Monday, June 8, 2009

Meet the Manager.

I asked Dr. Frank Pigula, the man who operated on my son's heart, how the heart re-starts after being stilled by potassium during heart surgery. "It wants to beat," he said.

"It wants to beat." Just that. I was amazed by that simple yet profound answer, just as I was impressed by his willingness to answer any of the questions we had in a patient and understandable way.

But, then, we experienced the same openness and willingness to communicate during our overall experience at Childrens Hospital of Boston, the hospital which is ranked by US News and World Report as the top hospital in America for pediatric cardiovascular surgery.

When Nickie had pre-operative tests, the nurses and technicians explained in simple terms the MRI, the Stress Test, everything with a cooperative and patient attitude. The day before the surgery, Dr. Pigula sat with us and talked about the surgery, using his hands and diagrams on paper to show us as simply as possible where he would place the pulmonary valve and how he would correct the tricuspid valve. Before he left the room, he hugged Nickie and said, "I'm going to take good care of you."

And he did, for over six hours. Our son went to the ICU after his surgery, and Dr. Pigula came to check on him and to talk to us. At 10:30 pm, after having operated on our son for much of the day, Dr. Pigula sat in the Parents' Room in ICU with us, even though he was visibly tired, and reviewed the operation in terms we could understand. It allowed us to go to the hotel, assured that Nickie was receiving the best care in the world.

The surgical repairs required to make my son's heart function normally were complex, but Dr. Pigula successfully communicated to my wife and me, two parents, filled with fears and anxieties, who had only a basic understanding of a very complex situation. Despite his extraordinary expertise, Dr. Pigula reached us. For people like us on opposite ends of the technical spectrum to successfully communicate, with emotions and fatigue thrown in to the mix, was nothing short of miraculous.

When I visited the ICU the next day, Nickie was connected to a variety of monitors and medications. On the first day I asked Patrick, his one-on-one ICU nurse, about the various drugs dripping into the veins of my son.

"Dopamine helps his right ventricle with pumping," Patrick said as he worked around our conversation. "The morphine is for pain. The heparin keeps the tubes open and the nitroglycerin is for his coronary arteries."

Patrick told me about the milnirone, also, but I forgot to listen, amazed as I was by the monitors that measured the oxygen saturation of his blood, his heart rhythms, his blood pressure and his body temperature.

On the second day in ICU, Lauren, his new nurse, told me Nickie would have the breathing tube removed when he was able to breathe on his own. After she finished telling me, an announcement came on the intercom in the ICU inviting any visitors who were interested to meet "Meet the Manager." Lauren and I smiled at each other and I said, "I'll go meet the manager just to tell him or her how great you folks are." Nickie waved to us with his right hand and nodded his head up and down in agreement.

In the 18 ICU rooms, children of all ages, many of them babies, struggled to regain their health, some struggling for their lives, and the intercom invited visitors to "Meet the Manager." While these young patients struggled to regain their health, the rest of us struggled to communicate.

And, it is a struggle. Whether we place ourselves or our loved ones in the hands of medical professionals and have an overall understanding of things but lack the particulars, or whether we are sitting with a customer trying to explain computer technology to the uninformed, we must be able to answer questions and concerns in a clear, understandable, courteous manner and usually with great simplicity. Any communication that does not do that will likely fail. Then, if we're in a business setting, we'll hear, "I'd like to speak with your manager."

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