Getting old sucks — at least when it comes to medical issues. Some health challenges can feel overwhelming, and some are simply beyond our control. The good news: There’s so much more that is within our control, driven toward successful outcomes by our experience, training and personal perseverance. With that in mind, I’d like to share my story of a recent health scare that opened my eyes to the far-reaching impact of firefighting — and the power of not only advocating for our own health but also looking out for those around us.
Stage 3 kidney failure — maybe
My primary care doctor was reviewing two iterations of blood work I had done as part of my annual physical. Among a bunch of other medical-speak, he mused, “Your kidney function was at 56% on the first reading, and it’s down to 52% now.” Without knowing the context of the numbers, I thought that didn’t sound too great. I was right.
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The doctor went on to explain that kidney function decreases as we age — a natural part of the aging process. However, at my age the function should be at about 80%. Then the doctor said some of those words that would haunt anyone: “Those numbers are consistent with Stage 3 kidney failure. Your numbers are not good, and if we can’t get that under control, you will need to go on dialysis.”
The doctor referred me to a nephrologist for the “next steps” — steps I had never contemplated.
The nephrologist asked all the typical questions and appeared skeptical when I reported that I was a non-smoker. We then discussed my 30-plus years on the front lines in the fire service and talked about my current physical activity status. The doctor was not too concerned yet and ordered another set of blood work to look for a “different marker.”
Fortunately, that next set of tests showed that the other marker was better than “normal,” and the doctor detected no abnormalities with my kidney other than its current function, now back up to 56%. She surmised that my 30 years of carcinogen exposure as a firefighter was the cause of the decreased function. She also noted that she usually sees these numbers in patients who have been long-time smokers, but that people in strong physical shape sometimes operate just fine in this range.
It was a difficult conversation, particularly given that this was the second time in two years that I faced a serious health situation. You may recall my story from last year, when I first heard the radiologist proclaim, “Mr. Bashoor, we found a mass on your lung.” The mass turned out to be a collapsed lung and infection from a lingering pneumonia — there was no cancer. The internist managing my 33-day hospital stay proclaimed on day 15 that most people don’t survive the type of catastrophic perforation and collapse I faced, and that it was only because I was in such good physical condition that my body was able to fight off the illness happening within it.
The wake-up call
The nephrologist stated as such a simple matter of fact: “Smoking isn’t just bad for your lungs; it’s bad for your kidneys and other organs too.” To me, her words were much more profound.
In the past 10 years, we in the fire service have focused significant energy on exposure protection and cancer prevention, and I’d say 99% of the focus is on lung cancer. But as my nephrologist so aptly lamented about carcinogen exposure, “It’s not just about your lungs.” Regardless of the focus, that kind of preventative and proactive talk simply didn’t occur when I was stepping onto the line 44 years ago. “Firefighting is dangerous, get used to it” was the mantra.
Today, I find myself asking, who’s next? These conditions seem inevitable for those of us who fought fires under those conditions for so many years. But it is NOT an inevitable conclusion for those of you still fighting fires today. Yes, firefighting is a dangerous profession. No, you do not have to expect that you will experience lung cancer or kidney failure.
What you can do
Most of us have had a friend or family member who passed away due to a cascading effect of one ailment on top of another. When your body is in “fighting shape,” you’re in a better position to have a better outcome when that first ailment strikes you. And while there are countless ways to stack the health cards in your favor, I’ll distill the advice to these most critical — and controllable — actions related to our work:
- Wear your PPE, and make sure you find a way to get at least two sets of gear;
- Keep your SCBA in use until air quality has been measured as safe;
- Conduct a gross decontamination of anyone that has operated in an IDLH, before they remount any vehicle;
- If a second set of PPE is available, bag the contaminated gear to take back to the station or a vendor for cleaning;
- Take a shower immediately upon returning to the station — do not go crash on the couch before you shower;
- Visit the First Responder Center for Excellence for connections to many resources and information available; and
- If you’re a smoker, STOP SMOKING.
We’re in this together
While I was once a “smoke-eater,” today I am a strong advocate for health and safety. Safety is not a one-way street, nor a linear idea. Beyond prevention and operational efficacy, we can help each other on the health front too.
As I have researched my own medical issues, I have found that the heart of the story is in all of the people behind the scenes — not only the ones working to keep us from getting into these conditions but also those who are looking for ways to take care of us if and when we find ourselves facing a health challenge. There are so many great people and groups working behind the scenes, but I’d like to spotlight two nonprofit organizations in particular.
