Ottawa nurse Margaret Lerhe was crossing Elgin Street near the National War Memorial on Oct. 22, 2014 when she heard gunshots. Within minutes, she was at Cpl. Nathan Cirillo’s side, part of a team working desperately to save the life of the 24-year-old reservist who had been gunned down while on ceremonial sentry duty.
She later vowed the attack that killed the young soldier would not make her afraid, that she would still run and move around the city without fear.
But it has changed her in other ways.
Since that day, the altruistic nurse, now 68, has travelled the world volunteering with Doctors Without Borders, has worked with the Red Cross in one of the hardest hit Quebec nursing homes early in the pandemic, and has donated one of her kidneys to a stranger. The attack on Cirillo and Parliament Hill, she says, “just galvanized me into action. It was life-changing.”
At the time of the attack, one of her best friends was losing a son to cancer — about the same age as Cirillo.
“Those mothers losing their sons was just so tragic, I thought, ‘Someone out there has a son who has kidney disease. You can make a difference.’ ”
Lerhe became an anonymous kidney donor in October 2020. Though she never met the recipient, by her own choice, she cherishes the card she received telling her what a profound impact her action had on that person’s life.
Today, she is part of The Ottawa Hospital’s new Transplant Ambassador Program working to promote living kidney donations by telling her story and helping to inform and support others. She is one of 17 ambassadors in the volunteer program that started in Ottawa earlier this year.
Lerhe said she wonders why more people don’t do it.
“I think it is just something so tangible that you can do without risk to yourself that has such a huge impact on a person’s quality of life. I don’t think people appreciate what a difference it makes on that person’s day to day quality of life.”
She has been praised for her generosity, but she doesn’t see it that way.
“I am 67, what am I going to do with it? I really see it as a spare.”
The TAP program relies on volunteers like Lerhe, who have been donors, and Ottawa’s Fiona Gilfillan, 63, a kidney recipient, to talk about their own experiences and help those who might be able to donate or to receive a kidney better understand the process. It is also aimed at helping to increase kidney transplantation rates across the province.
Living kidney donations have plateaued in Ontario over the past decade, at a time when demand has been increasing, said Jessica McDougall, living donor co-ordinator with The Ottawa Hospital. Diabetes and high blood pressures are two leading reasons for kidney failure.
Not only do patients do better after receiving a kidney from a living donor, compared to a kidney from a deceased donor, but the wait for deceased donors can be many years long. And patients can receive a kidney from a living donor before their kidneys fail, which further improves their outcome.
In 2017, the Transplant Ambassador Program was launched as a pilot at 13 renal centres in the province. Today, there are 150 transplant ambassadors at all 27 renal centres in Ontario, including in Ottawa. There is also preliminary evidence that the program, part of a broader provincial access to kidney transplant strategy, is helping to increase living donor transplants overall, in addition to pre-emptive transplants — done before a patient’s kidneys have failed.
McDougall said having former recipients and donors available to tell their stories offers crucial support to patients and families.
“It is one thing to hear it from health-care providers, but to hear a patient’s story and connect with somebody in their shoes is powerful.”
Gilfillan has already shared her story with a woman whose mom had to go on dialysis.
“She was at sea.”
Gilfillan said hearing from someone who had been in kidney failure prior to receiving a donor kidney brought comfort to the family.
“Just to know you aren’t alone” can be reassuring, she said.
She said meeting people through the program has made her realize how important it is. “I have seen what it can do and how it really helps to buoy people up.”
Gilfillan, who has had diabetes since she was a child, underwent a kidney transplant when she was 27 after her kidneys failed. Her brother was her donor.
The transplant, she says, was “life-changing”.
As for her brother, “He never hesitated.” She said she has spoken to other donors who experience a “sense of joy” that they are able to help someone in such a way.
That, too, is an important message to get across. Some patients recoil at the thought of asking friends or family to donate.
That is a particular problem in Canada, says Susan McKenzie, a kidney transplant recipient who co-founded the program. In the U.S., there is a lot of focus on “the big ask” — helping patients and their families learn how to ask someone to donate a kidney. In Canada, because many have a level of discomfort with asking, it has been modified to be “the big tell” as a way to raise awareness about living donor transplants.
Transplant ambassadors such as Gilfillan and Lerhe embody that.
They also know that living organ donation benefits both the recipient and the donor.
“The person is doing it because they want to help. They are doing it as a gift to you,” said Lerhe.
In Ottawa, at The Ottawa Hospital, between 30 and 40 living donor kidney transplants are done every year. The remainder of the 100 kidney transplants are from deceased donors. Numbers were down by around 30 per cent in 2020 as a result of the pandemic.
Kidney transplants not only vastly improve the quality of life of patients, but they save the health system millions of dollars in dialysis costs.
Am earlier version of this story misspelled nurse Margaret Lerhe’s name.