Aviation and Transplantation

Hello, and welcome to the gifted like podcast where we have conversations about organ tissue and idol nation. I'm Roy Stehl. Hi, Joey Boudreau. I'm Sally Gentry.

And thank you so much for listening guys, coming up on this podcast. Aviation and transplantation, how one organization is addressing the challenges. And today we're going to talk about living with grief and how to help others grieve. That and a whole lot more.

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Ready? Here we go. The gifted like podcast crew is proud to welcome Steve Johnson, chief operating officer for the Indiana donor network to the podcast. Hey, Steve.

Good morning. How are you? Great. Great.

We were just here and we're sitting in awe because we're learning that the Indiana donor network started an aviation program from scratch in order to save more lives. So our jaws are dropping and we want to know all about this and how did you even start in this program and this process? Yeah, sure. So actually my background is both as a pilot as well as a clinician and I spent many, many years in critical care transport, which to most be your medivac helicopters.

So I both flew the crew member but ran several programs throughout the United States doing that kind of work. I actually was in Indianapolis doing that specific work for one of our major transplant centers. They actually asked me to come over and take a look at the OPO because of the transport needs that they had as a transplant center and as an OPO and that's kind of how I got involved and I came over here and looked at it and I said, wow, you guys, you know, this is a really important part of your business and not just important critical to your mission. And you know, I was able to kind of give them some of my ideas of how I thought that we could put something together that would positively impact donation and transplantation.

That's the way it was born. So let's talk about logistics. So you have your own jets planes? Like how does this work?

We actually, we actually know how four jets. So we have four customization CJ3. We just actually took the liver of two brand new jets. Yeah, just December 24th I think is what we actually got on Christmas Eve.

So nice Christmas present. But we standardized our aircraft. They're light jets. So, you know, they are able to travel quickly, which is important.

They're also very efficient from a fuel standpoint and an expense standpoint. They have a lot of advanced technology for safety purposes and they're really a good platform for all weather operations and they can go really long distances. Steve flown like saving organs back to Indiana from as far as California. So Steve, you know, so I was fortunate enough to meet Steve a few years back at one of the conferences as the CEO there.

So take us from Steve, you know, working in aviation to Steve now, COO of Indiana. How did this transpire? Well, if you would ask me five years ago or if you had told me five years ago that I would be, you know, the COO of Oregon Procurement Organization, I would have looked at you and said what's that? Yeah.

So, you know, when I came over here for the first time and I started consulting with them and helping them kind of, you know, look at what they could do from the aviation standpoint, I think a lot of us probably had this story. I know Lori reading about her background, it sounded like she kind of had the same aha moment. You know, spending my entire life doing critical care transport, I thought that was a pretty neat life saving mission. It didn't take long coming over here to OPO for me to just say, wow, what an amazing thing that these people do every day and what an amazing thing that I could be a part of.

And I'm not just saying that it was literally with one of those things that I just loved the mission. The people were amazing. And it was something that, you know, every time, specifically aviation wise, every time we hit the start button on that aircraft, we're going to be saving someone's life. That wasn't the case with every helicopter transport.

And don't get me wrong, it's fantastic work and very necessary life saving work at times. But a lot of times you're moving people from point A to point B. There's a lot of satisfaction in knowing that every time we roll that airplane out, we're, you know, fulfilling that promise and saving somebody's life. So, I mean, Joey, it just feels good.

So you actually have seen in working with families and potential recipients, you can see then that it can be a benefit to both sides. Both certainly. And, you know, from the aspect of making sure that, you know, we're not pushing back, you know, our times and putting some of these pressures on families to really just, again, I don't take this lightly. It is truly fulfilling the promise for both sides of the donor family, as well as those people waiting on that life-saving transplant.

There's no doubt that it is impactful for both. So back to your story of, you know, you meeting with Indiana donor network, the folks there. So at what point did you guys, and then of course becoming COO, at what point did you guys see that, you know, that this was just going from a challenge that needs to be overcome to the fact that, okay, now you guys have such a big fleet. And from that, what have you seen as the biggest areas of basically biggest takeaways, positives and things besides those that you had mentioned, you know, with the donor families and recipients?

When a lot of transplant centers and OPOs look at aviation, I think they look at it as one piece of the puzzle. And even more so, I don't want to minimize this, but it almost is like calling a taxi. You know, this is just, and that's the way that it has been looked at in the past. And so we wanted to take a fresh look at it and say, look, we are 100% dependent on transportation.

Logistics are so important. And we can provide safety and value at a level that doesn't exist today. And so I think the first realization for Indiana donor network was when I came in and did a safety audit of the operator that they were currently using. And we found a lot of areas that needed significant improvement.

And we're putting our teams and our transplant teams and our OPO teams on these aircraft, and they have 100% trust that there's been the due diligence done behind these. And that's not always, you know, that's not always what we found and we knew that we could do that better. And then we hear stories of, you know, our coordinators and our teams working so hard and making so many phone calls trying to solve these logistical problems. Even just finding an aircraft to come do this work was just really a burden.

And so we saw opportunity there. Then we started looking, of course, at the, you know, cost component. You know, in some way that we would be able to provide more value to our healthcare system and to everyone involved in it. And that was a clear picture that said, yes.

And so all these things were pointing at the direction that, you know, we are huge consumers of aviation for a very important reason. We have the ability and expertise to do it better. And if we can prove that, then we might be able to serve others and be able to accomplish it for them as well. And so those were kind of all the pieces that started coming together.

And I think with any project, you look at it and you say, okay, you know, what is the benefit and what are the risks? And frankly, we just had this really, really long benefit list. And the risk list was empty. This is something that we do.

And it was something that we knew could be, you know, impactful. And so this is years ago. And, you know, of course, you guys didn't, or maybe you did, I didn't see it coming years ago. All the upcoming allocation changes with each and every organ at this point right now, Liver has been front and center for the last year and a half.

But you know, for those of you out there, you know, there has been a bigger push to have broader sharing for all the organs so that, you know, the sickest person on the list, even though that person is two or three states away, still has that option of, you know, that organ that's available at that point. Stephen and I have been in many meetings throughout the past couple of years together in these conversations. And now we're finding out that flights will increase, you know, and because of this, obviously that's one of the, you know, negative consequences that has to take place. When you're broader sharing, of course, you'll be traveling more.

And we're understanding that there's going to be a significant uptick in air travel. So you guys were definitely at the kind of forefront of being able to prepare for this while we were all sitting behind waiting. Joe, I would love to sit here. And in fact, you know what, I will just sort of have it all to say.

Yeah, I anticipated all of this. You know, five years ago, I was sitting here with my Magic 8 Ball. Our allocation rule is going to change with broader sharing. So let's just say yes.

Yeah. No, it wasn't that. You know, we, five years ago, when we did this, we were doing a dissolma problem that we had at the moment. And we knew that this was something that, you know, we thought we could do well.

And certainly, to your point, Joey, I think that with broader sharing, we certainly are going to see a much more significant demand in certain areas upon air transportation. But I mean, even some of it's kind of a perfect storm. And it's something that I'm really concerned about. I know a lot of other leaders in the OPO world are concerned about.

It's not just that it's the commercial aviation environment's changed drastically over the last 10 years. What we did anticipate, and we saw coming that we were going to, at some point, have a pilot shortage. I don't know if you guys have heard about this, but there's a very significant pilot shortage throughout the United States. You know, post 9-11, our aviation industry, commercial aviation industry, was hit very hard.

And we saw a lot of flight schools go out of business. We saw the ability for people with a pilot's license and people to qualify pilots. It was very hard for them to get jobs because it just weren't that many out there. And so it wasn't attractive for people to come into the business of being a pilot.

Our military has stopped training as many pilots, whether it be drones or financial cutbacks. Our number of pilots coming out of the military is the lowest ever. And so all of these things can create this perfect environment where all of a sudden we're in this boom. The airlines are growing faster than they ever have.

Boeing is reporting that they are building more airplanes than they ever have. Our airlines are literally trying to start up pilot training programs so that they can supply themselves with pilots because there isn't anyone out there. So what do you think is right now behind all that? I mean, what's happened that people are not wanting to become pilots?

