Lynne Daus visits her daughter every Sunday, bringing flowers and healing crystals. There, in Evergreen Hill Cemetery in Chagrin Falls, the sunlight drapes her daughter's headstone in a warm light. Gentle pines keep a vigil as Daus quietly shares another moment with Jordan.
On a recent warm August evening, she's planting a fresh row of hen and chicks along the marble's border. They look like the lotus flower engraved on the marble marker, where an elegy is etched for eternity: "Loving Daughter Sister Earthly Spirit." Small gems and heart-shaped stones are assembled nearby. "She was a little hippie chick," Daus says.
Three and a half years ago Jordan died after overdosing on heroin. She was new to the drug, and, like many of its victims, she was taken abruptly. A boy whom she met in treatment happened to show her how to snort the drug, and within two months Jordan was gone. She was one of 198 people to fatally overdose in Cuyahoga County in 2014, a number that seems almost quaint compared to 2017's projected death toll of 816.
Jordan walked a path that's very familiar to many Northeast Ohio teenagers. A little bit of recreational weed came first, and, as far as Daus knows, that and everything else was available to her daughter by the time she got to high school, a time when it's easy for kids to get their hands on whatever drugs they're seeking; walk down the hall between social studies and biology and you'll inevitably run into somebody who's got pills. Xanax, a benzodiazepine used to treat anxiety, was Jordan's favorite.
"If you listen to these kids and you see the statistics, they start at a young age," Daus says. "That's step one to addiction."
After Xanax came Vicodin and Percocet, opiates often ground up into a fine line and snorted.
Jordan entered treatment for her addictions at New Directions in Pepper Pike during her senior year at Kenston High School. She was hooked, and she herself knew that she needed help. But Jordan's insurance provider wouldn't cover the spin through residential treatment -- she wasn't specifically using heroin or other IV drugs. She ended up going sober on her own and attending outpatient treatment.
From March to September 2014, Jordan was clean. She graduated from high school. Along the way, though, heroin showed up. In September, Jordan relapsed. In November, she overdosed.
"She overdosed the night she had gone to a new treatment center," her mother says. Newly graduated and freshly 18, Jordan had been seeking a program for adults, and, her family later learned, trying to get away from the guy who introduced her to heroin. "She was scared, and thought she was going to die," Daus says. By nightfall on Nov. 10, 2014, Jordan was in the hospital, surrounded by the frazzled panic of a family looking for a miracle.
Daus received a call from the new treatment center the next day, while she was still at the hospital. Employees there were excited with Jordan's initiative and sense of commitment. They also let her know that Jordan hadn't wanted to tell her mother about the heroin because she didn't want to disappoint her. "Which is so typical of teen addicts," Daus points out now. The timing of the phone call added another layer to the oncoming tragedy.
Jordan overdosed on a Monday. She went into surgery on Saturday. Only then did four other people get a new shot at life.
The simple numbers that surround the matter of organ donation have always been on the dire side. Less than one percent of registered donors will be deemed medically "eligible" for that procedure when it comes time. As of Aug. 17, around 116,756 people around the U.S. were awaiting a life-saving organ transplant. The ratio errs on the side of sadness.
The United Network for Organ Sharing (UNOS) is the national agency that advances organ availability and connects donors with recipients. Across the country, organ donations are up in exponential numbers. While general awareness and education is one thing, a very important part of that sudden increase is the American opiate addiction crisis. [As annual fatal overdoses climb ever-higher in counties like Cuyahoga, so too do the number of potentially transplantable organs.] (Brain death, the medical terminus of an overdose, is the most conducive circumstance for organ donation.)
In 2017 so far, 33 percent of organ donors in Lifebanc's 20-county northern Ohio region were overdose victims. That's up from 24 percent last year and 16 percent in both 2015 and 2014.
"It's alarming," says Heather Mekesa, chief hospital and clinical services officer at Lifebanc. And she's quick to point out that the number of eligible overdose organ donors is only a fraction of the total overdoses that actually occur. The trend shows no sign of slowing down. In 2012, opiate overdose victims were blips on Lifebanc's radar, individual referrals making up a minute fraction of the whole; from 2014 on, the reality of the crisis intensified.
And, instinctively, it feels strange to describe things this way, but this is a true silver lining in the spread of opiate addiction and abuse. In Ohio, it's one of the few rays of good news to shine through the weekly pile-ups at county coroners' offices.
If it seems like a reach, Mekesa points out that opiate addiction is tagged as just one more "high-risk factor" in a donor's eligibility (like hepatitis or HIV). Opiate addict organ donors are treated no differently than any others. There's a spectrum of boxes that need to be checked before a transplant can be approved, including a blood type match and similarities in body size, and organizations like Lifebanc will also note whether the donor had a history of chemical dependency. Furthermore, a recipient can reject the organ on the basis of any high-risk factor -- even if the proposed transplant is a perfect match.
But because organ transplants are rare in general, it's not something that gets a lot of press or a lot of public debate.
To that end, LifeBanc and its advocates engage people throughout the community, especially high school students, who are generally more vulnerable to the creeping overdose crisis and who more often than not will end up registering as a licensed driver for the first time at the state BMV. Organ donation is presented as a way of saving lives, whether that be the archetypal classmate who is using heroin or the terminally ill patient desperately in need of a pancreas.
Despite the stark framing, only about 56 percent of Ohio adults are registered as organ donors.
Based on simple observation alone, a rising number of those men and women are opiate addicts.
By 10 p.m. on Monday, Nov. 10, quite soon after she snorted a fatal dose of heroin, Jordan Daus was in a bed at University Hospitals' Ahuja Medical Center. Her family surrounded her, weeping and working fast to make decisions on her behalf. The clock ticked quickly, but there was still a sliver of hope that Jordan might be saved.
A Facebook page called "Pray for Jordan" displays the week in gripping photos.
Jordan didn't have a driver's license, but she had made the very clear decision to tell her mother that she wanted to be an organ donor in the event of an unexpected tragedy. In the hospital, it falls to the next of kin to articulate a person's wishes (even if his or her ID bears the Ohio organ donor insignia). For years, Daus was a secretary to a heart transplant surgeon at the Cleveland Clinic. The topic of organ donation regularly came up in conversation with her daughters. "They were heavily involved with that I did," Daus says. She knew what her daughter would have wanted.
Almost immediately at the hospital, doctors explained to the Daus family that the outlook was not good for Jordan. Extensive brain damage was an inevitability, and a spectrum of tedious, mechanical tests were undertaken to confirm brain death. When asked, Jordan's parents explained that their daughter quite clearly wished to be a donor. For the Daus family, it was, at the very least, one less thing to worry about as the worst unfolded at the hospital.
It's hard to imagine a more devastating tightrope to walk: To move forward with the organ donation process, doctors needed to run tests to confirm brain death. That's done through a three-test process wherein two physicians must independently verify that all brain activity has ceased and that there is no medical hope for resuscitation. The apnea test is particularly harrowing; Jordan was taken off the ventilator, and physicians tested brain activity and physiological reflexes over the course of 10 minutes. The threat of cardiac arrest loomed.
"We were still fighting for Jordan's life," Daus says, holding back tears as the sun sets in Chagrin Falls. "It was a conflict. You're fighting for your daughter's life, but yet you want her to be able to have this test that says your daughter's dead because you want other people to get her organs." Time, somehow, moves excessively fast and ploddingly slow in those moments.
By Thursday, Jordan was strong enough, in a distant and relative sense of the word, to withstand a 10-minute apnea test. Shortly after noon, she was determined to be brain dead.
This is, for all intents here, among the best-case scenarios for young men and women who overdose on heroin in 2017. With a caring and dedicated family to guide her final wishes through a grueling five-day hell in the ICU, Jordan's death played out painfully. More than 100 of her friends and classmates came through the hospital to say goodbye and, inevitably, to see the cold reality of the opiate crisis unfold against their own personal lives.
Prior to the Saturday surgery, the LifeBanc procurement team came into the picture. All donation-related decisions are made by them and directed by their professionals before and after the operation. For Jordan, the team was able to save her heart, liver, kidney and pancreas, each of which went to a different person. (While those life-saving organs are healthy in most cases, known opiate addicts are not allowed to donate tissue.)
Recently, Jordan's liver recipient reached out to the Daus family. He donated to Team Free Spirit, their Run for Recovery fundraising team, which put them over the top of their goal. Over emails, he has explained to the family how cherished Jordan and her memory are to him.
Daus says that she's found great solace in how parts of her daughter remain on this plane, and how her organ recipients have responded in joy. The man who received her liver, an Ohio man, tells Daus that her daughter saved his life. Every morning, at sunrise, he and his wife give thanks to Jordan, and every night, at sunset, they express their gratitude again.
These days, Daus is a fixture at Lifebanc's Richmond Road office. She joins other parents in the current of grief and in the optimism of ongoing organ donation advocacy and outreach. When she says that Jordan's death cannot and will not be in vain, she's not alone in her hopes.
