Posted by
Scott Slater on Tuesday, June 01, 2010 2:09:00 PM
Scott Finch-Slater
"911, what is your emergency?"
"My husband is very sick, I think he might be dying."
"Where is he now?"
"I dragged him from the bed in a wheelchair.....in the living room...he won't wake up!"
"Does he have a pulse?"
"His eyes are open but he isn't looking at anything....I can't tell...he's.. oh no he slumped over.....stay with me..stay...Oh God!
"Get him out of the chair and on the floor, the medics will be there in three minutes, the station is just around the corner, Is he breathing?"
I can't tell....he's gray and his hands are cold...please don't leave me..I love you very much!"
"Can you hear the sirens?"
All stories have a beginning and an end. Sometimes the end may eventually be the beginning.
The story you are about to read is a testimony to the fragility of life but it is more than that, it’s a story of the dedication of teams of health care professionals working under extreme conditions and with a determination to preserve life. It is a story played out every day in hospitals around the world; many have a tragic ending. This story begins with Harborview Hospital in Seattle Washington on May 18th 2010 around 2 pm.
The Trauma Department at Harborview Hospital was expecting the arrival of a medi-vac helicopter from Skagit Valley Hospital in Mt. Vernon Washington within the next 40 minutes. Harborview Hospital had been advised by Dr. Matthew Russell of Skagit Valley Hospital that he was airlifting a 55 year-old-man who was extremely ill and near death.
Background
When medics got him to SVH he was barely conscious and his wife had not yet arrived. Medics from the Stanwood/Camano Fire Department, the small town where the man lived put the 55 year-old on forced oxygen prior to arriving at the emergency room. By the time the man reached the ER his brain was receiving enough of the life-saving gas for him to provide a little medical history. Dr. Russell learned that the 55 year-old had just returned from a trip to the Philippines the week before. His first thought was that he might be dealing with a tropical disease, possibly of an unknown origin. Skagit Valley Hospital was not equipped to deal with tropical diseases so he made the decision to medi-vac him to Harborview Hospital, near downtown Seattle where experts in tropical medicine are on staff.There were probably some in the emergency room at Skagit Valley Hospital who read Richard Preston’s, bio thriller, The Hot Zone and thought about Ebola, Marburg or one of the other diseases that struck hard, fast and were generally lethal.
Dr. Russell had ordered a chest x-ray and one look at the film made it clear the 55 year-old male’s right lung was completely missing in the film; a bad, a very bad situation all the way around. By this time whatever made the man sick had moved on to the blood and other vital organs and put the 55 year-old man in a battle for his life.
As the medical evacuation helicopter touched down at Skagit Valley Hospital the 55 year-old man had already been placed on a ventilator because he lost the ability to breath on his own. By now the man’s wife had reached the ER only to see her husband’s neck flexed back and hooked up to every piece of equipment that could be forced down the throat and into the lungs. The wife gasped in horror at the sight and was jolted even further by the sound of the ventilator.
Nurses from the helicopter had the man on the cot and in the helicopter within a few minutes and as the blades came to full speed and the helicopter began to rise, the man’s wife cried heavily as she wondered if that would be the last time she would see her husband alive. She had been told to call family members immediately as her husband was in very critical condition and his life was in the balance
The helicopter, with its nearly dead cargo touched down around 2:40 p.m. at Harborview’s LZ (landing zone) and a team of nurses got the sick man to the trauma unit and feverishly began work to save his life. All medical professionals know that death is a part of life but each death has an impact on them. They are professionals but more importantly each team member is human being and with that comes emotions; right now it was to keep this middle-aged male from leaving his family and friends but also from leaving the doctors, nurses and medical assistants who were trying to save him. At Harborview Hospital there are no statistics, there are lives, souls and families.
Hours passed while the 55 year-old man was in the 'triage unit' at Harborview. During that period his body was receiving IV fluids to combat the effects of what doctors call “third spacing.” It’s a condition where the body expels fluids between the cells and causes swelling. In the case of the 55 year old male his legs, arms, feet and hands were three times their normal size. Blood was drawn to identify the microscopic army that was engaged in a full assault against the man. A new danger descended on the team: a high fever began as his body attempted to fight the invaders. The fever was rising quickly and had to be brought under control or it would kill him as well. Because of his sedation the man was not aware that his body had been packed in ice several times to combat the fevers.
By the time the man’s wife arrived at Harborview her husband had been moved to intensive care. She had not expected him to be alive when she arrived. As she made her way to ICU a very kind nurse named Laurie pointed her to the room or rather curtain of 205 where her 55 year-old husband lay in critical condition. To the man’s wife the numbered curtains looked more like airport boarding gates for flights to unknown destinations.
