Thursday, March 20, 2014

Delivery Deficit

I have a bad feeling about Princess. I don’t think she will get heart surgery and I don’t think she will make it. And I really hope I am wrong.  

With Princess we don’t have a medical diagnostic dilemma. We have a delivery dilemma.

The technology that exists to diagnose Princess is magical. Not too many years ago who would have thought bouncing sound waves off a 7.5 pound baby's heart could be done in Port-au-Prince, one of the most dilapidated cities on the face of the earth? And who would have thought that these sound wave images could be converted into a video that showed Princess’s tiny beating heart full of dark holes begging for repair.

And just as amazing who would have thought that this video could be "downloaded" to a little laptop computer and then "uploaded" with a wireless signal for the rest of the world to see? This just doesn’t seem possible.

With this technology cardiologists in four countries have now seen Princess’s echocardiogram and all agree she has a congenital heart defect called complete AV canal. And they all agree she needs surgery.

In the old days doctors were good with their ears diagnosing congenital heart disease. And a few could have accurately diagnosed babies like Princess without a sound wave test. But heart surgeons back then could not have stopped the baby's heart and repaired the heart because there was no good way to circulate blood. And at the baby's autopsy the surgeon would smoke his cigarette, shake his head, and stare at the hole in the heart that killed the baby. But today we have incredible bypass technology. A skilled surgeon and bypass team now connect the baby to bypass, stop the heart, fix the heart, restart the heart, and remove the baby from bypass.

All of this diagnostic and curative technology is available and being used everyday. We all know what is wrong with Princess and we know how to make her better.

But for Princess it might as well be 1950. We have diagnosed her but we have not agreed to do anything for her. The real challenge for Princess now will not be finding new technology or disseminating information about her. The challenge is to repair OUR hearts and deliver Princess the care she deserves.

John A. Carroll, MD

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