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The Reluctant Donor
The only sibling with healthy kidneys, Suzanne is ambivalent about donating a kidney to a sister she's not even sure she likes--but she makes the offer. Eight family members, including her mother, have died from the disease. Now her sisters have PKD and each need kidney transplants. The Reluctant Donor exposes Suzanne's doubts, raw fear, and strong Irish Catholic family history. Her terror at the prospect of surgery is offset by her wonder at the small miracles that surround her. Inspired by her faith and the courage of those who came before her, Suzanne Ruff navigates uncertainty with humor and honesty.
232 pages, Paperback
First published April 4, 2010
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November 3, 2018
“A machine to keep you alive is a miracle. A body part given as a gift so you may live is also a miracle. Science plus miracles equal the gift of another day.”
Earlier this year I was diagnosed with polycystic kidney disease, a condition that runs in my family. My grandmother had it; my mother, plus an aunt and several uncles and cousins, have it. In my extended family it has meant dialysis and kidney transplants from both living donors and cadavers. My mom’s transplant back in summer 2006, from her cousin, was a major blessing.
So I brought a very personal interest to Ruff’s memoir of how PKD has affected her large, Irish-Catholic Chicago family. A sepia-toned photograph in the center of the book tells a solemn tale: six out of eight of the family members pictured would have PKD as a contributing factor in their deaths, if not the direct cause. Ruff’s aunt, Sister Mike (a nun), decided that the lives of people with children were more important than her own, so she didn’t press for a dialysis machine; when her kidneys failed in her forties, death followed just a few months later.
I’ve always known there’s a long waiting list for transplant kidneys, but I was surprised to learn that dialysis machines used to be rare; demand far exceeded supply, and the procedure was not covered by Medicare until 1973. In 1971 health officer Paul V. Joliet told The Daily Mail (Hagerstown, MD), “Kidney disease is a very catastrophic illness that only the very, very wealthy people can afford.”
Things had greatly improved by the time Ruff’s mother needed dialysis and a transplant. Joan sounds like a feisty, lovable character, with plenty of good advice on being a patient: fight for your rights (the meek ones often end up being carried out feet first), get up and walk as soon after surgery as you possibly can, and appreciate the joys of an entirely ordinary day. The whole family relied on both faith and humor to get them through painful experiences; I especially liked this account of Ruff’s Uncle Jack’s dialysis days: “Saturday was also the day Aunt Dorothy did her wash so they jokingly referred to Saturdays as ‘Washing Kidneys and Clothes Day.’”
Here’s another shocking thing, though. Ruff’s parents had her and her two sisters tested for PKD, along with Joan, when the girls were teenagers. But, having gone to all that trouble, they then lied about the results! They said no one had PKD, but in the end, three out of four of them did; only Ruff was spared. This is how she ended up donating a kidney to her younger sister, JoAnn – despite bad blood between them and Ruff’s almost overwhelming fear of needles, anesthesia and pain.
The more interesting sections of the book are about Ruff’s family history. Her internal struggle to convince herself to go ahead with organ donation makes for some pretty repetitive moaning. Almost as annoying was her husband Bill’s mantra leading up to the surgery, “you don’t have to give your sister a kidney today!” What’s the point of encouraging blithe unpreparedness with a phrase like that? Putting off the dread, I suppose, but what about when the day itself comes? Bill immediately switched to “At this time tomorrow, it will be over. ... And, you will never have to give anyone a kidney again.” Oh well. Whatever gets you through, eh?
I also took mild objection to Ruff’s unhelpful interventionist view of God: “God assembled the people in my life to teach me the lessons. He moved them around like chess pieces, a king here and a queen there, a rook and a knight, in and out of the game. The way they lived and the way they died were my lessons.” How offensive is that, seeing other people as mere pawns in your own life?
In general, the writing isn’t great. This is self-published, and it shows. Skimming back through, I just found a page with 16 of my proofreading marks; on most pages it’s more like 2-3. I was particularly irked by Ruff’s habit of starting sentences with “And,” – both the conjunction and the punctuation are ill-advised. There’s also a tendency to over-writing when trying to portray emotions: “Genetic disease. Those two words made my spine shiver, my ears ring, my throat close, and my heart pound; I became lightheaded and faint. Terror crept into my core and gripped me in its vice [sic]. My world came to a standstill and would never be the same again.”
