Courtesy of the NewYorkTimes.com | By Tim Lahey, M.D. | Photo by University of Vermont Medical Center| Originally Published 04.02.2019 | Posted 06.30.2019
Hospitals across the United States are holding honor walks to show respect to patients at the end of life who are donating organs to others.
The double doors of the surgical intensive care unit opened into a hallway crowded with dozens of hospital employees. A hospital bed emerged, and we all fell silent.
Most beds roll out of the I.C.U. briskly, en route to radiology or an operating room, whirring with the beeps and blinks of monitors and the quick conversation of busy nurses.
This bed was different. It moved at a stately pace, and the team that accompanied it was changed as well. Nurses steered, but there was no chitchat this time. A tall anesthesiologist leaned over the head of the bed to squeeze a bag valve oxygen mask with clocklike regularity.
People in street clothes trailed close behind the bed, unsure of where to look. These were the parents of the young woman in the bed, the one we had all come to honor.
This was an “honor walk” for a dying patient about to donate her organs to others.
With the consent of loved ones, and with the operating room ready for organ donation to begin, hospital leadership invites all staff members to participate. In my hospital, the University of Vermont Medical Center, the clothing in the crowd reflected the different jobs we’d been pulled away from: There were white coats and ties, crumpled blue scrubs, bouffant surgical hats and expensive pinstripe suits. A priest who wore a neon pink Hawaiian shirt over his clerical collar looked up and down the hallway and smiled.
The honor walk takes place at an odd pause between life and death: Either brain death has been declared already in a donor whose heart still beats, or the donor’s heart will soon stop beating.
I looked at the woman in the bed. Her eyes were closed. Her skin was sallow. She wore the usual hospital gown and identity bracelet. IV tubing and telemetry wires still snaked onto the bed. It all looked so superfluous, there in the final minutes of a life whose exact end was already known.
An honor walk is a powerful act of community. Something solemn, even sacred, happens in those 15 minutes in the hallway. We wait and talk with people from all professions and all walks of life. Together, we honor a great sacrifice. We give thanks. We hope to help a grieving family in a moment of fathomless loss.
Jennifer DeMaroney is an organ donation coordinator who brought the honor walk to my hospital in an unconventional way. Instead of working the byzantine committees of a billion-dollar hospital bureaucracy, Ms. DeMaroney says she stormed in unannounced to the office of Eileen Whalen, the hospital’s president, with a photograph of another state’s honor walk, asking if we could do the same thing.
Ms. Whalen, a former trauma nurse and governing board chair of the Center for Donation and Transplant of New York and Vermont, approved our first honor walk on the spot.
Ms. Whalen said it was an easy decision. She wanted to provide grieving families with a way to give back, and for everyone to help those families endure their loss. She agreed with Ms. DeMaroney that the honor walk lets families know “we think the people who donate to save a life are heroes.”
We need those heroes — desperately. The United Network for Organ Sharing estimates that more than 113,000 people are waiting to receive organ transplants. More people donate organs each year, but still, in 2017 over 6,500 people died while on the waiting list.
I spoke with Missy Holliday, organ operations director at LifeCenter in Cincinnati, where an honor walk garnered national social media attention. Ms. Holliday said LifeCenter began honor walks in December 2017 in response, in part, to intensive care unit nurses who wanted a way to honor former patients who donated. The staff has learned to place a chair in the hallway the day of an honor walk in case a family member needs a moment to sit and cry and receive support.
And the ritual has entered the popular culture as well: Last week an episode of “Grey’s Anatomy” adapted the hallway ceremony for a powerful scene involving a victim of sexual assault.
Back in my hospital, as the young woman’s bed rolled out of sight, we knew a private ritual would soon begin. Somehow, her parents would say their final farewells. Then in a brightly lit operating room with all the high-tech tools of modern surgery at the ready, a masked surgeon would reach into a young woman’s still-warm body in order to turn one family’s devastating loss into new hope for numberless strangers.
Tim Lahey is an infectious disease specialist and director of clinical ethics at the University of Vermont Medical Center.