ENCORE: The gift of life
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When a body is discovered 10 miles out to sea, it sparks a mind-blowing police investigation. There's a man living in this address in the name of deceased. He's one of the most wanted men in the world. This isn't really happening. Officers finding large sums of money. It's a tale of murder, skullduggery and international intrigue. So who really is he?

I'm Sam Mullins, and this is Sea of Lies from CBC's Uncover. Available now. This is a CBC Podcast. Happy Holidays. I'm Dr. Brian Goldman. This is White Coat Blackheart. At this time of year, many of us are reflecting on giving and on gratitude. Today's show, which was broadcast originally in December 2023, definitely hits the mark. Minnie. Hello. You are not Minnie. No.

I know. I knew you weren't. I knew you were a St. Bernard. Hello. How are you? Minnie, a slobbering St. Bernard with an ironic name, greets me at the door of this tidy home in Ottawa. Minnie is a rescue dog, an important clue to her owner's predilection for altruism. But before we meet the altruist, I'll let you in on a little secret. For me and Heather, this is a reunion. Remind me how you and I first met. We have a history. We do, yeah.

Not for the faint-hearted. You planned that. That's brilliant. Okay, we first met, I want to say, 12 or 13 years ago when I was working at a local mental health hospital. You were doing a story that included electroconvulsive therapy. So you arrive on the day and we are with the patient and they...

How electroconvulsive therapy works is they put these sensors next to the head and it generates, it creates a seizure. Right. And the patient's seizure started. And this was the thing you had come to record. Right. And I fainted. Right. In the middle of what you were trying to capture. And...

I remember opening my eyes and there you were, and you had completely shifted gears. You were no longer the journalist. And you said... Back when I could multitask. And you said in just the nicest, calmest, Hi, my name is Dr. Brian Goldman, and you fainted. And it was so sweet, but that's our history. The rest of Heather's history since that day is pretty extraordinary.

In this season of Bearing Gifts, it's been said that the highest form of giving is the anonymous kind. I've come to meet Heather, rescuer of dogs like Minnie, to find out the incredible things she's done and continues to do for human beings. Hi, my name is Heather Badenoch. I am a living liver donor and also a communication strategist for charities. In 2018, Heather donated part of her liver to a complete stranger.

a child who was then admitted to SickKids in Toronto. The operation took place at University Health Network, also in Toronto. Heather and the child are both living. They've never met and never will. In Canada, there's a dearth of donors, and Heather wants to change that, beginning with how and why she became an anonymous living donor. You went from the person who fainted in front of me to becoming a living organ donor.

which is a bit of a reach. How did that come about? Transplant, organ transplant had been on my radar for a long time before I actually applied to do it. I saw the story of a little girl in the local paper and she needed a living liver donor. I was a blood type match for what she needed. I immediately decided, which apparently amongst donors is normal. That's how they do it. We often make that quick decision.

filled out the 11 or 12 page health history and wonderfully did learn a couple of months later it was in the paper that the little girl had received the piece of liver that she needed from the dad of one of her school friends. I asked Toronto General could I stay in the process and just leave it up to them to choose the recipient who needed it the most and they said yes. So the screening continued from there and I was accepted. You had to have blood testing?

They wanted to make sure that you, if you wanted to be a donor, it was for the right reasons and not for the wrong reasons. Can you say more about that? The screening process to be a living donor starts with the online application form, 11 or 12 pages, incredibly thorough about your health history.

I hoped but had doubts that I would be accepted because my health history is not perfect. It includes a double hernia, five spontaneous lung collapses, two lung surgeries. I thought, what are the odds? But let's give it a go. Sure enough, they said how you present on paper is good enough for you to continue on to the rest of the process, which is imaging, x-rays, x-rays.

Many meetings with the transplant team, transplant nurse, transplant surgeons, a psychological evaluation, asking lots of questions about motivation, meeting with a social worker to ensure that I had the social supports, that I had a financial plan for the time that I would be off work, etc. They are incredibly helpful.

and take very good care of the donor. Before they'll ever consider matching you to a recipient, they want to make sure that you as the donor can be as healthy as possible. In 2016, you're matched with a recipient. What happened then? Unlike what you see where there's a deceased donor and people must move very quickly,

The living donor process is this calm, organized process where you get at least two weeks notice that you are going to have the surgery. The recipient also gets about that much notice. As the surgery date approached, they said that the surgery would be delayed, that the recipient wasn't well enough at that time for surgery, pushed it back a couple of weeks. And they got in touch with me as we got closer to that rescheduled date to say, don't come yet. We'll call you.