So while I’m not sure I would recommend this book to someone who doesn’t have a personal stake in organ donation, for those who are interested in an autobiographical account of genetic disease and/or transplant surgery, it’s a quick and pleasant read.
Earlier this year I was diagnosed with polycystic kidney disease, a condition that runs in my family. My grandmother had it; my mother, plus an aunt and several uncles and cousins, have it. In my extended family it has meant dialysis and kidney transplants from both living donors and cadavers. My mom’s transplant back in summer 2006, from her cousin, was a major blessing.
So I brought a very personal interest to Ruff’s memoir of how PKD has affected her large, Irish-Catholic Chicago family. A sepia-toned photograph in the center of the book tells a solemn tale: six out of eight of the family members pictured would have PKD as a contributing factor in their deaths, if not the direct cause. Ruff’s aunt, Sister Mike (a nun), decided that the lives of people with children were more important than her own, so she didn’t press for a dialysis machine; when her kidneys failed in her forties, death followed just a few months later.
I’ve always known there’s a long waiting list for transplant kidneys, but I was surprised to learn that dialysis machines used to be rare; demand far exceeded supply, and the procedure was not covered by Medicare until 1973. In 1971 health officer Paul V. Joliet told The Daily Mail (Hagerstown, MD), “Kidney disease is a very catastrophic illness that only the very, very wealthy people can afford.”
Things had greatly improved by the time Ruff’s mother needed dialysis and a transplant. Joan sounds like a feisty, lovable character, with plenty of good advice on being a patient: fight for your rights (the meek ones often end up being carried out feet first), get up and walk as soon after surgery as you possibly can, and appreciate the joys of an entirely ordinary day. The whole family relied on both faith and humor to get them through painful experiences; I especially liked this account of Ruff’s Uncle Jack’s dialysis days: “Saturday was also the day Aunt Dorothy did her wash so they jokingly referred to Saturdays as ‘Washing Kidneys and Clothes Day.’”
Here’s another shocking thing, though. Ruff’s parents had her and her two sisters tested for PKD, along with Joan, when the girls were teenagers. But, having gone to all that trouble, they then lied about the results! They said no one had PKD, but in the end, three out of four of them did; only Ruff was spared. This is how she ended up donating a kidney to her younger sister, JoAnn – despite bad blood between them and Ruff’s almost overwhelming fear of needles, anesthesia and pain.
The more interesting sections of the book are about Ruff’s family history. Her internal struggle to convince herself to go ahead with organ donation makes for some pretty repetitive moaning. Almost as annoying was her husband Bill’s mantra leading up to the surgery, “you don’t have to give your sister a kidney today!” What’s the point of encouraging blithe unpreparedness with a phrase like that? Putting off the dread, I suppose, but what about when the day itself comes? Bill immediately switched to “At this time tomorrow, it will be over. ... And, you will never have to give anyone a kidney again.” Oh well. Whatever gets you through, eh?
I also took mild objection to Ruff’s unhelpful interventionist view of God: “God assembled the people in my life to teach me the lessons. He moved them around like chess pieces, a king here and a queen there, a rook and a knight, in and out of the game. The way they lived and the way they died were my lessons.” How offensive is that, seeing other people as mere pawns in your own life?
In general, the writing isn’t great. This is self-published, and it shows. Skimming back through, I just found a page with 16 of my proofreading marks; on most pages it’s more like 2-3. I was particularly irked by Ruff’s habit of starting sentences with “And,” – both the conjunction and the punctuation are ill-advised. There’s also a tendency to over-writing when trying to portray emotions: “Genetic disease. Those two words made my spine shiver, my ears ring, my throat close, and my heart pound; I became lightheaded and faint. Terror crept into my core and gripped me in its vice [sic]. My world came to a standstill and would never be the same again.”
So while I’m not sure I would recommend this book to someone who doesn’t have a personal stake in organ donation, for those who are interested in an autobiographical account of genetic disease and/or transplant surgery, it’s a quick and pleasant read.
January 11, 2011
Good story - really makes you think about the life of a dialysis patient and how fortunate those of us not on dialysis are.
