Behind every organ, eye, and tissue donation is a team of professionals working together to honor a donor’s final gift. Among the first to encounter potential donors are Emergency Medical Services (EMS) personnel and Medical Examiners. These roles are essential, yet often underrepresented, in conversations around donation.
At HonorBridge, Alyssa Schuster serves as the bridge between these professionals and the world of organ and tissue recovery. With a background as both a paramedic and medical examiner, Alyssa brings a unique perspective to her role as the EMS/Medical Examiner Liaison, helping to educate and build understanding between the two worlds. Her work ensures that everyone has the knowledge and tools to support donation. Below, Alyssa shares her journey and explains why education is key to saving more lives.
Can you tell us a bit about your background in EMS and as a Medical Examiner?
I was a full-time paramedic with Wake County EMS, which runs about 140,000 calls a year. It’s a high-volume system, based in Raleigh, so we saw a lot of shootings, stabbings, car accidents, overdoses, and general medical emergencies… that was our day-to-day. We’d respond and provide whatever care was needed, wherever it was needed.
Alongside that, I spent three years working as a Medical Examiner, covering Durham and Orange counties. Those are large areas, home to major hospitals like UNC Chapel Hill and Duke, so we stayed busy. I was on-call for 12-hour shifts and would respond to various types of death scenes—natural deaths, overdoses, suicides, and homicides.
My role involved investigating deaths. This meant going to the scene, taking photographs, talking to witnesses, law enforcement, family members—whoever had relevant information. I also did external examinations in some cases, drawing blood for toxicology, documenting trauma, and sending certain cases for autopsies. Afterward, I would complete the investigation report, sign the death certificate, and hope not to get called to court.
What drew you to that field initially?
Honestly? The X-Files. I grew up watching it with my mom in the ’90s, and that show sparked my interest in investigations and the stranger, lesser-known parts of life. I originally wanted to be a trauma surgeon, but once I realized the amount of school and debt that would involve, I pivoted to becoming a paramedic. That opened the door to becoming a Medical Examiner—North Carolina requires either a paramedic or nurse license for that role, and it just grew from there.
How has your experience in EMS shaped your role at HonorBridge?
My knowledge of anatomy and physiology has been helpful, especially in talking to medical examiners. For example, if they’re concerned about how donation could affect a death investigation, I can walk them through what we’re doing. We can work around certain concerns that the pathologist must help move forward with donation. I can speak their language, which helps build trust and cooperation.
How did you come to work for HonorBridge?
HonorBridge found me. I had met my predecessor a few years ago while working as a medical examiner—she had invited Durham and Orange County MEs to visit the office. Later, I applied for a different role at HonorBridge and didn’t hear back right away, but Sydney Burgess, an HonorBridge recruiter, reached out and said, “Hey, I think you’d be perfect for this EMS/ME Liaison position.”
At the time, I was starting to burn out from EMS. The 911 calls were becoming overwhelming, and I knew I needed a change. The timing was perfect. I interviewed, it felt like the right fit, and here we are.
What does a typical day look like for you in your current role?
I split my time between EMS and Medical Examiner outreach, but right now the focus is mainly on Medical Examiners. I provide education to both groups, because honestly, neither typically gets much training on donation.
When I was a paramedic, I knew HonorBridge existed and that we were supposed to call for DOAs (dead-on-arrivals), but that was about it. As a medical examiner, it wasn’t much better.
I work to change that. I meet with regional autopsy centers and the pathologists working cases across North Carolina to streamline workflows and explain how we can help with investigations. We can take photos, draw blood, access medical records, coordinate with law enforcement and families—whatever is needed to support the medical examiner’s work. If they see us as helpful, they’re more likely to approve donation.
On the EMS side, I offer continuing education—PowerPoints, conversations in ambulance bays, swag, you name it. I explain how tissue donation works, what we can procure, how these tissues help the living, and how long we can recover tissues after death. Many EMS personnel assume someone’s “too sick” or “dead too long” for donation, but that’s often not true. We can recover skin, bones, tendons, and ligaments, even hours later. There’s also a state protocol through NCOEMS (NC Office of Emergency Medical Services) requiring agencies to call us, and many don’t know about it. My job is to change that.
Since working in donation, is there a story that’s really inspired you?
Yes—an 11-year-old girl with a terminal illness. I don’t know the full backstory, but I do know that before she was very sick, she had a conversation with her family and said, “When I die, I want to be an organ donor.” And she did donate recently.
That really hit me. She was so young, but she wasn’t afraid. She just wanted to help people. I have an 11-year-old myself, and I don’t know if he’d have the bravery to say something like that. It was incredibly moving.
One common donation myth is that medical teams won’t try as hard to save someone who’s an organ donor. What would you say to someone who believes that?
As a paramedic, I’ve never looked at somebody’s license for that heart, and I would imagine it’s the same for everyone else. I never even thought about it. I think one of the issues with EMS is that you forget that organ donation is even a thing, which is why my current job is so needed—I’m always having to remind them to call us for DOAs. I was focused on saving someone’s life, not their wallet. It’s all hands-on deck.
If you could share one thing with the public about donation, what would it be?
I wish more people knew how far one donor’s gift can go, especially tissue donors. One tissue donor can help up to 75 people. That’s incredible.
Organ donation is more limited, sure, but equally impactful. And again, being a registered donor doesn’t affect your care in any way. In fact, you’re likely to receive even more attentive care because the process is handled so carefully and respectfully. Everybody that I’ve run into regarding organ and tissue donation has been very respectful of the patient’s decision and the family’s wishes. We try to make sure that everybody—the patient, the family, law enforcement, the medical examiner, the hospital staff—is happy. We always strive for the best outcome possible.