Through my eyes...

By Gary Wortz, MD / Son in Law

I'll never forget the text message waiting for me on my phone the morning of December 4th. It was a dark cold morning in Kentucky, and I was the first one up. Upon waking, I noticed a text message waiting for me from Tim Philpot, Danny's brother. In all too calm and plain text, it simply said

"Call me when you get up".

 I was not prepared for the message I would get. Tim explained that Danny had a massive heart attack, and was in the ICU. I immediately went back upstairs, told Mary the news, and then in an oddly responsible manner, went to work to take care of my own patients who were scheduled to see me that day. I had a long drive to work, and my mind began racing. Which artery? How long to treatment? Did he take aspirin? Why did this happen? ICU? That can't be good...

Tim told me he was on his way down to Atlanta from Lexington, and he would give me an update as soon as possible.

The rest of that day was a blur. As soon as I got home, we left for Atlanta. I remember getting to the hospital at just before 11pm and rushing into the ICU just before visiting hours were cut off. I knew what he would look like. I was scared that Mary and Micah would be shocked though.

The ICU is a place you don't ever want to be in. There are no good reasons to be there. If the walls could talk, they wouldn't begin to tell the heartaches that have taken place there. It is not a place where Karma is respected. In fact the rule of the hospital is the more tattoos and less teeth you had, the better your chances of survival. However, it was the good who die young, and the upstanding citizens that get the raw deal in here.

The ICU can be a place of detachment between life and living, between people and personhood, between the body and the being. There is no way around it. People become boiled down to a summation of their diagnoses. You might hear

"who's got the LAD infarct in 7"

 (Translation:who is the nurse taking care of the guy who had a massive heart attack in ICU bed 7). The problem was the LAD infarct in 7 actually happened to be my father in law. My job was to let the hospital staff know that Danny Philpot was not just an LAD infarct, and that it really mattered that he got better.

As the only physician in the family, I was the point person to try to put Danny's condition, and prognosis in perspective. This was a job I was somewhat uncomfortable with, but nevertheless, I had to rally to perform. I am an eye surgeon, and as such, specifically migrated away from critical care. I've never been good at giving bad news, and I was struggling to find any good news to tell the family.

So, when we saw Danny, he looked just like I had suspected. Multiple IV lines, many "drips" of medications, an endotracheal tube and a ventilator. Not a pleasant sight. Essentially, he was being kept alive by the machines. To make matters worse, there was a suggestion of pulmonary edema, as well as an aspiration pneumonia. He had a fever, and the more data I gathered, the more bleak the outlook. Here were the facts: LAD infarct after prolonged angina. Cardiac arrest. Ejection fraction of 10%. Pulmonary Edema, Fever, and aspiration pneumonia. If I had to give odds, I would have put the chance of any meaningful quality of life at less that his ejection fraction. The only thing I could come up with to tell everyone was "He is stable, and right now, stable is all we can hope for".

The rest of December was touch and go. We made so many trips to Atlanta that I can't really even remember exactly how many trips we made. We kept hoping we could see Danny when he woke up, but it just never seemed to happen. Finally, the sedation was weaned off and amazingly he came back to life, or at least that's how it seemed. Then, the next thing we knew he was home for Christmas.

The pop drop is a term ER docs use to describe a family that drops off a family member with a chronic debiliating disease in the ER so that they can go off on a vacation over the holidays. In some ways, this was a reverse pop drop. Danny wanted to be home for Christmas, and they were willing to give him that chance. However, when we arrived in Atlanta for Christmas, Danny looked really bad. He could not even transfer from his wheelchair to the recliner. We were glad to see him, but I was very concerned that he still needed to be in the hospital. Throughout the day, we attempted to make the house more accesible for Danny, and Tim and I even went and bought him a roll away bed so he did not have to climb the stairs to sleep. As the day turned to night, it became more evident that the situation was turning more serious. I insisted we go the ER, and Danny agreed. His blood pressure was about 60/30. Clearly he was in serious condition. He was readmitted to the hospital, and eventually made the recovery we have all been amazed to witness.

So, what is the meaning of this story? On the surface, you may be able to dismiss this as a story of a guy with bad cholesterol, bad cardiovascular luck, who ended up receiving great care from a great team of doctors and now is going on with his life. I don't really see it that way. To me this has been a story of faith. My education and training told me to expect the worst, but my faith told me believe in the great physician. This has been a story of family also. I have always loved my father in law and my wife's Atlanta family, but distance has always been a barrier to connecting on a deeper level. Through this experience, I have gained relationships that I always wanted, but never knew how to develop.

This is also a story of second chances and reprioritization, and I mean this for me rather than anyone else. I have learned that every day with my family is precious, and to live every day like it might be my last. Every day someone is dying, having a heart attack, getting cancer, or developing a chronic disease. Don't blame God when your number is called. Just thank him every day it is not.