May 19, 2013
Even if your family has no connection with PKD (Polycystic Kidney Disease) or you aren't facing a decision about organ donation, you will still find inspiration within the pages of this book, hope and a personal glimpse into unselfish devotion to family. Its an intimate story of Susanne's decision of organ donation, a decision made hardest by the emotional as well as physical impact upon her and her family from a devastating genetic disease. Suzanne honestly examines how she found strength to make the selfless decision to donate her kidney to her sister. She shares with the reader how her family, many stricken by the PKD, loved and supported one another through much suffering and loss. Insightful and even humorous at times, anyone who has been ill or cared for a sick loved one, who wonders why suffering exists, or who has prayed for a cure, will find this an inspirational read and a ray of hope within the often darkness of illness. A beautiful written novel of the joys and fears that many of us have faced.
February 4, 2017
Excellent read, very interesting imperfect family dynamics, and touching spiritual elements. Although I think we all know the ending before we even begin the book, the journey does not always take the predictable course. I enjoyed the irony, humor, and colorful depictions of family along the way.
September 19, 2011
A Touching story about a family that struggles with a horrible genetic disease. Suzanne is honest, witty, and personal. Will make you laugh and cry! Entertaining and educational.
January 29, 2015
An intensely personal and brave memoir of the struggle, both emotional and physical, of being a kidney donor, this book challenges and rewards readers with insights and affectionate prose.
January 25, 2022
If you or a loved one are impacted by PKD, then this book is a great read. I felt like I was making connections with every turn of the page. It was like I was reading a story about the lives of my own family members. It was heavy and uplifting at the same time.
A must read for any PKD warrior.
A must read for any PKD warrior.
December 13, 2025
learning as much as I can about living donors so it was good to read a person's perspective.
August 18, 2016
I always hate to knock a book, especially a memoir, mostly because I know how difficult it is to even write them, but this book was NOT for me.
From the very beginning, the very first few pages, of this book a few things are made clear by the author. 1- The author's sister is dying of kidney failure/disease. 2- The author is too afraid of surgery to save her sister's life.
It is number two that I could not get past. And because of that one reason, I could not once, not ever relate to or sympathize with her. It's entirely possible that my own morals and beliefs clouded my abilities to reflect with the author, because she tries very hard to make the reader see her side of the story. Unfortunately, I just could not understand the simple fact that she was "too afraid" to donate her sister her kidney.
She spends the first 3/4 of the book moaning and groaning about how terrified she is to give up a kidney, something that she doesn't even need, and one of the more painless organ donation surgeries that exist. She is consoled, her husband is a saint for dealing with her, she has these fears... And then poof! In the last quarter of the book the kidney is donated and she is a HERO.
I'm sorry she was afraid of donating an organ. I'm glad she got over it. And I still have only on emotional connection with this woman: anger. When your sister's life is on the line, when your family's life is on the line, you do what it takes to bring them back, and you don't bitch and moan about how bad YOUR healthy, perfect life is while you are doing it. The end.
From the very beginning, the very first few pages, of this book a few things are made clear by the author. 1- The author's sister is dying of kidney failure/disease. 2- The author is too afraid of surgery to save her sister's life.
It is number two that I could not get past. And because of that one reason, I could not once, not ever relate to or sympathize with her. It's entirely possible that my own morals and beliefs clouded my abilities to reflect with the author, because she tries very hard to make the reader see her side of the story. Unfortunately, I just could not understand the simple fact that she was "too afraid" to donate her sister her kidney.
She spends the first 3/4 of the book moaning and groaning about how terrified she is to give up a kidney, something that she doesn't even need, and one of the more painless organ donation surgeries that exist. She is consoled, her husband is a saint for dealing with her, she has these fears... And then poof! In the last quarter of the book the kidney is donated and she is a HERO.
I'm sorry she was afraid of donating an organ. I'm glad she got over it. And I still have only on emotional connection with this woman: anger. When your sister's life is on the line, when your family's life is on the line, you do what it takes to bring them back, and you don't bitch and moan about how bad YOUR healthy, perfect life is while you are doing it. The end.
