The other day I received a message from a patients’
mother I took care of more than 15 years ago, during my residency. “He made it.
Medically, mentally, physically, and academically, he did it!” She also attached his graduation
picture. He is a man now. Where did the time go? Max is a child who grabbed my heart in a very
special way from the moment we met. By
that time, he and his family were well accustomed to the hospital atmosphere;
everyone knew Max and loved his smile.
He is still one of the most adorable children I have ever known.
He was almost 2 years old when I met him on the inpatient
unit after admission for an infection.
His mom had this air of confidence about her because she knew her son
better than anyone in the world, yet she put up with those of us who were
inexperienced residents still learning. During
her pregnancy, ultrasound detected a small heart defect. At 6-8 weeks of age, he was taken to the catheter
lab to have the defect fixed. He was
still symptomatic after surgery, a repeat echocardiogram found a hole between
the upper chambers of his heart, known as an Atrial Septal Defect or ASD.
He was two and half months when they performed open
heart surgery to repair his ASD and during that operation, he sustained a
stroke. The recovery was lengthy. The risk of stroke in children is higher in
males and highest during the first year of life. Of those who survive, 50-80% have permanent
neurologic deficits. Long-term
disability is common including cognitive and sensory disorders, seizures,
speech and language delays, poor attention, behavioral problems and poor quality
of life. Max was in the hospital and quick
diagnosis helped him not only to survive but ultimately, thrive.
Having a congenital heart defect is one of the major
risk factors for stroke in children. Misdiagnosis
is common because the symptoms are very different when compared to adults. In newborns, the first symptom is often
seizures involving only one arm or leg. Max
had other setbacks to overcome along the way including an arm abnormality which
required multiple operations and other health issues complicated by his history
of stroke. It seems like yesterday he
was two and three years old and would come bounding into my clinic for well
child and sick appointments like he owned the place.
There are a few reasons I decided to write about Max. First, I would like both him and his mother
to know how proud I am of all they accomplished over the last decade and a half. He will graduate soon and plans to go on and
attend an Art Institute out of state.
Second, I hope this story gives hope to parents of children with congenital
heart defects, prematurity, or any other disease or disability you feel stands in
the way of your child achieving their dreams.
Anything is possible.
During my final year of residency, I received an
award for the Best Continuity Clinic. As
a pediatrician who planned to return and practice in my hometown, it is an
accomplishment of which I was proud. Max
is part of the reason I received this award. He and his family taught me about
the full spectrum of pediatric care:
seeing him in my clinic, admitting him to the hospital a handful of
times, and after one hospital discharge on a holiday weekend, making my first
official “house call” to check on him.
In my opinion, the physician-patient relationship is
the most powerful force existing in medicine today. It has kept my love for this career alive
even on the worst days. Being part of a
childs’ life and changing it in some small way for the better is something to
treasure. Thank you for sending me
school pictures over the years and thank you for letting me share this
story. “Medically, mentally, physically,
and academically, he did it!” Max has
many more triumphs ahead for Max, there will also be many for other children
who struggled early in life to survive.
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