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When my stepfather, Skip, learned he had Stage 4 renal failure, he had two options. One was dialysis, which would prolong his function at the current level. He refused. The other option was to receive a new kidney.

So I gave him one of mine.

I was nearly 6 when my mother started dating Skip. I was accustomed to the life of an only child with a single mother who was putting herself though nursing school and working at the same time. I had a close extended family, an Italian-American mélange of aunts and uncles and grandparents that coddled me, the baby of the family, and who made it their mission to fill in the gaps that my mother couldn’t. “Il sangue non è acqua,” my grandfather liked to say. Blood is thicker than water.

Skip was a hippie with long hair, a mustache and a Jeep. He was different from the macho men in my world with their Cadillacs, cards and cigars. They viewed him as an outsider and so did I.

My mother and Skip had been high school sweethearts who went on after graduation to marry other people. By the time they reconnected, their marriages were long ended, and they realized that they wanted to spend their lives together.

Within a year, there was a wedding. To his credit, Skip earnestly embraced his new role as stepfather. He seemed determined to make up for our lack of shared DNA. He whitewashed our basement and set up a classroom complete with chalkboard. I stood up front and played the teacher. Skip sat at a child-size school desk and gamely took the pop quizzes I doled out. He indulgently took sips of my swamp water (a concoction of rocks, sticks, chalk and water). Built me a tree house. Still, I was unmoved. How could someone just become your family overnight? Il sangue non è acqua.

As a teenager, I was downright nasty. And if he called me out on my disrespect, I lashed out. “You’re not my real father!” I screamed to him from the stairwell just before slamming my bedroom door, effectively ending the conversation. Though my mother and I had the out-and-out battles, Skip was the default object of my scorn and derision. His calm and steady demeanor made him an easy target. Undeterred, he would leave work early and come to my track meets and cheer. He would drive me 40 miles round-trip for my guitar lessons. Still, I treated him like a mere acquaintance, taking pains to refer to “my mother” and “my real dad.”

But just what did it mean to be a real dad? Skip was the one who picked me up from school, took my temperature when I was sick, and knew how I liked my macaroni and cheese (with only half of the cheese packet). On field trip days, he always managed to slip out in the morning and buy me a special lunch from the local deli. He did all this without expecting anything in return. But I always held him at arm’s length because I didn’t think he was mine to hold on to.

On the day I left for college, Skip loaded up all of my gear into his Jeep and we made the drive from Cape Cod to Boston. I had chosen his mother’s alma mater, which pleased him to no end. But though we had settled into a mutual respect, there was still only so much of our relationship I would claim — I still made sure to write in “STEP” above cards that said “To My Father” — or better yet, would select blank ones where I would just write “SKIP” in big block letters.

My freshman year, I made my new friend, Molly, tell stories about how close she was with her parents and how much time they all spent together. She was from a family of seven — she and her two biological sisters were adopted together by parents who also had two sons by birth. It sounded complicated on paper, but the whole family was so happy together. So why couldn’t I be?

When I was in my early 20s, Skip helped me out with money for things like car repairs, keeping a running tally of money I owed him in his office. But when I married and had children of my own, he simply took it down, effectively wiping the slate clean. He made me a toolbox. He turned up on weekends to install shelves or help paint the apartment. He was a doting grandfather, actively involved in my children’s lives.

When my mother called two weeks before Christmas to say that Skip was sick — really sick — and needed a new kidney right away, I was shocked. He hadn’t mentioned anything about seeing a doctor, hadn’t seemed under the weather. So I resolved to see if I could become a donor. For the next several months I scuttled over to the hospital for various appointments in between teaching my classes. Had an EKG. Gave a lot of blood. Completed 24-hour urine samples and checked off the requirements, one by one. Signed the waivers. And waited.

In April, I was told that I was a match. In order to complete the preoperative requirements, one of my final visits was to see the organ donation social worker. “This should be good,” my husband mused dryly. “You talking about your feelings. Ha.”

The social worker, Barbara, seemed particularly intrigued by what I considered a minor detail. “Why do you want to give this kidney to your stepfather?” she asked.

“Because he’s my father?” I said quietly, as if asking myself the question.

But there was more to my answer. I needed him. It was his quiet support for all of those years that kept me afloat, even if he often stayed in the background. That was just his way.

Six months after the surgery, Skip sent me a card at Thanksgiving. Inside was a note in his almost indecipherable scrawl. “To my Daughter, thank you for giving me my life. And for never making me feel like I owe you something in return.”

I cried then — not out of sadness, but out of relief. Those were the words I had wanted to say to him for years and couldn’t — or wouldn’t. But knowing that my kidney was now working to keep him healthy was a start. And in the end, because of the transplant, we were connected by blood.