Looking Back Babies Are Us

floor for obstetrics. New mothers enjoyed eight new air-conditioned rooms—four dedicated to delivery and four to labor.

Back then newborns were whisked off to the nursery, where nurses bathed them, collected their inked footprints for birth certificates, VOLUME 5, ISSUE 1, SPRING 2006 AN UPDATE FROM SAINT LUKE’S HOSPITAL OF KANSAS CITY c.1950 and attached plastic wrist ID bracelets. Saint Luke’s Hospital expands with a new Today, the hospital uses an inkless procedure for babies’ footprints, floor dedicated to its littlest patients which are added to the legal birth certificate and a keepsake version for parents. And security bands accompany the plastic bracelets. In post-WWII America, births were booming by 1950—rising some Plus, Saint Luke’s practices Baby First: Babies and mothers enjoy 179 percent. special skin-to-skin bonding time during the first hour after birth, Responding to the baby boom, Saint Luke’s Hospital launched a which helps to jumpstart babies’ physical systems and initiate $2.4 million expansion, which included a new wing with an entire breast-feeding. +

A Stitch in Time Saint Luke’s cardiologists use high-tech test to catch plaque before heart attack

Corkscrew device helps neurologists stop stroke in midstream

Oncologists use “second-look” surgery to spot recurring ovarian cancer

14 Saint Luke’s Voices Table of Contents SPRING 2006

IT’S NEVER TOO LATE INDEX COVER Wake Up Call TO TAKE CHARGE OF YOUR HEALTH. Excellent health care starts with managing risks 350,000 A Stitch in Time Number of times each year doctors in 4 Ticker trouble seemed remote to Asher Langworthy— and knowing warning signs. Saint Luke’s can help you do both the United States perform coronary artery bypass graft surgery, which until an optional exam uncovered a time bomb in his chest The theme of this issue is “be proactive.” You’ll read about a man who had a simple test to reroutes blood flow around blocked arteries in the heart detect heart disease. He had no prior symptoms, so he was surprised to learn that he was a SEE PAGE 4 FEATURES candidate for heart surgery. Today he’s feeling fit, thanks to early detection and treatment. From Out of Nowhere 8 Fact: Half of Americans who die from heart attacks had no previous symptoms. 225,000 No one thought teenager Amanda Horne could have Number of times each year that strokes strike people younger than age 45 a stroke—until one struck. But Saint Luke's doctors You’ll also meet a young woman who Saint Luke’s Hospital Leadership SEE PAGE 8 stopped it with a unique procedure experienced a potentially fatal stroke. The Right Rev. Barry R. Howe CHAIRMAN SAINT LUKE’S HOSPITAL Thankfully, rapid transport to the hospital Robert H. West PRESIDENT Back in the Swing SAINT LUKE’S HOSPITAL 10 24 Avid golfer Vicki Cooney battled ovarian cancer with the and quick intervention by the Saint Luke’s G. Richard Hastings CHIEF EXECUTIVE OFFICER Percent of time ovarian cancer is help of Saint Luke’s gynecological oncologists—a special SAINT LUKE’S HOSPITAL diagnosed while still confined to team saved her life. Mark S. McPhee, M.D. CHIEF OPERATING OFFICER one ovary team dedicated solely to fighting female cancers SAINT LUKE’S HOSPITAL SEE PAGE 10 Fact: Half of stroke deaths occur outside Saint Luke’s Report Editorial Advisory Board DEPARTMENTS hospitals. When a stroke occurs, time is Candace L. F. McDowell Mark S. McPhee, M.D. 5 of the essence. New & Noteworthy Edward T. Matheny Jr. Percentage of children who, by first 2 Paul W. Nelson, M.D. grade, have noticeable speech Saint Luke’s Mid America Heart Institute ranks among The good news is that most risk factors for disorders—most with no known cause John T. Russell the nation’s top 100 heart centers; hospital staffers learn SEE PAGE 12 stroke and heart disease can be changed or John D. Yeast, M.D. to habla español to communicate better with Spanish- Corrine D. Everson minimized through simple lifestyle changes: speaking patients; Saint Luke’s “quality leader” earns Sources: MedicineNet.com, Saint Luke’s Cancer Editorial Management Governor’s Quality Leadership Award; and more • Controlling your blood pressure Institute, advocatehealth.com, National Institute on John C. Francis EXECUTIVE EDITOR Deafness and Other Communication Disorders • Eating a low-fat, high-fiber diet Kenneth C. Huber, M.D. Caroline Millard MANAGING EDITOR Patient Profile Executive Medical Director PRODUCTION ASSISTANT 12 Candice Blackwell Straight Talk. Sam Barker’s speech turned to gibberish • Exercising for 30 minutes most days Mid America Heart Institute Ami Swanigan PRODUCTION ASSISTANT when he was a toddler. With help from The Children’s Mark McDonald PHOTOGRAPHER • Managing blood sugar if you have diabetes SPOT, he’s now a talkative teen Wylie Communications Inc. EDITORIAL CONSULTANT • Not smoking Draw The Line DESIGN CONSULTANT Advertising and Design Leadership in Caring 13 Saint Luke’s is here to help. For more than 25 years, we’ve been recognized as the area’s First, Do No Harm. When it comes to ethical dilemmas Saint Luke’s Report is published three times a year by the premier cardiovascular center, performing more heart procedures than any other heart Saint Luke’s Hospital Foundation and Saint Luke’s Health at Saint Luke’s, the color scheme always includes shades System Marketing and Public Relations. Address corre- of gray center in the region. Our stroke center has earned a reputation as a national leader in acute spondence to 10920 Elm Ave., Kansas City, MO 64134. Copyright © 2006 Saint Luke’s Hospital. Material in this stroke intervention. And we’re continually inventing and implementing new procedures and issue may not be reproduced in whole or part without Looking Back permission from the executive editor. 14 technology that benefit patients in the Greater Kansas City area—and around the world. Saint Luke’s Hospital is an Equal Opportunity Employer. Babies Are Us. Saint Luke’s Hospital expands with a new Services are provided on a nondiscriminatory basis. floor dedicated to its littlest patients Want to learn more? I encourage you to call Nurseline at (816) 932-6220 to find a physician If you do not wish to receive future issues of this publication, please let us know by writing to the address or schedule a healthy heart exam. It’s never too late to take charge of your health. + above, calling (816) 932-3412, or sending an e-mail to [email protected]. To learn more about Saint Luke’s Hospital, call NurseLine at (816) 932-6220 or visit saintlukeshealthsystem.org. New and Noteworthy

