As HonorBridge marks 40 years of saving lives through organ and tissue donation, we’re proud to highlight the contributions of Dr. Thomas Nakagawa—a world-renowned advocate for pediatric donation and transplantation.
Dr. Nakagawa is a board-certified pediatric critical care specialist, the Associate Medical Director for HonorBridge, and a Professor of Pediatrics at the University of Florida College of Medicine–Jacksonville, where he holds a clinical appointment in the Department of Pediatrics.
In his role with HonorBridge, Dr. Nakagawa oversees the medical management of organ donors, collaborates closely with hospital intensive care teams, and plays a key role in educating medical staff. While it is (admittingly) nerve-wracking to interview a man who has lectured in 20 countries and published more than 130 peer-reviewed manuscripts, book chapters, editorials, and abstracts, Dr. Nakagawa’s warmth, humor, and humility is instantly disarming.
Ask him for a headshot, and you might get a photo of Mr. Miyagi from The Karate Kid. Talk to him about golf, and he’ll readily admit he’s still chasing his first hole-in-one. As a child, he knew he wanted to be a doctor—but he once dreamed of becoming a race car driver, too. In fact, he even got a taste of that dream in adulthood, hitting 167 mph in an open-wheel Indy car at Charlotte Motor Speedway.
Dr. Nakagawa’s playful demeanor and penchant for “fun facts” have served him well throughout his 37-year journey in pediatric critical care. That journey began in 1992 as an attending physician in Norfolk, Virginia, where he experienced his first encounter with organ donation and transplantation.
“When you’re trying to take care of kids as a new attending, it seems like everything is trial by fire,” says Dr. Nakagawa. “I lost seven or eight kids in those first couple of months. It was pretty challenging. We had one child pass, and I remember asking the charge nurse, ‘so, what’s next?’ She told me we call the organ recovery people to come in and see if the child could be a donor. Eventually, an organ donation coordinator (ODC) named Bruce Nicely walked into the unit, and I remember him asking me a lot of questions about this patient. I spent several hours with him, and before I left, I said, ‘if you have any other questions let me know, you can call, and I’ll be back in a couple of hours.’ Bruce later told his CEO, Helen Bottenfield, that the new intensivist had been really helpful. That was my gateway into all of this.”
With Helen’s encouragement, Dr. Nakagawa got involved in regional hospital and donation committees in Virginia. After a decade in Norfolk, he joined the faculty at Wake Forest School of Medicine, where he took part in the nation’s first organ donation collaborative.
“They recognized that they didn’t have pediatric representation, and Helen said, ‘I have just the person,’” he recalls. “This really set the foundation for me to walk down the path to where I am today, and that path could have been very, very different. I’ve been in this field for 37 years, and a lot of people don’t practice that long, because it’s hard. But the one thing I found is that the good that comes out of a child’s death through donation has been the motivating force for me to continue what I do. Every time a child dies, they take a piece of my heart with them. But even though they took a little piece of my heart, there’s something that comes back when donation happens and that gift of life is given to somebody else.”
While at Wake Forest, he connected with HonorBridge (then Carolina Donor Services). Around 2013, then-CEO Lloyd Jordan invited him to join as Assistant Medical Director. Today, despite residing in Florida, Dr. Nakagawa continues to serve HonorBridge as the Associate Medical Director, working alongside Chief Medical Director Dr. Nancy Knudsen.
“What’s unique about Nancy and me is that we’ve both been on each side—ICU care and donation/transplantation,” says Dr. Nakagawa. “It’s very unique because you can blend those experiences very well and it gives you credibility in both worlds.”
Although it’s been over a decade since he began his lifesaving work at HonorBridge, Dr. Nakagawa continues to be impressed by the organization’s growth, innovation, and collaborative efforts.
“HonorBridge is deeply embedded in the communities it serves,” he says. “It continues to be the heartbeat (no pun intended) of the communities and hospitals in our service area. We recover organs and support the transplant mission, aiding the physicians and surgeons involved. We’ve strengthened relationships with hospitals and intensive care units, positioning ourselves as leaders in organ donation and transplantation in the state. The growth has been tremendous, and I think it’s fantastic.”
When asked what has been most rewarding in his life’s work, his answer comes without hesitation: the families.
“To sit with so many families throughout my career, to listen to the stories about their child, and to see how in their darkest times they can still think about others is still beyond my comprehension at times,” he says. “When you’ve lost a loved one, a parent, even a pet, everything seems to go on hold. How these families find that courage to want to help somebody else in their moment of grief, it continually amazes me, and witnessing it is one of the most rewarding parts of my career.”
One particularly special part of Dr. Nakagawa’s journey is the Butterfly Promise Garden at The Children’s Hospital in Norfolk, Virginia. This donor memorial wall honors pediatric donors and their families, and each child is remembered with a copper butterfly bearing their name.
“Early in my career I wanted to find a way to honor these children and families,” says Dr. Nakagawa. “The memorial garden was a big project, and I was happy to help lead it. When I’m back in Virginia, I still stop by the hospital and go and sit in the garden. I sit and think about all these families that leave the ICU without their most valued possession, which is their child. As a champion for donation, I don’t know where the families find that courage. You listen to their stories, and it rekindles your spirit and helps put things into perspective.”
After nearly 40 years of witnessing the impact of donation, Dr. Nakagawa offers donor families a heartfelt message:
“Thank you. You allow us to do what we do because of the gift you’re willing to give to others,” he says. “Believe that goodness comes out of that, that we care for you, and that we’re going to try and make everything happen to ensure that the legacy of your loved one lives on. Thank you for the gift but also thank you for reminding me how precious and fragile life is. In what can be an ugly world at times, but you’re a reminder that kindness and love still exists.”
To close the interview, we asked Dr. Nakagawa how he hopes to be remembered. His response was as heartfelt as the work he’s done.
“I’d like to be remembered as an advocate for children and families and as someone who was there during the most difficult and challenging times in people’s lives. I hope I made a difference in at least one life, or maybe many, through donation. I want to be remembered as a teacher, a leader, a visionary, and a mentor—someone who inspired others, just like my mentors inspired me. As I reflect on my journey, I think about those who shaped my career and my responsibility to pass that on to the next generation of teachers and leaders.
More importantly, I want to be remembered as a loving father and husband. Despite many shortcomings, I tried my best to balance the rigorous world of critical care medicine and my role as a father and a husband. Ultimately, I want to be remembered as someone who made a positive impact and made the world a little bit better. That’s why we show up every day—to make a difference.”