A couple of things is that what was going on for a long time is it was hard. You really had to pay your dues. And so Sally, it was not fun to be a young pilot with no hours. I mean, you really had to do some terrible jobs to build your hours so that it would be qualified to go fly.

And how many hours does that take then to do that? Oh shoot. In today's world is different than it was back then. But you know, we're going to be back in the day.

We're for you to be considered for an airline job. You probably would be, you know, for a first officer three to four thousand hours of flight. So you're talking about a couple of years then. At least.

And you're doing things like, I mean, you're ferrying airplanes. You're flying parachute people. You're doing whatever you possibly can and living off ramen to do that. So now we're facing this perfect storm where we're, you know, and we need to remember that that transplant happened at 2 a.m.

Not 2 p.m. Right. And so, you know, it takes a special group of pilots and a special, you know, personality to want to go out there and do this kind of work. And a lot of these charter operators are just not staff and they, to do the kind of work that we do at the time that we do it.

So it's really interesting to watch that. It is interesting. It's not the right word guys. It really is something that we're concerned.

And I'm trying to help solve for because I think with the allocation rule changes as well as the pilot shortage, we're going to have some real challenges trying to deal with e-flageistics. So Steve, of course, you know, in the OPO world, we're always trying to look to be more financially responsible with every aspect of the donation process. And you had mentioned earlier that, you know, you looked into this and one of the aspects that you really liked was it made financial sense. How are you able to make it more cost effective than the rest?

It paints a really clear picture or a painted a really clear picture when we evaluated this. We're always looking at it as to how we can be good partners with our transplant centers and provide value in the aviation world. These transportation is a significant expense. And looking at it, seeing that we would be able to set up as a non-for-profit and competent providers of air transportation, we knew we would be able to provide this service at a much lesser expense than what you would be paying, you know, these on-demand charter operators.

And no take away from them. That's another job is to, you know, to make a profit. Our job is to save lives through the facilitation of donation and transplantation. So our mission is the same, but very different.

And it has been a huge financial benefit for our transplant centers, as well as our surrounding transplant centers that you like the service. So the 501c3 gives you guys an advantage, how? Well, two things. One, we don't have a owner or a board of directors that is looking for a financial return.

As a non-for-profit, we are going to, you know, those dollars are going to go back to these entities that use it. So that in itself takes away that, you know, 20 to 30 percent margin that operator is going to be looking for to make in profit arena. Also just being a non-for-profit, you know, we are not taxed the same way that other people would for just their operations. So all of those savings that we see are going to, again, go back to our transplant centers and others that use us.

With the uptick of 20, we're talking about 50 percent flying livers right now to about 74 percent of the livers that are recovered for a transplant will be flown to the recipient. So, you know, he talked about the perfect storm of, you know, now you've got a lot more need for the commercial, a lot less charter. It's at two o'clock in the morning. It's not very attractive.

I'm sitting on pins and needles quite honestly, Steve, you know, to see, you know, what's actually going to happen with us. It's, and this is the thing is we've all modeled this to the best of our abilities, but as we know, there's so many variables and, you know, the geography and demographics and everything that go into, you know, our transplant system, you know, we can't anticipate all of it. And yeah, it is, you know, we as TSG, we're trying to do everything we can to as you educate and to help any program, you know, whether it just be improved their safety or work with them on trying to create their own aviation program or placing even placing aircraft and pilots for them strategically. We're doing whatever we can to help.

So that's a big part of what we feel like our role can be is to be that trusted resource and OPO community to kind of help navigate the best of our ability. So what we've been talking about is this aviation program and where to save more lives, txjet.org if you want more information, but we were looking through these stats which are pretty impressive and the pros of having this program. So, decreasing time to transplant, decreasing the expense associated with transporting 24 seven dependable travel. But the stats guys since 2014, they have flown more than 2000 organs just in 2018, 495 life saving flights.

And then this one was a jaw dropper. Well, between 2014 and 2018, you've made the equivalent of four trips to the moon mileage wise. Yeah, we thought that was a fun statistic to throw out there. Yeah, our guys get a big kick out of that.

And you know, the, you know, what's amazing is, you know, how the OPO and transplant community captivated me, it captivates our pilots. Our guys constantly talk to me. I mean, they're part of our OPO, they're part of our program. They're not just people that hang out at the airport.

They're with us all the time. They're at all of our meetings, our events. They're here at the office. You know, the pilots become such a part of who we are and what we do.

And that's kind of a neat thing to see develop. But they see it the same way we do. They're so passionate about it. And I think that's a really huge.

I do. I do. You wear so many hats. You want to show us.

So I, you know, I certainly they allow me in the airplane. The fun stuff. But you know what's neat is that these pilots when they talk about it, they just love what they do. They love going home and telling their family that they're not just transporting people in the back of an airplane.

They're transporting something that is going to change people's lives. And they love that about it. And they're passionate to hear them talk about the fact that they are proud that, you know, they can provide that comfort for the teams and our trans-plants, surgeons and others that are in that aircraft. They're like, you know, that 30 minutes, 45 minutes that they're in the back of our aircraft might be the only quiet 45 minutes that they'd get for the next 14 hours.

And they understand that. So how do you recruit these people? You know, why they recruit themselves? Really?

They do. And for all those pilots listening, they'll love this coming. And pilots are like 14-year-old girls with cell phones. They talk a lot.

And I have a teenage daughter, so I can say that. If you are doing something and you're doing it well in the aviation world, they communicate. They know who's doing good work and what that work is. And, you know, are they flying good equipment?

Are they getting good training? Is there operations fantastic? Pilots, just like anybody else, they want to be proud of what they do, who they do it with. They want to be proud of their job.

They want to be proud of it. And so, you know, our team is pretty much self-recurricular. That's great. Are you guys the only OPO doing this at this point?

Do you know how to be checked? So we are not. There are a couple of, so we are the only ones with the model that operates the way that we do. If you get down into the details, we are the only OPO.

We're certainly the only OPO with four aircraft. But there are a couple other OPOs that either own or dedicate leaves at aircraft. But I think we are the only OPO that actually we, we employ our own pilots. So we own our fleet.

We operate our fleet. We have our own pilots. So we really are the full spectrum of an aviation operation. Yeah, exactly.

And we set it up in its own independent 501c3 with its own governing board as well. Nice. And so what's to come, Steve? I mean, you've come this far.

Where are we going? You know, I think that probably something that you guys have a lot of conversations about is we don't know. We're doing it. I was like, what's he gonna say?

Okay, yeah. We're looking and we're saying, you know, we are living in amazing times in the donation of Transplantation World. You know, things don't necessarily change in the Transplant community at the speed of light and they are now. And it is really going to, I mean, we all know that we're going to see that we're going to have to be agile and we're going to have to be ready to adjust.

And that's, I think, what we're preparing for is to make sure that we can be as agile as possible. The other thing we're trying to prepare for the best we possibly can is to have as many resources available to absorb the need that's going to be out there. We never want to hear that there was an organ that wasn't transplained because aviation was not available. It's just something that's unacceptable and we want to make sure that we do the best that we can make sure that doesn't happen.

Amazing. All right. Steve Johnson, Chief Operating Officer for the Indiana Donor Network. If you want to know more about what we were talking about, if you were as fascinated as we continue to be TXJet.org.

That's TXJet.org.org. There's a video on there. Thanks for your stats. What you're staggering.

Just an amazing job, Steve. We appreciate you. Lori, Joey, Sally, thank you guys so much for having me. At this point in the Get to Life podcast, we are going to be talking about grieving in everyday life.

Who better suited to talk about that, Joey, than who? Then our favorite, very own Sally. How was your favorite? Wait, let's go back.

What? Favorite, very own Sally. He's sticking with that line, so I'm very pleased to hear that. She's our favorite.

Well, you know, Joey and Lori, that coping with death is vital to our mental health because, you know, everything that we think about affects us physically and a lot of times, of course, our physical health is affecting us mentally. But to go on to this right here, it's only natural that you're going to experience grief with the loss of a loved one. Or it could also be with the loss of a pet or loss of a job or loss of a significant other. I mean, there are many deaths that happen throughout our lifetime, and it may not necessarily be that natural death of an individual or sudden death of an individual.

And so the best thing for people to do is, unfortunately, time is the only healer and you just can't rush through it. I know we've all talked with folks that say, well, you know, if we could just hurry up and get this over with or if you just move on, you'd be a whole lot better off. I want you to get through all the first. Yes.

Yes. And then, regrettably, that just doesn't work that way. That's just not how our life is destined to be. But you know, it's important you seek out caring people.

You don't want to surround yourself with basically negative people that don't want to have to talk about it or don't want to have to talk with you about it because they think they're exposing their own selves. And they're not thinking about you as that person that really needs this sort of caring assistance. But you can express your feelings. You can tell that people look, this is how I'm feeling.

I just can't deal with this today. And to be honest with yourself, when you were talking with others, take care of your health, you know, try to at least try to eat something halfway, be so healthy for you. As you know, when you're in the depths of depression, which comes with that grief most of the time, you don't really care what you're eating or drinking or anything else. Maybe if it makes you feel better, you do it.

But you might find that you're much better off if you can't eat something that's a little bit more healthy for you, except that life is up for the living. I mean, people will go on. Lives go on. We would like to believe that when each of us dies, the world will stop, but it doesn't.

So we have to come to those terms at a fairly, I think, young age, whatever that might be young. Okay. We're all the same age. That's it.

Yeah. And then, you know, post-home major life changes don't automatically say, well, all right, that's that's it. I'm moving. I don't know, Colorado or something like that.

I mean, I think it's also kind of having another child. Many times people say, you know, I've just lost a child and I will have to say, well, maybe if we have another child, it will help things. But that doesn't change that grief for that child that you have just lost. So, you know, be patient with yourself because it can take months and they take years, but keep moving forward.

Don't stay right there in that grief cavity of your life because then you can never live your life to the fullest or help your other children or help your spouses or have you been on my life, girl. I lost my mom when I was young, but I had this pattern. Nothing could be changed in the hat. Like if anything were to be changed and that would really upset me.

So, I've trouble with change and I'll stuck for a long time until my brother is like, come on. The positive person coming in, but then understand it back then. Well, that's right. Because when it happens to you and that can be whoever you might be out there, it's always about you.

You don't even think that it's about someone else that may have experienced something similar to it. And the thing is that once you realize, oh my gosh, I could have been talking to Kirsten or Joey or to you about this because they do know what I'm talking about. I think there's a great sense of relief that people can seek out others that don't judge or make hurry up statements to them where they can just really share what's going on. And you know, if worse comes to worse, seek out side help.

And I don't mean that in a negative connotation. I'm just saying, if you don't think there's anyone there that you can really share your thoughts and feelings with, honestly, seek out a counselor. So, if I was Laurie's friend at the time and her support, what would be the best way for me to be her friend and support her? Do I talk about her mom or do I stay away from those subjects?

What are the best things to say? I think the best thing to do is it sounds like your mother means so much. I know this is a tremendous loss. What can I do to help?

Can I go to the grocery store for you? Can I watch the kids? You know, you want me to take your car and you get it serviced? I mean, things that we just don't normally think about doing.

And if she doesn't want to talk about her mom, well then you just don't talk about her mom. And you don't say, oh, well, you know, I think I know exactly how you feel because, you know, I've had the death in my family. And well, that doesn't help any of us. So, you know, if you want to be helpful, be helpful.

But don't just say it and then go on with it. It is all about me and it's not about you. Right. One for me is that first big holiday, I think it was Christmas.

And then everybody checked on you leading up to Christmas and then I felt like everybody just stopped. Like they had to go on with their lives and I was just there in a dark house with no change for a long time. And but now I get it, right? Like I get it.

Like they're ready to move on and I just need a little more time. And somebody don't really drag me. Well, that's right. And I think the thing too is that I don't know too many people who want to talk about death.

Right. And so that's a subject that even though we all know that it's all going to happen for each and every one of us, we just don't want to talk about it. And I think that's where we kind of get into a bad situation with folks because after a few months it's like, oh no, if I run into her again, oh my geez, I don't want to talk about whoever this loved one might be, but it's deceased. So I, on the other hand, of course, working with Lopa and seeing it every day, I'm more comfortable than most, I guess.

