One For the Heart

A UN of doctors saves a little American from ventricular septal defect

Her mother was young, I'd say early twenties, and seven months pregnant. Kinley's Dad was the crew chief for the mother's brother, who is a stock-car racer. The extended family, including Kinley's affable grandfather and grandmother, had combined a race the brother had in central Florida with a vacation, and had come down in a caravan of a large mobile home and a couple of pickups and the trailer with the race car on it. They were up around Lake Okeechobee when Kinley got very, very sick. From the first small-town hospital where she was taken, they'd rushed her to Palm Beach. She nearly died there. She'd picked up a viral infection that had taken firm hold in her repaired heart. It was touch-and-go for two weeks in Intensive Care, but they finally got her stabilized enough to fly in a helicopter down to Miami Children's for surgery. That had taken place two weeks before Joe's ordeal.

She was getting better, though. The hospital had roped off a section of the rear parking areas and the grandparents had parked their mobile home there. They were well into their fifth week away from home. But Kinley was a little better each day. We saw her a few times a day, usually being strolled around by her pretty and friendly big-bellied Mom, or carried through the halls by her stocky, strong, scrub-faced Dad, who wasn't a teenager but looked like one. She couldn't walk -- her legs were too insubstantial to hold her up. But one afternoon, supported by her father, she was taking a few halting steps.

Nico and I would greet Kinley and she would acknowledge us with the faintest smile. Her grandfather told us that she hadn't said a word since coming off the respirator a week earlier. She'd been on for four weeks, and the doctors said her throat was probably sore. But her mother also told us that she'd been examined by a child psychologist, who'd diagnosed deep depression.

COURTESY DOUGLAS GRANT MINE
The three handsome Mine boys, with little Joey in the middle; Doug and Nicki, rear
Steve Satterwhite
The three handsome Mine boys, with little Joey in the middle; Doug and Nicki, rear

"I guess even babies can get depressed," her mother said. "Lord knows she has reason. They say she'll come out of it, though."


Near noon, a little over four hours since Joe had been taken to the operating room, Nurse Jane came up and found Nicki and I walking in the hall.

"They're finishing up, and Dr. Burke asked me to come out and tell you that everything went very well," she said. "He'll be here to talk to you himself in fifteen or twenty minutes."

A sort of elation rose through my body. It welled up from my feet.

Nicoletta and I hugged. She was obviously happy too, but less inclined than myself to take this as the point at which nothing else could go wrong.

Ten minutes later Dr. Redmond Burke found us. He was smiling.

"It went very well. We cleaned out all the obstruction and closed the VSD and his heart is now in great shape," he said.

He had a contact sheet of color photographs and we stepped into the waiting room where we could sit down and he showed us the closeup documentation of the operation, pointing from picture to picture explaining what was what; the exposed heart itself, like a smallish wet red mango, before being incised. Then the view into the ventricle as he opened the incision with a two-pronged thingy. There was a lot of white tissue, with just a slot through it.

"That white is all scar tissue, and it was more than I'd expected to see, from the echo. You did the right thing in deciding to do it sooner rather than later, because this was a great deal of obstruction."

The horizontal plane of scar tissue had divided the ventricle nearly in two, drastically obstructing blood flow. What Burke found was that, more than a case of right ventricular outflow tract obstruction -- Joe really had a double-chambered right ventricle. But it was now a cleaned-out well-pumping single chamber, with no jet of blood shooting through the septum from the other side. He'd put a kind of purse suture around the tiny hole, and pulled it closed.

"I'm very pleased," the doctor said. "They'll be bringing him out in a few minutes and he's already off the respirator, breathing on his own. Which is rare, to come out of the OR already off. He's a strong boy."

Now I allowed myself to be completely overtaken by joy. Nicoletta, too. We thanked the doctor, who said he'd be seeing us periodically.

About ten minutes after Burke left us, Nicki was sitting in one of the chairs and I was standing in the doorway of the waiting room. Up the hall a bed on wheels turned the corner and as they came toward me, I realized it was Joe: "Nicki, Nicki, here he comes!" They stopped him right in front of us, and he was still out cold, and very pale. He had the sheet pulled right up to his chin. The woman who was going to be his nurse in Intensive Care, Deborah, said they were going to get him set up in his room, get the monitors and IV stuff all attached and hooked up. She asked for five minutes.

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