And then right before they said, the exact words were that transplant was no longer foreseeable for that recipient. That was heartbreaking. You cried for someone you'd never met. I still do, apparently. Because that was the opposite of what's supposed to happen and the opposite of why I signed up. And so I said to the transplant team, I'm not backing out forever. I am absolutely committed to doing this, but I need some time.

And about six months later, I got back in touch and said, OK, I'm ready. Can we start the process up again? And then in 2018, you found out that you matched again. What happened? Yeah, I was actually right about to take a trip to India to a friend's sister's wedding.

And when I learned that I had a match, of course, I immediately offered to cancel. What had happened the last time and the potential for this recipient to get too sick for transplant or I didn't care anymore about the trip. My focus was on the recipient. And they said, no, your recipient is really stable. We promise. Have your trip. I had my trip. Came back. Unfortunately, tested positive for exposure to dengue, which delayed things. But this is also part of the thorough, thorough, thorough testing that they do.

But eventually the surgery happened. What does the procedure look like from your point of view as a living unrelated donor? I arrive early in the morning. I have a really lovely heated blanket. They take me to the OR and I take a nap while Dr. Mark Cottrell and his terrific team did what they expertly do. And then I woke up.

In the recovery room? Yeah, I woke up and had an incredible, incredible nurse. They get you up on day two to go for walks. They warn you that day two may be your least favorite day. It may not be a nice day. Pain meds are starting to wear off. They've really disrupted your digestive system. You may feel nauseous, all of the things. But we're turned out to be...

almost foreshadowing for the rest of my incredible recovery. I loved day two. We got up, I had my first walk. My husband actually made a video and I'm beaming as we do a lap and I get back to my room and we wait a little bit and I'm like, okay, let's do that again. Yeah. You opted to be an anonymous donor.

Which is different because there are campaigns and there are stories really of recipients and donors finding each other and having reunions. But you chose a completely different path. Why? After the person I first applied to give to thankfully successfully got a donor, I didn't know anybody else on the waiting list. But in my mind, I had committed to this. If I was prepared to give to a stranger in the first place...

I'm still giving to a stranger and I didn't feel like I needed to know who they were. But even if the option existed for my recipient and I to meet, and that option does not exist. We have only the option to write anonymously. But I'm not sure I would engage in meeting if that were available. My feeling is that, and it's been five years, I've thought a lot about this. This was a gift freely given.

The feelings that I have, the joy that this has given to me is more than enough. But you found out that it was successful. When and how did you find out? The evening of the surgery, after it had happened, I was visited at my bedside by Dr. David Grant, who had done the recipient's surgery. And he said that the recipient was doing well. And then for four years, I didn't know anything.

And on the fourth anniversary of donating, as has been my habit, I sent an email to Dr. Cottrell and wished him a happy liverversary. And he wrote back and quite unexpectedly told me that my recipient is doing really well.

I printed that email off. It sits beside my desk. I can look at that every day. And more recently, when I had a checkup with a hepatologist, with Dr. Nazia Selsner, she also shared that it's, quote, all good news. It gives me peace. All I want to know is that they're okay.

I don't need to meet them. I don't need their gratitude. I just am so happy to know that they're okay because that's the point for them and for their family to take away, hopefully, some of those worries. Heather says she's satisfied just knowing the child who received part of her liver is doing okay. She is less certain of how she'd feel were that not the case. We'll be right back.

I'm Katie Boland. And I'm Emily Hampshire, who didn't want to be here. On our new podcast, The Whisper Network, we want to speak out loud about all the stuff that we usually just whisper about, like our bodies, our cycles, our sex lives. Basically everything I text to you, Katie. So this is like your intimate group chat with your friends. And we can't wait to bring you into The Whisper Network. This journey is a nightmare for me. I'm doing it for all of us. So you're welcome.

You're listening to White Coat Blackheart. This week, getting inside the head and heart of Heather Badenoch, who gave part of her liver to a child she's never met. Heather became an organ donor back in 2018 and made a full recovery. In her day job, Heather runs a communications business that specializes in not-for-profit agencies. Now she's using her experience as a donor and her skill as a communications professional to help would-be organ recipients and their families.