February 6, 2015
This inspiring book had me from page one. The fact that it is a true account of a courageous family who struggles with a genetic disease is powerful, but when you add what the author endures in deciding whether or not to donate a kidney to her sister, the story becomes a very personal one written with both humor and sadness. For many who have never heard of PKD, the book also educates and brings attention to a disease that has in the past been overlooked even though it affects 12 million people worldwide. Since our family, too, shares in the fight with PKD, I have read several books on the subject, yet this book is the first one that puts a "face" on this disease. It has and continues to help those who read it understand not only PKD but how it affects relationships within a family for generations. I have read it and reread it and have been inspired each time!
September 10, 2016
An honest, first person account of what it's like to be the donor who selflessly donates an organ to save the life of another. I hope to never be in a position to make a similar decision, but I suspect there are many who do face such a harrowing life choice. They will certainly find comfort in this memoir.
Like the author, I was raised Irish and Catholic and found so many connections to faith and cultural identity woven throughout the pages. From the familiar Irish odes to the mystical interventions of faith, I saw my own history reflected in Suzanne's Ruff's history. I felt anguish for Ruff as I read about family members passing from the disease at much too young an age. But I also laughed throughout the book because Ruff peppered in hilarious anecdotes about her family.
Ultimately, I think this is a story about faith and families--and about finding strength from both.
Like the author, I was raised Irish and Catholic and found so many connections to faith and cultural identity woven throughout the pages. From the familiar Irish odes to the mystical interventions of faith, I saw my own history reflected in Suzanne's Ruff's history. I felt anguish for Ruff as I read about family members passing from the disease at much too young an age. But I also laughed throughout the book because Ruff peppered in hilarious anecdotes about her family.
Ultimately, I think this is a story about faith and families--and about finding strength from both.
January 23, 2012
This books was a nice look into somebody struggling with the decision to donate a kidney, and as a sufferer of PKD, I was interested. If you don't have a connection with PKD, though, I'm not sure this book would be all that appealing. It's kind of choppy, poorly paced, and it's not like there's any suspense--I mean, who is going to back out of a kidney donation that will save a sister's life? I'm glad I read it, and like I said, it's a good look into the world of PKD, but I can't say it's the best book I've ever read.
May 5, 2015
This is a heartwarming and heart-breaking story of genuine love from a sister to a sister, albeit given reluctantly. It is heart-breaking that a family has a history of polycystic kidney disease and failure. Why me? Why us? Why is there no cure so people can avoid dialysis? Many questions to answer. There is sorrow combined with an over-powering love. Hope and courage abound in these pages. I have met the author, a hero, and she has won my admiration. She is a very motivated speaker on the need for kidney research and the need for donors.
August 22, 2013
A very informative, true story about a family plagued with the deadly disease, PKD, which destroys the kidneys. It is heartbreaking to see how this disease can run rampant in families and affect everyone in the family - even those who never contract the disease. I was already an organ donor when I read this book, and I think anyone reading it who is not a donor will perhaps re-examine their choice and grasp the opportunity to save a life (or many lives) when they are gone.
January 7, 2015
As a professional working in the dialysis field, I found Suzanne Ruff's account of PKD heartbreakingly inspiring. People dealing with kidney failure have both the blessing and curse of dialysis to prolong their lives. I have seen countless journeys from the dialysis perspective, and I was captivated to hear Ms. Ruff speak from the living donor perspective. I will highly recommended this book to fellow clinicians, kidney patients and their family members.
June 18, 2015
I stumbled across this book and so glad I did! I loved the stories within the story, the personalities, the emotions and the unconditional love - from start to finish. I read with a tissue in hand at all times -- I cried hard and I laughed hard and I cried some more. I was educated on PKD and it confirmed my already present desire to be an organ donor. Do yourself a favor and check out Suzanne Ruff and her very funny, very loving, and very giving family. You'll be glad you did!
April 25, 2011
You can not imagine how great this book is!!! A must read for anyone with PKD or considering kidney donation.
May 31, 2012
Perhaps I enjoyed this one more than others since it hits a little close to home for me.
February 5, 2015
The author of this book is honest about her fears of donating her kidney, and her strength to do the right thing. I highly recommend this excellent book.
October 7, 2015
Interesting memoir - makes you want to ensure you have the organ donor box checked on your DL.
Displaying 1 - 20 of 20 reviews