Five-year-old Sarah Miller stood on her tiptoes at Mercy General Hospital’s admissions desk, hugging a small cardboard box tightly against her chest. Inside were her favorite dolls, including one her mother, Anne, had lovingly sewn by hand years before. With tears in her eyes but determination in her voice, Sarah pushed the box toward the receptionist and whispered that the dolls were all she had to pay for her mother’s operation. Only hours earlier, Anne had been struck by a speeding car while pulling Sarah out of its path. Now Anne was unconscious, and with no insurance, no nearby relatives, and no adult to speak for them, Sarah had walked into the hospital believing that precious things could be exchanged for another person’s life.