Kidney.

Humanists believe morality begins with skeptical inquiry and that goodness is something people bring to an indifferent universe. So five years ago this week, I gave a kidney to save my dad's life.

In the summer of 2018, I woke up in Nashville missing a kidney.

My throat burned from a recent intubation. Dissipating anesthesia fogged my vision and memory while fentanyl coursed through my veins. My abdomen screamed when I laughed because the top half was glued to the bottom along a fresh five-inch scar. I felt alive. I felt dead. I was the happiest I have ever been in my life.

I had saved him.

1. Salvation and its discontents

I am an atheist. That means I don’t believe in god. Exactly why I’ve rejected the god of my Catholic ancestors could be the topic of another essay. Suffice it to say, I was raised religious, but no longer believe in gods … or saints, or angels, or afterlifes or souls.

And I bring this up now because it’s surprising to some.

In kidney donor forums, the more common story is a faith-based one. Religious people being moved by their faith — and only after intense prayer — to give someone else in need the gift of a more complete, more vigorous, more fulfilling life. They are moved by moral commandments to love thy neighbor and give unto others as you would have them give unto you. They walk through a universe infused with meaning, where every challenge and triumph serves a higher purpose, where everyday actions are intertwined with the divine.

I don’t view anything through that lens. My universe is an indifferent place. It neither hates us nor loves us. And it’s certainly not communicating to us through the movement of atoms or the flow of cause and effect.

And yet I also gave a kidney, five years ago this week. For a Catholic recipient. In a Catholic hospital, where no one had ever heard of a “humanist.”

The religious reader might ask: why? If all is permitted — if there is no god to punish the wicked, or lift up the righteous, or even provide an objective set of ethics — why go to the trouble, the pain, the inconvenience of living donation?

And it’s at this point that most questioners would arrive at one of two possible explanations for my donation:

1. I am acting irrationally and unreliably. I’m basing my moral decision-making on something flimsy that pretends to replace godly ethics but will come crashing down the moment a clever Jesuit starts poking holes in its logic, or …

2. I am some form of fool or liar. I am still structuring my life by religious principles. Perhaps I don’t realize I’m doing it. The principles are just so deep I can’t shake them, can’t help myself from loving thy neighbor. Or perhaps I am secretly religious, knowing god exists, but rebelling against him by pretending not to believe.

The first answer paints me as a philosophical wildcard, the second a misotheist. Neither are correct. My donation was not a fluke, nor was it secretly devout. To the contrary, I don’t think it was much of a moral choice at all. In fact, it was inevitable. And it was atheism that got me there.

Now, atheism is simply one answer (No) to one question (Do you believe in god?). That’s it. You could be an atheist who believes in ghosts or reincarnation. You could be an atheist who draws their worldview from communism or feminism or anti-natalism. The “atheist” tag doesn’t necessitate any of these other labels, nor does it forbid them.

Atheism is only and simply the non-belief in god.

But in my experience — and for most American atheists — the realization that we are alone in this universe, with no god coming to save us and only each other to rely on, tends to lead non-believers toward some common beliefs and some consistent conclusions about how to behave.

For me, that ultimately meant trusting a surgeon to remove my left kidney and rapidly but expertly give it to my dad.

And I did this not despite my atheism but because of it.

Christianity teaches we were created in one way or another by an all-powerful god. I think the truth is more terrifying and more freeing.

2. Kidney failure on the high seas

In the summer of 2017, one year before the surgery, I went to hell in Skagway, Alaska.

The cruise ship had departed from Seattle — full to the brim with the worst, most entitled people on earth, as well as the underpaid staff those entitled people were eager to mistreat, and the duty-free shops, set to open only upon international waters, where those entitled people could buy luxury items without paying the sorts of taxes meant for poors back on the mainland.

And I was set to spend the week with these miserable, entitled assholes. But hey, it was my grandparents’ 50th anniversary, my whole family was there and I had an unlimited drink pass.

Maybe it would be alright.

It was alright until the morning we ported in Skagway — a foggy coastal town, stuffed deep into one of Alaska’s many narrow bays and surrounded, on most sides, by stunning, misty fjords.

I met my mom on the way off the boat.

“Your father had a rough night,” she said.

Rough night indeed. A few years back, he had been diagnosed with diabetes. That new condition started a steady deterioration of his eyesight, and hindered his mobility. It attacked his kidneys too, and he was eventually diagnosed with kidney disease.

Sometime in the middle of the night, somewhere off this continent’s west coast, that kidney disease turned into full-on kidney failure. Kidney failure is exactly what it sounds like: the near complete loss of kidney function.

