Contributor Simi Juriasingani
Hospital Heroes is a new series of interviews that will put a spotlight on the diverse career profiles of individuals who work at hospitals. The goal is to raise awareness about diverse career paths in medicine and healthcare that contribute to improving patients’ lives. Join us as we meet these heroes, and learn how they contribute to improving patients’ lives.
“This is a unique job and there’s only a few of us doing this across the country…”,
“...hundreds of transplant recipients benefit from our work each year.”
“ I could have been a doctor, but I got to have a different and unique career path in healthcare instead.”
Hospital Hero: Mahms Richard-Mohamed
Position: Transplant Donor Specialist
Motto: Fail to prepare, prepare to fail.
What are your main responsibilities as a Transplant Donor Specialist?
My main responsibility is to take the referral of an organ for transplant and discuss the organ’s suitability and the recipient’s suitability with the consultant on-call. If the organ is accepted for that recipient, then my responsibility is to organize the transplant team for the recovery/retrieval of the organ. I participate in the organ coordination, perfusion, preservation and, partially, in the distribution.
How many weeks in a year are you on-call?
26 out of 52 weeks. So, over the past 38 years that I’ve been doing this job, I’ve been on-call for 19 years.
What could an on-call week look like?
There is no such thing as a “typical” on-call week. We may have a week with minimal activity where we spend hours on the phone [with Trillium Gift of Life Network (TGLN)] , but nothing comes of it because offers are rejected. We could also have a week where we receive several referrals that are accepted and we are retrieving organs one after another, to the point where we don’t sleep much for several days. So, you can go from a week of call where you can go home and have a life to a week where you only go home to sleep and come back for another organ retrieval.
What could the timeline of one transplant case look like from start to finish, in terms of your involvement?
Let’s say I get a call about a liver offer at midnight. The donor information is emailed to us. I would also have the recipient’s information because every organ offer is for a specific recipient, which is determined by the provincial algorithm for patients on waiting lists. After reviewing the information, I would contact the consultant on-call from the liver transplant program. We would discuss the case and any concerns we have. If it’s a good donor with no complications, we may know within an hour that we are accepting it. If additional workups are required to make the decision, it could take a few more hours.
If we accept the organ, we would have to wait for TGLN to allocate all the other organs from that donor before we can even think about when the transplant team would leave for the retrieval. The process of allocating all the organs can take anywhere from 4 hours (for a standard donor) to approximately 24 hours (for a donor with concerns).
Once all the organs have been allocated, an OR would be booked at the hospital where the donor is based on the availability of all the organ recovery teams (cardiac, lung, abdominal, etc.). In this case, I would indicate our liver recovery team’s availability to TGLN, factoring in the time it would take to travel to the hospital where the donor is. Deceased donor surgeries usually occur in the evening (after 5pm) so that scheduled elective procedures aren’t interrupted. Once that time has been set, all the teams would finalize how they will get there (book flights, plan ground travel, etc). The recovery of all the organs will take around 4-5 hours and then there’s the travel time back to our center. So, the entire timeline of a case takes anywhere from 24-36 hours, maybe even longer due to workups, availabilities, etc.
The transplants are usually done as soon as possible to maximize organ viability.
What qualifications/skills would someone need to be hired as a Transplant Donor Specialist today?
There is no specific training ground for this. In terms of education, someone from the Allied Health fields would be perfect. Any job that allows you to gain experience with managing unstable patients would provide you with the right background. So, nurses, paramedics, physician assistants, etc. would have the right training. Another important aspect is what they are looking for and what they are willing to do. This job will wear you down and burnout happens in 3-5 years. To make this into a career that spans decades, you need to find a person with the right mindset – someone who works hard, can work long hours and is willing to give up nights, weekends and family time. The final piece is looking for what the candidate can bring to the team because having people with diverse backgrounds facilitates innovation and efficiency.
What is the best aspect of your job?
[In our job], we have a patient in desperate need of an organ transplant. We have another patient who has suffered a catastrophic event and their family has agreed to donate their organs. I am the conduit between those two patients. We can help someone in dire need of a transplant. There’s a whole team involved in this process and as one of the links in the chain, I have a chance to make someone’s life better today. I’m enthusiastic to go to work because my job gives me the opportunity to make a difference in someone’s life.
What is your least favourite aspect of your job?
I won’t miss the on-call. There have been many times, after a full day of work and tucking the kids into bed, where I’ve gotten a call just a few minutes after laying down. In the moment, you think you’re tired. But you drop that feeling because that call is happening as a result of someone’s tragedy. Being on-call also affects the work-life balance. This job can put a lot of pressure on your spouse and family. I have a very supportive family, but I’ve missed some family events while I’m on-call. My colleagues and I recognize the importance of family, so we try to cover each other to make sure that we all have the time we need to be with our families.
What do you know now that you wish you’d known at the age of 21?
There’s no substitute for experience. When you come out of school, you know nothing. Organ preservation, especially, is completely different than what you would expect when you see it in real life. Nothing can prepare you for the impact that organ donation has, even on the people in the room who work with the organs. But when you are there, you have to want to learn and you have to be energetic, both mentally and physically. Being young gives you the energy to learn how to do this job but you also need to have the passion and the reason to want to keep doing this.
What advice would you give to someone who wants to follow in your footsteps?
Be enthusiastic. Youthfulness brings enthusiasm. So, a young graduate from community college or university, once they qualify for the job, should bring their enthusiasm and excitement to do this job. This is a unique job and there’s only a few of us doing this across the country, so it’s important to be passionate about it because thousands of transplant recipients across Canada benefit from our work each year.
I really wanted to go to medical school, but that didn’t happen for me. This is pretty darn close to that. I wanted to be a doctor, but I got to have a different and unique career path in healthcare instead. I have loved every part of my career and I still do, even though I’m retiring in a few months. I’m grateful for the people who helped and trained me along the way. I’ll always look back at my career and remember how rewarding it was.