An important point must be made: the 55 year-old man has only scattered recollections of events until he was successfully removed from the ventilator and feeding tube. The recollection of events is a compilation of the memories of all the parties involved but the description he paints of home before being found by his wife were truly terrifying. They were also verified by the man’s wife and their neighbor.
At Harborview Hospital the man’s daughters saw their father on the ventilator and feeding tube and they wept at the thought they may soon be making funeral arrangements. Presently however, doctors needed to obtain as much medical history as possible to win the game of medical Jeopardy. The 55 year-old man's wife was integral to the game
Her part of story begins May 16th, 2010, and 6,000 miles away. The 55 year-old man and his wife traveled to the Philippines every other year to visit relatives. They hoped to retire there in a few years. The couple always traveled together, never once having been separated. This trip was different. The woman's 55 year-old husband flew home from the Philippines a week earlier while his wife stayed to do some business with her sister. What she didn’t know, couldn’t have known, was by the time she returned her husband had been under full microbial assault and had not gotten out of bed for two days.
Here is what the 55 year-old man could piece together before the wife’s recollection begins. His work week ended on Friday as usual but having just gotten home the Monday before he was still having jet-lag. That Friday evening while he was having a burrito followed by ice cream, strawberry his favorite, something terrible was happening deep inside his body. As the 55 year-old man was finishing the first DVD of Band of Brothers he began getting sleepy and shut down the DVD and lights and headed to bed feeling fine. If only he knew that within three hours the terrifying monster growing inside him would explode without warning, he would have rushed himself to the nearest hospital. There were no symptoms or warnings of the events that would soon render the man gravely ill.
The monster within struck suddenly and struck hard around 3 a.m.. The 55 year-old man arose to fill his water bottle and as he sat up in the bed the spinning caused him to vomit and fall face forward into the dresser next to the bed; the impact probably knocked him out. At some point, the 55 year-old man managed to crawl back into the soiled bed and made no further attempts to get out.
The man’s wife was scheduled to arrive at SeaTac Airport, in Seattle Washington on Sunday morning; two days after her husband had grown ill. Having arrived in Tokyo from Manila she checked into the flight home. The man’s wife learned the plane was full and the airline was asking for volunteers to take a flight leaving the next day. The enticement was a free roundtrip ticket from Tokyo to anywhere in the United States, or from the U.S. to Tokyo. Also, part of the deal was an overnight stay at a five star hotel at the airport with complimentary dinner. The kicker was the first class flight the following day. The 55 year old man’s wife signed up because she never passed up airline bumps and the freebies that go along. Feeling like she hit the jackpot, she wandered over to a small eatery near her departure gate to await the announcement. Unease came over her as she tried to finish her noodle soup. As her mildly upset stomach focused her attention, her name was called at the airline desk for her to sign the necessary documents required for the “bump.”
At their home, 6,000 mile away her 55 year-old husband was growing more ill by the minute and by now had no orientation as to whether it was night or day or even what day. His wife, in Tokyo, paced back and forth trying to figure out why something inside her told her to get home immediately. She decided she would not take the deal and returned home on her regularly scheduled flight; something was wrong; very wrong and the dread that consumed her was like nothing she had ever experienced. There was nothing she could do for the next 12 hours as her Delta flight cruised through darkened skies across the North Pacific.
The light grew brighter through the cabin windows of the Airbus A-330 as dawn began to spread across the eastern skies. Two hours from Seattle the final meal service started. Some of passengers were sorting through carry-on baggage putting away books, music players and other items. The 55 year man’s wife could not take her mind off home and what might be happening there. She thought a few times she might be overreacting but she couldn’t rid her mind of that nagging sense of urgency; the next two hours were hell for her as she took a pass on the meal. The 55 year-old man's wife fell into a light sleep and awoke when the pilot placed the A-330 in its landing configuration.
The Airbus landed uneventfully and pulled up to its assigned gate. As the overseas passengers got off the plane they were directed to customs inspections. The 55 year-old man’s wife managed to break line and get near the front, apologizing for the emergent situation she knew existed at home but was unable to explain. Customs does not allow use of cell phones until the passenger has been stamped through. Passing customs the 55 year-old man’s wife frantically dialed home just to be reassured by her husband’s voice and to tell him what time the airport shuttle would drop her. The wife dialed several times with no answer. She prayed her husband just didn’t hear the ring; he’s well known for that.
While barely aware his situation was as bad as it was and growing worse, he had lost all bladder and bowel functions. He was now so disabled just moving caused him to vomit. The 55 year-old man had neither food nor water for two days and the dark red water excreting from his bladder proved how desperate the situation was.
The 55 year-old man's breathing was getting more difficult and every move caused him to lose his breath. The 55 year-old man did become aware that his arms, hands and fingers were enormous and it reminded him of the cartoon Popeye. The United States Air Force tattoo from so long ago was now just a large splotch on his right arm and completely unrecognizable.
