The Sharp Experience Documentary Video: Episode 9

(28:32)
Witness the inspiring work of Sharp caregivers in this documentary.

For more information: Find a Sharp-affiliated doctor or learn more about Sharp.

Transcript

Operator: Trauma Team Alpha. Emergency Department.

Nurse: 55-year-old female, fall from a horse, drug around the corral.

Doctor #1: Sharen, wiggle your toes for me. It hurts?

Doctor #2: We have a minimal pulse here.

Doctor #1: Call the ultrasound tech and tell him to come now.

Announcer: These are stories of real people.

Colleen: We participate in people's lives when they're the most vulnerable. When they're frightened. We share those moments with them and ease them through that time.

Betty: You know I trust you with my life.

Dr. Thomas Terramani, Vascular Surgeon: Patients don't realize that they have this...ticking time bomb.

Betty: He says...you probably won't get to the hospital if that bursts.

Enrique: I always saw myself as a family man, get married, have kids.

Doctor: Fertility levels fall after spinal cord injuries.

Enrique: I've been in the chair for 29 years.

Elizabeth: There's been a couple times where my grandma thought that it was all going to end.

Jennifer: Prognosis is you live about five, six years.

Michelle: She's in need of a transplant. And we all pray that she gets that in time.

Announcer: These are stories of The Sharp Experience.

Helicopter Radio: Sharp,  Medic 17...I have a trauma  for you guys.

Radio Nurse: Go ahead, please.

Helicopter Radio: OK, 55 year old female, weighing approximately...

Overhead Page: Trauma Team Alpha, Emergency Department.

Nicole, RN: 55-year-old female, fall from a horse, drug around the corral by the horse.

Dr. Bellezzo: She came to us with injuries that are potentially life threatening.

Nicole: The whole process of healing starts the minute they come into the trauma room. Right away, the best thing you can do is control their pain.

Sharen: [groans]

Nicole: You're flat on a board. You just took a helicopter here, and you're rushing into a trauma room and you've got eight or nine people grabbing at you, cutting your clothes off, covering you with blankets, putting in IVs.

Dr. Bellezzo: Call to the OR.

Nicole: We always right off the bat say, "This is the trauma team. We're here at Sharp Memorial Hospital. We're going to take care of you. This is what's gonna happen."

Dr. Bellezzo: I'm Dr. Bellezzo, hang on one second. I'm Dr. Bellezzo, Dr. Kill's gonna be with you in just a moment, OK?

EMT: ...was dragged around a corral, hit the cement posts all the way around, three times around. Husband reports that a helmet came off during the event. She has trauma to her left abdomen and left chest.

Dr. Kill: X-ray, come over here. Hon, what's your first name?

Sharen: Sharen.

Dr Kill: Sharen, wiggle your toes for me; hon,squeeze my hand. Good.

How about your belly? Hey, Sharen...Sharen I want you to bend your legs, hon. How about this leg, bend this one. Why can't you bend it? It hurts?

Nicole: We're gonna get some stuff done, OK? I know, sweetie.

Sometimes just whispering to a patient, "This is what we're doing. I know you're in pain" is the most comforting thing. Holding their hand....

Cozetta, RN: That line's working great, it's working like a champ.

I hate to tell a patient, “You're gonna be OK" because sometimes things can completely turn around and it's hard to regain trust. That's a definite no-no.

Dr. Kill: We have no vital signs yet guys?

Nurse: 93 over 52. Low blood pressure.

Dr. Bellezzo: She had a low blood pressure. She had a high heart rate, and in the setting of trauma, that can only mean blood loss from somewhere. So the next step is to figure out where that bleeding is and stop it.

Dr. Kill: Call the ultrasound tech and tell him to come now.

Cozetta: They're on their way.

Nicole: When you have a patient with abnormal vital signs that are consistent with bleeding yet there's are no outward signs of bleeding, we use ultrasound at the bedside, to determine where the bleeding is coming from.

Dr. Bellezzo: We found that she had had a spleen injury.

Nurse: She's got fluid around her spleen.

Dr. Kill: Is the OR ready?

Nicole: They said come up whenever we need to come up.

