How to save a life
January 30, 2013 at 11:36am facebook
Times of crisis often bring people together. What's even more impressive is when those crises bring people together to help a person in need. That's exactly what happened at VA's Brooklyn Campus when a top notch neurosurgical operating room had to be pulled together in a hurry. Before Super Storm Sandy, VA's Manhattan Campus was VA's referral center for Neurosurgery. Because of the temporary closure of the 23rd Street facility, Dr. Uzma Samadani, Chief of Neurosurgery, and her team relocated to the Brooklyn hospital where neurosurgery had never been performed before.
Among the most complex of surgeries, neurosurgery requires not only highly skilled surgeons, nurses and technicians, but very sophisticated equipment including the Stealth image guidance cranial navigation system and highly sensitive neuro-monitoring equipment. All this was formerly housed in Manhattan, not to mention surgical instruments and a supply of specialized anesthesia medications and many other items such as the frame that keeps the patient's head in position for a brain operation.
Dr. Samadani said that Executive Chief of Medical Staff Dr. Michael Simberkoff was committed to having neurosurgery temporarily established in Brooklyn and to taking whatever measures were necessary to bring all of the essential components together to continue to serve Veterans. "It wasn't just the neurosurgery service who took care of this Veteran," said Dr. Samadani. "It was a massive effort involving leadership, nursing, anesthesia, radiology, pharmacy, medicine, oncology, critical care, and a consulting neuro-monitoring service from NYU. There are a lot of tiny details that need to be checked, double checked, and triple checked before the surgeon picks up the scalpel to remove a brain tumor. Every 'what if...' needs to be considered for both before and after the actual case. Many people worked very hard to make this possible."
The impetus for having everything ready for brain surgery was a patient's need. Vietnam-era Army Veteran Bobby Smith came into the Brooklyn Emergency Department (ED) having had a seizure. "My left hand was trembling. I couldn't control it," recalled Smith later. Following a second seizure, the left side of his face and body was paralyzed, his speech was slurred and he couldn't swallow. He could not lift his left arm or leg at all. Smith was diagnosed in the ED with lung cancer that had spread to the right side of his brain and lodged near the area controlling movement on the opposite side of his body.
As a Brooklyn resident, before the storm, he would have been referred to Manhattan for surgery. Now, it turned out, he was cared for in his home borough.Dr. Samadani knew that if she could remove the walnut-sized tumor he would recover much of the use of his left side. Her team performed a three hour operation to remove the tumor. Three days after the surgery, he could lift his left arm and hold it almost as steadily as his right arm, and he could even stand-up. His speech became fluent again. "He'll walk, which will at least give him a fighting chance against the cancer," noted Dr. Samadani. Smith still requires weeks of radiation therapy for his lung cancer, but at the moment, he's enjoying life without paralysis. Ready to go to rehabilitation for further strengthening just four days after the surgery, Smith gave a thumbs up as he joked with his wife and sister about keeping his beard trim. "I feel great," he said.