JOHNSON – The Honour Walk – a moment of grief and hope

Reader Beware – this story may be triggering to some.
Please take care.

THIS IS A STORY about a family that experienced an extreme situation; a family death in the ICU department of Royal Inland Hospital. The focus of this story is on the attending staff and specifically a moment that occurred in the ICU department.

For privacy reasons there will be very limited details regarding the patient or the family, except to say that I am a member of this family.

In February, a 36-year-old male, with some genetic cardiac history, experienced a heart attack.  He was found unconscious, CPR was initiated, emergency services arrived quickly, he was defibrillated successfully, then transported to Emergency, where he crashed again and again required resuscitating.

This young man never regained consciousness.

At this time, he was transferred from Emergency to Royal Inland Hospital’s Intensive Care Unit, or ICU.  For those that don’t know, ICU is where the very highest level of medical care can be provided, patients here are usually on life support, where machines are breathing for them or providing other organ functioning tasks in order to sustain life.  As well, many different pieces of monitoring equipment will be attached to the patient, to provide continuous information as to their medical status.

This is the most serious end of healthcare and hospital care.  The staff are exceptionally well trained, and are all part of a large and well-functioning patient focused health care team.

Not only is the training and professionalism of the staff on this ward obviously at a high level, their caring, compassion and availability to family members to answer questions, show they are aware that they are helping family members through an extremely difficult time … exemplifying the very real human commitment to their patients and families.

Back to our story.

Because he was not breathing on his own, our male patient was intubated with a tube down the throat, and the function of breathing was done for him using a machine.  Then a CT scan was ordered. The medical reality going on here is that if a person’s heart stops, then oxygenated blood stops being transported to the brain and if this flow of oxygen to the brain is not quickly reestablished, then a range of consequences can happen, resulting in the person receiving permanent brain damage, or the brain stops completely and dies.

So, immediately these functions are taken care of to maintain mechanical life, and this provides a window of time for tests or other medical interventions. As long as he is breathing, the heart will continue to pump, and therefore the rest of the body will continue to operate.

What we discovered is that in such a worst-case scenario, this window also gives the family time to begin dealing with the reality of the situation.

To make a long painful story brief, and to get to the point of this story, a day or two later he was medically confirmed as brain dead and this was not going to change.  He is gone.

Let’s back up a day or so.

As a part of the process when meeting with the primary ICU doctor, social workers and nursing coordinators in ICU, one of the questions asked was in regards to any previous knowledge of his views and choices about organ donation.  He had not discussed this with any of us, and we as a family were in agreement that this would be possible.

In between this moment and follow up heath care team discussions about this, the family met and discussed it privately, as well as made a range of other decisions that needed to be made on his behalf.  By the time we were told about the final diagnosis and prognosis, we were prepared to discuss and move ahead towards organ donation, and this decision was given to the team.

Well … that started a roll of communications and activities in the organ donation / transplant world, a surgical team and coordinator was dispatched from Vancouver to Kamloops, and the system kicked into high gear regarding potential recipients … recipients that apparently could have been anywhere in Canada awaiting an organ.

In the meantime, a huge set of tests was performed to find out the viability of his organs for transplant, a process that would take a day or so.  This was good as it also provided a little time for family to begin working towards trying to accept what was happening.

At the same time, we also had group phone meetings with transplant team coordinators on the coast, who began to explain how this works … what will we see.

—————–

For brevity, a quick summary of what will happen on the day, and the hour everyone is ready:

– the transplant coordinator will be near the room, and is in contact with the bedside care team and the surgical team in an operating room elsewhere.  She will give the final nod to begin the process, when everyone is ready and standing by.

– The breathing tube will be removed, on the order of the doctor.

– a clock starts, and the family surrounds the bed.

– after a length of time of not breathing, his heart will naturally stop.

– if for whatever reason his heart does not stop within the next 60 minutes, specific organ donations are cancelled, as each organ has an exact timeline as to how long it can sit in the body without adequate blood circulation or oxygen.

– if the heart does stop within that timeline, the family must not touch the chest area, as that could restart the heart on its own, potentially negating specific organ transplantation use.

–  once the heart stops, two doctors will declare that the person has passed.

– within five minutes, he will be speedily taken to surgery.

That’s the last moments of the process … or so we thought.

—————–

The family was invited to escort our young hero down the hall and out of ICU towards his next step, the gift of organ donation.  But time is of the essence. The staff pushing did not meander, this was a quick, determined walking pace, every minute mattered.

As his bed entered the hall, his mother followed, and the rest of the family cued behind.

As soon as we left the room, and turned right down the main hall of the department, we saw every single staff person working on this busy ICU ward, stand along the hallway leading to the outside door and elevator beyond.

Many dozens of people.

All standing silently side by side, watching this hero and his family, provide for others in desperate need.

It was shocking and affecting.

We very quickly realized that although our own experience has been one of profound loss and grief, at the same time, it is also one of hope and compassion.  Our simple decision on his behalf to donate organs for transplant, resulted in this intense moment of respect shown towards us.

We did not expect that.

Without a doubt, for this writer this experience is right up there with the birth of a child or a marriage, but a very different and singular moment that awakens you to the dichotomy of pain as well as the hope to help others.  There is nothing like it.

The Walk of Honour was a profound experience not soon forgotten by this family.

But what exactly is an honour walk, and why is it so impactful?

Let’s delve into the history of this compassionate practice.

The exact origin and date of the first Honour Walk are not well-documented.

However, it appears the practice began in 2011 at the University of Wisconsin Hospital in Madison. Then it was a part of a Grey’s Anatomy TV show episode in 2019 where it became popular, and it appears that hospitals around the world picked up on it.

The symbolism behind the honour walk is about a final tribute to the patient’s life and their selfless act of organ donation. It serves as a moment of reflection and acknowledgment of the profound impact of their decision to give the gift of life, to others in need. Moreover, it offers comfort and support to the grieving family, demonstrating that their loved one’s legacy will live on through the lives saved by their donation.

‍For families facing the loss of a loved one, an honour walk can provide a sense of solace and peace amidst their grief. It honours the patient’s memory and highlights the profound impact of the decision to donate, offering a glimmer of light in the midst of tragedy.

Moreover, the honour walk also serves as a reminder to hospital staff of the human connection at the heart of healthcare. It embodies the essence of humanity in healthcare, and is a powerful expression of compassion, respect, and gratitude. It reinforces the importance of caring for patients and their families during their most vulnerable moments.

What is going on here is the gift of life,
and the recognition that this matters,
far beyond the pain of grief and loss.

We will move on, as we all do after moments in life that affect us to the core,
… but this is also a memory we will all hold as one of the most impactful … and beautiful.

Register to BC Transplant – be an organ donor
https://register.transplant.bc.ca/

David Johnson is a Kamloops resident, community volunteer and self described maven of all things Canadian.