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Maybe I'm missing something, but what's so sad about this situation versus the past? In the past, he would have just died, but "what things have come to" is that medical technology has advanced to the point where he has a shot of making it another few years.

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I think perhaps the wording might have confused you (and now reading again I can see why.) I was merely expressing sadness at the situation, that the man found himself left with no other possibilities. Particularly the quote: "It was either die or do this transplant. I want to live. I know it’s a shot in the dark, but it’s my last choice." By "things have come to" I didn't mean in society, I meant in his life.

I see. Yes, your wording did confuse me a bit. Thanks for clarifying.

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