5 Questions with… Jennifer Smith, Hospital Donor Strategist for New England Organ Donor Services

If you were going to take bets on which member of the Smith family would be interviewed by GOOD Morning Wilton, you’d be more likely to win if you put your money on Wilton Public Schools Superintendent Kevin Smith.

But instead, in advance of National Donor Day on Feb. 14, 2025, we are very excited to feature our conversation with Jennifer Smith, who has been working with the nonprofit New England Donor Services for the last six years. NEDS coordinates organ donation in the region that spans Connecticut to Maine, helping to facilitate a process between hospitals, donors and donor families, potential donors and transplant centers. The work Smith and her colleagues do is demanding, emotional and critical as they seek to help save lives and honor those who give the gift of life. [This interview has been edited for brevity and clarity.]

1. Can you explain to people the work you do — what working for an organ procurement organization is all about?

Jennifer Smith: New England Donor Services is an organ procurement organization, and my agency is responsible for any donations that take place from Connecticut to Maine. Currently, I’m an in-house coordinator at Yale New Haven Hospital and St. Raphael’s [Hospital], both of the Yale campuses. I’m basically the liaison between Yale Hospital and my organization, and I try to facilitate the best donation process for the hospital team and the donor family, to make it as easy on both parties as possible.

In my current job, I don’t interact with donor families, I only work with the hospital team, the nurses and doctors. My previous role was called a family services coordinator, and I was part of the team that primarily works with donor families. I was the requester, we would approach families of patients that were candidates for organ donation, whether or not they were registered.

2: That sounds really hard. What do you say to people and how do you make that ask?

Smith: Every role is really challenging, but that one you do carry a certain load. It’s both a beautiful thing, but also tragic. It’s a family’s worst nightmare, the worst day of their lives, and you’re approaching them and asking for something. I used to be so amazed by families that would not even think about it, they’d just automatically give. They probably feel like everything’s been taken away from them, but they don’t even flinch. ‘Yes, of course. How can we help? That would be amazing if we could take another family out of this scenario. Yes, please, how do I do that?’ It didn’t always go that way, but still… I believe in donation. I’ve been registered since I got my license at 16, but I think I would need a beat before I’d get there, especially if it was my child. And these people are just beautiful. It’s nice to know they’re out there.

We were on call from 6 a.m. to midnight, so if something was going on, we would have to stay to support the family however we could. Depending on the need, it wasn’t uncommon to drive three-and-a-half hours, meet a family at the hospital, and then come home late at night.

There’s so many myths and we’re so poorly educated about organ donation. I had no idea what it entailed before I worked here. I thought, I’m going to sign up to be a donor, and I will donate, and I will help. But you have to die in such a specific way that it’s such a unique gift. You have to die on a ventilator. If someone were to get in a car accident and die on the side of the road, they would not be able to donate their organs — possibly tissue, but… Unfortunately donation gets a really bad rap. People get very visual when you talk about it, and they don’t want to be cut. They think it’s barbaric where it’s actually a very respectful process. They think if you register to be a donor, you may not get the care that a non-registered person would because they just want the organs — which is obviously not true. Actually — especially at Yale, especially when it’s going down that pathway, teams have to protect and preserve the organs until the family is approached, so the organs are still viable, if it’s something that the family is interested in.

You’re meeting a family at their worst grief, so it’s a challenging, very sensitive conversation. Sometimes they’re willing to give you the time, and sometimes they’re not. I was always super transparent and just appreciative of them even having the conversation. I would ask, ‘What is it about makes you uncomfortable?’ Sometimes they would say, ‘Oh, I just knew, we’ve had conversations. I just know it’s not something that they would want.’ Sometimes they’re like, ‘She said she didn’t ever want to be cut.’ I always tried to let them know that it’s their decision and that they’re in control.

Unless the patient is a registered organ donor. There’s something called ‘gift law,’ and if the patient’s registered we would do our best to honor their wish and move forward, even if the family was opposed to donation. We try to do that with the family supportive and on board, and as much in control as they can be.

If we’re given the time and opportunity, we try to just have a conversation. We want it to be an educated conversation so that you’re just not believing myths you may have heard or stories that aren’t true. People go online and find these barbaric stories that are just not true. We do our best to make it as factual and as educational as possible.

They have the right to say no. And then we just say, ‘Thank you for your time.’

3: Are there any really memorable, special anecdotes that you’ve experienced while working in organ donation?

Smith: At Yale, they’ll do honor walks, which are very meaningful to families. If we do have a family supportive of donation, and the patient is going for [organ] recovery, all the hospital team members and staff will be alerted, and those who are available and not busy with other patients will line the hall on the way to the operating room, out of respect, and they’ll walk with the family to the OR.

If the patient has not been declared brain dead, the family does have the opportunity to be with the patient when the tube is removed, so they can be with the patient when the patient’s heart stops, and they pass in that setting. They can write a passage or something, and we do a moment of honor, and then a family statement, if they wanted to read what they have. We’ll escort the family out and the patient will go in for their recovery surgery. Then the next day, we can share with the family the gifts that were recovered and a little bit about the people that their loved one was able to help, and that can be very meaningful.

We do have some very beautiful stories of brides [who are recipients] walking down the aisle with the donor family father, just because they’ve established this beautiful relationship. But I’ve worked with [some] families and it does take a while to connect because of survivor’s guilt. They feel really guilty that they got to live another day while someone else had to die for that to happen.

