Tears streamed down Paula Coulter’s cheeks as she softly spoke to her 39-year-old husband Tim about their children and their future plans. She didn’t know if he could hear her. But she hoped he could.She held his hand as he lay motionless in his bed in the Intensive Care Unit at Barrie’s Royal Victoria Hospital, knowing that none of the plans she spoke about would be fulfilled. Tim was in a coma. Of all the uncertainty Paula had experienced during the last few days she was very sure of her husband’s wishes should he pass away. He wanted to be an organ donor.Tim had lived life to the fullest and when the father of four died, he gave seven other people the chance to live their lives to the fullest. “Tim and I had talked about organ donation and the quality of life we wanted if we ever were really ill. I knew that if he ever was put on life support he would not have wanted to live like that,” says Paula, 37. Although, the couple had discussions about organ donation, no one could have anticipated how soon such a decision would come into play. On March 18th 2009, while at an early evening physiotherapy appointment, Tim suffered a severe headache, followed by seizures which almost instantly sent him into coma from which he would not wake. The last time Paula would hear from Tim was via a text message sent to her at 3:32 p.m. that day which ended with “Me XO.” Paula responded back with “Me Too.” That would be the last words shared with her husband of 10 years. There would be no more conversations, no more messages, just a blur of pain, and a sea of decisions that had to be made. Among those decisions was one of the most difficult, and yet the most clear – the decision to donate Tim’s organs. Once declared brain dead there was no doubt in Paula’s mind that Tim would want to donate as many of his organs possible. Yet, there were many miles to travel before Paula would have to say her final good-bye to Tim. When Paula got the call from the physiotherapist office that her husband was not feeling well, she had no idea that when she got there her husband would be surrounded by paramedics. “When I saw the ambulance I had this sinking feeling and I thought, ‘Oh, this is not good,” she says. Those words would be repeated to her by physicians on both sides of the border during the next four days. “I stood at the doorway watching what was going on. I could see he was having seizures and couldn’t breathe. Then the adrenalin kicked in and I had to take care of matters.” That meant taking their two small children, Joshua, 6 and Lucas, 3, to the babysitter and then getting to RVH to be with her husband. She also knew her family would not be far behind, some even ahead of her as many of the family work at RVH. Tim’s sister Dawna Stafford works in Mental Health and her husband Ken, is a Mental Health Nurse, and sister-in-law Brenda Coulter, is an RN in the Imaging Department. Other siblings Dianne and Greg weren’t far behind either, as were Tim’s two older children Nick and Samantha, as well as Tim’s mother Bobbie. Once assessed at RVH, Tim had to be sent to a neurological trauma centre in Buffalo, where experts there would operate to locate the source of the bleeding on his brain. “After the surgery in Buffalo the doctor came out and told me that it didn’t look good and that she had done all she could do,” says Paula. “If Tim would have woken up, he would have had major brain damage. That’s when we decided to bring Tim home. I wanted the boys to see their dad one last time.” So the family made the long, sad journey home. Tim’s eldest son, Nick, stayed with him and they flew home together, while the rest of the family drove back across the border. The family contacted the Trillium Gift of Life area coordinator, Cathy Ritter, prior to arriving back in Canada. “We do not approach the family until the individual has been declared brain dead, however in this case they contacted us because they knew of Tim’s wishes,” says Ritter, who arrived in RVH’s ICU to meet with the family almost as soon as they arrived. Once everyone had said their goodbyes to Tim, including his four children, it was time to give the gift of life to others. Organ and tissue donation is a program fully supported by RVH’s ICU staff and physicians. “The intensivists consider end-of-life preferences to be an integral component of critical care services. We fully recognize the vital role that fulfilling every patient’s preference to be a tissue and organ donor has to the amelioration of grief suffered by loved ones left behind,” says Dr. Giulio Didiodato, RVH intensivist. As soon as the word went, transplant teams from multiple medical facilities swiftly arrived at RVH, to retrieve the organ that was specific to the recipient from their area. They were assisted by RVH’s operating room nurses and anesthetists. Currently, there are 1,700 people on the waiting list in Ontario for an organ transplant. Sadly, every 2.8 days someone on the list passes away. It is important, says Ritter, to not only discuss your end of life wishes with family members and sign your donor card but you should also register your wish to donate. Registration forms can be found on the Trillium Gift of Life website. “RVH is dedicated to supporting families in one of their darkest hours by helping them to honour their loved ones’ end-of-life wishes. Last year, we were able to work together to enable five people who died at RVH to donate their organs,” says Cathy Ritter, Organ and Tissue Donation Coordinator, Simcoe-Muskoka, Trillium Gift of Life Network. “These donations meant a second chance at life for 18 people. Approximately 50 additional people were able to become tissue donors by donating their eyes and or bones thus improving the quality of life for another 300 people.” Tim Coulter was one of those donors. He was able to give the gift of life to five people and improve the quality of life for two others. His heart went to an adult female; lungs to a young female, liver to an adult male, kidney to an adult female; pancreas and kidney to a young man, and his eyes went to two separate recipients. “He’s our hero – in life and in death,” says Dawna Stafford, Tim’s sister. “My sister Dianne put it perfectly when she said: ‘The exact moment that all of our hopes and dreams came to an end, seven pagers went off somewhere.’ So, while we were holding a funeral, somewhere there were seven gatherings of another kind.” That’s exactly what Tim would have wanted. Yet, for those left behind it doesn’t take away the pain of losing Tim. “To some degree it makes making sense of his death a little easier to bear, but if I could, I’d wish him back in a heartbeat,” says Paula. “He was the most selfless and generous person you could ever have met, and this is what he wanted. This is a gift of a second chance at life, and I hope they take it and truly live life.” She knows for sure at least one of the recipients is doing just that. Shortly after the transplant operations were completed, Paula received a thank you letter via Trillium Gift of Life from one of the recipients. “I read it and just burst into tears – happy tears,” says Paula.