Meet Laurie McDonald, a seasoned transplant social worker celebrating her 24th anniversary at University of North Carolina (UNC). With a master’s in social work from Boston University, McDonald has dedicated her career to supporting lung transplant patients and their loved ones. A former president of the Society for Transplant Social Workers, McDonald is passionate about the profound impact of her work. “My title is officially ‘case manager,’ but I like to say I’m a transplant social worker,” she says with a smile.
We sat down with McDonald to learn more about her journey, the challenges and rewards of her job, and her thoughts on organ donation.
What inspired you to specialize in supporting lung transplant patients and their loved ones through organ donation?
I had been a medical social worker before I moved back to North Carolina and I wanted to continue to do that, and a transplant job was available. I didn’t know anything about transplants, but it sounded interesting. And so I took the job and I just fell in love with it from the outset, and it’s become my whole career. It’s just been so stimulating and interesting.
What is the biggest question you get asked about your job?
People often say, “You can transplant lungs? I had no idea!” Some people are just totally shocked. They’re curious about what I do as a social worker on the team. They’re trying to wrap their heads around what that would look like, so I walk them through the basics.
Would you mind walking us through the basics?
Sure! I usually get involved with lung transplant patients during the evaluation stage. I do a two-hour psychosocial evaluation, which is a lot about education. I meet with the patient and caregivers, explain the process, discuss resources, and talk about how their lives will be affected. We cover the risks and benefits, their hopes and fears. I also gather background information about their support network and mental health, checking for issues like substance use disorders that they may need some help to work on before they’d be a good transplant candidate. Helping them understand fundraising and the relocation requirements of UNC is also part of my job. Then, if they get listed, I follow them for the rest of their lives. I offer a lung transplant class that patients and caregivers attend, which doubles as a support group. During their hospital stay, I meet with them regularly, help with discharge planning, and continue to follow them closely for the first year after the transplant, checking in on mental health and resources.
What do you love most about your job?
I love that I’m available to people forever. Just a couple of weeks ago, I saw someone who had a transplant over 20 years ago. We hadn’t seen each other in a long time, and it was so cool to reconnect. I love the relationships I build with patients and their families, and the long-term connections we form. Another rewarding aspect is working with my team. Transplant care involves a multidisciplinary team, and the collaboration is something I cherish. We take really, really good care of our patients and support them through so much.
How do address the internal turmoil transplant patients often have after receiving their lifesaving gift?
Our transplant clinic is named after Jason Ray. His parents, Emmitt and Charlotte Ray, spent years of hard work raising money to donate to the UNC Center for Transplant care to keep their son’s memory alive. They were at the hospital presenting a donation one day when I had a support group scheduled, and I invited them to stay for it. Someone in the group expressed guilt over receiving lungs, knowing someone had to die for them to get the transplant. Emmet Ray, Jason’s father, said, “If I could do anything to get my son back, believe me, I would. But I can’t. And he didn’t need those organs. I don’t want you to feel guilty. I want people to live their best life with the gift Jason was able to give them.” Hearing this from a donor’s father was incredibly powerful. I encourage patients to reach out to their donor families when possible, transforming feelings of guilt into proactive gratitude and healing.
How do you collaborate with other members of the transplant team, such as physicians, nurses, and psychologists, to ensure holistic care for patients?
Our team functions as a cohesive unit. We have weekly meetings to discuss patient care and keep each other updated. This multidisciplinary approach ensures that we provide comprehensive, coordinated care. Personally, I’ve experienced significant health issues with my loved ones that weren’t transplant-related, and I realized how unique and special this team-based approach is. It’s something I believe should be the standard of care for everyone.
Have you ever witnessed a donor family meeting their loved one’s recipient?
Yes. One memorable moment early in my career was when a heart recipient met his donor’s family. We gathered in a private room at a restaurant in Durham. The donor’s mother brought a stethoscope and asked to listen to her son’s heart beating in the recipient’s chest. He gladly agreed. Despite their different backgrounds, this connection brought immense joy and closure to the donor’s mother, and the ability for the recipient to say thank you face-to-face. It was a beautiful, touching experience.
Can you give us an example of how one of your patients’ lives was changed following their donation?
A young man with cystic fibrosis was actively dying when he received new lungs. While in the hospital, he made a list of things he wanted to do post-transplant. He aimed to surf and run a marathon. Now, he has completed multiple Ironman triathlons and surfs regularly. When people ask about his scars on the beach, he sometimes says they’re from a lung transplant or a shark bite, depending on his mood. Either way, it’s a great story!
I will say that some recipients feel a burden to achieve something extraordinary post-transplant, but that’s unnecessary. Lives are transformed simply by being able to engage in everyday activities, like playing with children or attending family events. One patient was excited about turning 50, while her friends dreaded it. Transplants change perspectives and families, making everyday moments precious. You don’t need to become an Ironman; just living a normal, healthy life is incredible.
As a transplant social worker, do you have a message for the donor families?
I want to say THANK YOU! These deaths often happen out of the blue to healthy people in the prime of their lives. And of course, it’s the family’s worst day. And to have the grace and generosity on your worst day, to say I want to help somebody else, is just the most amazing gift.
What would you say to someone who is hesitant to register their decision to become an organ donor?
I’ve witnessed the incredible care ICU staff provide to donors, and it’s clear to me that every life is precious and that they’re going to do everything they can to save somebody. When that’s no longer possible, they take such care and cherish the donor. And it’s beautiful to hear those stories. I had the privilege to be part of an honor walk one time, just serendipitously, and it was so moving. And so, I think if people have fear, it’s most likely unfounded. It’s so important to ask questions and get more information, and it’s so important to register. The hope is that you’re never going to have to give that gift, but if something tragic happens and you haven’t taken those steps, you might have lost a beautiful opportunity.
What’s your advice for those who are still awaiting a lifesaving transplant?
Try to live your life in the moment. Look at the things that you can appreciate and feel gratitude for so that you don’t spend time worrying about tomorrow, because worry never helps. But gratitude always does.
More than 100,000 people are waiting nationwide for a lifesaving organ transplant, including more than 3,000 North Carolinians. Together, we can make a difference. Register your decision here: https://bit.ly/3hmiWKE
