Code Blue
I had a surprise visitor today at my office, one who took me back 35 years. Surprise, because her sister’s children were the patients, because she lives 1500 miles away, and because she lives at all.
It was the first of February 1974. I was at Childrens Hospital of Los Angeles making my teaching rounds when I got an emergency call from the hospital next to my office, 15 miles away. A newborn was delivered who was blue and desperately ill. Nowadays a team of neonatal specialists would have been on the spot. In fact the diagnosis likely would have been made by ultrasound. But in 1974 we had not quite opened our first Neonatal ICU. The general pediatrician attended high-risk deliveries, treated sick newborns, did spinal taps and other procedures as we were trained to do. My neonatal training had been almost a decade earlier, but under the legendary Bill Silverman at Columbia-Presbyterian. He had literally “written the book” that every budding neonatal specialist, doctor or nurse, used.
The date was significant. OPEC had come upon the scene and disrupted our love affair with the auto. Gas was rationed. The Highway Patrol had new marching orders that day. Speeders would be rounded up without mercy. I don’t know how fast I was going the first time I was pulled over in my BMW, but the officer was sufficiently alarmed at my story that he put on his flashers and had me follow him the last few miles to the hospital. Was he a great humanitarian, or was he just checking out my story? He did tell me he had a new baby at home.
I spent most of the day at little Guadalupe’s incubator, keeping her oxygenated and doing what I could until the Childrens Hospital ambulance arrived hours later. She was blue because her heart wasn’t structured correctly. Most of the heart’ s output was shunted away from the lungs and oxygen could not get where it was needed, a so-called right-to-left shunt. Perhaps you have heard of Tetralogy of Fallot. This was worse; in fact there was no name for her mess of a heart.
At about 5 p.m. she was on board the ambulance and I was to follow. However, the driver did an odd thing. Instead of turning right toward the nearest freeway on-ramp, he turned left into the teeth of rush-hour traffic. Of course he had a siren, but he was wasting precious minutes. I headed west and entered a busy freeway. In a few minutes I transitioned to the 101, only to be pulled over by another CHP officer. The usual question: “Where are you going in such a hurry”? I said “I’m following an ambulance to Childrens” but he saw no such vehicle. I did quite a sales job explaining that the driver had gone the wrong way, and again I was let off the hook. At 11 p.m. I finally headed wearily home. This time I had no excuse for being pulled over a third time. ( The BMW just won’t go slower?) Somehow he let me go, and I’ve only been pulled over for speeding twice since then.
“Lupe” survived her emergency surgery but the best the team could offer was a palliative procedure to correct the shunt partially. She was given at most seven years to live, and likely much less. Digitalis, diuretics and many other drugs would be daily necessities.
Like most handicapped children I’ve known, she radiated a joy for life. Seven came and went, and so did grade school, middle and high schools. At 22 she got married and moved to Texas. Of course having a baby was too risky, but she did that too. Today she introduced me to her 7-year-old son Daniel.
If you look real hard you can see the bluish skin color, well-hidden by her dark Hispanic skin. She breathes harder than normal and her fingertips are “clubbed”. But what I see is a miracle.
A few years ago Alan Rickman and Mos Def did a TV movie called “Something the Lord Made” about the pioneering team of surgeon Alfred Blalock and pediatrician Helen Taussig at Johns Hopkins, and the first successful heart surgery. It was just after World War II. In the movie Dr. Blalock and his brilliant lab tech, Vivien Thomas (who was black) saved the first infant.
It wasn’t quite that neat. About a half-dozen patients died before their first success. One was my cousin Harriet. She was 21 and had months to live at best. She had never left her house. Her life was home-schooling, knitting and family. She was a stunning beauty but for her plum color. Any exposure to infection would have been life-threatening. She knew the risk of surgery and welcomed it.
Harriet was one of my inspirations for my choice of career. How far we’ve come in just my lifetime! Seeing Lupe reminded me of that today.