Dr. Bellezzo: I have a minimal pulse up here.

As the ER docs, one of our specialties is managing the ability of the patient to breathe. That leaves the trauma surgeon the freedom to assess all the other patient's injuries.

Dr. Kill: She's got a left-sided superior/(inaudible) fracture, she's got a massive iliac wing fracture.

Dr. Bellezzo: You can lose a whole body's volume of blood in the pelvis.

There we go, back one, two, three.

Dr. Kill: Okay, lock it down, lock it down.

Dr. Bellezzo: A pelvic binder is this contraption that goes around her pelvis and wraps it tight so that those pelvic fractures that are now open and bleeding get pulled together so that the bleeding will then stop.

Dr. Kill: Call the OR. Cover her up. We're going. She's at level one.

Dr. Bellezzo: She's going to the operating room under the care of a trauma surgeon in a situation where she needs an operation that will save her life.

Dr. Kill: Go, go, go. Let's go, let's go, let's go.

Peter: She knows horses better than anybody I know. Twenty-five years ago we would go ride together, ride down the beach together. It was great. Great horse woman.

The horse spooked, took off, and then he planted his front feet and Sharen went through the reins. So when she hit the ground, she was being dragged by the reins and the lead rope. The horse started to drag her and he dragged her around the arena, all the way around, probably three or four times. She had both hands like this to stop from being hung, from being strangled. And every time I'd try to make it stop, the horse would dive around me. What he was doing was throwing her this way and this way, like at the end of a whip line.

That's when she hit those concrete posts. It was a really bad sound. It was horrible. It was really horrible.

Dr. Kill: I need a clip-o-plier. Medium and large. We removed the spleen and she had a ruptured stomach. She had about a 6-by-4-inch blowout at the back of her stomach.

Nurse: We're still getting O negative.

Dr. Kill: We used a combination of suture and surgical stapler to close the hole in the stomach. Give me a suture.

I paint a very realistic picture to families and give them the whole range of what can happen.

Peter: I don't remember his exact words but he communicated this is as serious as it gets. There was a chance that she could die.

Sharen: I knew inside there were major things hurt. I didn't see a way that this was gonna end except with dying, truly, I didn't.

Cozetta: I have to give you a hug.

Nicole: You look absolutely wonderful.

Peter: You know what you should do for a living?

Cozetta: What's that?

Peter: What you're doing.

Colleen: Our work is very personal and that makes it emotional. We take these people home in our hearts. We take them home in our minds. We think about them when we go home.

Cozetta: It's a blessing. A miracle. I look and go, oh my God you look wonderful, because the last time I saw you it was pretty bad. And to see you now, up and walking...that's gonna make me cry.

Colleen: When patients come back to us, they don't realize the real gift is just seeing them. Everyone who does this job, loves it. The pride you feel in what you do, the feeling of accomplishment, returning people to their hopes and dreams...to their life.

Sharen: Come on...good boy. [laugh] It's been a while, that day I did everything wrong. I just skipped every one of my own rules. I went from A to Z. None of this is Harry's fault, the horse.

Peter: When she finally woke up, I had a feeling that it's gonna be okay. And you know what, she's alive. That's as perfect as you can get. She's alive.

Sharen: If you don't understand what life is about, you can sit by a horse — and you'll figure it out.

Betty: There's a little thing that goes on between Elizabeths that are called Bettys and Bettys that are just Bettys. Real Bettys are sassier (laugh).

In my yearbook underneath my picture it said Spaghetti Legs because I... I played basketball until I couldn't even stay up on my feet anymore. I put everything into it. This tells you a great deal about me.

Jamie, imaging technologist: All right Miss Betty, you can come on back with me.

Betty: Every two years I get a chest X-ray. The doctor had called me up and said, Betty, did you know you have an aneurysm? I said no. And that was about five, six years ago.

Jamie: I'm gonna put an IV in you now.

Betty: I have good veins, too.

Jamie: My, gosh...you've got a hose in that one.

Dr. Terramani: Most patients don't realize that they have this, what I usually refer to as a ticking time bomb.

Betty: They are little time bombs, you know. They could go off any time.

Dr. Terramani: When it ruptures you have seconds to live.

