On modern medicine

For the last few days, we've been through quite a scare at our house. Three days ago, one of my wife's cousin's kids, whom I'll call "John" was para-sailing with his brothers on a lake in central Florida. Apparently, he let go when he was too high and fell, face down. It resulted in a five and one-half inch tear in his aorta -- in medical lingo a "dissecting aortic hematoma."

John, who is 18, was taken immediately to a hospital in Winter Haven, from where he was flown by helicopter to a hospital in Tampa, where he immediately underwent surgery.

For the last few days we've been worried about possible spinal cord or brain damage from loss of blood and lack of oxygen, so when we received the following e-mail on his condition from another cousin who is a cardiologist, we were greatly relieved:

I am happy to report that John continues to do very well. He is fully awake and alert ... during the night he had his nurse call [his dad] at the hotel and then spoke with him ("I want to go home!") He will be moved out of the surgical ICU and may start to eat regular food today or tomorrow.

With each passing day his risk for serious complications is significantly reduced, and his post-op course is all that could have been hoped for. I can tell you from my experience that his surgeons have performed a "once-in-a-career" masterpiece of surgery (based on my second-hand information about what was involved). His primary surgeon is the Chief of Thoracic Surgery at the University of South Florida Medical School and has reportedly taken an extreme personal interest in John's post-op care (which is often left primarily to Residents and Fellows in a teaching hospital setting).

To get up on my soapbox for a minute: for all the complaints about American medicine we hear these days, this is just one more example of how far medical care has advanced since I began (40 years ago!!!). When I interned [in Atlanta in 1968] we provided state-of-the-art acute care, but we could hardly have imagined the kind of surgical and medical equipment and procedures that are available now. John is at Tampa General Hospital, which means the care he received is actually the same as it would be for anyone with trauma taken to that large city hospital. Now we just have to take the steps to make sure any and every teenager (and child and adult) in this country can have access to that kind of care at times of need. The only impediment is bureaucratic waste and personal greed at every level along the "food chain" of healthcare delivery. It is up to all of us to insist that changes be made so that success stories like John's are the rule and not the exception.