You need your kidneys to filter your blood and to balance both chemicals and blood pressure in the body. Without your kidneys, all the waste and extra fluids start to build up, sapping you of strength, energy and life. Without modern medical care, you will die.

More than 37 million Americans are living with chronic kidney disease. They won’t all experience kidney failure, but many will. And those who do live a diminished life.

Living with kidney failure requires a grueling regimen of hemodialysis — the cleaning of one’s blood — typically by way of a permanent port added to one’s body. In-center hemodialysis sees patients reporting to the hospital three times a week, hooking up to the machine for two to four hours at a time. At-home dialysis sessions can be shorter and more frequent, but that’s still two hours or more up to six times a week.

At best, each session buys a patient a few hours of consistent high-level energy. Then it’s back down into the slog, until the next time they can get in for another session.

I didn’t know any of this in Skagway. I didn’t know much of anything. What I knew is that my dad had a rough night, that he needed medical care the ship doctor couldn’t provide, and that he might die if that medical care was not forthcoming.

We couldn’t see him or do anything for him and it was decided we needed a distraction. So my siblings and I, shell-shocked, were ushered off to the grimmest glass-blowing seminar the tourism industry of Skagway has ever seen.

The two employees there did their best to be chipper. The only other attendees, a young couple, kept their distance. We went through the motions and produced some fine ornaments, but we weren’t really there.

On the way back to the ship, an ambulance chugged down the pier toward us. We knew who it was even before we saw our mom in the passenger seat.

My parents never returned to the cruise ship. We were told Skagway was short on medical professionals, so my dad was flown to Anchorage.

Back on international waters, we had limited cell service and therefore limited updates. We were left to wonder, for a whole day, whether our dad was dead or alive.

I took every distraction that horrible trash ship could offer, from tiki bar to treadmill, until I was dangerously full of pina colada and lactic acid.

Eventually, we learned Dad was stable and he would live, but he’d never have the same quality of life. The road ahead of him was a dark one, limited in length and scope — a life lived in the moments between dialysis sessions.

We returned to the mainland a few days later, the cruise a bizarre, dissonant memory, that ship forever lodged in our reptile brains as the place where we might have been orphaned.

3. Atheist grief

What’s an atheist to do in moments like these?

I imagine this is the sort of event that might give a Christian a crisis of faith. After all, what kind of loving god would do this to my dad?

I know that if I ruled the universe and let this sort of thing happen to any of its denizens, I would be an asshole. So we need some pretty strong theology to explain how god isn’t.

And doubtless, the Christian can find that strong theology. It’s a test. It’s an essential part of a bigger plan. It’s an inscrutable piece of a more glorious whole. It’s not as bad as it could have been — and maybe that’s the point?

An atheist doesn’t need theology, strong or otherwise.

Isn’t it miserable being an atheist? Not at all. When I face misfortune and misery, I don’t have to explain it away. It’s a relief, honestly, that my dad’s ill health, or the death of a friend, or an earthquake that kills 59,000 people is not part of some grand plan.

There’s a reason you’re not supposed to tell grieving people that their loved ones are in a better place, or that everything happens for a reason: It doesn’t help. It might even do the opposite. Refusing to face grief head on drags it out, drags you down, and saddles you with a cognitive dissonance that troubles your sleep and haunts your days. You’re left spinning, in denial, as you desperately seek to attach meaning to mindless injustice.

Atheism allows a more fruitful approach.

We don’t need to ponder why the universe would do this to us. It didn’t really. It just is.

But we’re here now. We’re in it. And the better question to ponder is what can be done. And by asking what can be done, we start to admit the truth and to take agency. And we might just do something heroic, or at least helpful to our fellow travelers.

Of course, sometimes there’s nothing we can do to stop the tragedy. Death happens. The atheist can face death and admit what it is. Irreversible. Permanent. Real.

We can’t resurrect the dead. But we can comfort the grieving. We can be there. We can listen. We can ask loved ones for their memories and their stories. We can cry along with them and share in their pain. We can return to that core truth that we are social animals and no social animal should suffer alone.

But this extends to all forms of loss and grief. The atheist is free to skip right past that fruitless first stage of grief where individuals try to explain away tragedy by pretending it has some higher purpose.

Thankfully, kidney failure is not death, not right away. And we have more space to work with. More options available to us.

Here, atheism is more helpful too. There’s no praying our way out of this. There’s no miracle or divine intervention that will get these kidneys pumping again. If there’s going to be a solution, it has to come from us.

So we ask what can be done, and the answer, in our modern world, is clear.