Betty: Dr. Terramani says you probably won't get to the hospital if that bursts.

Dr. Terramani: When the public hears aneurysm the first thought that goes through their mind is brain aneurysm.

Betty: I have two aneurysms.

Nurse: Are you warm enough?

Betty: One is aortic which is right around your belly button. The other one is iliac which is buried in your pelvis.

Dr. Terramani: Abdominal aortic aneurysms are a breakdown of the artery. And it becomes weaker as it dilates bigger and bigger.

Margie: She's very photogenic.

Dr. Terramani: It's exactly like inflating a balloon. You can get it to get bigger and bigger but there gets to a point where it can rupture. People lose consciousness, they have a heart attack and then they die.

Betty: It's not important to me to live for a long time. I'm a poster child for quality of life.

Margie: There you go.

Betty: Thank you, Margie.

Margie: You're welcome.

Betty: I've been so active all my life. To take that away from me would be to take away part of my soul, I think.

Dr. Terramani: How are you doing?

Betty: I'm doing fine. How are you?

Dr. Terramani: Nice to see you.

Betty: Nice to see you.

Dr. Terramani: So I have your CT scan results and your aortic aneurysm is still small. Your iliac artery aneurysm is the one that has changed.

Betty: Oh, okay.

Dr. Terramani: So it's over twice. It's about two and a half times size normal.

Betty: You know you live with this for a while and nothing's happening. And then all of a sudden, oh, okay it's time we do something.

Dr. Terramani: The traditional way of fixing aneurysms was with a big incision. Patients are in the intensive care unit for two or three days, they're in the hospital for five to seven days, so that stress on an older patient is significant.

Betty: This is the first time that I have felt a little bit nervous.

Dr. Terramani: Your anatomy is conducive to fix it with a minimally invasive stent graft. So the stent graft is going to go to there. so all your blood flow goes inside this tube and not into these two aneurysms.

Betty: It's very good news that I am able to be a candidate for stent surgery.

Betty: If you tell me that it's time...

Dr. Terramani: I think you'll do fine with the treatment.

Betty: Okay, how confident are you?

Dr. Terramani: In your case we'll seal 98 percent.

Betty: Thank you very much.

Dr. Terramani: You're welcome.

Betty: You know I trust you with my life.

Dr. Terramani: We'll take good care of you.

Betty: I know you will.

Every now and then you think of where you might be if one of them burst.

Nurse: And what's Dr. Terramani doing for you today?

Betty: Two aneurysm stents.

You don't whine. You know you overcome. That's the way I was raised.

Nurse: Hey, you can put this lovely hat on your head here.

Betty: Hello.

Dr. Terramani: Did you get some sleep last night?

Betty: I...yeah. I can't wait for this to be over.

Dr. Terramani: Excellent.

Betty: Unfortunately, I bet Dr. Terramani that mine would burst before he would operate on me.

You remember our bet?

Dr. Terramani: What was our bet?

Betty: They're gonna burst before you operated on me.

Dr. Terramani: So then I...then you owe me money.

Betty: Maybe he'll be a gentleman and not accept (laugh).

Dr. Terramani: You're a tough one.

Betty: I know.

Dr. Terramani: I'll see you back there, okay.

Betty: But you love me, right.

Dr. Terramani: I love you a lot, okay. Okay, see you later.

The stent is pre-manufactured into a delivery system.

Anesthesiologist: You're gonna go to sleep in a few seconds here okay.

Dr. Terramani: The first thing we do is we make two small groin incisions.

Anesthesiologist: You have a nice nap, Betty.

Dr. Terramani: We advance the delivery system up into the top part of the aneurysm.

We ready to roll?

Nurse: We're ready.

Dr. Terramani: Let's see the main device.

We land the stent right below the kidney arteries and it has the precise ability to land exactly where you want it.

Nurse: You like that mark?

Dr. Terramani: Yes.

So you’ll see the stent expanding there. Now there's a stent covering the aneurysm here.

Nurse: You like to see that first stent come open.

Nurse: Yeah.

Dr. Terramani: Open it up a little bit more.

Doctor: This where you get your seal.

