April's Story: Organ Donation and the Bridge Between Death and Life

It just so happens that April lives in our neighborhood and I recently began giving her daughter piano lessons. Inquiring one day as to what April does for a living, I discovered she serves in a very unique role; one I didn't realize existed.

Every diver's license indicates whether a person wishes to be an organ donor (or not), but have you ever thought about what that process entails? Of course, we think of the end result - a life being saved with the gift of our organs, but how does that work, exactly? 

For that process, there are people like April who serve as the bridge between donor and recipient.

April works for an organization called LifeSource;  one of many organizations in the U.S. that procure human organs and tissue for donation to others. 

It takes a very special type of person for this intense work of compassionately, yet effectively and quickly procuring organs in the midst of a family who is grieving the loss of their loved one so that the donated organs can be given to someone who may be in desperate need. 

[S]: So, April, why do you live in our little town of 400 or so people?

[A]: It was kind of accidental. We had close friends who lived here, so when we found this chunk of land for a very cheap price we couldn't pass it up. The school district was attractive to us as well, so this was perfect.

[S]: Has it proved to be perfect?

[A]: I would say yes and no. Yes - being that I love that my kids are, for the most part, safe here and I love that they're in a good school system. I dislike the drive. Other than that, it's proven to be pretty good.

[S]: Where did you grow up?

[A]: In South Dakota - Aberdeen which is in northeast South Dakota. I was in Eureka, South Dakota until I was 11 and then we moved to Aberdeen until I graduated high school. Then, I I went to school at Presentation College which is a small Catholic college. After graduating from there, I went and worked a year in a prison as a nurse and then went to Indian Health Service and worked as a nurse for three years at the Hopi and Navaho reservations. Then, I came back and worked for the Rosebud reservation in South Dakota. Then, I moved here to work at Mayo as an RN.

[S]: Think about your high school years, in Aberdeen South Dakota...what's the first thing you think of.

[A]: How confused I was, I guess. Um, 'cause I was a jock, then I was preppy, then I hung with the punk crowd. I was never just one certain person.  

I think I had all these identities because I wanted to fit in somewhere. I got bullied a lot, so I felt like I needed to make an identity that would be okay at the time. But, when I was a jock that's when I got to the good stage, because I was good at it. I was very good at track and field. 

[S]: Who are you now?

[A]: I think, now, I am mostly just a mom. I mean, that's what I feel like. My career is great, but, I do it for them - my kids. Everything I do is for my kids, and so I feel that, um, I'm just a good mom.

[S]: Dog mom, too. [Note: April's family has 4 dogs]

[A]: Yes, dog mom, too. Animal rescuer.

[S]: During those high school years, what's the most trouble you got in?

[A]: I never got in trouble, but I do remember this girl who didn't like me and was talking to me while I was in my car. I had my window down about halfway and I must have said something she didn't like because she punched me in the mouth. I had braces on and it knocked my braces off. I got out of the car and I was gonna chase her, but by that time I got out she was far away. I got in trouble for getting my braces knocked off.

April and her husband, John

April and her husband, John

[S]: Why did this girl punch you?

[A]: I don't know. That was the only time I'd ever been involved in something like that. I think I won that fight cause she ran away. 

[S]: Was it over a boy?

[A]: I don't think so. I think we just didn't like each other. We never talk, but we're friends on Facebook, now.

[S]: Oh, Facebook! Bringing assailants together since 2004!

[A]: I don't know what she does, but she looks really different now and she's a grandma. 

[S]: You mentioned earlier that you're a dog rescuer, do you have a dog rescue story that's especially touching?

[At that, April's daughter, Addison jumped in...]

[Addison]: I have a dog story! Once we rescued a dog on the highway when I was on the way to a Girl Scouts swimming party at the YMCA in Rochester. We found this husky mix, I think it was a mutt, but I don't know; it had one blue eye and one brown eye. We drove it to Cascade, the vet, to see if it had a microchip. Then we went to Paws and Claws, but it was closed, so we drove around a little bit and waited for Paws and Claws to open. Then, we brought the dog inside Paws and Claws. Its owners came and got it the next day. 

[S]: That's awesome! Great job, Addison!

So, this is gonna be really weird, but I'm gonna name six different words and after each word tell me whatever pops into your head.

[S]: Sky               [A]: Blue

[S]: Rock             [A]: Hard

[S]: Touch           [A]: Don't!

