Why You Treat Me Like a Dog?: Every Once in a While, There's A Patient

Tuesday, June 06, 2006

Every Once in a While, There's A Patient

Miguel was born with a hole in his heart. He grew up in a small town in Mexico, with his poor, penniless parents always hoping that the hole would close on its own (as they often do). But every doctor who would listen to his young heart would invariably look up at his mother and shake his or her head, no.
By the time they crossed the border and moved to the L.A. area, Miguel was a teenager. He grew appropriately, meeting all his milestones and despite his "asthma" he was able to play soccer with his friends. His parents, illegal aliens, could not afford medical care for him and certainly didn't have medical insurance.
They brought him to the pediatric cardiology clinic at County Hospital, where again, the doctor would look up and say, "no, the hole is still there." Repair of the hole would require a pediatric heart surgeon, and the County didn't have one. His parents couldn't afford to pay for the surgery, and for some odd reason, no one ever helped them find other ways to get surgery for Miguel. He was lost to follow-up for a few years. Why bother, he and his parents thought.
I met Miguel in my first months as a training cardiologist at County Hospital. It was in the adult cardiology clinic, he was now 24 years old. He continued to play soccer, as long as his "asthma" wasn't too bad. He was married, had one son and had a part time job as, of all things, a luggage handler at LAX.
His was an exciting case for a training cardiologist. Putting a stethoscope on his chest was like listening to a veritable concerto of heart sounds, murmurs and gallops. We reviewed his records from the pediatric clinic and together with one of my mentors, I set out to work him up - completely.
An echocardiogram was arranged - the ultrasound images showed us the gaping hole between his two ventricles. One of his heart valves had been sucked into the hole with every beat for the last 24 years, and was beginning to collapse. He needed surgery.
His part time job did not provide him with insurance, though luckily by now he had obtained legal documentation and had a green card. Social workers were contacted and we began the process of obtaining adequate insurance coverage for what was now a very complex and unusual surgical procedure.
Two years passed – I continued to see him in clinic on a regular basis. In the mean time I was able to arrange for the necessary preliminary procedures to be done at County Hospital, and actually performed most of them myself. The social workers continued to work on arranging for surgery at Major University Medical Center.
Then one day in the fall of my last year of training, his insurance came through! By now his wife was seven months pregnant with their third child. The first two had been screened for heart disease and were spared; the third one’s fetal ultrasound was also encouraging. We arranged for Miguel’s surgery.
The heart surgeons at Major University Medical Center operated on Miguel and he did great! I visited him on the second day post-op. He had just finished vomiting his first meal. He had been given spaghetti and meatballs when all he should have had was jello and clear liquids… But he did fine.
I continued to see him in the clinic for the remainder of my training. He knew that I would soon be leaving County Hospital to enter private practice. On my last clinic visit with him, he asked me where I was going. I told him the name of the practice, and where it was. He said to me, “Doc, you have done so much for me and saved my life. I am going to get insurance, and I am going to come see you in your private office.”
Yesterday morning, five years almost to the day from that last visit, Miguel was waiting for me with a huge smile on his face in an exam room in my office. He had been promoted to a full time dispatcher, qualified for insurance and tracked me down. He now has two healthy sons and a healthy daughter. He still plays soccer, and even coaches his eldest son’s soccer team. His “asthma” is gone.

- posted by wanderer @ 11:56 AM

Comments:

I'm so glad you "wandered" into this young man's life and helped to make a HEARTy difference!

# posted by

torontopearl : 6/06/2006 7:09 PM

Wanderer: you made me cry. What a life-affirming story. How wonderful for you.

# posted by

cruisin-mom : 6/06/2006 8:38 PM

Pearl- yes, me too - I learned alot from him, and was glad to help him out. I've noticed that you love puns!

Cruisin' - darn it, I hate it when I make you cry. But I know they are good tears! We docs sometimes get cynical about what we do, but then a patient like this comes along that kind of realigns our sights.

# posted by

wanderer : 6/07/2006 8:31 PM

Me love puns?? Nah... Whatever gave you that idea?
By the way, aren't we due for a story about *beautiful Bella*?

# posted by

torontopearl : 6/07/2006 9:32 PM

Wow, great story in every way. Miguel went from illness to health and also from dependence on charity/government to independence and productivity. It's the kind of touching human interest tale that makes me think that the gazillions of dollars spent on him were worth it and perhaps he should not have been arrested after the first sentence of this story and deported. Although I'm still on the fence.

Moreover, you're a great doctor and a good person.

# posted by

Doctor Bean : 6/07/2006 11:23 PM

See Bean, that's what I keep telling you. Welfare works!

;)

# posted by

wanderer : 6/08/2006 8:50 PM

Great story. I have a patient that I first saw when I was a resident in the urgent care clinic. When I joined my practice in Wauwatosa, she came to see me there. She followed me to my new practice as well. I've been seeing her now for almost 15 years.

She sent me an email recently. She told me that from the moment she first saw me she knew I was going to be her doctor.

Maybe she's stalking me?

# posted by

PsychoToddler : 6/14/2006 2:46 PM

P.T. maybe she thought you were Jerry Seinfeld.

# posted by

cruisin-mom : 6/15/2006 6:57 AM

Wanderer? where are you? Hope you're okay.

# posted by

cruisin-mom : 6/19/2006 7:36 AM

Thank you we're fine! Took a little vacation - will post when inspiration hits...

# posted by

wanderer : 6/20/2006 4:01 PM

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