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In his eyes, he truly has sacrificed for this woman. He loved her enough that he wanted not only to save her life, but to share his life with her--what did he get?
Betrayal. If she did cheat on him, than that would cut sharper than a scalpel's blade--because he showed great regard for her, but she showed little to no regard for him.
There just isn't any logical standard of conduct above and beyond what any person would be expected to give in a relationship, just on the basis of his having given her an actual piece of himself--it's impossible to expect something more loving, more true, more passionate. But what about just simply honesty, trust, and not running around? He reasonably expected that much.
I don't think he actually wants her to surrender the kidney, go on dialysis, jeopardize her health. But also, I think he is grief-stricken about what they went through together and how the relationship was broken, and he is making this absurd request in the hopes that she thinks about it, as well. I think this has just gotten to the stage where he can't express that in words, and has moved on to large, headline-grabbing gestures.
On the flip-side, however, this might have been something that was always between them: "You owe me." Enough to drive her away. Enough for him to still try and wield the power of it over her life. He may have not meant to bring it up, at first--until he was bringing it up in front of people who knew how ill she was, and how much she needed that second chance--and how he parlayed that into trying to own her by holding it over her head and making her feel insufficiently grateful. Which necessarily destroyed their communication--how does one rescued damsel speak to her hero? And maybe she needed to find someone she could be equals with. Without that shared blood between them, that laid such a claim on her independence, and held her back from really appreciating the life she had won back from the brink. To remind her that she lives a healthy life now because of him and that she is always connected to him, just rubs her face in how she was made a dependent of his by fate.
Or some combination thereof. It would be a good tv mini-series. I'd watch it.
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