NEW ORLEANS — Sisters can be best friends or sibling rivals, but few can say they would not be alive without the love of the other.
Sisters from Livingston Parish defied all odds they were given by doctors to live. And then one of them did it again when she decided to become a mother. And it was that decision that, decades later, would again, save her life.
It was the early 1970s, ages before the internet or cell phones. Richard Nixon had not yet resigned. Young people protested against the Vietnam War and the idea saving someone's life by donating an organ was rare.
"It was revolutionary, absolutely revolutionary," said Dr. Mary Killackey, a Tulane Abdominal Transplant Surgeon and Chair of Surgery.
"Greater love hath no man than this, that a man lay down his life for his friends," Shirley Judge, 71, reads from her Bible.
But while other college-age women were going out in their bell bottoms and peace sign chokers, sisters Shirley Judge and Pam Mulkey faced a serious life and death decision.
"I'm going to save my sister. She's my best friend," Pam Mulkey, 69, remembers deciding.
"I went in a coma. She (Pam) begged them to keep it on because I wouldn't live two weeks," Judge said about a machine that was filtering her blood for her failing kidneys.
The temporary machine Shirley was on, bought a little time for her failing kidneys. Rheumatic fever, as a little girl in the 1950s, slowly began stealing their function when she was 13.
"He (the doctor) told my mom and me that I probably would not live past 25. Don't tell a teenager that! I almost didn't graduate on time. I mean I'm thinking what's the point?" remembers Judge.
Weeks, even months, were spent at Charity Hospital. At times, Pam slept on the floor to be near Shirley. On June 1, 1971, Pam gave Shirley one of her kidneys.
"I was thanking God that she was the donor, because we're like two peas in a pod," Judge said.
"She really took a risk. And her sister took a risk to give her this kidney. The surgeons that were here at the time, were doing cutting edge surgery," Dr. Killackey noted.
Dr. Killackey wasn't born at the time her Tulane colleagues performed the sister-to-sister transplant. She says even with today's medical advancements, a living donor kidney will only last, on average, around 14 years. Pam's kidney lasted 45 years in Shirley. It may be one of the longest in the region.
Still, there was another twist yet to unfold.
"Our first date was April 3, 1976. We were married April 23, 1976," Judge said about her second husband.
Then in 1978, Shirley at age 29 got a news that would normally make a family happy, but worried JJ, her preacher husband.
"I get home and I told my husband. He kind of got upset because he's thinking I'm going to lose her," Judge recalls.
Her pregnancy scared doctors too, who thought she might not survive the pregnancy.
"He said, 'Well I still want to do an abortion, because we don't know how long you will live, how the baby will turn up, and I said, 'Well if I don't live it's fine. She's got her daddy,'"
Shirley and their baby girl, Joy, outlived JJ. He passed with cancer in 2008.
Then eight years later in 2016, Pam's kidney was finally failing in Shirley.
It was Joy, now a grown woman with children of her own, who matched her mom.
She writes "Four decades ago, Mom had to make a decision. She had to choose between me or herself. She chose me. I chose her."
Joy wants no spotlight or role in this story. She says it's her mother and aunt who did something brave at a time when organ donations were in their infancy.
On Jan. 26, 2016 two Tulane surgeons went to work. Dr. Anil Paramesh harvested Joy's kidney from her body. In nearby O.R, Dr. Killackey transplanted it into Shirley. A daughter had now given rebirth to a mom.
"This is never an easy decision even though you may want to help somebody else or you love somebody else. It is risking your own life to help somebody else. There truly is no greater charity than that," said Dr. Anil Paramesh, a Professor of Surgery at Tulane and Surgical Director of the Kidney, Pancreas and Living Donor Transplant Program.
In his office, he keeps the super hero action figure Joy gave him as a reminder of their bond.
Still, the Tulane transplant team was not done yet with this remarkable family.
"She asks me, 'Is this Pamela Mulkey?' I said, 'Yes.' She said, 'I think we have a kidney for you,'" Mulkey remembers the late night phone call in December.
Last year, diabetes and high blood pressure had finally taken the function of the one kidney Pam had been living with since giving the other one to her sister in 1971. Now at 69, she needed transplant surgery.
"One of the good things the national system has, is that if you've donated before, you go right to the top of the list, and so she was able to get a kidney reasonably quickly," said Tulane Transplant Surgeon Dr. Kofi Atiemo.
Weeks ago, the family of a complete stranger, donated the organs of a deceased loved one. Tulane's Dr. Kofi Atiemo implanted that kidney into Pam. For one week, it lay quiet. Then on Christmas morning it began to work.
"I told the lady at Walmart, and all I said, 'This year I got the best Christmas in the world. And she said, 'What'd you get?' I said, 'I got a new kidney,'" Mulkey giggled.
You could say Pam, Shirley and Joy are bonded like the women in Steel Magnolias, but this true story has a happy ending. Remember what M'Lynn said about her daughter's passing, "I realize as a woman how lucky I am. I was there when that wonderful creature drifted into my life."
Well these women are not only lucky to have each other, but their very lives are dependent on it.
Pam is still unable to get back in her own home since the August floods of 2016. Her sister Shirley opened her home to her right away.
Ed. Note: A previous version of this story misstated Shirley Judge's age when she found out she was pregnant. Shirley was 29 years old, not 39.