The Billy Moon Foundation
The Billy Moon Foundation, named for FDNY Firefighter Billy Moon who died after a fall in the firehouse, was established by his widow, Kristina. Celebrating Billy’s final act of selflessness through organ donation, the Foundation strives to spread the message about registering to be an organ donor. According to its website, presentations by the Foundation and Kristina Moon have reached over 15,000 people and raised over $20,000.
Kidneys For Communities
Prior to and completely unrelated to my kidney scare, I had interviewed Kidneys for Communities - First Responders founder Atul Agnihotri about their program for first responder kidney donations. While encouraging first responders to become living organ donors, Agnihotri wanted to spread the word about their program that helps find kidneys for those in need. He explained that the more donors who are entered into the system, the more options become available in blood type and compatibility for everyone in need of a kidney. (Watch our interview here.) Allow me to share two Kidneys for Communities success stories with you:
A Marine and a firefighter
On Jan. 9, 2025, a retired U.S. Marine and National Guardsman who had worked at Ground Zero following 9/11 got the call that would save his life. The lifesaving kidney he had been waiting years for was on its way, thanks to a stranger more than 2,400 miles away in Calgary, Canada.
That stranger was a firefighter and fire truck mechanic. This firefighter answered the call after an email from the International Association of Fire Fighters and Kidneys for Communities appeared, asking for help to become a kidney donor.
The process to identify a match involves a complicated algorithm of factors, including blood type and human leukocyte antigen. The beauty of a focused-community approach is even if the donor is not a match, the patient can still receive a matching kidney through a paired kidney exchange. Through community-directed donation, a donor gives on behalf of a community — such as first responders — so that one donation can help another first responder, while enabling members of two to three other communities to receive transplants through the chain. That was the case here.
Through a paired kidney donation, this firefighter’s gift didn’t just save the Marine — it enabled two additional transplants, a teacher and a veteran, multiplying the impact. By April 2025, the Marine was back on the water, completing an eight-mile kayak race to raise funds for veterans — powered by a new kidney and renewed purpose.
Though they remain anonymous to one another for now, these two public servants share an extraordinary bond — a firefighter and a Marine connected by one act of courage.
A fire chief and a firefighter
After 51 years of public service, retired Pennsylvania Fire Chief Charley Westcott never expected to live a long life, but it wasn’t a fire call that threatened his life. First, his kidneys shut down, then the kidney drugs stopped working, and in 2022, Westcott found himself on a transplant list. His life was reduced to 9½ hours a day of dialysis in the hopes of staying alive long enough to find a donor.
Firefighter Bethany Sims learned of Chief Westcott’s situation and wanted to help, so she went through the three-month-long testing process. Against many odds, Bethany was a match, and she agreed to donate one of her kidneys to the chief. While matches are normally achieved through connecting total strangers, in this case, the donor and recipient work together.
Thanks to the Kidneys for Communities programs, these public servants are alive and well today.
Next step: Be your own advocate
During my health scare of 2024, it took three ER visits to convince doctors something wasn’t right. Sure enough, the third time was the charm to determine the problem. It was my overall physical fitness that allowed my body to continue to function at a survivable rate.
And this year, when the bloodwork pointed toward kidney disease, I did not have any of the symptoms the doctors expected me to have. My persistent physical fitness activity helped ensure that my body could function normally, despite the impacted kidney function.
Of course, being an advocate for your own health and wellness is about much more than a physical fitness routine — although it is a great place to start. Being an advocate means knowing your body, speaking up when something doesn’t seem right, and doing to work to protect it from harmful external factors.
Like we acknowledged, some health factors will be beyond our control, but there’s so much we can do to set ourselves up for long-term success, long before we know what that health scare will be. For me, looking beyond cancer to consider the impact of firefighting on my kidney health was an eye-opener. Cancers caused by firefighting will always be insidious, but we must protect all corners of our body — and look out for our brothers and sisters as well.
This year, when I registered my vehicles, I registered as an organ donor as well, and I am taking the extra step to register with Kidneys for Communities. While my kidneys might not be a great match for others, I am hopeful my other organs are healthy enough to be a lifeline for someone in need. After all, life is not just about us as individuals, and “it’s not just about your lungs!”