her work, Saint Luke’s now stands as a The Nov. 15, 2005, issue of the Health Care quality leader in the health care industry. + Journal of the American College of Cardiology featured a new study by John Spertus, Powerhouses M.D., M.P.H., F.A.C.C. The study You can count Saint Luke’s Health Meet KC’s Top showed African-Americans have more chest pain, worse quality of life, and Hola! System President and CEO G. Richard Hastings among the nation’s top medical Heart Expert worse physical function than Caucasian leaders. patients one year after suffering acute Kansas Citians take heart: Saint coronary syndrome. Modern Healthcare named Hastings to its Luke’s Mid America Heart Institute is The magazine publishes original “100 Most Powerful People in Heath among the best in the nation. Where does it hurt? peer-reviewed clinical and experimental Care” list. It’s the second year in a row The Heart Institute was named in the that the magazine has recognized reports on all aspects of cardiovascular 100 Top Hospitals®: Cardiovascular disease. AFTER A BUDDHIST patient died, Saint Luke’s staff Hastings, who ranked No. 24 this year. Benchmarks for Success study this past Dr. Spertus’ research is the first study allowed monks to pray over the body 96 hours until they He credits his Saint Luke’s colleagues October by Solucient. Each year, to examine racial difference in health deemed it OK to move the patient. Buddhists believe a for the honor. Solucient, an Illinois-based health care status outcomes—including symptoms, information firm, ranks the nation’s top person’s conscience remains in the body for a variable time “It’s Saint Luke’s employees and function, and quality of life—between after death, so it mustn’t be disturbed. physicians who’ve earned this recognition Caucasians and African-Americans. for me,” Hastings said. “They provide “I hope the study results will encourage When Jehovah’s Witness patients opt against blood transfu- the quality patient care that repeatedly physicians to be more aggressive in their sions for religious reasons, Saint Luke’s offers the Blood earns Kansas City and Saint Luke’s recog- follow-up care for African-American nition for leading the nation in health patients,” Dr. Spertus said. + Conservation Program. These patients’ blood is recirculated care delivery. I’m flattered to once again during surgery, giving them a life-saving alternative that be included on a list of notable national adheres to their religious doctrine. health care leaders.” New Heart Modern Healthcare readers voted Twenty-two staffers signed up for “Seeing Vases: See it in for this year’s honorees from a list of Director Keeps English, Say it in Spanish,” an introductory Spanish class 300 finalists. More than 185,000 votes were cast. + the Beat designed to help them better communicate health care terms with Spanish-speaking patients. Good news for Saint Luke’s Mid America Heart Institute patients: Your Respecting spiritual beliefs, valuing individuals’ differences, hearts are still in the right hands. Saint Luke’s New technology and innovative care have and embracing diversity is a priority for Saint Luke’s. In fact, helped Saint Luke's Mid America Heart Institute Cardiologist Kenneth C. Huber, M.D., Quality Leader our leaders launched one of the country’s first health care earn recognition as one of the top hospitals brings 20-some years of medical expertise diversity initiatives a decade ago. In December 2005, Saint When it comes to quality, Sherry for heart care in the nation. to his new role as the Heart Institute’s Marshall ranks at the top. Executive Medical Director. Huber, a Luke’s Diversity Council turned 10. Clinical Assistant Professor of Medicine Marshall, Vice President of Quality Made up of employees from across the health system, the for Saint Luke’s Health System, received performing acute-care hospitals on their at the University of Missouri-Kansas City, Diversity Council’s goal is to cultivate a welcoming environ- the Governor’s Quality Leadership cardiovascular services and performance. took over the reins from David Steinhaus, Award this past November. Saint Luke’s Mid America Heart M.D., this past October. ment for staff, patients, and the communities Saint Luke’s Given annually by the Excellence Institute was the only Greater Kansas During his career, Dr. Huber has serves. Diversity committees promote such activities as + in Missouri Foundation, the award City area hospital named to the list. published nearly 40 clinical studies, training, education, recruitment and retention, and patient practiced at the Mayo School of recognizes a Missourian who demon- relations throughout the health system—even at the board strates exceptional commitment to the Medicine, and spoken at numerous of directors level, which now has a diversity committee. pursuit of performance excellence. Studying Hearts clinical conferences. He’s also led Saint Luke’s Interventional Cardiology depart- During her tenure, Marshall has “Embracing and celebrating diversity is part of what makes and Race ment and its Cardiac Catheterization Mick Allison, Director of Physician Recruitment and Retention, and nurse championed the use of the Malcolm Saint Luke’s a stronger, wiser, and more compassionate Lab. He is president of Cardiovascular Nicole Cruse celebrated the 10th anniversary of Saint Luke's diversity Baldrige management philosophy across A top cardiology journal has covered Consultants P.A., the physician practice organization,” said Cheryl Bevel, Vice President for Diversity. + initiative with Cheryl Bevel, Vice President for Diversity (center). Saint Luke’s, as well as the design, Saint Luke’s research on African- that manages the Heart Institute. + development, and deployment of the Americans’ quality of life after suffering Balanced Scorecard. Thanks in part to acute coronary syndrome.

