At the Crossroads: Patient Stories

I’ve been in the cardiology business for 20 or so years. Although I have found the diagnosis of our patients interesting and feel a sense of accomplishment after an intervention, what I have also found interesting is our patients’ past. Every day in the cath lab we are bombarded with new technologies, new procedures and more paperwork. We have forgotten about the patient. If we take a second to talk to them, our patients have a fascinating history. This month’s issue of Cath Lab Digest launches At the Crossroads, a new column featuring interesting stories we in the cath lab have heard from and about our patients. I have a couple I remember from over the years about patients being forced out of their homes in 1945 because of the war in Europe. In our facility, we see World War I, II, Korean War (etc.) veterans and family members that have had their lives uprooted by historical conflicts. Other patient life stories may include incidents from the Depression era, or even things that patients have accomplished in their lives that stand out in their mind. At the Crossroads will offer a change of pace from our usual clinical fare. Here we can read about the life endeavors of our patients. It may help us remember that this patient in front of us on the cath table is not #5 for the day in this room with Dr. Whatever, but rather a fellow human being with an interesting story or two to share. Patient histories encompass years that most of us have not seen or been a part of. The experiences our patients have endured throughout their lives sometimes can give us perspective and remind us of the gravity of our position in the cath lab. We’re at their crossroads in life, so to speak. We are there to extend aid in whatever manner we can to help our patients continue their lives. My Memorable Patients Here are two stories I’ll remember for a very long time: An 87-year-old gentleman came to us at 3:45 am with dyspnea hypotension and in cardiogenic shock. He had severe angina for a week, but decided to stay at home. After a right and left catheterization and left anterior oblique (LAO) cranial left ventricular (LV) gram was performed, it was realized that he had a large ventricular septal defect (VSD) with a 2:1 shunt. After a surgical consultation and much commiserating with everyone involved, it was realized that this gentleman’s chances of safely getting off of the operating table were about 10%. There was no chance of intervening in the infarct vessel, as it seems the horse had already left the barn. When presented with this information, as this gentleman was still conscious and alert, he thought about the options that were cast in front of him and preceded to state, Just show me the back door. Not understanding his response, we reiterated the situation and again his response was the same. He understood the situation quite well. I’m 87 years old and my wife is upstairs in your CCU. She would not recognize me if I was standing right next to her. We have no close family. I really have no reason to go through any procedures to prolong the end, he said. We were amazed at his candor, especially concerning his state of affairs. The cardiologist and thoracic surgeons left the room and I was alone with the gentleman. While holding pressure on him after removal of the sheaths, he raised his arm and stated, Well, I guess I don’t have to worry about this anymore. What’s that? I said. Well, when I was 15 years old, I was working on a Freihofer’s truck. One day a loaf of bread was falling off the back of the truck. I reached for it and fell off. I broke my arm, but we never had enough money to get it set correctly. Now I guess I won’t have to think about it anymore. He quietly expired one hour later in a private room. Another interesting patient was a gentleman who is employed at the Stratton Air National Guard Base in Scotia, New York and is a member of the 109th Airwing Lift Group. His division flies to Antarctica to stay for one month at a time to maintain the equipment there. He was a member of the group that flew down to the McMurdo Base Antarctica in 1999 to rescue Dr. Jerri Nielsen when she was diagnosed with breast cancer. We have all read and heard this story many times so I won’t be redundant. The story that I find very interesting is about where he hikes to when he is down there the depot. Time out for a history lesson: In the early 1900s, British explorers Robert F. Scott, Ernest Shackleton and Edward Adrian Wilson, from the ship Discovery, attempted to be the first explorers to reach beyond the 79th parallel on Antarctica They left from base camp on November 2, 1902. The temperature was -40? F when they set up a depot with some of their supplies about 60 miles inland. They continued their trek, reaching beyond the 82nd parallel for the first time ever. After 93 days and 960 miles (300 miles farther than anyone before them), they arrived barely alive at the depot where fresh food and supplies awaited. These explorers finally reached the ship and returned home. Located 60 miles from McMurdo Base Antarctica, the depot has become a shrine for hikers in Antarctica. To share the experience that these explorers endured is something craved by many adventurers. Although now a much easier trek with the advent of GPS systems and current hiking equipment, the gentleman we worked on in the cath lab hiked there again this past November and will be sending our cardiac cath lab a picture of him standing next to the depot with the Ellis Hospital cardiac catheterization logo. There are many stories to be shared regarding special people we have encountered in the lab. Share your stories for publication with column editor Bruce Coyne at bnkc99@msn.com Next month’s story Christmastime: Man, another young one.

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