Dr. Terramani: Hold respiration.

Nurse: Holding. I think that might be good. That might be the ticket right there.

Dr. Terramani: I like it up top. I like it down low.

All right, bring the lights back on. Call out to the family and let the daughter know everything is going fine.

She should be able to go home tomorrow. She'll be able to walk out of the hospital and then, you know, slowly go back to resuming activity but no more time bombs.

So, mom's doing great. No bandages so she'll just have two little incisions.

Betty's daughter: That's great.

Dr. Terramani: We did your surgery on the second of August and now we're about 23 days later.

Betty: I don't have to worry about anything bursting.

Dr. Terramani: Now your aneurysm in the abdominal aorta is sealed. Common iliac is sealed. The chance of either of these two aneurysms rupturing is basically zero percent. So that's good news, the bad news is you lost the bet.

Betty: I know [laughing]. Thank you so much.

Dr. Terramani: You're welcome.

Betty: My girlfriend and I are planning to go to Paris in the spring. I've never been to Paris [laughing]. Au revoir.

Jennifer: A couple of weeks ago my son told me, Mom, since your eyes are yellow do you cry yellow tears? And my mom's like, "You do," because I guess I was crying and my mom wiped them and they're yellow tears.

Dr. Tarek Hassanein, Gastroenterologist: Jennifer was born with a genetic defect in her liver — Alpha One Antitrypsin Deficiency.

Hey, Jennifer, how are you?

Jennifer: I was diagnosed six years ago. They told me I had a terminal illness.

Dr. Hassanein: The liver produces certain proteins to protect our body. In her case the liver is not producing these proteins. She developed end stage of liver injury.

How's the pain?

The patient's body cannot tolerate that degree of liver dysfunction and the patient ends up dying.

Jennifer: I have so much gratitude to him. Every time that I've been so close to death he's pulled me out.

Dr. Hassanein: When the swelling gets down, the healing gets better. When the liver is not working, the body swells.

Elizabeth: My mom's been sick since I was in third grade. I remember the day she got diagnosed. We have a joke that my mom comes to visit home. She doesn't visit the hospital [laugh].

Jennifer's Mom: You look beautiful as ever.

Jennifer: Thank you.

Elizabeth: There's been a couple times where my grandma thought it was the end, that it was all gonna end.

Dr. Hassanein: The liver has a capability of regenerating. In her case, the problem is even the new cells have the same genetic defect.

Jennifer: Prognosis is you live about five, six years. I really don't know what it is to be normal, not to have pain or nausea.

Dr. Hassanein: A new liver would fix the problem.

Michelle: She's in need of a transplant and we all pray and hope for her every day that she gets that in time.

Dr. Hassanein: We have this new treatment, albumen dialysis. They call it MARS, molecular adsorbent re-circulating system. Now we can remove a lot of the toxins that the liver should be removing.

Nurse: Hi, Jen.

Dr. Hassanein: MARS can buy them time 'til they get their transplant.

Elizabeth: Maybe I'll get my mom back like normal, the way she was before she got really sick.

Dr. Hassanein: A healing environment is not only giving medicines or doing procedures. It is all aspects of patient's well-being, nutrition, mobility, and improving the environment around them, make them less anxious.

Elizabeth: My grandma calls him a big teddy bear because he's so sweet, but he's still like, manly.

Kathleen: We incorporate a lot of different therapies such as music therapy, aromatherapy, massage therapy.

Colleen: We're not just taking care of a single patient. We're taking care of that patient and their family, their parents, their children, because the whole family's affected by what we do here for that one patient. The outcome will change the course of their life.

Michelle: We've shared a lot of her ups and downs with her. The nurses and all the staff, we've seen her at her worst. And really her attitude and her spirit is a gift to us.

Jennifer: At no time do I feel sorry for myself, I can either let this get me down or I can continue with my life.

Dr. Hassanein: She's fighting her disease and our commitment to her is to get her to the transplant.

When she got the transplant her daughter was the happiest person on earth.

How are you? Look at this...

Pam, RN: I didn't know you could turn her into a beautiful young woman again. You do her hair too?

Dr. Hassanein: The liver is perfect. The liver is working very well.

