Tissue donation is the ultimate gift

Carson Palmer Connection (3:55)

Carson Palmer's latest ACL injury ended an eight-year connection with a woman and a family he's never met. (3:55)

Reporting for the ESPN The Magazine story on Carson Palmer and the growing use of donated human tissue in orthopedic surgery began this summer with two incredible days in Illinois and Wisconsin that spanned the relationship -- between donor and recipient -- at the heart of this little-known industry that is helping so many elite athletes.

This Flem File is the story of one donor and of the recipient I met on that trip.

THE SON of a longtime high school baseball coach, a 3-year-old Michael Collins pushed his stuffed animals off his bed so he could sleep with his catcher's gear, wrought-iron mask and all.

The love he felt for his father's game never dimmed. As a middle infielder for Heartland Community College in Normal, Illinois, Michael hit a home run for the Hawks in the 2012 NJCAA World Series. Even after moving on to nearby Illinois State University, where he was a senior exercise science major, Michael was invited to join the Heartland coaching staff. But he turned them down to coach alongside his dad, Jim, at Normal's University High.

Charming and driven with a steady inner compass rare for his age, Michael was the kind of kid who would call for a designated driver if the need ever arose. And that's exactly what he did just before 2 a.m. on Saturday, March 29, when the car carrying Michael and two classmates was struck at an intersection by a drunken driver who had run a red light traveling more than 100 mph. After pleading guilty to aggravated driving under the influence, the driver, Jamie Webb, was sentenced to 14 years in prison.

A belted, front-seat passenger, Michael took the brunt of the collision, suffering massive craniocerebral injuries. After four days in the ICU and two brain surgeries, when Michael's fate had become imminent, his family agreed to honor the pledge he made on his 18th birthday to become an organ and tissue donor.

His mother, Kelly Collins, still remembers the day Michael announced he had signed up as a donor. "A letter arrived from the secretary of state," she says. "That day Michael was breezing in and out of the house doing something and I said, 'Hey, you signed up to become a donor?' And he yelled back, 'Yep!' I said, 'Do you know what that means?' 'Yep!' And out the door he went. He didn't ask permission or our opinion. Signing up was the right thing to do, so he did it. That was Michael."

Of the 3 million people who die each year, less than 1 percent become organ donors. As a result, almost one person a day dies in this country waiting for an organ. Although Michael was on a national registry, when any patient's death is imminent or brain death has been diagnosed, hospitals are obligated to contact the organ procurement organization that services their region. (There are 58 federally regulated OPOs.) One of those groups in Illinois is Gift of Hope, located just west of Chicago. It dispatched a team of counselors to help the Collins family through the process. "At my lowest point, I told God, 'The only way I'm going to be able to keep breathing is for you to show me the good to come out of this,'" Kelly says. "This donation was the beauty we found in all this. I want him back so badly. I want his physical presence. I want him at dinner with me. I want him playing with his dogs. I want him on my couch, or playing golf with his dad. I want to be yelling at him for something he did. But when you can't have him back, your only choice is: Are you going to allow something good to come out of this?"

Still, it's an almost unfathomable request: Asking loved ones, oftentimes parents who have just lost a child, to give even more. The connection between donor and recipient involves a 1,000-link chain of tiny miracles, and it starts with a moment of nearly divine selflessness that leads to a gift no one could ever truly be worthy of. "I am constantly amazed at how gracious people can be even on the worst day of their lives," says Emily Maxwell, a donation counselor at Gift of Hope. "This is the most amazing part of us as human beings: being able to think about helping someone else's life at the absolute worst moment of your own life."

"Michael was the ultimate athlete from the time he was born," Kelly continues. "To think that it has now come full circle, that his cartilage and bone and tissue could live on and benefit other athletes in this higher way, well, I looked down at the list of possible donations they gave me and just kept saying 'Yes, yes, yes, yes.'"

As darkness fell on April 2, the Collins family linked hands with those of the organ and tissue transplant teams that had been assembled in the ICU unit of the Advocate BroMenn Medical Center in Normal. Gathered for the last time at his bedside, the family sung "How Great Thou Art" as a sudden rolling thunderstorm shook the hospital windows. After his life support was turned off, Michael passed quickly, at 9:05 p.m., allowing surgeons time to recover enough of his organs and tissue to save or improve the lives of as many as 200 recipients.

A few weeks after burying their son, the Collinses received a letter from a woman in the Bronx who could now see after receiving Michael's corneas. It was imperceptibly small, but a tiny bit of the avalanche of grief the family was buried under lifted. Michael's kidneys, pancreas and liver went to patients at Northwestern. Inspired, Michael's friends and family created MCStrong, a pay-it-forward Facebook campaign that has gone global.

In the hospital lobby after the process was complete, Jim was speaking to a family friend about Michael's organ donation when he mumbled something, offhand, about him also giving "just" tissue. Without warning, the man reached over and grabbed Jim by the shoulders, startling him out of his fog of grief and exhaustion. His own son, he explained, had a degenerative condition in his knees as a teenager that left him crippled by joint problems and pain. A gift of donated tissue had allowed his son to walk again and even return to his beloved basketball court.

