order to get his father the absolute best outcome and protect his Navy career at the same time. After a brief discussion about fitness for duty, I figured there had to be more to this issue. And, since the Naval Justice School taught me not to “shoot from the hip,” I told him I would look into it while he finalized his travel plans. After a little bit of research, I found BUMEDINST 6300.8A
, “Donations, Transplants, and Disposition of Organs and Tissue.”
The instruction states that active duty Sailors may serve as living-related or -unrelated organ donors in the absence of better matched volunteer donors. To do so, the Sailor must receive written counseling from his or her immediate commander and a medical officer prior to becoming a living donor. Specifically, the Sailor must understand that his or her ability to remain in the naval service is contingent upon a favorable medical evaluation after the procedure.
In addition, prior approval from the Navy Bureau of Medicine and Surgery
(BUMED) is required when a living organ donation is to be performed in a non-Army/Navy Organ Transplant Service Facility. I discussed the requirements with Cookson when he returned to our office. He understood the risks and maintained his determination to assist his father. After obtaining the required counseling and finalizing his legal documents, the only lingering problem for him was the necessary approval by BUMED.
It was a Friday morning in Italy, Cookson was scheduled to fly out on Sunday to New York, where his father was hospitalized, and no one on the east coast of the United States was awake. Phone calls and emails went flying all afternoon between me, the local hospital staff and BUMED staff judge advocate, Cmdr. Salvatore Maida. With Cmdr. Maida’s help, I was finally able to put Cookson in touch with the Living Donor Transplant Coordinator at BUMED, who screened and approved his request right over the phone. With all necessary approvals and travel plans in place, Cookson left Naples, and arrived safely in New York early on Monday morning. To his pleasant surprise, BUMED staff called him later that morning and offered to move his father, a retiree of the United States Air Force, to Walter Reed National Military Medical Center in Washington, D.C. (“Walter Reed”) for screening and treatment. Grateful for the opportunity, the Cookson family accepted and left the same day for Washington, D.C.
According to Cookson, his father, Cookie, was seen by more physicians and nurses at Walter Reed in the first 60 minutes of his stay than during the entire 30 days he spent in the New York hospital. As a result, and completely out of character for him, Cookie was left speechless by all of the attention. When he was finally able to find his voice, Cookie expressed sincere gratitude for his transfer to Walter Reed. During his stay, the staff at Walter Reed devoted countless hours and resources to his treatment, he was surrounded by family, and a veterans’ organization brought the Buffalo Bills cheerleaders to visit him. Cookson said his father was overjoyed by his positive experience and treatment at Walter Reed.
Sadly, Cookie’s disease had spread from his liver and he was diagnosed with stage four cancer. The staff at Walter Reed determined that the liver transplant was no longer viable, but suggested Cookie undergo chemotherapy in a final attempt to save his life. They moved Cookie back to New York, close to home, to undergo treatment. On August 22, 2011, Cookson spoke to his father for the last time. His father said to him, “Chris, I am fine. I love you and will see you again soon.” Six hours later, in the early morning of August 23, 2011, Cookie passed away. Despite the circumstances, Cookson told me the assistance his family received from our office and BUMED “meant the world to him” because he was able to be there with his father and see him so happy and cared for during his final days.