A Look Back
by Kathy Tachynski & Jennifer Holman
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.