For Yolanda Coffey, a successful day at work is as much about tragedy as it is triumph.
The 40-year-old El Segundo resident works as a family care coordinator for OneLegacy, a Los Angeles-based agency that finds organ and tissue donors for the nearly 100,000 men, women and children nationally who desperately need them to survive.
But for one life to be saved, another must be lost.
"A lot of people ask me, `Why would you do this job? You're talking to people who have just lost somebody they love; death is all you see,"' Coffey said. "But if they say yes to donation, we know that somebody else is going to have a chance to continue their life."
Since most organ and tissue donors are the victims of catastrophic accidents, organ donation isn't discussed as an option until all efforts to save the patient have been exhausted and he or she has been declared brain dead (the medical and legal definition of death).
It is then - while the body is still on life support to keep the heart pumping and the organs alive - that Coffey must approach the legal next of kin to ask them to consider donating their loved ones' organs.
"As hard as it is - at 3 o'clock in the morning, when I'm emotionally drained because we've been dealing with somebody that has died traumatically and dealing with grief - I leave there honored and just humbled by the experience," .
Often, Coffey said, she is faced with having to speak with family members who are registered as donors but who, for one reason or another, don't know the wishes of their hospitalized loved one.
"They are then faced with having to make that decision for them," she said.
It's a tragic trade-off, but a worthy one. According to organ donor groups, a single organ donor can save the lives of up to eight people, while a tissue donor may save or enhance the lives of more than 50 people.
Organs that can be donated include the kidneys, heart, lungs, liver, pancreas and intestines. Tissue donation can involve the corneas, middle ear, heart valves, bone, veins, cartilage, tendons and skin.
Organs or tissue that aren't used for transplants are used for research (unless the donor or family member has specified otherwise).
"We have been called in on patients who were on the transplant list themselves and they've had a stroke or had cardiac arrest," Coffey said. "We still have to approach their family members about donation, even though they, themselves, did not get an organ. Usually, the family will say, `You know what, because somebody didn't say yes, we have to say yes."'
Sometimes, the decision to donate stems from the desire to keep a loved one alive. Somehow.
That's how Faiez and Christina Ennabe of Diamond Bar saw it two years ago when their 19-year-old son, Andrew Ennabe, died after being struck by a car.
It was heartbreaking: Their son was dead, but his organs could be used to help people.
"We had never thought about it before," said Faiez Ennabe. "Initially, it was a selfish thing - I was not thinking about helping other people, I was just thinking, `If I can keep his heart beating, if I can keep his lungs breathing."'
He continued: "We decided that, yes, we want to donate as much as possible of Andrew to keep him going, to keep him alive" said Coffey, who worked as an EMT before starting at OneLegacy four years ago Mourning the loss of a loved one is hard enough. To then have to make the decision whether to donate his or her organs can be too much for some families to bear.
According to OneLegacy, 20 percent to 40 percent of those approached to donate a loved one's organs say no.
When 18-year-old Brandi Renee Guereca died of a rare brain aneurism in 2006, her mother, Denise Guereca, did not want to donate her youngest daughter's organs to anyone.
"My mom was like, `No, we're not donating, you're not going to open her up, you're not going to take her organs,"' said Brandi's sister, Briann Guereca, who is now 27. "I told her, `Brandi wanted this. We should honor her wishes."'
As it turned out, Brandi already had given legal consent to donate. Just months before her death, the young Montebello resident had become the first person to sign up online with the California Organ Donor Registry.
And, according to legislation enacted July 1, 2006, registering with the Donor Registry via its Web site http://www.donatelifecalifornia.org or through the California driver's license application, is considered legal consent.
Historically, signing a donor card and placing a pink dot on your license was considered only an "intent" to donate; familial consent was still required.
"My sister and I had already discussed that we would donate our organs," Briann Guereca said. "She was kind of cocky about it. She had said anybody who had her organs would be so lucky because they came from her."
And they were. Brandi's organs saved six people and helped more than 70 others.
"We heard from the man who has her liver - he had been born with a liver disease," her sister said. "We can't help but feel like we did something good, to save his family from the pain that we went through." Those who do say yes aren't quickly forgotten.
OneLegacy keeps in contact with the donor family for several years, offering support and keeping the family aware of how their loved one's donations were used. If both parties agree, OneLegacy will help arrange meetings between the donor family and the transplant recipients.
"It is still difficult for me to believe that there is something of Andrew living somewhere even though he's not here," Faiez Ennabe said. "But once you get that emotion out of the way it's an unbelievable feeling. I feel good because his death did not go to waste. He is still going strong and he's helping someone live a normal life."
According to OneLegacy, Andrew Ennabe's donation helped more than 50 people.
"I would love to meet every one of them, to see the difference he is making in their lives," said Ennabe, who has since started a charitable foundation in his son's name. "He did not die in vain."
According to the United Network for Organ Sharing, 18,659 organs have been transplanted in the U.S. from 9,490 donors so far this year.
It's not enough. There are about 100,000 people on the national organ transplant list - 20,000 of them in California - and a third of these people will die before getting the transplant they need, according to Donate Life California.
"There are people who are on the kidney list for 10 years," Coffey said. "We haven't been able to cure cancer, we haven't been able to cure diabetes, we don't have a cure for AIDS, but this is the one thing that people can actually say yes to and people could live."
Myths about organ donation may be preventing people from becoming donors.
Here are the facts:
- Myth: A person can be "too old" to donate.
- Fact: Almost anyone can be a donor. The oldest organ donor was 92; the youngest, sadly, just 18 days.
- Myth: Someone with diabetes or hepatitis cannot be a donor.
- Fact: People with pre-existing health conditions, including hepatitis and diabetes, may still be able to donate. However, some conditions, such as HIV and actively spreading cancer, would disqualify a person as a potential donor.
- Myth: "If I am a donor, doctors will not try as hard to save me."
- Fact: It is only after every attempt has been made to save your life that donation will be considered. In fact, patients must receive the most aggressive life-saving care in order to be potential organ donors; if the heart stops, for instance, blood flow to the organs will stop and the organs will begin to deteriorate.
- Myth: "Donating my organs will prevent me from having an open-casket funeral."
- Fact: The organ donation operation is done under surgical, sterile conditions, in a hospital operating room, with all incisions made in locations that would be covered by clothing. Doctors go so far as to insert prosthetics into the body if bone is removed.
- Myth: Only the major organs can be donated.
- Fact: Though the major organs - including the heart, lungs, liver, kidneys, pancreas and small bowel - can save lives, the tissues (including skin, tendons, veins, muscle, cornea and bone) can be just as important. Skin, for instance, can be used to graft onto burn victims or to repair cleft palates.
- Every 12 minutes another name is added to the national organ transplant waiting list.
- An average of 18 people die each day from the lack of available organs for transplant.
- Approximately 1 million tissue transplants are performed annually. Source: Donate Life California/
FIND OUT MORE
To learn more about organ and tissue donation in California, or to register as a donor, go to http://www.donatelifecalifornia.org.
“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”
Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves