Another superhero

I met Michael at 7 a.m. in the Emergency Department.  He had returned to the hospital because of a fever.  Just a few days before, he had been discharged home on intravenous antibiotics for a urinary tract infection.

Michael was no ordinary person. Eight long years ago he was involved in a motor vehicle accident that shattered his cervical spine and damaged his spinal cord.  He lived the life of a quadriplegic – unable to move anything at all from the neck downwards.  His urinary infection came about because of his paralysis – his bladder could not empty normally and was continually at risk for infection.  Now, there was another problem that required some investigation.  I talked to him, I examined him.  On his leg, just above his sock, I found the tatoo ‘No Fear‘ in blue ink.  To continue living with these conditions required an extraordinary courage.  My thoughts turned to other patients I had cared for who were quadriplegic.  One gentleman I was amazed to learn worked as a telemarketer — somehow by blowing through a straw he could make calls from his bed and sell stuff.  I decided at that time I could never again be rude to telemarketers.  What if?…

My thoughts returned to Michael.  He had no significant complaints and there was nothing ‘localizing’ in his examination.  He most likely had a ‘line’ infection – the IV tubing that provided his antibiotics must have become contaminated with bacteria which entered the blood stream.  He would need his IV line removed.

Over the next day, he improved dramatically.  I got to know him more while he was in the hospital recovering.  He seemed to be a regular guy – a real ‘dude’.  I don’t know exactly how he managed to live each day with his condition.  The problems in my life seemed small.  I felt inspired.

I thought of Christopher Reeve and the tremendous work he started for the disabled.  Christopher inspired me just like my patient.  What were the important things in life?  Family, friends.  Each day had value.  Too often we take for granted even the most basic things.

I smiled to myself to see Michael return home.  I knew he was living.

RW

Prayers for the heart

Felix always seemed to have a ready smile for those around him. Even the first time I met him in the hospital when he was suffering from an infection in his abdomen. Unfortunately, he had complications following a surgery and now required antibiotic treatment. I realized he would need long term therapy, so he would need a PICC line (which stands for Peripherally Inserted Central Catheter). With the PICC line, he could finish his antibiotics at home.

Felix went home and continued his treatment. A short time later, however, I was called urgently to the Emergency Room. Felix had returned with fevers and chills. He felt very ill and appeared ashen. I listened to his heart and heard an unnatural sound – it was a heart murmur. Blood cultures confirmed he had a heart infection, or ‘endocarditis’. The PICC line had to be removed. I called the thoracic surgery team to assist – but unfortunately they wouldn’t operate on Felix. They said his condition was too poor.

I knew this meant he would die. Without functioning heart valves, the heart would soon become exhausted, his lungs would fill with fluid, and he would pass away from us. It was an awful prospect. He was so young. Even though he was gravely ill, he still managed to smile at us. His mother looked to me for an answer. I tried not to take away Hope, but it was a bleak prognosis. Without the surgeons help, I didn’t know how much time Felix would have left.

I decided to use a powerful antibiotic called daptomycin. This medicine would at least kill off the germs responsible for damaging his heart. Each day I made rounds, expecting to find an empty room. Each day I found Felix, still smiling, with his mother close by.

Day after day became week after week. Felix hung on. His heart somehow kept going and his lungs remained clear. After THREE weeks, the surgeons seemed to realize they could operate after all. Felix underwent valve replacement surgery and had an uneventful recovery.

I could hardly believe his good fortune. Medically speaking, he shouldn’t have survived. Those were impossible odds to overcome and I never knew ‘how’ he did it… until just recently when I bumped into his mom. She told me her secret “I prayed for him every day” – then I knew, of course! I smiled to myself, this really was a fantastic miracle.
RW

The Pink Rose

Mrs. Peone was a relatively young woman, fifty-something. Too young, for the Fate handed to her. She had been diagnosed with breast cancer just a few months before.

Unfortunately, the initial surgery and harvest of lymph nodes showed widespread disease. The cancer had taken root. Her plastic surgeon tried to reconstruct the breast area after that initial surgery. It was a valiant effort, but complicated by infection. Microbes took advantage of the patient’s weakness, festering into the area. I saw redness and breakdown of the tissues. The pain was palpable: this was as much a psychological wound as physical.

MRSA – a ‘superbug’ explained

There has been a lot of media buzz about MRSA recently. In a way, it is good that finally some attention is being paid to this problematic ‘superbug’. There should be more health education in this country, as evidenced by the palpable fear spread by these news headlines.

MRSA or Methicillin Resistant Staphylococcus Aureus has actually been around for decades. Humans and microbes have been engaged in an ongoing battle ever since the development of the first antibiotics. Penicillin came into widespread use in the 1940s. Staph aureus or ‘Staph’ pretty soon figured out a way to overcome this ‘poison’ and resistant strains started emerging. Penicillin at first seemed like a ‘miracle’ drug. Patients who were supposed to have died from infections were saved!

I remember an old retired doctor, Dr. Chotkowski, who lived at the end of our street. He described to me his first time using penicillin in 1943 to save the life of a young girl from Staph sepsis. In those days, big doses were given with big needles in the butt. Painful to think of, but at least this girl lived thanks to this new medical breakthrough.