It is a strange job that I do, because I can go from one moment having a conversation with the family preparing them for the inevitability of death, to organising the organ donation process, to, the next moment, helping a mum to say goodbye to her son. So yes, my job is very strange, but that’s my job.
My name is James Van de Walt, I’m a specialist nurse for organ donation and I work in the London team and I’ve been doing this job for five years now.
It was a Saturday morning and I was on call and we got a call from a hospital – they had a patient who had an out of hospital cardiac arrest. He was at home with his partner when he had the heart attack and he’s very young, thirty, and there wasn’t much, they’ve tried everything to save his life but there wasn’t much more they could do. The partner did CPR to get his heart back. So what that tells me is that one, I will probably meet his partner. I also know that his partner will be very upset because doing CPR on somebody when you’re not a medical professional is quite traumatic.
The first and most important thing of my job is to meet families in hospitals, whose loved ones have the potential to donate their organs, to find out what their loved ones’ wishes were and then to guide them through the process. When you get a phone call like that you don’t always know what to expect, especially if it’s A&E, because A&E is fast paced. There’s always a little room at the end of a corridor and in the room was the patient’s mum, dad, sister and his partner. The first thing I normally do is I ask the family would they like to have a cup of tea. Have they had anything to drink? When was last time they ate some food? The big part of our job is to help families sort out those little things because then they’re calmer, they’re more relaxed, they can hear what we have to say to them.
The father was very uncertain about organ donation – mum was very positive about organ donation and his partner said that they’ve had a conversation about it and they wanted to donate. And that’s very important to us, that all the family should be on board, all the questions should be answered. Dad wasn’t very positive. Dad had questions and I could see that he had questions. “Why should we do this? I’m too upset to think about this. Isn’t this our business? Why should I think about other people’s business?” which are very valid questions. “Why should we do this?” You know, how do you answer somebody with that why should you do this? Why did this happen to you, why did your loved one have a heart attack this morning? It’s not fair. And I just explained to him that one, he wanted to do it – he verbally told his partner that he wanted to donate his organs if ever he would die and therefore we should honour his wishes. But, secondly, life has chosen you guys today for this to happen. The impact that you will have giving an opportunity of life to somebody else would be incredible. This is a gift that a human being is giving to save the life of another human being and because it’s such a special gift the body will be treated with incredible respect and dignity and privacy – dad was very happy about it. It was like “Yes I want to honour his wishes. I want a bit of him to continue to go on”. There was a feeling of relief in the room. The way they were sitting whilst we were having the conversation was with their elbows on their knees, or they had their arms crossed with their chests or they were fiddling with their hands and then that moment of relief. They sat back in their chairs and their arms relaxed and there was this atmosphere of relief because the family, not only have agreed to donate organs, they have not only agreed to save other people’s lives in a horrible situation that they were in, but they were also in a situation of “We now know what we need to do”.
I see the death side. I see the heartbroken side – dealing with that family that’s heartbroken, but my positive side that I have is to explain to them how many lives they saved. This specific family that we’re talking about, it was two years ago that they donated. And he was able to donate his heart and the recipient is doing very well even though the reason the donor died was because of a heart attack, but the heart is working and he was able to donate his lungs and the recipient to receive the lungs is doing very well. He was able to donate his small bowel and pancreas and a segment of his liver. And that all went to one specific recipient and that recipient is doing very well as well. The other segment of his liver and the kidneys also went to three other recipients and they are doing very well. So they are, yeah, that’s in total eight recipients whose lives he was able to save. And then you’ve got tissue donation which is your skin, eyes, tendons, bone. Yeah, his tissues alone, at this moment in time, it’s helped up to six people. So you know that’s a lot of people. And, yeah, two years later eight people’s lives were saved, six people’s lives were changed.
The specific family that I spoke about, I still write to them on the anniversary, once a year, to give them an update on how all the recipients are doing, and we have, at that specific hospital where he donated, we have a memorial for all the organ donors and I have met them there a couple of times just to spend a bit of time with them, make sure that they’re OK. You’ve met a family who, in a very dark, very sad place, was still able to think of other people, and it’s a privilege to know that as humans, we still are fundamentally good and it’s a privilege to meet people like that.