Don’t let the Water get in the Boat

I was back at the University of Alabama at Birmingham (UAB) in May of 1988, getting ready for one last heart operation. My Cardiologist had sat down with my parents and I at an earlier appointment and discussed possibly performing a version of the Fontan Procedure (See “A Final Note:” at the end of this post!) on me. It was really a two stage operation, but my first two surgeries roughly equaled the first part of the Fontan, so I would only need the second part of the operation. I would never be normal, my Cardiologist told me, but this final operation would bring me as close to being heart healthy as I would ever get.

This was the first time that everything hinged on my decision. I had been underage for my previous surgeries, so the responsibility had fallen to my parents. Since I had just turned 21, this time the Go/No Go was my decision. After steeling myself to the thought of all the pain and recovery time that would be involved, I decided to have it. All of the testing and X-rays had given my surgeon the information he needed to devise a plan he was confident in, and he and his team met with me the night before.

“Any questions?” he asked.

“Just don’t start without me,” I joked.

Dr. Albert Pacifico had been my heart surgeon the first time I had been a patient at UAB in 1977. Pacifico is known for two things: being good, and working fast. He averages eight heart operations a day, when the typical surgeon performs two a week. As far as Cardiac Surgery is concerned, he’s the superstar.

The next day, the crap hit the fan. As soon as the surgical team opened my chest, things began to spin out of control. Opening my rib cage tore some scar tissue that had became attached to the back of my rib cage, and I began to bleed profusely. Dr. Pacifico was world renowned and had probably performed more heart operations than anyone alive, and he needed every bit of that skill to get the bleeding under control. “Imagine your chest cavity is a boat, and your blood is water,” he later said as an explanation. “You never want to get too much water in the boat.”

“Shoot, doc,” I groaned. Talking after surgery isn’t the easiest thing to do. “You should have woken me up. I would have bailed out the boat while you fixed the leak.”

The leak was starting to get ahead of him; every time he sealed one bleeder another would pop open. I was bleeding out faster than the surgical team could put it back in.

As he always did, the surgeon came down to a Conference Room where the families of his patients had been summoned. He normally called out a name, and the family members would group around him as he consulted an index card and summarized the operation. (This was a long time before Health Record Privacy became such an important issue.)

“I will speak to you two last,” he told my parents. My mother gasped and began to cry.

The Patient Representative stepped forward. “That’s not the way we handle that,” she said, placing enough emphasis on the word so there was no doubt what THAT was.

The news still wasn’t good. The bleeding had been stopped, but I had required 20+ units of blood. A lot of water had gotten into the boat. I was in recovery, but I wasn’t recovering. I wasn’t going downhill, either; so you could say I was just holding my own. And then he said the phrase that has come out of every surgeon’s mouth:

“We’ll know more in a few hours.”

The waiting room was huge. UAB had designed a building that contained all of its surgical suites and all of the recovery areas, which meant the entire ground floor was a unit’s waiting room. The surgical unit waiting area was over there, while ICU was here, and surgical recovery over there, but if you took out the walls you would have one large room.

So the families sat and waited, talked, and followed each other’s progress. A good report cheered everyone, while bad news made the room grow somber. A young lady – my father thought she was a teenager, but he later learned she was an adult who ran a hairdressing shop in a nearby suburb – heard about me and gathered her friends. “We need to pray for this young man,” she said.

At about the same moment, my surgeon sat by my bedside in Recovery and studied my chart. He was by himself, which was quite unusual. Pacifico was usually at the head of a five to ten person entourage. And he had been reading for an hour, which was also quite unusual for him. Finally he snapped the chart shut and ordered a change in my medications, and from that point on I began to improve.

A miracle? The skill of an experienced, trained surgeon? “Yes” is the answer to both questions. I believe God still works miracles, and I also believe that He does a lot of them without any fanfare. Heart Surgery is a modern miracle, but what about the guy who invented the Band-Aid? His little idea has probably saved just as many lives, and possibly more.

This story doesn’t end here. A few years later, my cardiologist commented, “It’s probably a good thing that there was so much trouble when we tried to perform that Fontan on you. We’re learning that it’s not working as well as we hoped, and some of those who have had it are actually worse off than they were before.”

The hero you find may not be the hero you are looking for.

A Final Note: As I mentioned, these events occurred in 1988. The Fontan Procedure that was to be performed on me (And that eventually showed poor outcomes) is not the Fontan that is being performed today. The operation has undergone several revisions and is now much more effective.

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One Response to “Don’t let the Water get in the Boat”

  1. Tell your story: How to make it simple « Adventures of a Funky Heart! Says:

    […] attention the moment you begin. If you’ve read Funky Heart, then you probably know that my third heart surgery went wrong when they cut my chest open. So I begin by saying “I’m probably the only person in the […]

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