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Pualine McCormick
A Look
Back
This past year the Canadian Transplant Association (CTA) celebrated
a significant milestone – 20 years of promoting organ
and tissue donation awareness in Canada. But few of us know
how it all started. Recently, we were privileged to interview
Pauline McCormick, the first registered nurse in Canada
to become an Organ Procurement Coordinator. She spoke
about her work as a nurse in nephrology and the beginnings
of the HOPE (Human Organ Procurement and Exchange) Program
in Alberta. Pauline has spent countless hours promoting organ
donation and helped send the first Canadian team of transplant
recipients to the World Transplant Games in England. Her efforts,
and those of other ‘pioneers’ like her, helped
establish the foundation for today’s CTA. Join
us for “a look back”………….
Pauline McCormick graduated from nursing school in 1966 in
Liverpool, England and came to Canada in 1967 to work as a
registered nurse at the University of Alberta Hospital (UAH)
and the Royal Alexandra Hospital (RAH) primarily in coronary
care and intensive care. At the time, only one hospital in
Edmonton offered Hemodialysis treatments, so patients had
to make the often hazardous trip across the city for dialysis
at the UAH. Frustrated by that process, Pauline decided in
1976 to learn the treatment herself and the care of patients
on chronic dialysis.
In the same year, the realization was forming that the need
for dialysis was growing and the number of transplants was
not keeping pace. Pauline, and eight other nurses from nephrology,
formed an education interest group to teach the public about
the need for organ donation. “We went out to anyone
who would listen to us”, Pauline said including schools,
service groups, and other organizations. Working full time
and providing these sessions became very demanding, but the
group persevered. “If one couldn’t make it, someone
else from the group would go”.
Initially, the group received support from the Kidney Foundation
and, together, they lobbied the provincial government to fund
an organ donation program. In 1979, they received a one-time
grant of $50,000 to develop the HOPE program, the second of
its kind in Canada (after MORE – Multi-Organ Retrieval
and Exchange). Dr. John Dossetor, a nephrologist at the UAH,
is credited with coining the acronym for HOPE. The money was
divided between Calgary and Edmonton to cover an office and
salary for one coordinator each. Pauline became the HOPE Coordinator
in Edmonton - with a pager and a converted storage room for
an office. Doctors Bettcher and Lakey served as Clinical and
Surgical Directors at that time.
Initially, HOPE was only involved with cornea and kidney transplants
but, soon, Pauline began receiving calls from the Burn Unit
asking for skin. At the same time, Dr. Ray Rajotte (known
today for his work on the Edmonton Protocol) was starting
islet cell transplant research and asked if HOPE could get
consent for pancreases. Orthopedic surgeons were using bone
transplants to stabilize spine and long bones after surgical
resection (usually for cancer). At that time, there was no
“tissue bank” - skin and other tissues could not
be stored although researchers were beginning to work with
methods of cryo-preservation. Coordination of organ retrieval
and transplantation was a demanding and exacting, time-sensitive
task. Pauline was typically on call 24 hours a day, 7 days
a week. She even had a few favorite spots where she would
pull off the road and catch a few minutes sleep in her car
when the trip between the hospital and her St. Albert home
was just too long.
But, it was exciting to be a part of the early days in transplantation
at the UAH. As the HOPE Coordinator, Pauline worked with hospital
administrators, physicians, staff, patients and families (often
both recipient and donor) and the media. Patients awaiting
kidney transplant usually had a pre-operative dialysis run
and it often fell to the HOPE Coordinator to do that. Pauline
traveled with the team for distant retrievals. She remembers
the first donation of a liver from Alberta - a little girl
in Grande Prairie had met the brain death criteria. From her
hotel room, Pauline put the word out to other hospitals and
a team from the United States arrived for the organ. And Pauline
continued to travel throughout the province providing both
public and medical education on organ and tissue donation
and transplantation. Soon Dr. Dennis Modry would add heart
and lung transplantation to the program. With the expansion,
Pauline was a vital resource helping to establish/revise policies
and procedures - including the creation of both Clinical (Recipient)
and Retrieval (Donor) Coordinator positions.
