Renee and Rusty Small consider themselves fortunate.

But in August, 2000, luck almost ran out for the Maumee couple.

Their 2-year-old daughter, Rachel, lay in a hospital room suffering complications from a liver transplant she needed because her own liver wasn't functioning properly.

“The doctor said if she didn't get another transplant by the weekend, she wasn't going to make it,” recalled her father, Rusty.

In the movie John Q., which this weekend was the No. 2 film in the country, another father hears similar news about his son, who in the movie needs a heart transplant. Actor Denzel Washington, playing the father, becomes so desperate after hearing his health insurance won't cover the transplant that he pulls a gun and takes hostages in an emergency room.

The movie is an attack on the business of medicine in this country. As the movie points out, 40 million Americans lack health insurance.

It's a hard number to grasp, but look at it this way: That would be more than the population of Ohio, Michigan, Indiana, Pennsylvania, and Kentucky combined, or about one out of every seven Americans.

Doctors, hospitals, and insurance companies are portrayed as cold and uncaring in the movie, and Denzel Washington's luck goes from bad to worse throughout most of the film.

For the Smalls, though, a miracle of sorts happened. Their daughter's transplanted liver unexpectedly healed, and today Rachel, 4, is a relatively healthy child. She's a poster child for organ donation for Life Connection of Ohio, the organ-procurement agency serving northwest Ohio.

Despite their good fortune, the Smalls vividly recall the stress and frustration of waiting for a donated organ, as well as concern about paying for the operation.

So The Blade invited the Smalls to see John Q. with a reporter to get their impressions of the movie.

Both said the movie was “pretty good,” but they left a little disappointed.

Mrs. Small was frustrated that the movie made doctors and hospitals out to be cold and uncaring, which wasn't the case with their daughter.

“When we found out [Rachel] needed a transplant, my doctor just held me while I cried,” she said.

Movie buff Mr. Small, who said Denzel Washington is one of his favorite actors, said the film should have been more accurate about its portrayal of another crisis: the shortage of organ donors. He was disappointed the movie focused so much on costs.

Not that costs aren't substantial, he added. In his daughter's case, the transplant and related medical expenses totaled more than $1 million. Almost all of that was covered by his company's insurance plan.

Money became an issue because insurance initially didn't cover tube feedings for Rachel before the transplant, but thanks to lots of paperwork and persistence on their part, they got Medicaid to grant a waiver to pick up most of the costs.

With Medicaid, private insurance, and the variety of other programs, he said he was skeptical someone would be denied emergency care like a transplant, a view shared by organ transplant officials.

“What I worry about is what happens when Rachel gets older,” Mrs. Small said. “Will she be able to get insurance?”

While Mr. Small said the movie is too harsh on doctors and hospitals, he thought the movie did all right in highlighting how critical insurance - or the lack of it - is.

“The problem with insurance is it's all about money,” he said. “It's `How much can your company afford?'”

Mr. Small said he sympathizes with hospitals and insurance companies struggling to pay for expensive operations such as transplants. He said he doesn't know what the answer is to the millions of Americans without health insurance. John Q. attacks the wrong people; doctors and hospitals aren't the problem, he said.

Maybe the answer is buried in a brief bit of dialogue at the end of the movie in which a talk show host says Americans have to look no further than the mirror when it comes to someone to blame.

Paying for health care takes money, the host points out, and taxpayers are often reluctant to pay more taxes.

Mrs. Small said she doesn't know whether she feels the same way as the talk show host, but she does know one thing: “We were lucky.”

First Published February 27, 2002, 8:31 a.m.