“Learn to die and thou shall learn to live. There shall none learn how to live that hath not learned to die.” These words, written centuries ago in the Book of the Craft of Dying, highlight the need for us, as humans, to attain a relationship with all aspects of our life, including its ending. Regardless of religious predisposition, learning how to deal with this time of transition for ourselves and our families helps to bolster strengths for our communities in facing the inevitable with dignity and comfort.

In witnessing the profound challenges of medical caregivers, humanitarian aids, relatives and friends of the dying, and by those journeying alone through the stark, unfamiliar territory themselves, I have witnessed important lessons in confronting these issues for myself. But as a society, we Americans have moved away, in succeeding generations, from the lessons and concepts that witnessing death provides. Through confrontation and example, we can begin to reclaim our connection to this period in our lives when many questions are answered, when myths are dispelled.

Grandmother would recall how things were done when she was a child in Coastal Oregon, reminiscing about the sense of community that surrounded those times when people came together to help provide comfort and condolences to the dying and their families. It was this outreach of support that brought her and her neighbours together, but this was also a time for coming to terms. It was not so long ago, three or four generations perhaps, that we used to observe, firsthand, the dying and the dead. We learned more about ourselves through the experience of confronting the inevitabilities of our own mortality.

I am working on a project to photograph various ways in which different civilizations deal with this time of dying in order to compare and contrast the rituals and traditions that shape our understanding of our beliefs and culture.

Recently, I followed the lives of 10 heart transplant patients waiting for their hearts to come in. A cross-section of humanity, they are old white men with bad diets, young black girls with unexplainable energy, new mothers, and old fathers who are waiting for that which no one can hope for: that perfect someone who will die so that they may continue to live.

Last year, 50,000 Americans needed a new heart, and 95% of them will die without getting one. Of the 7,683 lucky enough to land on the national transplant list, only 2,340 got new hearts. There is a shortage of transplantable organs in America thanks to many technological advances, including the airbag and its effects on the survivability of car wrecks. Understanding that a better economy keeps the desperation of random acts of violence and robberies to a minimum, and combining this with a society that does not remind people often enough to consider donating their useable organs, it is easier to see why this trend is increasing with each new year.

The impact of the shortage affects even those who receive transplants. Since hearts are allocated to the sickest patients on the list, few get them at the optimal moment. The median wait is 207 days, which jeopardizes post-transplant health and results in astronomical medical bills. Most patients end up hospitalized, costing an average of $62,000 in preoperative care. And transplants are pricey-$100,000 for the operation, $50,000 for the first-year care and more than $20,000 a year, for life, for immunosuppressant drugs. Some patients have bills over 50 feet long.

The shortage is forcing doctors to take greater risks. They are retrieving hearts from cocaine users and older patients (10 percent of donors last year were older than fifty, compared with 2 percent in 1988), sometimes transplanting hearts that have been out of the donor body for more than four hours, when, many studies show, they start to deteriorate.

I hope to use these people’s stories as a call to arms, to signify and illustrate the necessity to change our collective perspectives on donation. In researching and exercising this project, it became obvious that there are too few good educational resources for those interested in, or directly affected by, the transplant shortage and subsequent life of waiting for an organ to come in. With an eager and curious perspective and an amazing amount of access to the workings of a hospital, I took the opportunity to make a lasting, political statement.

The relationships that I make in the stories that I take on most often last much longer than the resulting publication dates. I get close, and stay close; a consistent reminder of the responsibilities of my decision to create a platform for common people and the issues that affect their lives.