Gifts of Love

Gifts of Love

Twice in the past 17 years, Ronald Paul of Potomac has needed kidney transplants. And twice, people close to him have stepped forward.

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Ronald D. Paul of Potomac is frequently characterized by family members and friends as the kind of man who would give the shirt off his back to anyone who needed it. He’s also a guy who finds it difficult to accept even a sweater for his birthday, they say. But Paul, the chairman and chief executive of Eagle Bancorp Inc. and EagleBank, has been the recipient of two particularly generous gifts over the last 19 years: two life-saving kidneys.

On Jan. 21, Paul, a 53-year-old with an indefatigable work ethic, underwent his second kidney transplant at the Washington Hospital Center. The donor was friend and colleague Kathy McCallum, 49, of Bethesda, who has worked for Paul since 1982 and is chief financial officer of Ronald D. Paul Companies. The transplant was successful, with McCallum’s kidney taking the place of a transplanted kidney from Paul’s brother, Steven Paul of Gaithersburg.

Ronald Paul and his wife, Joy, had been married for three years when he underwent a routine physical for a life insurance policy in 1982. Medical tests revealed telltale proteins in his urine, a sign that his kidneys were beginning to fail. Paul, 26 at the time, had no family history of kidney disease, so doctors suspected the development might have been a residual effect of childhood scarlet fever.

Paul was diagnosed with focal glomerulosclerosis, a condition in which the filtering units in the kidneys become progressively scarred for unknown reasons, eventually resulting in kidney failure. He took medication for eight years and followed a restrictive, low-protein diet, but his kidney function continued to decline. With Paul facing years of dialysis, his nephrologist suggested a transplant.

“I fell apart; it was devastating and frightening,” Joy recalls. “I thought it was life or death—but there are options in kidney disease that I didn’t understand at that point.” She immediately went into what she calls “full research mode” and contacted the National Kidney Foundation/National Capital Area. Within hours, Joy had reams of information about kidney transplants and had found Dr. Jimmy Light, director of transplantation services at Washington Hospital Center, the surgeon who would perform both of her husband’s operations. After meeting the couple, Light told them that “dialysis can keep you alive, but a transplant allows you to have a life.”

After learning of Paul’s need for a transplant, his brother, Steven, offered one of his kidneys. He says Ron would have done the same. “Ron would be the first one to offer if I needed it—he’s my big brother,” Steven says. “He’s always looked out for me—it was the least I could do.” A series of tests concluded that the younger brother was an acceptable match for the operation.

Steven was 30, married and living in Gaithersburg at the time. Like Ron, he left the family home in Oceanside, N.Y., to settle in the Washington, D.C., area after attending the University of Maryland. Ron and Joy Paul, both College Park graduates, met there during freshman year.

Steven’s offer of a kidney was especially valuable. A transplanted kidney from a living donor lasts longer than one from a deceased donor, says Julie Trollinger, transplant coordinator at the Washington Hospital Center, who worked with the Paul family during both transplants.

On Jan. 19, 1990, Paul, then 33, received Steven’s kidney during a six-hour surgery with no complications. Paul had a lot to live for: a loving wife; two daughters, Julie, then 6, and Robin, then 3; and the recently launched Ronald D. Paul Companies.

Steven’s decision to donate his kidney is rarely discussed by the brothers, but when it comes up, it’s often in a joking way. The transplant remains, he says, a testament to their brotherly love. “It was something we wanted to keep private between the two of us,” explains Steven, who bears a 19-inch scar from the surgery.

Early in 2008, Steven and his wife, Bonnie, were having dinner with Ron and Joy when Paul told them that Steven’s donated kidney was beginning to fail. It had already exceeded the typical 10- to 15-year lifespan of a transplanted organ.

Steven always knew the transplant wouldn’t last forever, but, he says, “I hoped it would—now there was nothing more I could do [for Ron]. It was a helpless feeling.”

A Second Gift

After learning the bad news from Paul that he needed another kidney transplant, McCallum promptly offered one of hers. McCallum was in excellent health and had a suitable blood type, and further testing showed that she and Paul were compatible for a transplant. According to Trollinger, as many as one-third of all living kidney donors today are not related to the patient. Improved immunosuppressive medications are so effective in blocking rejection that patients do not need a high-grade DNA match for a successful transplant, Trollinger says. In addition, a far less-invasive laparoscopic surgery is now used to remove a donor’s kidney, allowing the gift-giver to be out of the hospital in a few days, she says.