I'm not seeing him talking about death, but at the same time, I feel I'm fearful of when I bring things up to those that are close to me that have lost loved ones. I'm always afraid of saying their own things. I'm always afraid of, well, I don't want to tell him how the kids are doing after he lost his wife. Because it brings back the memories.

And I just don't know in those situations. Do I talk about that and keep bringing her memory up, or do I just stay in shy away from it and talk about everything else? I love hearing about my loved ones. I got those memories and things that may have forgotten and brings back other good memories.

Some sad too, but I mean it's healing. Well, and I think so too. There's very few people who do not want to speak about their child or their husband or wife or parents, whatever. And I think that just the kind thing to do is just say, I've been thinking about you.

Have you been doing? How are the kids? And then if this person wants to carry on the conversation, then they can't. Or they can just say, well, everything's okay.

Thanks for asking. And then you just go on with your everyday conversation. You know, you kind of leave it up to that particular individual. How far do they want to take it?

Yeah. Good stuff, guys. You have a topic you want Sally to tackle? Info at thegiftedlife.org.

And in every episode of the Gifted Life, we like to honor a hero. Today's hero is Jeremy Gary. Jeremy Gary, 29 years old, was head home from a workday in March 2007. Tragically, a car crash claimed Jeremy's life.

We learn about Jeremy from his family. Jeremy was a loving son, husband, and brother of six siblings. He had been married to his sweet wife for only five months. In remembering Jeremy, he allowed his faith in God to guide him.

Exhibited exuberance and displaying his love for family and friends, shared his infectious smile with everyone, reached out to help others with ceaseless compassion, showed his devoted loyalty as a friend, lighted the room he entered with his humor, was an avid LSU fan and is now tailgating in the sky, and was an organ donor of Fort Organs, his last gift to mankind. And now we pause to say thank you to Jeremy for the gift of life. And our question and answer segment today, how do Organs typically get to their recipients, Joey? Well, of course we heard from Steve, and quite often, charter flights such as theirs are one of the primary means of transportation.

It kind of depends on the organs. Hearts and lungs typically travel with the transplant surgeon. However, the transplant surgeon gets to the hospital from hospital to hospital. The organs in those situations travel with them.

Oftentimes, those are charter airplanes as well. Livers oftentimes are flown by charter because that's really only we're talking four to six hours between blood flow and blood flow. Kidneys are a little bit different. Kidneys can travel mostly ground sometimes if it's a few hours away.

We even fly kidneys through commercial airlines. The airline companies work closely with us. They take very good care. Actually, the kidneys sit there with the pilots.

So it varies, obviously, from organ to organ. And then even by region to region, because in some regions, especially the East Coast, where the population is so much denser and the transplant centers, the donor hospitals are so much closer, there's quite a bit of helicopter travel here. You know, it's not so much in the Midwest and South and the West, but certainly again, all different ways for the most part. If you have a question or a story that you would like to share with us, please let us know.

We'd like to hear from you. You could email us at thegiftedlife.org or you could even give us a call and you know that numbers 5, 2, 4, 6, 4, 8, 3, 4, 7, 7, we'd like to hear from you. You know, your story could inspire others to also give the gift of life. I believe that'll do it for episode 106 of the gift of life.

Yeah, we want to give a special thanks to Steve Johnson, a man of mini hats, pilot, COO of Indiana Dorna Network. Just a really all around good guy and for his innovative approaches that are actually helping the rest of us in the industry to overcome one of the biggest challenges and that's travel. And it was really nice to hear that his thoughts were about donor families in the potential recipients that he did place a great deal of emphasis on. This was part of why he's doing what he does.

And he could have flown to the moon by now. To 4 teams. I know since 2014 all those miles racked up. So just a neat guest, a neat program and we appreciate him taking the time.

Maybe you heard something that inspired you to register to become an organ tissue and eye donor. You can do that at registerme.org and you're part of our team guys and we hope that you go out and do something that you would normally do to help us make life happen. Thank you. This is a production of the Louisiana Organ Procurement Agency or LOPA.

The gift of life is hosted by Lori Steele, Joey Buutro and Sally Gentry. Our executive producer is Kirsten Hines. Producer is Shalom Caraway. Intern is Rebecca Rannem.

And we are recorded, engineered and mixed in our Cubbington Louisiana studio by Troy Perez.