2 3 Ticker trouble seemed remote to Asher Langworthy— until an optional exam uncovered a time bomb in his chest

Wiry and active, Asher Langworthy spent most of his days managing real estate—whether it was the cemetery he oversees, the rental properties he owns, or his own Prairie Village,

Kan., home. Even after hours, he rarely sat still: When he wasn’t charging up his treadmill, he was swimming or boating at

the Lake of the Ozarks. Like many people in their 70s, Langworthy and his wife, Audrey, occasionally discussed health issues

with their friends, such as exercise tips or new medical procedures. After hearing about a heart test called a CardioScan, his

wife had one and suggested he have the test, too. Using X-ray, it checks for structural problems in the heart and detects

calcium associated with plaque buildup that may lead to a heart attack. (See sidebar.)

“My father-in-law died of a heart attack at 75, my own dad survived one at 70, and I’m 71,” Langworthy said. “I’d had stress tests before, and they always came out fine. So this information A Stitch in about the CardioScan came at an eerily perfect time.” And Langworthy wasted none of it: He got the test soon thereafter.

Do Tell What Langworthy’s CardioScan showed was shocking: He had calcium deposits in his coronary arteries, the ves- sels that supply blood and oxygen directly to the heart. “Yet there was no outward clue that anything was wrong with me,” Time Langworthy said. “I’m 5-foot-7,

Cardiologist J. Aaron Grantham, M.D., detected patient Asher Langworthy's hidden heart disease Asher Langworthy looked hale and hearty, but a CardioScan caught a major case of undetected before it became full-blown. heart disease.

4 5 weigh 138, don’t smoke, and have always called coronary artery bypass graft eaten pretty healthily. I just didn’t look surgery. During the operation, Dr. like a cardiac patient.” Borkon removed blood vessels from But that’s what he immediately other parts of Langworthy’s body and became. used them to reroute the blood flow Put Your Ticker to the Test around the blockages. “Asher’s CardioScan test score suggested that he had more than a 20 Just three months after the operation, percent chance of having a heart attack Langworthy was back at work full time Wonder if your heart is choices that can help you prevent • A bypass operation, which removes within the next 10 years,” said J. Aaron and feeling frisky, although he’s fine- healthy? Check it out with heart disease. a vessel from elsewhere in your tuned his lifestyle along the way. Grantham, M.D., a cardiologist at Saint a basic exam body and uses it to reroute blood Luke’s Mid America Heart Institute. “I exercise at least five or six times a If you’re at intermediate risk— SAINT LUKE’S Mid America flow around the heart blockage So Dr. Grantham gave Langworthy week, either at Saint Luke’s cardiac rehab with coronary artery disease and center or at home,” Langworthy said. Heart Institute treats some of the symptoms (see sidebar at left), but a follow-up thallium stress test, which More Options showed that his arteries had narrowed “And my wife and I still go ’round about most serious, challenging cardiac with no known blockage—you’ll also: significantly. A subsequent heart what I’m allowed to eat. Apparently, but- conditions in the Greater Kansas City Your cardiologist may also recom- ter’s not on the list.” • Have an EKG, which records the catheterization revealed several severe area. But you don’t have to wait until mend other tests that aren’t part of a blockages in all three of his coronary But such are small sacrifices for a electrical activity of your heart and your heart is broken to discover a routine healthy heart exam: arteries. promising prognosis: excellent heart shows whether your heart is hidden problem. And that meant that Langworthy’s health ahead. enlarged, whether blood flow is suf- An hsCRP test, which detects high- next stop was