For nearly 18 years Graham and Britton Douglas believed they were fraternal twins. That was until Britton needed a bone-marrow transplant because chemotherapy for his leukemia had failed.
The Fort Worth, Texas, brothers learned that they were identical twins, sharing the same DNA, and therefore Britton could not receive his brother's bone marrow because their genetic make-up was too similar to fight the cancer.
Today, at 27, Britton Douglas is a healthy, successful Dallas lawyer, thanks to a bone marrow donation by a stranger.
But his twin brother, knowing that he nearly lost his only sibling, has been obsessed for nearly a decade with finding better ways to get more Americans to become donors.
"It's indescribable how much I love my brother," said Graham. "I don't know what I would do without him."
Graham's concept was so simple and yet could save the lives of tens of thousands of Americans with leukemia who are waiting for a bone-marrow transplant: packing a swab kit inside a box of bandage strips.
A senior creative at the New York City advertising agency Droga 5, he found his inspiration last year while teaching a portfolio class at a commercial arts school.
Year after year, he has challenged his students to find a creative solution to attract more donors. Two students he refers to as the "Spanish team" -- Alfredo and Alberto -- came up with the "germ" of an idea last year, and it has now hit the market.
The consumer healthcare company Help Remedies partnered with Graham and the world's largest bone marrow donor center, DKMS, to release the new product -- "help I've cut myself & I want to save a life." The cost is $4.
Before applying a bandage strip to a minor cut, consumers can swab their blood and then send the sample in a self-addressed, stamped envelope, along with their age and email address, to DKMS.
The donor center will then follow up to get more information on how the consumer can become a donor. All potential donors are anonymous and there is no obligation to donate bone marrow, even if a match is found.
The three-year-old start-up Help Remedies is known for its minimalist packaging and unusual product names. For now, the over-the-counter marrow registry kit is only available on its website.
"Like any over-confident ad guy, I saw a problem and wanted to fix it," Graham said. "Maybe I am naive, but finding a bone-marrow match should be as easy as a blood match."
From Idea to Reality in Just 3 Months
After fleshing out the idea for the kit, Douglas said he "blindly" started sending it out to large and small companies. He heard back from Help Remedies that same day.
"A lot of people pitch us with ideas that are pretty boring or we've seen it before," said company co-founder and CEO Richard Fine. "But this was such a simple, nice, smart idea and we pride ourselves to make healthcare simpler and friendlier."
The product has a "dual benefit and it helps people," Fine said. The design was taken from its concept to the marketplace in little more than three months.
More than 10,000 Americans are on a waiting list for bone marrow transplants -- the treatment of last resort for blood cancers like leukemia -- and only 6 in 10 will ever get the treatment they need to save their lives.
Only 30 percent of all patients will find a match within their family; the other 70 percent rely on strangers to give them a second chance at life, according to DKMS.
Blood cancer is only second to lung cancer as the leading cause of all cancer deaths in the United States, killing more children than any other disease.
"It could make a difference," said Britton. "A few drops of blood and you send it in -- that's incredible to me. It's just sitting in your medicine cabinet."
One of the Lucky Ones
Britton Douglas was diagnosed in the summer of 2002, just weeks before the twins were to begin classes at the University of North Texas. "Ten years ago, I didn't think I would be around today," he said.
"It all happened really fast," he said. "I went to the doctor with stomach ache and thought it was a virus. Thankfully, the doctor did a blood sample."
Test results showed a high level of white blood cells and Britton was sent straight to the emergency room and diagnosed with acute lymphoblastic leukemia, the most common form of the disease in children, according to the National Cancer Institute.
A double round of chemotherapy didn't work, but Britton was one of the lucky ones. He got a bone-marrow match in just two months.
Caucasians like the Douglas twins are more likely to find matches because their genetic make-up is less diverse. African-Americans and Hispanics have a much harder time finding matches since their DNA is more heterogeneous.
And due to what some attribute to socio-economic reasons, they are less apt to become donors, according to DKMS.
But transplant experts say many people have misconceptions about bone marrow donation, which is safe and relatively non-invasive. The risk to the donor is minimal and the body regenerates bone marrow.
Alina Supranova, vice president of partner relations for DKMS, said the kits have "huge potential."
"We want to get people talking and understanding this is a big disease and many out there need our help," she said. "We are not asking for money, but a part of themselves. You can donate yourself to save another person's life."
Who Can Donate; How it Works
Generally, anyone from age 18 to 55 and in good health can donate. "It's less restrictive than being a blood donor," said Supranova.
DKMS receives the swab by mail and asks the potential donor for more information, then schedules a lab test to determine tissue and human leukocyte antibody (HLA) type.
"If the hospital requests you as a donor, they let us know," said Supranova. "There are tens of thousands of combinations of HLA, which is why it's difficult to find a match."
There are two ways to donate: having blood collected from the arm during an outpatient setting or directly extracted from the hip in a surgical procedure that requires anesthesia. The first takes about five hours and the second requires an overnight stay in the hospital.
Once collected, doctors separate out the stem cells needed for transplant. Patients recover quickly and regenerate their bone marrow.
Supranova's dream is that every donor might one day meet the person whose life they saved.
Britton eventually met his donor -- a firefighter in his 40s from Fort Hood in Texas, a father with two children.
"He's a really down-to-earth nice guy," he said. "He does realize that he has affected my life and I have his life a lot, too."
Graham still remembers the pain his brother endured. Britton's recovery was a "game of inches," he said. "It was a big deal when he was allowed out to go to the mailbox."
Were it not for his twin, Britton would never have been able to register for online classes that spring semester when he was recovering. He was too weak to leave the house so Graham memorized his brother's Social Security number and posed as him in order to attend the required orientation.
"I know my experience really hit him hard," said Britton. "I cannot imagine what it must have been like to go through that second hand -- to watch someone extremely close to you who is near death."
Today, the brothers' love runs deep, even though they live 2,500 miles apart.
"Everyone says twins can feel each other's pain, and I think it's true," said Britton. "Even though we spent our childhood beating the crap out of each other."
To sign up for a bone marrow registration kit go to Get Swabbed.