Pauline persisted because of her strong belief in the positive
outcomes of organ donation. “It was not easy to convince
people to donate”, Pauline said. Every time she received
a page about a potential donor she thanked God for her faith
– each call was difficult and reactions were unpredictable.
A time of sudden, unexpected death is a difficult time to
approach a bereaved family but, ‘it is the only time’.
Pauline made it a priority to ensure the family understood
their choices – it was empowering, she added, “because
I knew the outcome would be so great”.
The problem of organ shortage remains the same today as it
did when Pauline started and she believes, “our greatest
failure (as a healthcare team) has been - not to ask”.
Pauline never received a complaint from families who declined
to donate - only from those that were not asked. She believes,
“People have a right to say yes or no and if that’s
their choice, that’s okay – at least they were
given the opportunity”. She adds, “We have failed
as practitioners to increase the asking. Looking at our population
and how much it’s grown, we should have a surplus of
organs available and we do not.” Pauline went on to
comment on the growing success of transplantation, improved
techniques and survival rates. “Clinical aspects of
transplantation have grown in leaps and bounds and organ donation
has not kept up. We can show the quality of life after transplantation
but…if we are going to sell transplantation, we need
to show how recipients are becoming successful parents, professionals,
etc.”, quoted Pauline.
We asked Pauline about the Transplant Games - she was instrumental
in sending the very first Canadian team (all Albertans) to
the Transplant Games in Southsea, England in 1977. They arranged
for reduced airfares from Air Canada and raised the rest of
the funds with bake sales and raffles. Pauline was unable
to go with the team that year but she did go to New York the
following year as the Team Manager - this time with a team
of 12 athletes from Alberta and Ontario. She credits the games
with ‘saving her life’. The teams had challenged
their Team Managers to a 3K walk around Central Park and when
Pauline finally crossed the finish line, she remembers seeing
her entire team standing there, cheering for her. “It
was a phenomenal feeling and changed my way of living –
health came first. I quit smoking and started running regularly.”
She still continues that active lifestyle today.
When asked for one of her most memorable moments working in
transplantation, Pauline was at a loss for words. “There
were so many”, she said. Finally, she recalled the story
of a young man who had a tragic ending to his life and was
in the ICU. His family lived in Newfoundland so Pauline called
his mother to ask if they would consider organ donation. The
mother was uncertain but told Pauline of a nun named Sister
Mary (no last name) who had been her son’s Sunday School
teacher and taught him ‘everything he knew about the
church’. If Pauline could find this nun (now living
with an order in Edmonton) and have her be with her son while
he received the final sacrament, then she could sign the consent
on behalf of the family. Well, through a series of phone calls,
Pauline finally found Sister Mary and met her at the hospital
- the young man became a multi-organ donor.
Another memorable, if less pleasant, event recalled was the
time she rushed to the airport to put a kidney on the red-eye
flight to Toronto and got a $50 speeding ticket! She did say
that the officer was polite enough to wait until she got the
donated organ to the plane. And then there was the morning
of the snowstorm that closed all the bridges in the city.
Pauline had to get a recipient in for transplant so she contacted
city maintenance and got them to plough the roads. Then she
arranged for a police escort to pick up the patient who had
to walk out to the main street because the snow was too deep
to get to his apartment. “In those days”, as Pauline
puts it, “you didn’t wait for administration to
approve - you just did it and asked for forgiveness later.”
Looking back, Pauline considers her work with the HOPE program
to be one of her greatest accomplishments. “It’s
like giving birth to a child”, she reflects, “it
grows up and matures and you have to learn to let it go. I
never dreamed that the program would ever be what it is today.”
Since her retirement in 2001, Pauline continues her humanitarian
activities with a small charity she helps in Ghana, West Africa.
She sings in two choirs, serves on parish council at her church
and is a member of the Catholic Women's League. She loves
politics and is presently involved in the upcoming elections,
serving as a campaign manager for an area MLA. She visits
a senior’s lodge once a week, enjoys walking and goes
to the gym three times a week. She loves gardening, taking
care of her home and her little terrier, Tilly. Apparently,
she still hasn’t learned how to slow down.
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