Margie, RN: Unbelievable.

Dr. Hassanein: Getting our patients to do well is the most satisfying thing in our career.

Tina, RN: Holy ****, I didn't even recognize you. Oh my gosh. Can I have a hug? You look great!

Dr. Hassanein: You know, you went through a long phase of being sick, now it's a new life.

Jennifer: I think I'm finally getting to a point where I'm going to be able to be a mom again. Like today she has my shoes on. And I was like, Elizabeth are those my shoes?

Elizabeth: She weighs less than me now. She's looked in my closet a couple of times and I'm like...hmmm, no [laugh].

Dr. Bakhtar: When I pick up a slide at eight in the morning and I put it under the microscope and it's malignant, there's an entire life story. This patient had a lump in her breast and this biopsy was done to determine if this was breast cancer.

Even though patients don't see me, I'm absolutely one of their doctors.

Being the person that actually makes the diagnosis and looks at the tissue, I'm probably best equipped to answer questions.

The specimen consists of a single fragment of tan dash red tissue...

So I want you to look at your pathology reports. "T" stands for tumor. And I want you to find the size of your tumor.

Angiolina: Dr. Bakhtar had the idea of "Meet the Pathologist" to help the patient who has already been told about their diagnosis, further understand it.

Dr. Bakhtar: Really what we're trying to do today is to give you an understanding of what disease you have so that you can ask questions.

Acknowledging someone's fears is putting yourself in their shoes.

Angiolina: The things that people don't know are usually the scariest.

Dr. Bakhtar: Did they remove the entire breast?

Female patient #1: No, not the entire, only a part, but still...is it a danger of spreading?

Dr. Bakhtar: For me things changed about a year ago. My wife was diagnosed with breast cancer. I remember looking at the slide myself and my heart dropping. I said it’s cancer and I remember my voice was quivering. I’ll never forget that experience. And I can tell you every time I look at breast cancer now my heart drops in the same way.

My wife had breast cancer in the eighth month of her pregnancy with our little guy who's 18 months now. And so I can appreciate what you all go through.

They're mothers. They're fathers. They're sons and daughters. They're wives like my wife.

My wife is doing extremely well. She's finished her therapy, is back to work and life is good.

Female patient #2: [Spanish]

Angiolina: She said she wanted to say thanks for doing this, that she says she thinks that women are going through all of this and not knowing what they're doing.

Dr. Bakhtar: The moment of diagnosis can be a devastating moment, but once patients are informed, they feel empowered.

Enrique: 2:56 water broke. Enrique, get ready. Let's get going. So here we are.

Bertha: Dilated almost to a 3. I feel another contraction coming. Feel right here hard.

Dr. Danny Keiller, Urologist: We looked at our spinal cord injured population of males, and realized that hardly any of them were becoming fathers after their injury, and we think that's an important part of life and so we started a program.

Lynne Beresford: I first met Enrique and Bertha in 1995. We were starting up this program and presented the idea to them and they got really excited for the possibility of becoming parents.

Enrique: I always saw myself as a family man, we get married, have kids, have a house.

Bertha: It never crossed my mind that I would date anybody in a wheelchair, no, just happened. We had that bond.

Enrique: I've been in the chair for, I'd say, 29 years.

Bertha: I mean he's a true gentleman. He'll open the door for a lady; he doesn't let anybody open the door for him. Everything that I could ever ask, he's got it.

Enrique: We were happy together, but there was a little something missing in our lives and that was kids.

Tomilyn, RN: Enrique, I'm Tomilyn, wonderful to meet you. So a little earlier than expected, huh?

Enrique: Yes it is.

Dr. Keiller: Enrique had been a patient of mine for several years before we started trying to help them with fertility issues. Fertility levels fall as time elapses after spinal cord injuries.

Lynne: It's not always just the male that has the issues with fertility.

Enrique: We're at the hospital. Everything's okay, so don't worry. What a morning.

Lynne: We were figuring out how to get genetic material from Enrique, also how to properly implant Bertha. It took 13 years of increasingly complex reproductive therapies before they had their first child.

Enrique: It was a miracle. We got Ivan, we got Ivan.