The airport transport bus pulled into the stop but the woman’s husband was not there. Her fears were confirmed. The wife made another call to her husband’s cell phone but only got voice mail. Terrified she called a taxi and arrived home within 15 minutes.
The door was unlocked and when she threw it open she saw and heard nothing. There was the smell of sickness and a deafening quiet. That alone made her afraid to take the next few steps that would lead her into direct view of their bedroom.In the bedroom she heard her 55 year-old husband say something but not to her; he didn’t know she was there.
No, her 55 year old husband was babbling to someone else he saw in their condo and who’d been staring at him since the night before. The words were gibberish but the tone was serious and with a tinge of fear. The 55 year-old man had his eyes wide open and questioned, to no one in particular, why the bathroom door was just hanging in mid-air; nothing attaching it to the wall or ceiling; suspended in space. According to the 55 year-old man’s recollection the figure he was talking to had been staring at him all night from just outside the bedroom door. It seemed clear the apparition was waiting for him to die. To his wife It became very clear the hallucinations were because of the greatly reduced levels of oxygen reaching his brain. She also wondered if this was what people called a near death experience and whether the figure was an angel here to take her husband away. The fear in her husband's voice as he talked to the figure made it seem demonic though.
The 55 year-old man’s wife, herself feeling the effects of jet lag, saw only her husband’s face and could tell he was extremely ill. The bedspread covered the enormous arms, hands and feet. She demanded he go to the emergency room-“NOW!” She knew the answer before asking the question. Her 55 year-old husband managed to say he’d be alright and to let him rest. It was true that he always recovered from illness. The man’s wife fell asleep next to him and would not awake until the wee hours of Tuesday May 18th. What awoke her from a deep sleep was her 55 year-old husband’s labored breathing; it was much too fast and extremely shallow. The man’s wife believed her husband was in the beginning stages of dying; she’d seen it before.
Had the 55 year-old man not reached Skagit Valley Hospital and then to Harborview Hospital when he did it wouldn’t have mattered, he would have expired.
Once at the five-state trauma center he was heavily sedated and with his hands tied down so he couldn’t pull the lines in his lungs and stomach, the 55 year-old had enough awareness to know charge nurse Laurie was standing nearby.
Dr. Susan Wong was assigned to the 55 year-old soon after the airlift arrived and worked feverishly to stabilize him. She visited him at least twice daily and when she did she spoke to the 55 year-old man in such a soothing voice he stayed completely calm.
Several attempts had been made to remove him from the ventilator but the 55 year-old man couldn’t draw enough air to oxygenate his lungs. When the time finally came, he was taken off the ventilator. It was only then that he learned family members had flown in from different parts of the county the day after being airlifted to Harborview.
“Good morning do you know where you are?” said Katie the morning nurse assigned to the 55 year-old man. "Yes, I'm in a hospital," the 55 year-old said. “You’re very perceptive. What was your first clue?” she said with a laugh. “You’re at Harborview Hospital. You were a very sick guy when you came in and you’ve been with us for a week now.”
More testing would be done that day including a new chest x-ray. Everyone on staff knew how sick the 55 year-old man was when he was rolled in from the airlift and doctors, their students and nurses were excited to see the new chest films once they became available.
The chest x-rays on May 25th, seven days after the 55 year-old man arrived at Harborview Hospital, showed absolutely no improvement. The right lung was still completely washed out; nothing visible, but that wasn’t the point. Even though the chest film looked the same and the 55 year-old man was still an extremely there was progress. Something about the film told doctors which of the five antibiotics was working. Drs. Wong, Merrill, King, Neff, Hudson and McCarren once again stopped to say hello and said he was looking great. Though emaciated, the man knew the statement was sincere and the immense swelling was gone.
New chest films were ordered on the afternoon of the 26th. Again excitement was with all who had cared for the 55 year-old man. Shortly after the films were developed the doctors raced to announce Ceftriaxone, a very strong antibiotic had the streptococcal pneumonia in full retreat. The 55 year-old man was winning the battle. He thought back to what Dr. Wong had said early on: "You survived this because you were very strong and healthy; there is no other answer to your survival." That is the reason the use of the man's age is frequently mentioned.
It may be obvious by now that the 55 year-old man is me but this story is about Harborview Hospital and all of the folks who had anything to do with the life-saving care they provided me. In the final attempt to publically thank the medical staff not previously mentioned there was also Emily, Jane and another night nurse whose name escapes me but her parents have a home in Alaska. If I’ve left out the names of others forgive me but you know who you are and the role you played in saving my life.
The pneumonia and sepsis will take several months of recovery. The ER staff at Skagit Valley Hospital and the team at Harborview Hospital, gave me another chance at life.