We cut ourselves open and give until it hurts.

The Christian celebration of Christmas, enhanced by additions from various world cultures, gave us the secular holiday we know and love today.

4. Christmas

At this point, you might be surprised to learn that I love Christmas. No, I don't believe that the events of the nativity story happened the way they’re portrayed and I certainly don’t believe that whatever occurred away in a manger two millennia ago has the spiritual significance we’re told it does.

But for an entire month every year, as our sun grows shy, we rebel against the darkness with string lights, we rebel against the cold with hot drinks and crackling fire, we rebel against the bitter loneliness by filling our days with thoughts of giving or acts of charity or the production of several hundred films pushing the same schmaltz-y vibe.

Christmas is one the best things humans do.

And as we opened our presents Christmas morning, five months after that fateful cruise, my dad opened a small envelope containing three tiny slips of paper. The first two were the sort of unremarkable coupons that small children dream up, decorate and cut out for their parents. Free hugs while supplies last or a lawn-mowing discount for half-off. As a man obsessed with yard work, my dad had collected dozens of these over the years.

But the third coupon was new.

One free kidney, redeemable at participating hospitals.

5. Humanism

Here’s what I believe: the universe doesn’t care about us, so we have to care about each other.

Life is simply more precious with an atheist worldview. Christians are passing through this realm on their way to eternity. But an atheist is a lucky mistake, a fluke, a collection of atoms that gave rise to consciousness. The atheist exists here and now and nowhere else and never again.

That realization inspires some other realizations about how one ought to approach the world.

Personally, I think “memento mori” is a strong case for a sort of responsible, dedicated hedonism. Enjoy the hell out of being awake because it’s back to the void at the end of this long day.

But looking outward, an atheist is struck almost immediately by the truth and necessity of the Golden Rule. All these other people, and to some extent all these other animals, are also awake for just a brief window. So all of my interpersonal actions, the entirety of my public life and also my political activity should be hellbent on making sure everyone else gets to enjoy their moment in the sun too.

But the Golden Rule is Christian! Well, not exclusively. Every major religion and ethical philosophy on the planet, including many that predate Christianity, arrive at some formulation of “Do unto others as you would have them do unto you.” We don’t even need the religion or the philosophy to get there. It’s just empathy operationalized. It’s an impulse most humans have — one that can be strengthened or eradicated through conditioning.

The difference, then, between my view and the view of most of my neighbors, is that I don’t think there’s any net to catch us if we fail.

Someone who lives a short, miserable life simply spent their entire existence suffering. There’s no heaven to make that right, nor even any great plan to make it useful. It just happened and we failed to stop it. That person doesn’t get another chance. That person will never exist again.

And it’s at this point where I think the Christian turns around, or stops reading. The prospect of a godless world is simply too grim and upsetting to contemplate, so why bother? The only thing lurking down that rabbit hole is depression and suicide. So I think I’ll stick with God, the Christian decides, even if I have doubts.

And that’s where I used to be, before I took my leap of faithlessness.

Clearly that leap is not fatal. I’m still alive and happy and treating others how I would have them treat me. But I don’t blame you for not jumping. I like to assign agency to my actions, but truly, I fell. And ever since I landed, I’ve never found a way to convince those still standing up there on the ledge that the land below is beautiful, fulfilling and free. But it is all of those things and more.

If you’re not interested in taking that leap, that’s okay. I hope you can put yourself in my shoes regardless.

Embody, for a moment, the subjective experience of atheism. Imagine standing alone before a vast and careless universe. In that reality, truly, what is there to do but find others and love them fiercely?

Love does more than make the vastness bearable. It actively sews meaning into a world that had none. Lonely creatures, unimaginable to each other except through great feats of empathy, finding each other in the darkness, building happy little homes together, writing constitutions, building starships, being clever, being funny, being curious, sharing kidneys.

So yes, the golden rule is self-evident. All we know is how we feel and we can make an educated guess that everyone else is in the same boat. I know that if I had to undergo dialysis several times a week, I’d consider a kidney the greatest gift in the world. (I’d be less likely to receive one, since Americans are less likely to donate a kidney to an atheist, but I’d love one all the same.)

There was no religious text I needed to consult. There was no god from whom I needed guidance. I didn’t need a religious philosophy. The facts led inevitably to their own moral conclusion.

My dad needed a kidney and he would continue to suffer without one. As several thousand people do every year, he would eventually grow too sick to qualify for a transplant. And after that, he would die.

Every day in this country, 13 people die waiting for a kidney that never comes. That means 13 families are left grieving. That means 13 people dissipate back into the lifeless universe.

