(Not Actually Very) Painful Love: Why I'm Joining the Bone Marrow Donor Registry.

My friend Sarah had a life-saving bone marrow transplant fifteen years ago this week. I didn't know her then, we wouldn't meet for another few years, but her transplant changed my life too.

Sarah survived leukemia, which she was diagnosed with when she was fourteen. Her form of the illness was a rarer one, and when she was diagnosed, she was told there was a 65% chance she would not live. Her doctors encouraged her to tell the people in her life she was close to how she felt about them in anticipation of her young life ending. I'm staggered by the thought of having had to contemplate one's own mortality, make meaning of it, at that unjustly innocent age.

There are some people who give so much and ask for things so infrequently that when they do, you take it incredibly seriously. Sarah's not one to ask for favours, so when I got an email from her the other day in which, reflecting on this very significant anniversary, she asked me to consider joining the bone marrow donor registry, I started researching the process. Donating bone marrow is something that I've considered ever since Sarah and I became friends in my dorm room in our first year at King's College. After a very short small-talk exchange, we bonded over how we both swooned about grand, impossible, romantic ideas. She told me about her illness that day too, and I told myself I would look into donation.

Here it is eleven years later, and I've put bone marrow donation off every time it comes to mind. The truth is, every time the thought has arisen, I've felt terrified by the prospect of how much it would hurt. I had heard that donation involved a painful extraction, and I'm someone who didn't get her ears pierced until I was 26 because I was afraid it would hurt too much. I cry in panic every time I have to get blood tests done because I can't stand the thought of needles piercing my skin. Needless to say, I've never even tried to donate blood. When I hand out clean needles to clients who use injection drugs, I have to sing inside my head or hum out loud to distract myself from the thought of all of the things associated with that physical act. I feel queasy just writing about it.

The tougher part of myself then responds to these fears with straightforward logic. Painful? Really? Because guess what's more painful, princess? Cancer. I know this rationally of course. When our friend Deirdre died, quickly but painfully, from leukemia three years ago, my resolve was renewed; I would donate bone marrow and maybe someone sick would live because of it. When I think about the hundreds of people who showed up to Deirdre's funeral and the pain my dear friends have gone through because of her death, or the families of all the other kids on Sarah's floor at the Sick Kids Hospital (none of whom survived their illnesses), or all the incredible things that Sarah and I have shared this past decade (including Paris parks and Prague potatoes), it is an easy decision. And then I start thinking: pain. Fear. Needles. Nausea. I start humming and do something distracting and I forget again. Acute fear is just so large-looming that it can block your very view of the thing your fear is keeping you from doing, no matter how important it may be.

I'm putting this out there to be held accountable by a larger audience for the promise I made to Sarah a few days ago to finally join the donor registry in both her and Deirdre's honour, but also in the hopes that those of you reading can learn along with me.

I've been doing some reading these past few days about what it's like to donate bone marrow, and I've learned a great deal already. First and foremost, most of the time during the actual donation, they put you under general anesthetic. You're not even awake when the extraction happens! Knowing this helps me immensely. I'm not a particularly brave person, honestly. I don't willingly do very many things that even push me out of my comfort zone, let alone into painful situations. I realize it would sound far more principled to write about how the pain of the donation is far outweighed by the benefits of providing potentially life-saving material to someone in need (which of course it is), but my fear is too paralyzing for me to be that heroic. If it wasn't, I'd have done this years ago. I figure at this point, being honest is the best policy. I think if we are open about what kinds of fears (particularly those that involve cost to ourselves) truly keep us from doing things for others, we can more effectively address them and (hopefully) move beyond them.

So it doesn't hurt nearly as much as I thought it would, that's the first thing I learned.

Here's what else, from the bone marrow registry program in Canada:

• When you join the registry, all you do is get a cheek swab so that your DNA can be tested and kept in the database. When a donor is needed, the database is searched for the best possible match. Only if you're found to be the best match among millions of donors (worldwide) will you be contacted to be asked to donate.

• It's actually the stem cells within the bone marrow that are used in transplants. A lot of the literature you can read about donation will talk about stem cell donation, which confused me at first.

• Often, the stem cells can be extracted in a way that's similar to giving blood. It's a non-surgical procedure. Both that and bone marrow donation through surgery are very safe and have few complications or even side-effects.

• Regarding post-donation pain: “Bone marrow donors can expect to feel some soreness in their lower back. There have also been reports of donors feeling tired and having some discomfort walking for a couple of days or longer. Most donors are back to their usual routine in a few days. Some may take a few weeks before they feel completely recovered.”

• Most people who donate are back home later the same day. The pain they experience after has been likened to having fallen on ice.

• The average length of time for donors to be on the registry is seven years. This means that joining is a long-term commitment, but also that it doesn't actually ask much of you until you're found to be a match.

• Joining the registry doesn't guarantee you'll be a match, but it does increase the likelihood that someone who needs them will be able to use your stem cells. The transplant significantly increases the possibility that the person getting it will live.

There's plenty more info on the OneMatch website. Check it out, and please consider joining the registry along with me.