"For his son, that tissue was every bit a life-saving gift," Jim says. "Whether it's a major organ or the tiniest piece of tissue, in my mind, it's all Michael, living on in someone else. To know that he's helping other athletes and making a positive impact even after he left the earth -- I'm telling you, Michael would be thrilled."

After speaking with Jim and Kelly Collins, over the next few days, I drove the 300-plus miles almost directly north to Wausau, Wisconsin, to speak to a recipient, someone on the opposite end of this connection.

TRAVIS SCHERTZ didn't even make it out of the parking lot before his mangled right knee began to throb, again. By June 2013, Schertz, a speedy 6-foot-2, 205-pound sophomore wideout at Minnesota State, had endured seven tedious, tortuous months of rehab following his fourth -- and, he was assured, final -- knee surgery. Yet as he turned his Kia into traffic heading toward Tucker's Tavern outside of Mankato, where he worked as a bartender during the offseason, Schertz's blond buzz cut was already soaked by tiny droplets of pain-induced sweat.

When he first arrived on campus, Schertz had dreams of fine tuning his power-forward explosiveness and following former Minnesota State receiver Adam Thielen to the NFL. Chronic cartilage problems, however, had left bone grinding against bone in his knee. Every time he used his leg, it shot white-hot, throbbing jolts of pain through his body, as if he had bitten his tongue. He sat in his car that day, crying, thinking about a documentary he saw on Steve Nash. At first, he scoffed at an aging NBA All-Star relating injury to death. But now? Hobbled and in constant pain at 21, it made perfect sense. "Your athleticism, the favorite, defining part of you, is dead," Schertz says. "So you really are mourning the fact that the part of your life you loved the most is now dead, and there's nothing anyone can do about it."

Schertz gutted out his shift at the bar. Then he spent the next month researching alternative, advanced and cutting-edge orthopedic solutions. A pattern emerged. Every hit seemed to include the name of the same doctor: Chicago's Brian Cole, the team physician for the Bulls and the White Sox and a pioneer in meniscal and cartilage transplants. Twenty years ago, doctors would have cleaned out Schertz's knee, helped him manage his pain and sentenced him to a life on the La-Z-Boy. Now, using tissue from donors like Michael Collins, Cole performs 50 meniscal transplants a year and has helped more than 50 elite pro and college athletes return to the field. "In many cases, this tissue is every bit as life-saving as an organ," Cole says. "I have patients call, crying, in pain, angry, depressed, immobile, and in a hurry for surgery. But I have to remind them to keep perspective: Someone has to die before you can get your new knee."

Schertz waited five months for a young donor with the same weight and bone measurements. On Nov. 20, 2013, he was on Cole's operating table at Rush University Medical Center in Chicago for the five-hour surgery to realign his tibia and replace his meniscus and cartilage.

By June, Schertz was running on an anti-gravity treadmill at 80 percent of his weight. He returned to campus in the fall and hopes to rejoin the Division II No. 1-ranked Minnesota State team next year. A registered donor himself, Schertz wants the family of Michael Collins and his own set of donors to know that the end of his chronic suffering and the continuation of his football dreams have been nothing short of life-saving.

"Not a day or a moment goes by that I don't stop in my tracks and think about the sacrifices and losses someone else had to go through so that I could fix my knee," says Schertz, who wept at his keyboard while composing thank-you letters to his own donors' families. "What can I do or say to that family to justify the fact that I still get to run and play and be healthy and active and pursue my football dreams at the expense of their son?"

As a testament to his donors, Schertz has been religious about his rehab. When I visited this summer, after a grueling rehab session, he grabbed his cleats, gloves and a bag of footballs and walked out onto the expansive empty practice fields behind Wausau West High. Schertz hadn't been cleared yet to run and cut. Instead, he simulated the final steps and movements of several different routes -- digs, outs, posts -- then hauled in bullets thrown to him by a friend and former college quarterback.

The leathery "thwack" of his giant hands squeezing each pass echoed across the empty field as Schertz secured the first 20 passes with ease. He changed routes and caught 20 more. Then he walked to the edge of the field and hauled in another 15 from a longer distance. Another dozen whipped by without hitting the ground. Out of routes, Schertz then stood seven yards away from the passer, catching lasers one-handed. Finally, pass No. 74 tipped off his left hand and floated to the ground.

I'm not even sure I can describe the smile on his face at that moment.

Schertz reached down, palmed the ball out of the grass and walked with purpose toward the bench. Once there he sat and, without realizing it, began to gently rub his hands over his new right knee in soothing, rhythmic circles.

He looked up into the sun and began to speak.

But not necessarily to me.

"I need to take care of this gift and honor it and make the most of it," he says. "It's no longer just my knee, I know that. It's the donor's knee too. It's our knee now."