the operating table. “Asher’s a perfect example of how a Consider getting the Heart Institute’s ficient, and other conditions sensitivity C-reactive protein, a marker simple, relatively inexpensive test can healthy heart exam, which begins with that signals inflammation in the The Surgical Solution detect heart disease in someone with no • Take a thallium stress test. This coronary arteries. symptoms,” Dr. Borkon said. “It may these basics: The next day Heart Institute cardiac Cardiac surgeon Michael Borkon, M.D., rerouted measures how much blood reaches have saved his life.” + surgeon Michael Borkon, M.D., the blood flow around life-threatening blockages • A family heart history, including any your heart during rest and during “Studies suggest that when plaque performed an open-heart operation in patient Asher Langworthy's heart. symptoms you have, your medical exercise on a treadmill builds up in the arteries, it can become history, lifestyle factors (such as diet, inflamed, making the plaque vulnera- • Have a heart catheterization if your exercise, smoking, occupation), ble to rupture,” said cardiologist J. stress test is abnormal. This test and whether family members have Aaron Grantham, M.D., of the Heart helps determine whether there’s a heart disease Institute. “A blood clot forms to heal blockage by running a narrow tube the rupture. If the clot is too large it • A physical exam of the chest wall, through an artery in your thigh up to Uncovering blocks the flow in the artery and during which a cardiologist listens the aorta and injecting a dye that causes a heart attack.” to your heartbeat and feels the illuminates the area on an X-ray heart’s pulse A CardioScan, which uses X-ray waves Coronary Artery Disease Red Light to map the heart’s structure. This • A lipid test, which measures test detects calcium, which often cholesterol levels in your blood If you’re at high risk—with symptoms accompanies plaque buildup that can MORE THAN ONE-THIRD exercise, but it can also be prompt- If you feel any of these symptoms, talk of coronary artery disease and a • A blood pressure test cause heart problems. of the time coronary artery disease lies ed by stress, extreme cold or heat, to your doctor. But if you have pain suspected blockage—your cardiologist in wait, without symptoms, then bursts heavy meals, alcohol, and cigarette that lasts more than 15 minutes, you Green Light, Yellow Light may bypass a stress test and “These tests are usually for people on the scene as a heart attack. More smoking. may be having a heart attack—so recommend an immediate heart who may not have typical symptoms Once that’s done, your cardiologist often, it blows its cover with one or immediately call 911. + catheterization. Depending on the that indicate heart problems,” Dr. • Abnormal heart rhythms will determine whether you’re at low, more of these warning signs: results, you may need one or more Grantham said. “If you have reason Sources: fda.gov/hearthealth, jama.ama-assn.org, intermediate, or high risk of heart • Heartburn guidant.com of these to treat your condition: to be concerned about your heart • Angina, which may feel like squeez- problems and proceed from there. • Nausea health, ask your doctor whether • Medication ing pain, pressure, or tightness in they’re right for you.” • Vomiting If you’re at low risk—without diabetes the chest under the breastbone. It • Angioplasty, which unclogs an and with cholesterol and blood To learn more about services may also occur as radiating pain in • Shortness of breath artery by inflating a balloon inside pressure levels in the normal range— offered at Saint Luke’s Mid America the shoulders, arms, neck, jaw, or • Heavy sweating the vessel your doctor will help you make Heart Institute, call NurseLine at back. It most often occurs after diet, exercise, and other lifestyle • Stenting, which uses a small wire (816) 932-6220. + mesh tube to prop open a vessel

