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Fix you (bypass heart surgery)

Posted Sep 11 2009 4:57pm









If Dr Vaughn Starnes hands be crafted by God, work on! He works with the grace of a ballerina, his pinkie fingers balancing his hands as they maneouver the remaining fingers into Reuben's heart.


By cardiopulminary bypass, Dr Starnes surgically repaired the hypoplastic arch (coartation), closed the ventricular septal defect (VSD, hole, murmur), resected the subaortic membrane, closed the patent foramen ovale (ASD), ligated the patent ductus arteriosus (PDA) and dilated the stenotic pulmonary valve. The operative report reads things like “We then noted the fairly large subpulmonic VSD. We patched the VSD”. It’s startlingly matter of fact. In layman’s terms, the outer shell of Reuben’s heart has been sewn in paches to fill in the holes, narrowed valves to the lungs and body have been dilated and the breastbone (sternum) that was cut open was closed with stainless steel. That’s the gruesome part.

The surgery itself took 2.5 hrs, 48 minutes of which Reuben was on cardiopulminary bypass which meant he was blue and cooled to the level of hyperthermia.

***





The senior charge nurse invites me to prep Reuben for surgery. We scrub Reuben’s body until he’s cleaner than he’s ever been before. It is an emotional ritual, my tiny participation in what is to come. The anesthesiologist arrives to take Reuben to the operating room and asks us to kiss him goodnight. My stomach rolls over with panic and tremendous anxiety as Cassandra and Lisa hug Jason and I. I need to sit down very badly and nurse Susan takes us to the kitchen in the parent’s lounge where we will wait out the surgery. We had an all night vigil by Reuben's bedside, photographing him with gusto as if each take were the last, singing to him, stroking his hair, taking turns holding him in our laps.

I awake with a startle, my head on the table, as the cleaner comes into the kitchen. So we’re prompted to move to another room to sit out the surgery. Collecting our things, Jason lags behind. I turn the corner and Dr Starnes, neutrally expressive, stares back down the corridor at me. A flash of recognition. Dr Starnes is 90 minutes too early back from surgery. A lifetime of emotion squeezed into seconds. My mind floods with feelings, at once trying to analyse his expression for some sign of falling into the 88-90% success bracket, beyond the statistics for morbidity and mortality, and yet, in that split second, I can read nothing. The short walk is empty save Dr Starnes at one end and me, the other and as the distance between diminishes, a terrifying sense of dread overwhelms me. I shout for Jason just in time to join Dr Starnes in saving me from fainting as my legs give way.

I recall the scene in the Terminator when Linda Hamilton breaks out of the sanitarium and, turning the last corner towards the elevator, is greeted by Arnie staring down at her at the end of the corridor. Linda’s momentum is brought to a rapid halt as she spins on her heels, running back down the corridor. I wouldn’t have made it as Linda Hamilton.

Dr Starnes visits us later and gives a passing glance to Reuben. "I was more worried about you than Reuben" he says.



It's as if we'd been asked to jump across the Grand Canyon whilst standing on the North Rim. We now find ourselves on terra firma, the South Rim and I can't believe we're here. The months ahead we'd dreaded, desperately waiting for him to grow to 6kg whilst watching him suffer to breath, each and every calorie being used to sustain his life with no reserves left to grow. All this condensed into days. The surgery at a weight unable to hover beyond 4kg.

I wipe the blood that has dripped into the crevasse of Reuben’s sweet neck. I kiss him goodnight.
The strange irony is that Dr Starnes also fixed Arnie’s heart.

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