Marlene Shay sees the world through similar lenses. She continues to visit Lifebanc for counseling, and she's taken on a leadership role in the organization's community engagement work. It's not something that she'd have envisioned five years ago, but Lifebanc's 2017 Legacy of Life Award winner now wears the title proudly.
In January 2014, her son Adam overdosed on heroin and, shortly thereafter, died in the neurointensive care unit at the Cleveland Clinic. He was 21.
"He was a kind, generous person who thought of others much more than he thought of himself," Shay says. Three years out, she talks about her son often. She shares the stories that brought him to the hospital that winter and she points out how downright thrilled Adam was to become a registered organ donor.
Leaving the BMV on his 21st birthday, Adam excitedly told his girlfriend that he may be able to save someone's life one day. "He knew what he was saying yes to," his mother says now, adding that Adam was very interested in the ontological and the ripples of consciousness that all of our lives create.
"We had probably talked about it at some point," she says, referencing Adam's decision to register. "It was not a topic of conversation that was, you know, 'You have to...' or 'This is why...'" Of course, on the other side of her family's tragedy, Shay is extremely informed on the matter and urges men and women in the Northeast Ohio community to think about it and consider how impactful organ donation can be. She dispels myths, noting that doctors will still work to save your life even if you're a registered donor and that no major religion prohibits organ donation.
In the end, Adam was able to give his two kidneys and his pancreas to two people who needed them desperately.
It's hard not to reckon with the seemingly divine forces of fate when Shay says that her son contracted E. coli when he was 6 years old and almost lost a kidney to the disease. For 21 days, he was on dialysis at Rainbow Babies and Children's Hospital; the medical procedure worked, miraculously, and Adam went home to live out his childhood. He and two siblings grew up together, passing through youth's various and wonderful rites of passage, all leading him to one last trip to the hospital.
The woman who received one of his kidneys and his pancreas is Karen Goodwin, a fellow local artist and former opiate addict herself.
She waited purposefully for a year before getting in touch with Adam's family. As Shay says, she wanted to give Adam a full year of sobriety before opening that door to communication.
"I'm so proud of him," Shay says. "I refuse to stand behind a pillar of shame."
Daus shares the story of her daughter's death often. She warns young Northeast Ohio students that a heart-rending fate awaits those who don't actively resist the addiction crisis, who don't educate themselves about what the disease of addiction can do to them or to loved ones. It's not a mission that she sought, but rather one that was pushed onto her. She's risen to the tragic challenge.
She says that she was particularly taken with one of her daughter's friend's comments on her Facebook page in the days following her death: "Jordan Daus was one of the most judged, least judgmental people I knew."
"She was an old soul," Daus says. "She always felt that she didn't belong here, that she belonged somewhere else." Knowing that about her daughter, Daus speaks with a sense of clarity that comes from her faith.
Now and then, she shares a story about the unseen forces working in the background of her life. In 1993, Daus moved to the Cleveland area; Jordan was not yet born. She took a job as the assistant to the chairman of neurology at the Cleveland Clinic. His name was Hans Luders, and he filled a mentor role in Daus' early career.
It was only in the weeks after Jordan's death, when sundry medical bills began filling the mailbox, that Daus learned that Luders, now a neurologist at University Hospitals' Ahuja Medical Center, had been the physician who administered Jordan's EEG. He had been the man in whose hands Jordan's final moments of life were placed.
"I believe that her life was mapped out for 18 years," Daus says. "I don't know how long mine is but I know that it is mapped out, and I know that certain people cross your life for certain reasons." It's the sort of serendipity that would have thrilled Jordan, and it's a cosmic ripple in which Daus can find solace these days.
After the undulating chaos of their daughter's death, the Daus family found themselves at Evergreen Hill Cemetery on a snowy November day in 2014, less than pleased with the prospect of burying their daughter right alongside the 40-mph traffic of Franklin Road. And so they were brought to the historic section, north of the rest of the cemetery, where stone markers stand tall from the 1800s.
"There was about a foot of snow out here," Daus says, scanning the knoll. "We got out of the car and stood: The sun hit my face and my girlfriend, and we looked at each other and we said, 'This is where we've got to bury Jordan. She has to be where she sees the sun and the moon.'"
It's a stirring location, framed by pine trees and birds, and it's where Daus takes time to reconvene with her daughter. It's where she reflects on what brought Jordan to this moment, and where the future will take her.