This is big brother right here. Mommy...

Lynne: When Enrique was injured his parents probably thought they'd never be grandparents and they are.

Tomilyn: And this is a boy or a girl?

Bertha: This is a girl.

Tomilyn: That's perfect. Everybody wants a boy and then a girl. Perfect.

Bertha: Another one is just more than we could ever ask for.

Tomilyn: Did you have a contraction now? That was a strong one. She's actually originally scheduled for induction but she came in because she ruptured. Husband is paraplegic. So in vitro is how they conceived.

Dr. Arlene Morales, Reproductive Endocrinologist: These are embryos. These are four individual embryos, and then we grow them for up to five days in the laboratory. This is what's called a blastocyst. It has placental cells already and this is later on day 5, it actually hatches out of its shell. And then we check a pregnancy test. That's our big day.

Lynne: I have a little smile on my face and I tell different people okay pray today this is their baby-making day.

Enrique: Focusing on the end result will get you there, just thinking about what you're going to have at the end, in your arms.

Dr. Morales: It does take a village to raise a child. Probably in the birth of these children at least 35 to 40 people are involved in all the steps along the way.

Lynne: With our spinal cord couples they have joked in the past, there's a lot of people in our bed helping us to make a baby.

Enrique: I had a three-wheeler accident, ended up with a complete spinal cord injury, a T-10, and 11. It's just like it was yesterday. I was 21...21.

Dr. Bastuba: One of the typical situations, with a fairly high spinal cord injury is that it affects the ability to give sperm out of the body. The most high-tech approach is where we actually go into the male's body and retrieve sperm surgically.

Tomilyn: We're just going to give you a little bit of Pitocin to kind of help make your contractions a little bit closer together.

Lora, RN: Here at Mary Birch we deliver over 8,500 babies a year. The work that we do here is really special.

Bertha: Oh. [breathing, moaning]

Lora: Sometimes all she wants is her mom or her sister to just stand there and hold her hand. We do that for them as well, but it's different when you have your mom.

She said she wanted you, her mom, and her aunt in the room for the delivery.

[NAT AUDIO] She is complete and plus 1 to plus 2, and she said she didn't push long with her first baby.

Lora: Are you excited?

Bertha: Yeah.

Lora: Yeah?

It's very cool watching the dads. That's one of the first things I do once the baby is born, is to look at the expression on his face.

Dr. Brahmbhatt: And we're ready to go. Bertha, when you have your contraction next, we'll tell you when to push.

Lora: So when you feel that pressure you let us know, OK?

Dr. Bhoomi Brahmbhatt, OBGYN: Oh, she's having a contraction.

Lora: You're having a contraction, ready to push? Go for it. Deep breath in, and push. Push, good...

Dr. Brahmbhatt: Two, three, four. Push, two, three, four, five, six, seven, eight. Good. Bertha, take a deep breath for me. Take a deep cleansing breath. When you're ready, take one deep breath in and push with all your might. Good. Two, three, four, five, six, seven, eight, nine, ten. Good. Right back at it. Baby is right there. Oh push, push, push, push, push.

Bertha: Oh my God. [over talking]

Nurse: [baby crying] Happy birthday!

Ready to cut the cord, Dad?

Nurse: She sounds awesome.

So what's her name?

Bertha: Emma Victoria.

Enrique: Emma my choice, Victoria her choice. Hi, Emma Victoria. Hi, baby. Welcome.

Lynne: A full life is possible after spinal cord injury. A full life.

Colleen: It's really a given that we're going to treat people with the newest and best equipment. We all understand that. But what we're bringing to that bedside that's different and unique is how much we care about them. How much we're hoping for their well-being.

Dr. Bakhtar: Patients know when you care. It's an entire manner that you approach a patient with. Doing what you need to do to support the patient medically and emotionally.

Colleen: Everything we do has an impact on these people's lives. They remember that nurse that touched them, they remember that someone put their arm through theirs and walked them down the hall. The kind words in the middle of the night, all those little things, all those simple acts of kindness and love are the things that matter. And that's the way health care should be.

The Sharp Experience begins when you choose a physician at 1-800-82-SHARP.