[S]: Laughter      [A]: Love it

[S]: Remember    [A]: Not so much

[S]: Rectangle     [A]: Circle

[S]: Now onto you work...describe what you do.

[A]: Basically, my job is to keep a person, who is an organ donor, alive until it's time to recover the organs so they can be given to a transplant recipient.

[S]: To be honest, I never knew organizations such as LifeSource existed. I guess I never thought about it even though I'm an organ donor. I just assumed it was the hospital or care facility that takes care of organ donation once a person passes. That isn't the case, so I'm learning. There is a "middle man" so to speak that bridges the gap between donor and recipient?

[A]: Yes, I intervene on behalf of the donor who has already been declared dead, or death is imminent. It's hard, especially for the family of a patient, to understand what it is I do. A person can be kept alive even after brain-death in order to recover the organs, so the family may perceive the person as still living because they can still see them breathing, but once I disconnect the machine they begin to accept that reality. Once a family comes to terms with the fact that their loved one is dead, then we can make a plan. We find surgeons who fly in and recover whichever organ they need for their patients. It can take up to 48 hours for this process.

Once the patient is declared dead, the hospital no longer has control over their care...that transfers to us. 

[S]: Even though a machine may be sustaining their organs?

[A]: We're using the hospital's machines until the family is prepared to let the patient go. 

[S]: How do you know when it's time to intervene - especially if a person isn't dead?

[A]: This was the hardest part for me to understand - when we are going to be involved or when are we not? Well, we have to reach a person within ten minutes of death, or receiving CPR, in order to recover any organs, so that has to be taken into consideration. 

There are some in our line of work who believe we should not show our faces until the patient is declared dead, but that doesn't always work because the family may need education on what organ donation means and what that might look like. Often, the family wants to know how many people their loved one can help.

I see it both ways because we don't want to seem like vultures trying to get a person's organs; which, is how some people see us. 

[S]: How do you navigate family that may not be ready to let go, or may not understand how procuring an organ has to happen immediately after their loved one passes? 

[A]: That is hard. The other night, I had about 30 family members in the room with their loved one. We had to get extra staff just to handle that. The patient was brain-dead, but her heart was still beating and the family decided to withdraw care. When we were preparing to withdraw care, 6 family members came into the OR at a time and each received five minutes. One woman held my hand and held onto me while she said goodbye.

Then, when a person dies and death is declared, we have five minutes. That's really hard because what do you say to a man who has been married for 45 years that he has to leave NOW because the surgeon literally has just five minutes to make the incision and get the organs out before they begin to deteriorate. 

In this case, we couldn't donate the heart, but we could donate the lung, the kidneys and whatever else looked good. We went down the list and found matches. 

Dealing with all of that and the work itself can be challenging. You want to be there for the family, but you have a job to do to get the patient what that wanted - for their organs to be donated. 

[S]: What I'm hearing is that we, as organ donors, should be having conversations with our loved ones about what might happen as a result?

[A]: It's really important that people have these conversations with their loved ones - whether they wish to be an organ donor or not. If a person isn't donor designated the next of kin makes that choice. Most family members, depending on religion, typically opt for organ donation if no designation is given - especially in the case of children.

It's a wonderful process, but people just don't know anything about it, so when they check the box on their driver's license they don't know what it means and it can take them off-guard when it happens. 

Organ donation can be a very meaningful and loving act. One person can save 60-90 lives with organ donation. And, there are many children on the transplant list.

[S]: That has got to be hard when you are working with children. Hard for everyone.

[A]: Yes. I see families cry then I start crying, but I think it's okay for me to cry with the family because they realize I care.  

[S]: What do you say to people who feel as if life-saving measures won't be provided if rescue teams or health care providers see they are an organ donor? 

[A]: Well, quite the opposite happens. We HAVE to keep a patient healthy and stable in order to recover their organs. Organs need to be healthy. 

[S]: How do you manage to remain calm and rational during this process? I think it would be hard to grieve with a family yet rejoice with another.

[A]: I've been able to separate myself a bit from that and rest in the knowledge that a life is saved because of this gift.

If you've never thought about organ donation, please consider this an invitation to do just so. If you are an organ donor - thank you! Talk with your family about what that means. It just might save a life.

I am thankful for organ and tissue donation as my husband was the recipient of donated bone after he broke his neck in 2009. 

LifeSource has created videos that demonstrate the gift of organ donation. Check them out and be inspired! And, grab the tissues!