You eventually found out that your communication skills and marketing skills were handy. You joined a Facebook group. I joined this Facebook group as a living donor, just looking to connect with other people in the transplant community. And over time, God asked if I would help to co-admin the group. I was that engaged. You noticed that when it came to would-be recipients putting out appeals, there are haves and have-nots involved.

What's the difference? One day, a mom of an infant was sharing in the group how she was doing. And she shared, I have sent an email to family and friends. We have not found a donor yet. She said, I know I need to write and send another one. It's just very hard for me to find the energy right now. And of course, the light bulb goes on for me.

And I said, can I help you with this? I can 100% write. I can speak about living donation, which is what you need to find. And she said, would you do that? I said, this would actually be easy for me. And I would love to help you with this. And so I wrote a draft, shared that draft with a bunch of other liver donors. And we...

together figured out what does a potential donor need to read, what's the information you need up front versus maybe later from the transplant team. And that mum sent that email. She did, within her extended circle of friends, find a donor for her son. He's doing great. All these years later, she still sends photo updates of how he's doing. It went from there. You're trying to help people

I guess one thing is that they may be very busy looking after a sick child and too busy to mount a campaign, which is, this is not an unambitious thing. What are some of the other characteristics where you're trying to even things up a bit? We know from the research that there are people who are more likely to arrive at their first appointment, actually with the transplant team, with a potential living donor or with a number of potential living donors. And we know that there are people who are less likely. And...

Typically speaking, if you are racialized, if you are a newcomer, statistically, your chances are less of finding your own living donor, of arriving to that first appointment with someone already potentially going to go through the process to give to you. I meet people who do not have...

the professional and social networks that you might have if you've lived in Canada for a long time. There may be cultural barriers. There may be stigma within a community. And I've been able to assist with so far more than 30 campaigns. When you help somebody with their campaign, what are the ingredients of a successful campaign? What makes it work? A successful campaign has the ingredients that we use in communications every day.

So we have a clear goal, find a living donor. We also have target audiences. And that is based on in part who the recipient is and in part who we know who's most likely to donate. And so the most likely to donate is fairly well established, right? We're looking for those people that maybe have a job and a caring profession, right?

We're looking for people who are probably registered stem cell donors. They are possibly blood donors. They may have a rescue pet. And so when I'm creating Facebook campaigns and then boosting them, paying money for them to reach more people and specific people, I'm boosting for those ingredients. On the other side, there's the ingredients that come from the recipient themselves.

who they are, what their hobbies and interests are, where they live, what their past or current profession is, anything that might help someone feel a connection to them. As Heather said, she's used her communications expertise to help many families mount campaigns to help find would-be organ donors. She also told me that her efforts have caught the attention of the organ transplant team at Toronto's University Health Network, where Heather donated part of her liver.

In our conversation, Heather mentioned one physician in particular who is part of the team. My name is Nasia Selsner. I am a transplant pathologist. I work at the Ajmera Transplant Program and I am the medical director of the Living Donor Liver Transplant Program here in Ajmera. I wanted to ask Dr. Selsner how the Living Donor Program at UHN came about and the influence of donors like Heather on

who have become unofficial ambassadors to the program. Dr. Nazia Selsner, welcome to White Coat Black Art. Thank you. What role does the Unrelated Living Donor Program play in helping meet the demand for organ donors in Canada these days?

Generally, the Living Donor Program is built with the goal to help people in need of transplant who simply cannot get an organ from the cadaveric pool of donors. And because of this knowledge and to avoid the death of patients waiting for a liver transplant, our program built the Living Donor Program as an integrated part of our transplant program in 2000.

to help patients who need a transplant getting a transplant through a living donation.

And as we were building the program and growing up, in 2005, a gentleman came forward and actually challenged our program at that time, asking us why he cannot donate to someone to whom he is not biologically or emotionally related. And the team brought together stakeholders from, you know, surgeons, anesthesia, hepatologists, ethicists,

and created a framework to look at this type of individual who came forward and wanted to help simply someone who needed a transplant without being biologically or emotionally related to them. This year, we have done somewhere around 130 anonymous non-directed living donor liver transplant in Toronto. And that is the largest number that

exists in terms of anonymous donation in North America. In North America? Absolutely. Wow. Why do you think it's been so successful? Well, I think it's grown because people simply start learning about that through knowledge and through understanding that doing these procedures is safe.

but also helps someone else who is in need of transplant. How risky is living donor organ donation these days? There are various risks, obviously. The biggest risk, I guess, would be if a donor died during surgery or immediately after surgery. That is the biggest and the most concerning risk. In Toronto, we have done

over 1,000 living liver donation surgeries since the program started back in 2000. And we are very, very fortunate that we never had this experience. And we are hoping that, you know, with all the checkboxes that we have in place, this would never happen. The risk is still very low, only somewhere around 1%.