6 7 No one thought teenager Amanda Horne could have a stroke—until one struck. But Saint Luke’s doctors stopped it with a unique procedure

College student Amanda Horne was using a day off from her summer job to catch up on laundry—and her boyfriend. She tossed clothes in the washer, dashed upstairs to shower

before a lunch date, then decided to call her mom at work. Horne had just dialed the number when a wave of dizziness sent

her reeling. “Mom?” said the 18-year-old Overland Park resident calmly into the phone. “I think I’m going to pass out.”

Her mother, Glenda Miller, thought know how precious such simple things the call was odd. are—until they get taken away. “I wondered why she wouldn’t answer “But Saint Luke’s brought me back. my questions,” Miller said. “Why wasn’t And I’m so glad to be here.” + she talking to me? At that point I was puzzled rather than recognizing any life- threatening medical situation. “She was 18 and had been fine earlier Not Just Your that morning. What could possibly hap- Grandfather’s Stroke From pen in that time frame?” Miller soon found out. After driving YOU CAN be too young to drive, too home, she discovered her daughter, col- young to vote, too young to run for president. lapsed on a bed. But you can never be too young to have a stroke.

Rush Job Each year strokes strike 120,000 women and Miller called an ambulance, which sped 105,000 men who are younger than 45. Certain conditions, such as sickle cell anemia, irregular Horne—now paralyzed on her right side— Kansas State University sophomore Amanda heart rhythms, and undetected heart defects, to Saint Luke’s South. There, doctors Horne can go wild for the Wildcats, thanks to a stroke-stopping procedure that left may put some young and middle-age adults at Out of looked at her brain with an X-ray called a her able-bodied and self-sufficient. particular risk. CAT scan, stabilized her, and transferred her to the Mid America Brain and Stroke Risk factors for all ages include: Institute at Saint Luke’s Hospital for fur- The Road Back • Untreated high blood pressure, which multi- plies the risk of stroke by four to six times ther treatment. After three weeks of monitoring in • Smoking, which triples your risk of a stroke There, neurologist Steven Arkin, M.D., specialized intensive care units, Horne caused by a blood clot diagnosed a stroke caused by a blocked transferred to Saint Luke’s South • Diabetes, which doubles your risk artery in her brain stem, the critical area for inpatient rehabilitation. There, she • Untreated high cholesterol that regulates involuntary activities like celebrated her 19th birthday as she Nowhere • Obesity breathing and heartbeat. This type of learned to walk and talk again. • Family history of stroke stroke is fatal in 90 percent of cases. Soon thereafter surgeons at Saint • Race—African-Americans are twice as likely as Dr. Arkin gave Horne a clot-busting Luke’s Mid America Heart Institute Caucasians to have a stroke drug called tPA in her vein. Then neu- repaired a hole in her heart: the reason • Taking birth control pills rointerventional radiologist Naveed she had a stroke. All babies have a hole Akhtar, M.D., pierced the clot with a spi- that should close soon after they’re born. If you or someone else suddenly has these signs ral-shaped device called the Concentric In Horne’s case, it never shut, which of a stroke, call 911 immediately. Also, check the Merci Retrieval System and twisted it out allowed a blood clot to pass out of her time so you’ll be able to tell health care like a wine cork. Saint Luke’s is one of the heart and travel to her brain. providers when the first symptoms appeared: • Numbness, weakness, or paralysis of the face few hospitals in the country routinely Now back at school, Horne is major- or limbs, typically on one side of the body using the device—a literal stroke of luck ing in family studies, engaged to her • Vision problems in one or both eyes for Horne. boyfriend, and writing a book called One • Confusion, trouble speaking or understanding “Fortunately, Amanda arrived here Step at a Time for young stroke survivors. • Dizziness, loss of balance, or coordination quickly,” Dr. Akhtar said. “If she’d gone any- “I’ve learned not to take things for • Severe headache with no known cause + where else, she might not have survived.” granted,” Horne said. “Just walking across the room is exciting to me now. You don’t