The atoms remain. But we are not the atoms. We are not the oxygen nor the fuel, but the fire. We are the combustion, brimming with light and heat. More fires will follow this one, but this fire will never burn again.

And every day, the universe snuffs out 13 of these flickering chemical reactions.

Knowing all of this, the moral answer presents itself. I knew the universe didn’t care about my dad. So I knew I had to. So I did.

Socrates believed an unexamined life is not worth living.

6. Atheist joy

I saved a life. And I will always have saved a life.

Any day I’m feeling down on myself, I can draw on that memory and know I am capable of great things — an eternally accessible reminder that I must not be so bad after all.

With atheism, the universe becomes more terrifying but also more wonderful. Life was not created for any purpose or end goal, but what could be more wondrous than life developing on its own? As Darwin put it, there is “grandeur in this view of life” where “from so simple a beginning endless forms most beautiful and most wonderful have been, and are being, evolved.”

Likewise, under humanism, your ethical obligations become more demanding but also more rewarding. I felt compelled to give my kidney, pushed by my own moral reasoning about how to behave in a meaningless universe. But I was not forced to give — no god coerced me with the promise of heaven or the threat of hell. I followed no commandment. I offered no prayer. And because this gift came from me, the afterglow I now enjoy is all the brighter. I can take part in the wonder of the universe by giving myself freely, making that gift purposeful by assigning it purpose.

In this way, existential horror begets existential joy.

There is no god coming to save us. And that’s distressing, at first, if you’ve been led your whole life to believe there is, indeed, someone coming to save us, someone who cares about us and shapes meaning out of our tragedies and triumphs.

As meaning-seeking creatures, what could be worse than realizing none of this is according to any divine plan? Tragedies with no purpose are sharper and cut deeper than tragedies dulled by their service to a higher good. (Perhaps. I would submit that dulling tragedies leaves us more miserable in the long run. But whatever you think of the tragedies, we must also contemplate what atheism means for the triumphs.)

Triumphs can no longer be explained as “part of the plan.”

From start to finish, my donation involved humans gathering their resources, intelligence, willingness and wits to alleviate one man’s suffering. Humans coming together for a common cause. Humans pulling off a feat so spectacular our ancestors would call it magic and label us gods.

If we’re just souls, then of course we would eventually do this. It’s inevitable that souls, bolstered by an all-powerful being or purpose, would pull off impressive feats.

But it’s not inevitable for apes. It’s not inevitable for beings who lucked into intelligence and moral reasoning and boundless curiosity. The odds were against us ever doing this and yet we did. In the name of alleviating our collective suffering, we dove fearlessly into the mysteries of the universe and resurfaced with godlike powers. We brought the unthinkable into the realm of the possible and then into the realm of the routine.

We did all this ourselves — not because of a divine plan, but in the absence of one.

I never knew awe until I left religion, but now I’m well acquainted. Learning that none of this had to happen is an endless source of wonder. Yes, it demands that you care for your fellow creatures with a new intensity and it assigns you the terrifying project of developing your own meaning and purpose in life. But it never stops being wonderful.

Atheism is only scary from the outside looking in. Once you leave god behind, a new universe of possibility opens before you — a universe unbounded by the whims or dictates of supernatural beings. In this new universe, we are free to explore and investigate and create and love, guided by our care for each other. To reach that point, we need only to recognize our freedom.

It’s not so bad to realize that we are all there is when you know that we are enough.

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Resources

If you’re curious, plenty of atheists have written extensively about holding a secular worldview and the beliefs or morals that worldview entails.

Existentialists and absurdists like Albert Camus have explored how one might find meaning in a meaningless universe. If you’re interested in building an ethical life outside of religion and you’d like more guidance than I’ve provided here, I’d recommend the philosophy of John Rawls, the fiction of Kurt Vonnegut, and the essays of Carl Sagan. Several atheists have developed thoughtful alternatives to the Ten Commandments, including Bertrand Russell and the authors of Atheist Heart, Humanist Mind.

The American Humanist Association promotes a set of Ten Commitments that I whole-heartedly endorse. They include such principles as critical thinking, peace, service and environmentalism.

But at the end of the day, all of these sources eschew dogma and orthodoxy and encourage individuals to develop their own moral precepts. The process of climbing your own Mt. Sinai and working out what you believe is worthwhile in itself.

On the kidney front, everything you could hope to learn about living donation can be found through the American Kidney Foundation at kidney.org.

I’ll leave you with this:

We are little fragments of the universe observing itself. Act accordingly.