Not all days in the life of a CV surgeon are all that great. Some are downright dreadful and cause you to think that it has not been worth it. Mostly those days are a result of some dreadful outcome in some patient you were trying desperately to help, and in your attempt to help you end up killing a patient. Not so much fun. Even though you deep down know you meant well and you should feel OK in a few short recovery moments, it really never goes that way and inevitably you really do mope around for days and even weeks, at least inside, where it hurts the most.
But its not one of those days today--no sir! Today has been one of the great days. Today was a very gratifying day, indeed! I performed my first minimally invasive mitral valve repair today and the operation went perfect and the patient is doing great. I hope this does not jinx him.
I started my course work some 3 years ago and have been to Atlanta, Philadelphia, and Toledo to see variations of this operation performed. I never dreamed years ago that I would ever fix a heart valve without splitting someones sternum open. The anxiety over this change in approach has truly been great and even more than other changes I have experienced over the years. Today was the day to finally do the operation and with over 20 people watching and scores more at my hospital awaiting the result to officially kick off the start of our mimi invasive heart surgery program my team performed perfectly. I am very happy !! It is a wonderful feeling to have succeeded after all the planning, team meetings and dry runs. Oh God it could have been so different if it had not gone well. Hooray for us and it even feels good to blog about it. Have a great night and rest assured I will be smiling. I will keep you informed of my patient's progress. Goodnight moon!
Friday, January 23, 2009
Wednesday, January 14, 2009
One single bullet
One thing that is impossible to do when blogging about past memories is to sort out those memories that have relevance. But clearly, there are some stories that stand out and tonights tale may just have shaped an entire career.
It was a very hot summer night and I was the night intern at a community hospital in Warren Mich. As an intern I did not make the big decisions. Iwas there to get patients through the night so their doctors could make decisions in the AM.
I was hanging in the ER after I finished another history and physical on what seemed like an endless stream of patient admissions. The double ER doors swung open and to our surprise two young men in there early twenty somethings were screaming--"she has been shot, she has been shot-HELP!! HELP!!" Well, now the adrenaline kicks in and we all run out to find the most beautiful young woman lying in the back of a car. She had a bright red blood spot showing through her clothing that was very stylish and otherwise consistent with party attire. She looked to be around 20 years old and had a beautiful gold cross around her neck. We rushed her into the trauma room and immediately started our work-up exam and resuscitation. The GSW(gun shot wound) routine was in full gear as I started to ask the patient historical questions. It was not long before we all noticed that this young woman was NOT doing well. Blood pressure was not holding with large volumes of fluid, heart rate kept increasing, and her abdomen under a single bullet entry wound was rapidly enlarging. This young women was bleeding to death.
The blood bank was notified to send blood, the surgical resident was called and came quickly, and the OR was notified as was the surgeon on call. The surgeon was on his way from his home about 30 minutes away. Our job was to keep giving blood and fluid until the surgeon got there to explore the abdomen and stop what was now obviously a major vascular injury. Easier said than done. The surgical residents and I were losing this battle and with each minute she got more and more pale and to make matters worse kept repeating to us " I am going to die--Please don't let me die " Just as we were whisking her to the OR her father shows up and wants to see his daughter and in his state of shock starts screaming " oh GOD don't let my baby girl die" and then we rush into the OR.
We got her on the OR table, prepped and draped the abdomen and then we waited for the surgeon. We waited and then we waited some more. The feeling of helplessness consumed our emotions to the point that we honestly thought of opening her abdomen ourselves but NONE OF US were adequately trained to fix the problem. We needed the surgeon. Oh God did we ever need a surgeon who could save this girl's life and we needed him NOW!!
The surgeon did come and he tried with all of our help and all the blood we could muster and all the skills he had to save that beautiful young Italian American women and she died that night right in front of us on the OR table from a single 22 caliber bullet directly through her splenic artery. That my friends was when I vowed to train and then train some more so that I would never stand helpless and watch somebodies baby die ever again. I have never been the same since that night. I haven't saved them all over the next 25 years , but it is heart warming to know that I mastered the skill sets to dive in and save more than my share and thank God I no longer have to go home with that helpless feeling I had that night so many years ago.
It was a very hot summer night and I was the night intern at a community hospital in Warren Mich. As an intern I did not make the big decisions. Iwas there to get patients through the night so their doctors could make decisions in the AM.
I was hanging in the ER after I finished another history and physical on what seemed like an endless stream of patient admissions. The double ER doors swung open and to our surprise two young men in there early twenty somethings were screaming--"she has been shot, she has been shot-HELP!! HELP!!" Well, now the adrenaline kicks in and we all run out to find the most beautiful young woman lying in the back of a car. She had a bright red blood spot showing through her clothing that was very stylish and otherwise consistent with party attire. She looked to be around 20 years old and had a beautiful gold cross around her neck. We rushed her into the trauma room and immediately started our work-up exam and resuscitation. The GSW(gun shot wound) routine was in full gear as I started to ask the patient historical questions. It was not long before we all noticed that this young woman was NOT doing well. Blood pressure was not holding with large volumes of fluid, heart rate kept increasing, and her abdomen under a single bullet entry wound was rapidly enlarging. This young women was bleeding to death.
The blood bank was notified to send blood, the surgical resident was called and came quickly, and the OR was notified as was the surgeon on call. The surgeon was on his way from his home about 30 minutes away. Our job was to keep giving blood and fluid until the surgeon got there to explore the abdomen and stop what was now obviously a major vascular injury. Easier said than done. The surgical residents and I were losing this battle and with each minute she got more and more pale and to make matters worse kept repeating to us " I am going to die--Please don't let me die " Just as we were whisking her to the OR her father shows up and wants to see his daughter and in his state of shock starts screaming " oh GOD don't let my baby girl die" and then we rush into the OR.
We got her on the OR table, prepped and draped the abdomen and then we waited for the surgeon. We waited and then we waited some more. The feeling of helplessness consumed our emotions to the point that we honestly thought of opening her abdomen ourselves but NONE OF US were adequately trained to fix the problem. We needed the surgeon. Oh God did we ever need a surgeon who could save this girl's life and we needed him NOW!!
The surgeon did come and he tried with all of our help and all the blood we could muster and all the skills he had to save that beautiful young Italian American women and she died that night right in front of us on the OR table from a single 22 caliber bullet directly through her splenic artery. That my friends was when I vowed to train and then train some more so that I would never stand helpless and watch somebodies baby die ever again. I have never been the same since that night. I haven't saved them all over the next 25 years , but it is heart warming to know that I mastered the skill sets to dive in and save more than my share and thank God I no longer have to go home with that helpless feeling I had that night so many years ago.
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