8 9 Avid golfer Vicki Cooney battled ovarian cancer with the help of Saint Luke’s gynecological oncologists— a special team dedicated solely to fighting female cancers

Two years ago, Vicki Cooney spent the winter preparing for the upcoming golf season. After coming home from her job as a personal banker, she took walks, did sit ups, and stretched

her legs. So when she felt a sharp tug in her groin, she figured she’d just pulled a muscle. But later that spring, Cooney’s

groin still ached from time to time. And she had a bladder infection that wouldn’t back down. That’s when a CT scan revealed

that Cooney—fit, active, and planning her next golf vacation—had Stage III ovarian cancer.

“To say I was shocked is an under- Seven months after her first statement,” said Cooney. “Five months procedure, Cooney opted for a “second earlier I’d had a pap smear and checkup look” operation that showed the cancer that showed that everything was fine. My had come back. Dr. Dudzinski removed husband and I just looked at each other it, and Cooney is now recovering. and thought, ‘This cannot be happening.’” Dr. Dudzinski also sends some of the cancerous tissue to a laboratory that tests Targeted Treatment which chemotherapy drugs the disease is Cooney’s physician referred her to resistant to. This enables her to zero in on Michelle Dudzinski, M.D., who is part of drugs that are likely to be effective in a group of gynecological oncologists at treating the disease. the Saint Luke’s Cancer Institute. The “In the late 1970s, we really only had team of physicians treats only cancer of one drug regime that was effective against Back the female reproductive tract. ovarian cancer,” Dr. Dudzinski said. The specialty is a rarity in the Midwest; “Today we have an arsenal of chemo- there are only seven such physicians in therapy drugs at our disposal.” the metropolitan area—four of them at Saint Luke’s. These “sub-specialists” have Teeing Off extensive training in the management These days, Cooney is focusing on of gynecological cancers, which allows healing much the same way she’s them to direct all aspects of a woman’s always focused on her golf game: with treatment from surgical procedures to knowledge, preparation, and patience. chemotherapy. Ovarian cancer patient Vicki Cooney opted She has regular checkups and blood tests The hope is to begin treating ovarian for “second look” surgery. Her gynecological to monitor her progress. And she’s cancer early, yet only 24 percent of all oncologist operated seven months after her exercising regularly, eating a healthy diet, cases are diagnosed when still confined to first surgery and removed small traces of and tending to her emotional needs. in the the ovary. The reason? Early symptoms— the cancer still there. Saint Luke’s psychiatric nurse Linda bloating and pelvic pain—are often vague Huber has helped Cooney learn to and easy-to-dismiss. than five years because of the advance- manage the illness. But that’s when survival rates are the ments in chemotherapy drugs.” “I’m learning to let go of control. most optimistic. Nearly 90 percent of For that reason, Dr. Dudzinski favors And I don’t sweat the small stuff any- women whose cancer is diagnosed in more,” she said. Stage I will survive five years, the point at an aggressive treatment plan. “The most Cooney also stays focused on her which a patient is deemed “in remission.” important step in treating ovarian cancer is the first surgical procedure,” she said. favorite pastime: golf. “Most ovarian cancers are diagnosed “Patients are then treated with “We’re looking at our next golf in Stage III and the cancer has already chemotherapy and, in some cases, spot vacation,” said Cooney. “I know I’ve got spread beyond the ovary,” Dr. Dudzinski radiation. Following this course of a lot of games left to play.” + said. “Five-year survival rates are then treatment, certain patients also benefit reduced to 40 to 50 percent. However, from a second operation to assess Swing many of our patients survive much longer whether the disease is truly gone.”