Because of the improved technology, McCallum’s donor experience was very different from Steven Paul’s. Says Steven: “[Since] the medical procedures are a lot different now, Kathy and I talked about it from a psychological standpoint; [for instance], what people will say to you. I’m uncomfortable when people say, ‘You saved [Ron’s] life.’ I’m kind of humble about that, like Kathy. She likes to joke that the transplant is job security; I called it a lease with an option to buy.”

McCallum, who grew up in Rockville and Boyds, Md., now lives in Bethesda. She first began working for Paul as a secretary 27 years ago and later earned her MBA at night. She knew her boss’ kidney was beginning to fail last year, but, she says, he continued to work “ridiculous hours, with a schedule most healthy people couldn’t keep up.”

“I’ve known for many years that if I could help by giving a kidney, I would,” McCallum says. “Ron finds it hard to accept a sweater for his birthday; it was hard for him to process getting a kidney again.” As with Steven 19 years earlier, “Ron knew [that] once I make up my mind, it’s not worth your time trying to talk me out of it,” McCallum says. “He knew not to waste his breath.”

Ron Paul agrees. “For those of us who know Kathy,” he says, “you don’t argue with her.” But it again was difficult for Paul to accept such an extraordinary gift. Both times “I kept asking, ‘Are you sure?’ to make certain there was no hesitation on their parts—and there wasn’t,” he says.

Joy Paul, 52, a social worker in private practice, says her husband of 30 years was faced with accepting a gift that is “beyond your comprehension—there is no way to adequately express your gratitude. It’s very hard for [Ron] to take a gift like this,” she says, “but you don’t have a choice.”

McCallum, Joy says, seemed very comfortable with her decision. “We were always close—she even drove me to the doctor’s office when I was in labor with Julie—we’ve shared so much of our personal lives together,” Joy says. “She’s been to all of the kids’ graduations and life cycle events—she has always been family, like another sister.”

McCallum, who is divorced and has no children, calls the Pauls her extended family. “Ron and I have a productive, close working relationship, and a very close friendship as well,” she says. “And I count Joy as one of my closest friends. [Ron] is so well-loved by a ‘bajillion’ people because he has a huge heart that he wears on his sleeve, with a genuine warmth and caring about him the minute you meet him. I felt like I was giving a gift to everyone.”

Surgery was scheduled at the Washington Hospital Center for Jan. 12, with Light to perform Paul’s second transplant. Ron, Joy, daughters Julie and Robin and their husbands, Steven and his wife and McCallum and her sister arrived at the hospital that morning. Just as McCallum was being wheeled into an operating room to have her kidney removed, medical staff discovered that Paul had developed a viral infection. The surgery was canceled. To the shock of the anxious group assembled in the waiting room, McCallum reappeared in street clothes and announced, “Well, that was quick.”

The transplant took place a little more than a week later, almost 19 years to the day after the first operation, in the same place, with the same medical team. The surgery went smoothly, and there were no complications. For McCallum, the nearly four-hour procedure was very different from Steven’s experience almost two decades earlier: Instead of a long scar like the one that wraps around his midsection, she was left with five incision marks, ranging from nearly invisible to about 1-inch long.

After the transplant, McCallum and Paul were hospitalized in nearby rooms. That afternoon, he walked into McCallum’s room, where family members were gathered. “We embraced, and there were a lot of emotions and tears,” Paul says. McCallum remained in the hospital for three days and returned to work a week later. Paul was hospitalized for five days.

Tom Murphy of North Bethesda is president of EagleBank’s Montgomery County operations and a longtime friend of Paul’s. He recalls his surprise on the day after the transplant, when he received a business e-mail sent by Paul from his hospital bed at 3 a.m. “It was nothing that needed to be addressed at 3 a.m.,” Murphy says, laughing, “but he just couldn’t turn it off.”

Undergoing two organ transplants has made Paul realize how vulnerable a human being is, at any age. “I’m so much more appreciative of relationships and how special they are,” he says. But his own relationships with Steven Paul and Kathy McCallum have not changed, he says, because they were so close before the surgeries.

And despite the challenges he has faced, Paul says he “never played the pity game—it wasn’t in the cards. I didn’t want to be babied. And I knew that I had too much to do and too much to live for. I love what I do—I can’t stress that enough. This was going to be a hiccup in our lives and nothing more.”

Today, with McCallum’s kidney dutifully doing its job, “I really think about how lucky I am,” Paul says.

Lisa Braun-Kenigsberg, a regular contributor to Bethesda Magazine, lives in Potomac.

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