I do have a story of a mother of a young child [donor], and she was able to meet the family and hug the recipient of her child’s heart, and so that was very meaningful for her. But it does take a little bit of time.

4: It’s sounds so emotional. It’s an amazing thing you’re doing, but I imagine it’s also emotionally exhausting.

Smith: That’s why I needed to transition [to the hospital in-house coordinator side].
Hospitals have certain guidelines as to when they’re supposed to refer a patient. When things are not looking very good, we’ll screen the patient to see if they’re a candidate for donation. If they are, we’ll follow them in the background. While we’re following them, you learn about what brought them to the hospital. Was it a car accident? Was it a 16 year old boy and he OD’d and he had never done drugs before? Or, was it a man putting up Christmas lights, and he fell off his roof?

So — when you’re a mom of five, especially — you start to want to just wrap everybody you love in bubble wrap. It’s the little things, it’s not a tragic accident, it’s just everyday life, these fluky things and they become these terrible stories.

When I was training, I was like, ‘Oh my god, I can’t go talk to this family. They’re hysterical, I can’t go in and ask them.’ It took me a while to realize that this is the worst day of their life, and [organ donation] is the only good thing that can come out of this today. I had to flip it. I tried to make it not so much about the death, but who they could help. That made it easier.

I love my job, as crazy as it is. The mission is absolutely amazing. There is a lot of sadness. I’m a social worker, so I like listening to people. I like helping people however I can. When you can flip it and it’s not about death and dying every single day, that this is the only good thing that could come of this terrible, terrible day, and the fact that you could save nine people — that, to me, is magical. Plus, with tissue [donation] the gifts are never-ending. So when you are able to call and tell the family, ‘I actually have some good news for you today.’ And you tell them [their loved one] was able to help a man in his 60s with the gift of his left kidney and that got him off dialysis, and now he can run and play with his grandkids. That’s what keeps you feeling that this is really good work. I work with some of the most amazing people — and it does take a certain type of person — but when you meet these families that say yes, you just feel like, ‘Oh my gosh, thank God you’re out there. It’s nice to be on this planet with you.’

It’s very hopeful. I mean, you get people who yell and scream at you, ‘What the heck are you thinking? Absolutely not, get out of here!’ Those are not the best days, but they’re entitled to that.

5: We like to ask people what their coming-to-Wilton story is and what they felt about moving here. I know yours is relatively unique, being married to Wilton’s superintendent.

Smith: I grew up in Fairfield, and so I was pushing for Fairfield. And Kevin really didn’t want to live in Fairfield, but he had always said, ‘I really would prefer not to live where I work,’ which I could totally understand. So we looked and continued looking, and looking. We expanded our search a little bit and there were houses coming up with our bullet points in Wilton. The more and more we looked, and the more time Kevin had been here, he was like, ‘You know what? The people are so nice and so down to earth that I think I can make an exception. I think it would be really good.’ So we ended up finding this amazing house here.

When I first started my kids were very, very little. We had just moved to Wilton, and I was just making friends. And the teachers and my kids — God only knows the stories that they told these teachers. They’d be like, ‘My mom comes home late at night, she got the organ!’ What does your mother do? So when I did get the opportunity to talk to the teachers, they’re like, ‘Why do you come home late at night with organs?’ [Laughs]

My job, obviously, took me away a lot, and it’s a weird work schedule — 12 hour days, 12 days a month, and on-call, so it was very time consuming. My parents live in Southport, and they helped a lot. My mom was meeting a lot of Wilton people before I was and she’d tell me, ‘Oh my gosh, you have to meet this girl. She’s so lovely. She has kids the same age as you!’ She knew all my neighbors, my neighbors all knew her. So it took me a while to meet people. I thought, I’ll meet them on the sidelines, because my kids were all athletes. But then COVID hit, and so there were no sidelines.

Little by little, I met people, through school events or whatever. And Kevin was absolutely right, people in Wilton are truly amazing. I know I sound like a superintendent’s wife, but the people here are very, very special people. I went to that prayer service [for someone fighting cancer] last week, and the fact that those things happen, the fact that people care in a different way, is very important to me. It’s just a very, very special place. And I’m thrilled to be here.

Q: Anything else that you want to tell people or for people to know?

Smith: Organ donation is a really respectful, beautiful process. If anyone ever has any questions, I would be happy to talk to them. Obviously we’re dual advocates, so we’re really working hard for those recipients. But I would never push donation on anyone. I hate when people call it like being vultures. It’s really not like that at all. But I encourage people to register, because really it’s such a unique gift.

In our region, the numbers of registered organ donors in Connecticut are the lowest. I think Maine is probably our highest, followed by Massachusetts. And it’s going down. All the time we think about what we can do to get the word out.

In New England alone, there are 6,000 people on the transplant waiting list. In Connecticut, there are 1,000 and nationally, there are 104,000 people waiting on the list. At Yale, just last year, over 1,900 people died waiting on the transplant list. And those are people that are just in New Haven based out of the hospital. It’s so, so important.

We don’t do a good job at the DMVs and explaining donation. I told Kevin they should consider putting it into the health curriculum, so that we’re more educated. It’s a very meaningful gift. But everybody has a right to their own decisions, I would never sway them otherwise. I would just hope that it’s an educated decision when they’re checking that box or not checking that box.

To learn more about donation and to register to be an organ donor, visit the Connecticut Donate a Live website. CT residents can also register when renewing their driver’s license at any DMV location.