10 11 Patient Profile Leadership in Caring Sam Barker Michael Thomas, Co-Chair of Saint Luke’s Hospital’s Ethics Advisory Committee Straight First, Do No Harm

When it comes to ethical dilemmas at Saint Luke’s, Talk the color scheme always includes shades of gray

Sam Barker’s speech turned to gibberish when he was a toddler. Ethical dilemmas aren’t black or For example, one elderly patient With help from The Children’s SPOT, he’s now a talkative teen white. Often patients and families had multiple medical problems must choose between two or more and was on life support. His son, “right” courses of action. understandably, couldn’t bear the WHEN SAM BARKER was Barker attended daily group speech thought of losing his father, yet 18-months-old, he babbled like any and developmental therapy. The Who’s on the committee? doctors determined there was no other toddler. He could name everyday SPOT provides intensive rehabilitative reasonable hope for improvement. objects and call for his “Mama” therapy to infants and preschool Doctors, nurses, hospital adminis- The son was grappling with and “Dada.” aged children with a range of speech, trators, as well as non-medical whether to continue life-sustaining hearing, learning, and physical people from the community and Then, almost overnight, he began measures. After consulting the disabilities. board members, like me. I’m a for- speaking gibberish. Barker quit form- mer teacher with a seminary committee, the son decided to ing recognizable words altogether. “The whole time we struggled with degree and training in ethics, so this continue life support but not to add Instead, he produced grunts and Sam’s speech, The SPOT was my committee assignment fit well with any additional medical procedures guttural noises. lifeline,” Harrison said. my interests. if further complications developed. His mother, Jill Harrison, had a difficult The focus changed from aggressive Chatter Box When does your committee time convincing health care profes- treatment to palliative care. Shortly Today, it’s difficult to imagine Barker get involved with a sionals something was wrong with patient’s case? thereafter, the patient died as a ever had a speech disorder. A her son. They dismissed her as an result of his illness. freshman at Shawnee Mission East in When anyone involved in a case anxious parent. Sam Barker's all talk—thanks to treatment Prairie Village, Kan., he enjoys Boy asks us—whether it’s a doctor, a What has your work on the for a childhood speech disorder at committee taught you? “I knew in my gut that something The Children's SPOT. Scouts, basketball, golf, and singing. nurse, a hospital staffer, a family wasn’t right,” Harrison said. “But no Last year, he even played Daddy Input from Michael Thomas and the rest of member, or the patient. It’s easy to discuss ethical principles one would listen.” Saint Luke's Ethics Advisory Committee helps disorder leaves children knowing what Warbucks in his school’s version in the abstract. But when you patients and medical staff do the right thing. What kinds of cases does No Longer Misunderstood they want to say but unable to form of “Annie.” your committee consult on? address a real-life case, decisions the words. become terribly complex. That’s “These days, he never stops talking,” What is the Ethics Almost any kind, from organization- Then Harrison was referred to The why it’s helpful for families and Harrison said. “We love it.” + “When we started at The SPOT, Sam Advisory Committee? al issues to patient care—especially Children’s SPOT at Saint Luke’s staff to gain the perspective of an was so frustrated,” Harrison said. when there’s a question about a Hospital. There, experts diagnosed We help families evaluate and objective third party. + “He couldn’t understand why we didn’t Barker with a speech disorder that choose what’s best for their loved patient’s long-term quality of life. In understand him.” Do you have a success story to share happens when the brain can’t about yourself or a loved one? ones by gathering data, establish- these instances, the question can communicate correctly with facial The SPOT became the family’s home- Please send an e-mail to [email protected] ing criteria, and leading them become, “Are we prolonging life or or mail to Saint Luke’s Report Editor, muscles. Called verbal apraxia, the through a decision-making process. prolonging suffering?” away-from-home. For three years, 10920 Elm Ave., Kansas City, MO 64134.

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