We've spoken with Heather Badenoch, who told us that she was an unrelated anonymous living donor in the program at UHN.

And she stressed the anonymity. She said that your program has had a hand in developing the rules of contact, such as they are between donor and recipient in an anonymous program. So tell us about those. So for us, maintaining anonymity is extremely important.

You have to take into consideration that, you know, some of these donors are donating to a child. And we really do everything we can to ensure that throughout the whole processes, nobody knows who is their donor.

And nobody knows who is the recipient, if they are the donor, non-directed. Obviously, you know, there are anonymous donors that hear about a particular story in the social media and they come forward and they want to donate to that particular person. So in this situation, we can only maintain anonymity from one side, but not to both sides. So we take that very seriously.

And we do not make any effort to create connection between a donor and a recipient. We believe it's not our job to do so. But obviously, you know, through social media nowadays, many people are able, if they do a lot of effort, to eventually find who was their donor or who was their recipient.

And I can tell you not everyone is interested among anonymous donors to know who they donated to or for the recipient to know actually who was their donor. They are simply grateful that there was an individual out there. We do our own efforts to raise awareness, obviously, about living donation in general.

So we have, you know, a lot of efforts into raising awareness, campaign, et cetera. But clearly as a program, we cannot participate into helping a recipient to create a social media or go out for appeals. We cannot say to a particular recipient, you know, this is the person out there you should contact because there has to be equity, you know, in terms of...

having access to TransPand. But what I think what she's doing is wonderful, helping people, setting up the social media appeals, walking them through that processes and, you know, helping them to get a donor. That I think is a wonderful thing she's doing.

that's really great. Do you think it has an impact? I do believe there is an impact. We are hoping that we can study this soon to have some answers, but I think it would be the only way to really prove scientifically the impact. But I do believe there is an impact. There is no doubt.

Dr. Nazia Selsner's team has now passed the 1300 mark for living donor liver transplants in children and adults. Meanwhile, Heather Badenoch has much more to contribute to living organ donation in Canada. And you want, you have plans, you want to scale up what you're doing into something bigger than just you and a small team. There are meetings that are happening and conversations with potential funders that

about how to scale this up, how to take what works. We now have a system really, right? I've got a toolkit. How do we then have more bodies doing this? Because here's what we know. There are a number of people who can find a donor on their own. There are a number of people who, if they just take the workshop, they can then go out and do it themselves. There are people who have a big enough network and privilege to do it. And then we know there are people who need the one-on-one support

hands-on help and for those people who might otherwise fall through the cracks that's where I want to help and that's where I would love to build a team of other volunteers who are maybe also communication professionals maybe from the transplant community but if not I'm happy to teach you if you want to learn so the conversations are happening about how we do that

And also how we do research that shows that hopefully shows that it actually makes the difference that we think it makes. And maybe you're not done being an organ donor. I am for sure not done being an organ donor. I still have a spare kidney and I have a family member who has an autoimmune disorder. So I many years ago offered, this is your kidney. This is reserved for you. You can have it.

I'm glad that you finally got to tell that story to me and I got to hear it. Thank you so much for speaking with me. Thank you so much. It's been an absolute pleasure. And there's more for Heather. She has volunteered to become an ocular stem cell donor. Small amounts of healthy tissue taken from her eyes will be removed to help restore the sight of a recipient. The procedure requires that Heather be awake with eyes wide open.

As I know from professional experience, Heather faints rather easily. To get ready for the procedure, she's been doing self-hypnosis. Heather, you're amazing. And on next week's show, it's that time of year when we think about positive changes to make in our own lives. Well, we're looking at that instinct writ large with a new planetary health menu at Vancouver Coastal Health. That's next week.

That's our show this week. Our email address is whitecoat at cbc.ca. White Coat Black Art was produced this week by Samir Chhabra with help from Jennifer Warren, Stephanie Dubois, and Isabel Gallant. Our digital producer this week is Ruby Buiza. Our senior producer is Colleen Ross. That's medicine from my side of the gurney. I'm Brian Goldman. From all of us here, have a happy and healthy holiday. For more CBC Podcasts, go to cbc.ca slash podcasts.